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Emotional experiences immediately prior to (emotional antecedents) and following (emotional consequences) deliberate self-harm and suicide attempts in female inmates (N = 63) were examined. Anger was the antecedent emotion reported by the largest proportion of individuals who had engaged in deliberate self-harm (45.16%), suicide attempts (40.9%), and ambivalent suicide attempts (30%). Relief and other positive emotional shifts were more common in deliberate self-harm (41.94%) (involving no intent to die) than in suicide attempts or ambivalent suicide attempts, particularly for persons with borderline personality disorder. These findings underscore the utility of discriminating between deliberate self-harm and suicidal behavior and highlight the potential role of anger in triggering such behaviors.

Despite the inclusion of nonsuicidal self-injury disorder (NSSID) in the DSM-5, research on NSSID is limited and no studies have examined the full set of DSM-5 NSSID diagnostic criteria.Thus, this study examined the reliability and validity of a new structured diagnostic interview for NSSID (the Clinician-Administered NSSI Disorder Index; CANDI) and provides information on the clinical characteristics and features of DSM-5 NSSID. Data on the interrater reliability, internal consistency, and construct validity of the CANDI and associated characteristics of NSSID were collected in a community sample of young adults (N = 107) with recent recurrent NSSI (≥10 lifetime episodes of NSSI, at least one episode in the past year). Participants completed self-report measures of NSSI characteristics, psychopathology, and emotion dysregulation, as well as diagnostic interviews of borderline personality disorder (BPD) and lifetime mood, anxiety, and substance use disorders. The CANDI demonstrated good interrater reliability and adequate internal consistency. Thirty-seven percent of participants met criteria for NSSID. NSSID was associated with greater clinical and diagnostic severity, including greater NSSI versatility, greater emotion dysregulation and psychopathology, and higher rates of BPD, bipolar disorder, posttraumatic stress disorder, social anxiety disorder, and alcohol dependence. Findings provide support for the reliability, validity, and feasibility of the CANDI.Keywords deliberate self-harm; self-injury; diagnostic assessment; emotion regulation; borderline personality disorder; DSM-5Until recently, nonsuicidal self-injury (NSSI), defined as the deliberate, direct, self-inflicted destruction of body tissue without suicidal intent and for purposes not socially sanctioned Reprints and permissions: sagepub.com/journalsPermissions.nav Corresponding Author: Kim L. Gratz, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. KLGratz@aol.com. Katherine Dixon-Gordon is now at the Department of Psychological and Brain Sciences, University of Massachusetts. Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.Portions of these data were previously presented at the annual meeting of the International Society for the Study of Self-injury in Chicago, IL, in June 2014. (Chapman, Gratz, & Brown, 2006;Gratz, 2001; International Society for the Study of Selfinjury, 2007), was studied primarily in the context of borderline personality disorder (BPD;Shearer, 1994;Soloff, Lis, Kelly, Cornelius, & Ulrich, 1994). Although NSSI is a cardinal symptom of BPD (prevalent enough to be considered the "behavioral specialty" of patients with BPD; Gunderson & Ridolfi, 2006), a rapidly growing body of empirical research demonstrates that NSSI is not unique to BPD (Andover, Pepper, Ryabchenko, Orrico, & Gibb, 2005;Gratz, Breetz, & Tull, 2010...

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