Catching up with Non-suicidal Self-injury 'Disorder': A Brief Review of Concepts and Recent Empirical Investigations

Abstract

The past two-and-half decades have produced a surge of research findings informing an abundance of patients displaying strong and frequent urges of self-harm (without suicidal ideation) but not fitting into any of the categorized psychiatric disorders (e.g., Borderline Personality Disorder-the most common disorder involving selfharm). Motivated by this we present a brief literature review of this confounding behavior known as Non-Suicidal Self Injury (NSSI). NSSI traditionally has been only a criterion of Borderline Personality Disorder (BPD). Findings in the last three decades however strongly suggest that (i) NSSI can often manifest in the absence of BPD, (ii) NSSI is best viewed as a transdiagnostic phenomenon due to its common co-occurrence with a variety of other psychological disorders (primarily depressive & anxiety disorders), and (iii) individuals indulging in NSSI (following the diagnosis criteria of DSM-5) generally tend to exhibit notably elevated levels of anxiety, depression and suicidal ideation compared to clinical control groups not practicing NSSI. While a multitude of factors have been investigated for their role as potential risk factors for NSSI, we found the inability to manage negative emotions (affect dysregulation) and prior history of NSSI to be most commonly reported. Childhood maltreatment (in its various forms), existing emotional disorders (mainly depressive & anxiety disorders), and cognitive variables like self-criticism and rumination are some of the other often-reported factors. We have also reviewed the various popular theoretical models of NSSI and found congruence between the core tenets of these models and empirical literature.