Nonsuicidal self-injury (NSSI) is included as conditions for further study in the DSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years) was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls). Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposed DSM-5 diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

Non-suicidal self-injury (NSSI) is an increasingly prevalent, clinically significant behavior in adolescents and can be associated with serious consequences for the afflicted person. Emotion regulation is considered its most frequent function. Because the symptoms of NSSI are common and cause impairment, it will be included in Section 3 disorders as a new disorder in the revised Diagnostic and Statistical Manual of Mental Disorders (DSM-5). So far, research has been conducted mostly with patients with borderline personality disorder (BPD) showing self-injurious behavior. Therefore, for this review the current state of research regarding emotion regulation, NSSI, and BPD in adolescents is presented. In particular, the authors focus on studies on facial emotion recognition and facial mimicry, as social interaction difficulties might be a result of not recognizing emotions in facial expressions and inadequate facial mimicry. Although clinical trials investigating the efficacy of psychological treatments for NSSI among adolescents are lacking, especially those targeting the capacity to cope with emotions, clinical implications of the improvement in implicit and explicit emotion regulation in the treatment of NSSI is discussed. Given the impact of emotion regulation skills on the effectiveness of psychotherapy, neurobiological and psychophysiological outcome variables should be included in clinical trials.

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