Different Clinical Presentations in Eating Disorder Patients with Non-Suicidal Self-Injury Based on the Co-Occurrence of Borderline Personality Disorder

Abstract

Non-suicidal self-injury (NSSI) and borderline personality disorder (BPD) features are common in patients with eating disorders (ED), yet little is known regarding the clinical presentation of ED patients who present with NSSI with and without BPD. The current study compared self-injurious, female ED inpatients with (n = 98; NSSI+BPD) and without BPD (n = 45; NSSI-only) on different self-reported clinical features. Results suggest that ED patients with NSSI+BPD differ from those with NSSI-only with regard to frequency of suicidal ideation, alcohol, drug or medication abuse, internalizing/externalizing psychopathology, interpersonal problems, and coping strategies, with the NSSI+BPD group demonstrating more impairment in each of these domains. Despite these differences in clinical presentation, however, groups did not differ in NSSI features. In sum, while self-injurious ED patients may present with similar NSSI behavior regardless of BPD diagnosis, those with NSS+BPD represent a group with much higher clinical complexity and greater treatment needs.

Dissecting pain processing in adolescents with Non‐Suicidal Self Injury: Could suicide risk lurk among the electrodes?

“…In recent years, the increase in Western countries of self‐injurious behaviours, especially during adolescence and young adulthood, has made NSSI a major public health issue (Klonsky, 2011 ). Because NSSI can occur alone or in comorbidity with a range of disorders, such as major depressive disorder (MDD; Hintikka et al., 2009 ), borderline personality disorder (BPD; Cerutti et al., 2011 ), eating disorders (Claes et al., 2018 ) and other disorders (Apter et al., 2008 ; Chart rand et al., 2012 ; Fliege et al., 2009 ; MacLean et al., 2011 ; Serras et al., 2010 ), the ‘DSM‐5’ proposal is now recommending to consider NSSI as an independent condition in need of further study. Since a few studies focused on the neurobiology of the disease in adolescents and its clinical course, the pathogenesis is controversial, particularly its link with pain processing, personality disorders and suicidality (Westlund Schreiner 2015 ) (Griep & MacKinnon, 2020 ).…”

Understanding Comorbidity Between Non-Suicidal Self-Injury and Depressive Symptoms in a Clinical Sample of Adolescents: A Network Analysis

“…48 Concentration difficulties are present in many mental disorders, such as anxiety disorder 49 and eating disorder, 50 which are commonly comorbid with NSSI. 51,52 In our study, concentration was assessed by one of the items on the PHQ-9 (Trouble concentrating on things, such as reading the newspaper or watching television), which was more subjective. More objective methods could be used in the future.…”

Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know

“…Finally, research indicates that NSSI and ED behaviors are associated with a range of psychiatric symptoms and disorders [ 6 , 79 ], with internalizing symptoms precipitating the onset of both behaviors [ 36 , 49 , 80 ]. While borderline personality disorder (BPD) has been associated with greater psychiatric comorbidity [ 81 ], studies recently linked problems with identity formation to the onset of both behaviors [ 82 •].…”