Non-suicidal self-injury (NSSI) disorder: A preliminary study.

Abstract

Non-suicidal self-injury (NSSI) disorder has been suggested for inclusion into the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, in preparation), yet there is concern that NSSI is primarily a function of high borderline personality disorder (BPD) symptoms. The purpose of this study was to examine the characteristics of NSSI disorder and compare it to BPD and other DSM Axis I diagnoses commonly seen in clinical practice to aid in the determination of whether NSSI should be considered a separate, valid diagnostic entity. Chart data were analyzed from the screening, intake, and termination information of 571 treatment-seeking patients in a general practice clinic. Patients were classified into one of three groups: NSSI without BPD, BPD (with and without NSSI) or a comparison condition for those who did not meet criteria for the first 2 groups. Participants in these 3 groups were compared on functioning at intake, psychopathology, and diagnostic co-occurrence. Results indicated important group differences regarding diagnostic co-occurrence rates, patient history of associated features, and impairment at intake. The NSSI group displayed similar levels of functional impairment as the BPD group, including on indices of suicidality. The BPD group reported increased experiences with abuse and fewer men relative to the NSSI group. Most in the NSSI group did not exhibit subthreshold BPD symptoms or personality disorder not otherwise specified. In conclusion, a potential NSSI disorder may be characterized by high levels of depressive symptoms, anxiety, suicidality, and low functioning relative to other Axis I diagnoses.

Rates of Nonsuicidal Self-Injury in Youth: Age, Sex, and Behavioral Methods in a Community Sample

“…6 In fact, as publication of the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) approaches, it seems likely that NSSI will become a new psychiatric diagnosis. 7 Given likely inclusion in the official psychiatric nomenclature, it is important to establish rates and behavioral methods used to self-injure among children and adolescents.…”

Subgroups of Adolescent Girls With Borderline Personality Disorder Symptoms

“…Amongst a small sample of adult psychiatric inpatients with a history of NSSI the prevalence of MDD was 54%, closely followed by the prevalence of BPD (Herpertz, 1995). Another study examining a adults from a general practice clinic found that within the subset (11%) of individuals who met criteria for NSSI disorder, 42% of patients met criteria for depression, and 11% had anxiety disorders (Selby, Bender, Gordon, Nock, & Joiner, 2012). A study of adult psychiatric patients who reported self-injury had a prevalence of depression of 71%.…”

Characterizing Interpersonal Difficulties Among Young Adults Who Engage in Nonsuicidal Self-Injury Using a Daily Diary

“…Although nonsuicidal self-injury (NSSI) has been recognized for decades as a serious clinical problem due to its associations with psychopathology, suicidality, and functional impairment (Glenn & Klonsky, 2013;Selby, Bender, Gordon, Nock, & Joiner, 2011), recent evidence suggests that NSSI is also associated with impairments in interpersonal functioning. Compared to individuals without a history of NSSI, those with NSSI report pervasive interpersonal problems, including poorer quality relationships with peers and caregivers (Claes, Houben, Vandereycken, Bijttebier, & Muehlenkamp, 2010;Gratz, Conrad, & Roemer, 2002;Hilt, Nock, Lloyd-Richardson, & Prinstein, 2008;Hoff & Muehlenkamp, 2009), greater loneliness (Giletta, Scholte, Engels, Ciairano, & Prinstein, 2012;Glenn & Klonsky, 2013;Guertin, Lloyd-Richardson, Spirito, Donaldson, & Boergers, 2001), higher rates of peer victimization (Giletta et al, 2012;Hilt et al, 2008), lower perceived support (Heath, Ross, Toste, Charlebois, & Nedecheva, 2009;Muehlenkamp, Brausch, Quigley, & Whitlock, 2013), and worse social problem-solving abilities (Nock & Mendes, 2008).…”