Background During the last decade there is a growing scientific interest in nonsuicidal self-injury (NSSI). The aim of the current paper was to review systematically the literature with a special focus on the associations between self-injurious behaviours and externalizing psychopathology. An additional aim was to review terminology and measurements of self-injurious behaviour and the connection between self-injurious behaviours and suicide in the included publications. Methods A systematic literature search was conducted on 31st December 2016 in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with two categories of search terms (1. nonsuicidal self-injury, non-suicidal self-injury, NSSI, self-injurious behaviour, SIB, deliberate self-harm, DSH, self-injury; 2. externalizing disorder, attention deficit hyperactivity disorder, ADHD, conduct disorder, CD, oppositional defiant disorder, OD, ODD). Results Finally 35 papers were included. Eleven different terms were found for describing self-injurious behaviours and 20 methods for measuring it. NSSI has the clearest definition. All the examined externalizing psychopathologies had strong associations with self-injurious behaviours according to: higher prevalence rates in externalizing groups than in control groups, higher externalizing scores on the externalizing scales of questionnaires, higher symptom severity in self-injurious groups. Eight studies investigated the relationship between suicide and self-injurious behaviours and found high overlap between the two phenomena and similar risk factors. Conclusions Based on the current findings the association between externalizing psychopathology and self-injurious behaviours has been proven by the scientific literature. Similarly to other reviews on self-injurious behaviours the confusion in terminology and methodology was noticed. NSSI is suggested for use as a distinct term. Further studies should investigate the role of comorbid conditions in NSSI, especially when internalizing and externalizing pathologies are both presented.
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机译：背景技术在过去的十年中，人们对非自杀性自我伤害（NSSI）的科学兴趣日益增长。本文的目的是系统地回顾文献，特别关注自我伤害行为与外在心理病理学之间的联系。另一个目的是审查所包括出版物中自我伤害行为的术语和度量以及自我伤害行为与自杀之间的联系。方法于2016年12月31日在五个数据库（PubMed，OVID Medline，OVID PsycINFO，Scopus，Web of Science）中进行了系统的文献检索，其中包括两类检索词（1.非自杀性自我伤害，非自杀性自我伤害， NSSI，自残行为，SIB，故意自残，DSH，自残; 2.外在性障碍，注意缺陷多动障碍，ADHD，行为障碍，CD，对立违抗性障碍，OD，ODD）。结果最后纳入论文35篇。找到了11个不同的术语来描述自我伤害行为，并用20种方法来测量自我伤害行为。 NSSI具有最清晰的定义。所有检查的外在心理病理学与自我伤害行为都有很强的联系，其依据是：外在组的患病率高于对照组，问卷外在量表的外在得分更高，自伤组的症状严重程度更高。八项研究调查了自杀与自残行为之间的关系，发现这两种现象与相似的危险因素之间存在高度重叠。结论基于目前的发现，科学文献已经证明了外在的心理病理学与自我伤害行为之间的关联。与其他关于自残行为的评论相似，术语和方法上的混乱也被注意到。建议将NSSI作为一个单独的术语使用。进一步的研究应调查合并症在NSSI中的作用，尤其是当同时存在内在化和外在化病理时。
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