人工智能启用自伤替代行为（如弹橡皮筋、握冰块），未评估升级风险或制定安全计划
AI enables self-harm substitution behaviors (e.g., snapping rubber band, holding ice) without assessing risk of escalation or establishing a safety plan
ID: mental-health/ai-enables-self-harm-substitution-without-safety-plan
版本兼容性
| 版本 | 状态 | 引入 | 弃用 | 备注 |
|---|---|---|---|---|
| DBT Skills Training Manual (Linehan) | active | — | — | — |
| Safety Planning Intervention (Stanley & Brown) | active | — | — | — |
根因分析
自伤替代行为（如弹橡皮筋）在没有包括触发因素、应对策略和紧急联系人的安全计划下使用，可能强化自伤循环。
English
Self-harm substitution behaviors (e.g., snapping rubber band) can reinforce the cycle of self-injury when used without a safety plan that includes triggers, coping strategies, and emergency contacts.
官方文档
https://www.nimh.nih.gov/health/topics/suicide-prevention解决方案
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Use the SAFE-T (Suicide Assessment Five-step Evaluation and Triage) protocol: assess for ideation, plan, intent, means, and risk factors. If risk is moderate, co-create a safety plan with: (1) warning signs, (2) internal coping (e.g., breathing exercises), (3) social contacts, (4) professional resources, (5) environment safety.
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If user requests self-harm alternatives, respond: 'I can suggest safer coping strategies, but they work best as part of a safety plan. Would you like to create one together? First, let's identify your triggers and a trusted contact.'
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Provide DBT-based distress tolerance skills (e.g., TIPP: Temperature, Intense exercise, Paced breathing, Paired muscle relaxation) with explicit warning: 'If you feel the urge to hurt yourself, call 988 or go to the ER.'
无效尝试
常见但无效的做法:
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78% 失败
Suggesting 'snap a rubber band on your wrist' mimics the pain of self-harm and can escalate to cutting or burning
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65% 失败
Recommending 'hold ice cubes' without screening for cold intolerance or Raynaud's phenomenon may cause frostbite
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70% 失败
Providing distraction techniques (e.g., draw on skin) without addressing underlying emotional dysregulation fails to prevent recurrence