Selbstverletzendes Verhalten im Jugendalter
Abstract
Selbstverletzendes Verhalten (SVV) hat seinen Beginn zumeist im Jugendalter. Internationale Studien berichten von Prävalenzraten zwischen 3 und 37 % (in Deutschland: 15–26 %) bei Jugendlichen. Es gibt Hinweise, dass aus neurobiologischer Sicht vor allem das serotonerge System bei der Entstehung und Aufrechterhaltung dieses Verhaltens beteiligt ist. SVV wird von den Jugendlichen häufig zur Beeinflussung aversiver affektiver Zustände verwendet, kann aber auch andere Funktionen wie etwa Selbstbestrafung oder einen anti-dissoziativen Effekt haben. Bislang existieren viele Diagnostikverfahren, von denen teilweise auch deutsche Übersetzungen vorliegen. Bezüglich psychotherapeutischer Interventionen gibt es Hinweise auf eine gute Effektivität der Dialektisch-Behavioralen Therapie für Adoleszente (DBT-A). Der Evidenzgrad für psychopharmakologische Interventionen ist im Kindes-und Jugendalter sehr gering, sodass vor allem psychotherapeutische Interventionen im Vordergrund der Behandlung stehen sollten.
Nonsuicidal self-injury (NSSI) usually starts in adolescence. International studies report prevalence rates between 3 and 37 % (for Germany between 15 and 26 %) in adolescents. From a neurobiological perspective, there is evidence that primarily the serotonergic system is involved in the origin and maintenance of this behaviour. NSSI is often used by adolescents to influence aversive affective states, but sometimes serves other functions as well, such as self-punishment or anti-dissociation. To date there are many assessment instruments, some of which are available in a German translation. Regarding psychotherapeutic interventions there is evidence for a good efficacy of dialectical behavioral therapy for adolescents (DBT-A). There is little evidence for psychopharmacological interventions in childhood and adolescence; thus treatment should focus on psychotherapeutic interventions.
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