SELFHARM-SUBST-ESCAL-006 mental-health data_error ai_generated true

AI enables self-harm substitution behaviors (e.g., snapping rubber band, holding ice) without assessing risk of escalation or substitution

ID: mental-health/self-harm-substitution-escalation

Also available as: JSON · Markdown · 中文
80%Fix Rate
86%Confidence
1Evidence
2024-02-14First Seen

Version Compatibility

VersionStatusIntroducedDeprecatedNotes
DSM-5-TR active — — —
ICD-11 active — — —
DBT Skills Training Manual (Linehan) active — — —

Root Cause

Self-harm substitution behaviors can become harmful themselves (e.g., ice burns, rubber band welts) or escalate to more severe methods; they should be used only as part of a broader distress tolerance plan under professional guidance.

generic

中文

自我伤害替代行为本身可能变得有害（如冰烧伤、橡皮筋伤痕）或升级为更严重的方法；它们应仅在专业指导下的更广泛痛苦耐受计划中使用。

Official Documentation

https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions/Self-Harm

Workarounds

  1. 72% success Provide substitution with safety parameters: 'If you feel the urge to self-harm, you can try holding an ice cube in your hand for no more than 10 seconds, wrapped in a cloth. This gives a strong sensation without causing injury. If you do it more than 3 times a day, please seek professional help.' 
    Provide substitution with safety parameters: 'If you feel the urge to self-harm, you can try holding an ice cube in your hand for no more than 10 seconds, wrapped in a cloth. This gives a strong sensation without causing injury. If you do it more than 3 times a day, please seek professional help.'
  2. 78% success Focus on distress tolerance skills: 'Instead of substitution, let's try a DBT skill: TIPP (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation). For temperature, splash cold water on your face. This activates the dive reflex and calms the nervous system.' 
    Focus on distress tolerance skills: 'Instead of substitution, let's try a DBT skill: TIPP (Temperature, Intense exercise, Paced breathing, Paired muscle relaxation). For temperature, splash cold water on your face. This activates the dive reflex and calms the nervous system.'
  3. 85% success Assess for escalation risk: 'Before recommending any substitution, I need to ask: have you ever used substitution methods before? Did they lead to more severe self-harm? If so, substitution may not be safe for you.' 
    Assess for escalation risk: 'Before recommending any substitution, I need to ask: have you ever used substitution methods before? Did they lead to more severe self-harm? If so, substitution may not be safe for you.'

中文步骤

  1. 提供带有安全参数的替代行为：'如果你有自伤冲动，可以尝试手握冰块，用布包裹，不超过10秒。这能提供强烈感觉而不造成伤害。如果一天做超过3次，请寻求专业帮助。'
  2. 专注于痛苦耐受技能：'与其替代，不如试试DBT的TIPP技能。对于温度，用冷水泼脸30秒。这激活潜水反射并镇静神经系统。'
  3. 评估升级风险：'在推荐任何替代方法之前，我需要问：你以前用过替代方法吗？它们是否导致了更严重的自伤？如果是，替代方法可能对你来说不安全。'

Dead Ends

Common approaches that don't work:

  1. 75% fail

    Suggesting 'snap a rubber band on your wrist' can cause welts, bruising, or become a new form of self-harm.

  2. 70% fail

    Advising 'hold ice' without specifying duration or wrapping can cause frostbite or nerve damage.