The Diagnostic and Statistical Manual fifth edition was released; however non-suicidal self-injury disorder remains in the research category. Looking through the research on this topic, there is a variety of views about treatment and classification not to mention even the name of the behavior has many different forms from self-injury to self-mutilation. This confusion may have led to this disorder not meeting full criteria for inclusion in the latest diagnostic manual. However, this issue has a high prevalence and evidenced based treatment continues to be explored to figure out best practices in the treatment of self-injury.
Zetterqvist (2015) found that additional empirical evidence is needed in support of non-suicidal self-injury being considered a disorder with the diagnostic manual. One hindrance to cohesive research on the topic has been the development of a consistent definition for deliberate self-harm without suicidal intent. Zetterqvist (2015) indicated that deliberate self-harm was the purposeful harm of body tissue for reasons that are not socially accepted or meant as a suicide attempt. This definition is becoming more uniform as the research continues to grow.
Another issue is that as of 2010 there was no specific evidenced based treatment for the treatment of self-injury (Nock (2010) as cited in Gonzales & Bergstrom, 2013). There is research on several different approaches from CBT to DBT and other manualized treatments but none have been given the gold standard in the treatment of self-injury.
To help in further understanding this disorder research is needed to further differentiate community and clinical samples beyond self-report to further prove validity and reliability of the diagnostic criteria (Zetterqvist, 2015). Research needs to be quantitative in nature versus qualitative. In looking thought recent literature on this topic, there is quantitative research but sample sizes are small. For example, Brausch and Girresch (2012) did a review of empirical treatment studies for adolescents who engage in self-injury. Turner, Austin, & Chapman (2014) did a review of psychological and pharmacological intervention in treatment non-suicidal self-injury. In addition, Nock, Teper and Hollander (2007) also presented a qualitative study on the psychological treatment of self-injury among adolescents. What was lacking was new research on evidenced based practices applicable to self-injury from a quantitative standpoint.
Continued research on this topic will help in further understanding how this disorder is a separate entity from such diagnosis as Borderline Personality Disorder. Maybe with continued growth this disorder will no longer be considered only for further research but will be a viable diagnosis in the future.
Brausch, A.M., & Girresch, S.K. (2012). A review of empirical treatment studies for adolescent nonsuicidal self-injury. Journal of Cognitive Psychotherapy: An
International Quarterly, 26(1), 3-18.
Gonzalez, A.H., & Bergstrom, L. (2013). Adolescent non-suicidal self-injury
(NSSI) interventions. Journal of Child and Adolescent Psychiatric Nursing, 26, 124- 130.
Nock, M.K., Teper, R., & Hollander, M. (2007). Psychological treatment of self-injury among adolescents. Journal of Clinical Psychology, 63(11), 1081-1089.
Turner, B.J., Austin, S.B., Chapman, A.L. (2014). Treating nonsuicidal self-injury: A systematic review of psychological and pharmacological interventions. Canadian Journal of Psychiatry, 59(11), 576-585.
Zetterqvist, M. (2015). The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature. Child & Adolescent Psychiatry & Mental Health, 9(31), 13p.
Rachel Collins, LPC is a clinical therapist working with children and adolescents in New Haven, Connecticut. Her specializations include eating disorders, self-injury and trauma related work. She has a history of writing articles, giving presentations and serving in leadership positions at the local, state, regional and national level.