Masculinity and Men's Self-Harm Behaviors: Implications for Non-Suicidal Self-Injury Disorder

A composite of clinical cases treated by the authors is presented to illustrate the complexity of understanding nonsuicidal self-harm as it occurs in men, particularly in the context of Non-Suicidal Self-Injury (NSSI) disorder, a condition for further study in the fifth edition of Diagnostic and Statistical Manual of Mental Disorders. As a function of adherence to masculine norms, intentionality, social acceptability, and functions of self-harm behaviors common among men do not appear to be in line with diagnostic criteria for NSSI disorder, despite these behaviors resulting in serious tissue damage worthy of clinical and research attention. Suggestions for novel approaches to the assessment and treatment of self-harm, particularly in light of men's difficulty identifying and discussing intentionality of self-harm behaviors, are presented along with specific recommendations clinical practice.