Background
Method
Results
References | Type of sample | Sample size (female %) | Age group Range Mean age (SD) | Country | NSSI criteria used | Prevalence (%) | Female (%) of those with NSSID | Instruments assessing NSSI disorder criteria |
---|---|---|---|---|---|---|---|---|
Albores-Gallo et al. [47] | School | 533 (54) | Children and adolescents 11–17 years 13.37 (0.95) | Mexico | Shaffer and Jacobsona (2009) | 5.6 | 66.7 | Self-Injury Questionnaire (self-report) |
Andover [55] | Community | 548 (46.5) | Adults 18–73 years 35.70 (12.23) | US | APAb (2013) | 2.6 (11.2 of those with an NSSI history) | 50.0 | Questions developed for DSM-5 criteria (self-report) |
Barrocas et al. [48] | School | 665 (55.0) | Children and adolescents 7–16 years 11.6 (2.4) | US | Shaffer and Jacobsonc (2009) | 1.5 | SITBI interview FASM CDI (self-report) | |
Bracken-Minor and McDevitt-Murphy [54] | College | 480 (79.8) | Young adults 18–54 years 21.30 (5.69) | US | Shaffer and Jacobsond (2009) | 12.9C
| ISAS (self-report) | |
Fischer et al. [49] | Clinical inpatient | 111 (65.8) | Adolescents 12–19 years 15.38 (1.72) | Germany | APA (2013) | 36.9 | SITBI interview | |
Glenn and Klonsky [23] | Clinical inpatient and partial hospitalization | 198 (74) | Adolescents 12–18 years 15.13 (1.38) | US | Shaffer and Jacobsone (2009) | 50 (78 of self-injuring sample) | 86.7 | ISAS (self-report) |
Gratz et al. [53] | Community | 107 with NSSI (80) | Young adults 18–35 years 23.86 (4.87) | Canada and US | APA (2013) | 37 of repetitive NSSI sample | 85.0 | CANDI Structured diagnostic interview |
In-Albon et al. [50] | Clinical inpatient | 73 (100) | Adolescents 13–18 years | Germany and Switzerland | APA (2012) | 56.2 | Only female sample | Clinical interview DSM-5 criteria reformulated questions |
Manca et al. [14] | School | 953 | Adolescents | Italy | Shaffer and Jacobsonf (2009) | 3.1 (49.2 of repetitive NSSI sample) | DSHI R-NSSI-Q SBQ-R (self-report) | |
Odelius and Ramklint [51] | Clinical outpatient | 39 (87.2) | Adolescents and young adults 13–25 years 21 (1.9) | Sweden | Shaffer and Jacobson (2009) | 46.2 of NSSI sample | 83.3 | Clinical interview DSM-5 criteria reformulated questions |
Selby et al. [45]A
| Clinical outpatient | 571 (53) | Adults | US | Shaffer and Jacobsong (2009) | 11.4 | 50.8 | Chart data |
Washburn et al. [52] | Clinical inpatient, partial hospitalization and intensive outpatient | 511 (90.0) | Adolescents and young adults 12–52 years 17.3 (6.2) | US | APA (2013) | 74.0 of NSSI sample | ABASI (self-report) | |
Zetterqvist et al. [46]B
| School | 3,060 | Adolescents 15–17 years 16.4 (0.89) | Sweden | APAh (2012) | 6.7 (18.8 of NSSI sample) | 83.4 | SITBI-SF-SR FASM (self-report) |
NSSI disorder characteristics
DSM-5 NSSI criteria
Criterion A
Criterion B
Criterion C
Criterion D
Criterion E
NSSI disorder versus NSSI, clinical controls and borderline personality disorder
NSSI disorder versus NSSI
References | Sample and age group | Groups being compared (n) | Variables | Results |
---|---|---|---|---|
Andover [55] | Community adults | NSSID (14) NSSI (111) | NSSI characteristics Impairment/functioning NSSI functions | NSSID > NSSI Those with NSSID reported NSSI on significantly more days in the past year, 86.64 (134.47) vs. 6.38 (35.89); that NSSI interfered significantly more with functioning, 28.6 vs. 6.3% and significantly higher levels of automatic functions, 3.79 (1.67) vs. 1.81 (1.88); 5.00 (2.00) vs. 2.41 (2.51) |
Bracken-Minor and McDevitt-Murphy [54] | College young adults | NSSID+/BPD+ (29) NSSID+/BPD− (33) NSSI−/BPD+ (37) | Demographics NSSI methods NSSI functions Emotion dysregulation Distress tolerance | NSSID+/BPD+ > NSSID+/BPD− Those with BPD reported significantly higher levels of emotion dysregulation, 105.28 (22.95) vs. 88.31 (21.56); self-punishment, 3.90 (2.04) vs. 2.39 (2.12); anti-suicide 2.41 (2.16) vs. 1.06 (1.87) and anti-dissociation, 2.38 (1.86) vs. 1.42 (1.73) functions and significantly more individuals reported cutting, 82.8 vs. 30.3% and burning, 48.3 vs. 24.2% |
Glenn and Klonsky [23] | Clinical inpatient and partial hospitalization adolescents | NSSID (98) CC with and without NSSI (100) | Demographics Diagnoses Suicidal thoughts and behaviors Emotion dysregulation Loneliness | NSSID > CCd
Significantly more individuals with NSSID were female, 86.7 vs. 61%; had an anxiety disorder, 73.5 vs. 41.2%; mood disorder, 66.3 vs. 33.3%; bulimia, 18.3 vs. 0%; BPD, 51.7 vs. 14.9%; suicide ideation, 67.1 vs. 29.2%; suicide attempt, 24.4 vs. 8.6%; more total axis I disorders, 4.23 (2.52) vs. 2.35 (1.76); and significantly higher levels of emotion dysregulation, 117.94 (28.07) vs. 86.62 (29.94) and loneliness, 27.12 (6.66) vs. 22.29 (6.15) |
Gratz et al. [53] | Community with recurrent NSSI young adults | NSSID (40) NSSI (67) | Demographics NSSI characteristics NSSI functions Emotion dysregulation BPD pathology Psychiatric diagnoses | NSSID > NSSIe
Significantly more individuals with NSSID met criteria for BPD, 45.0 vs. 19.4%; bipolar disorder, 20.0 vs. 6.0%; PTSD, 25.0 vs. 10.4%; social anxiety disorder, 37.5 vs. 19.4%; alcohol dependence, 40.0 vs. 17.9%; lifetime substance use disorder 65.0 vs. 37.0% and used burning as NSSI method, 55 vs. 31%; used a significantly greater number of NSSI methods, 6.45 (2.78) vs. 5.14 (2.69); significantly more overall interference and impairment associated with NSSI; significantly higher levels of emotional relief, 3.37 (0.96) vs. 2.73 (0.93) and feeling generation, 3.02 (1.20) vs. 2.24 (1.12) functions; emotion dysregulation, 109.42 (21.79) vs. 94.26 (23.07); symptoms of depression, 18.68 (11.28) vs. 13.99 (9.86); anxiety, 15.12 (9.81) vs. 9.31 (7.23); stress, 20.65 (10.00) vs. 14.20 (8.04) and BPD pathology 76.71 (13.20) vs. 67.89 (11.63) |
In-Albon et al. [50] | Clinical inpatient adolescents | NSSID (41) NSSI without distress/impairment (12) CC (20) | Demographics NSSI characteristics NSSI functions Diagnostic correlates Clinical correlates Suicide attempts Smoking | NSSID > CC Significantly more individuals with NSSID had major depression, 79.5 vs 30.0%; relatively more individuals with NSSID had PTSD, 28.2 vs. 5%; suicide attempts, 69.2 vs. 20%; significantly higher symptoms of depression, 13.82 (4.56) vs. 8.84 (5.73); 36.32 (12.32) vs. 23.36 (13.11); emotion dysregulation, 123.42 (25.80) vs. 97.79 (24.14); externalizing, 21.31 (11.32) vs. 12.91 (1.74) and internalizing, 33.75 (10.04) vs. 25.28 (9.67) symptoms; borderline symptoms, 186.62 (64.93) vs. 120.47 (76.01) and lower GAF scores, 53.70 (10.17) vs. 59.55 (6.40) NSSID > NSSI Individuals with NSSID had significantly higher levels of automatic functions of NSSI, 2.43 (0.84) vs. 1.54 (0.81); 2.08 (0.71) vs. 1.33 (0.51) |
Manca et al. [14] | School adolescents | NSSID (30) NSSI (24;34;111)c
| R-NSSI-Q tendencies | NSSID > NSSI Individuals with NSSID had significantly higher R-NSSI-Q scores |
Odelius and Ramklint [51] | Outpatient clinical adolescents and young adults | NSSID (18) NSSI (21) | NSSI frequency Psychiatric diagnoses Suicide ideation, attempts and risk | NSSID > NSSI Those with NSSID had a significantly higher mean number of self-harm methods, 8 vs. 6, and significantly more had a high suicide risk, 50 vs. 29% |
Selby et al. [45]a
| Clinical outpatient adults | NSSID+/BPD− (65) BPD+/NSSI∓ (24) CC (482) | Demographics Psychiatric diagnosis Global functioning Psychopathology | BPD > NSSID, CC Significantly more females, 88 vs. 51 vs. 52% and experience of abuse, 54 vs. 28 vs. 16%, in individuals with BPD BPD, NSSID > CC Significantly more individuals with BPD and NSSID had a depressive disorder, 46 vs. 42 vs. 25%; experience of abuse, 54 vs. 28 vs. 16%; mood swings, 96 vs. 80 vs. 40%; recurrent conflicts with others, 54 vs. 49 vs. 16%; strange beliefs or thoughts, 63 vs. 49 vs. 23%; aggression, 50 vs. 31 vs. 13% compared to clinical controls. Those with BPD and NSSID also had more previous treatment, 3.6 (1.4) vs. 2.9 (1.6) vs. 2.3 (1.6); higher clinical global impression¬, 4.5 (1.0) vs. 4.4 (1.2) vs. 3.4 (1.4); lower GAF scores, 56.8 (13.5) vs. 53.7 (13.3) vs. 64.0 (11.3); higher levels of depressive symptoms, 22.2 (10.2) vs. 24.8 (12.9) vs. 14.3 (10.6); suicide ideation, 6.4 (8.0) vs. 9.2 (11.7) vs. 1.9 (4.1); suicide attempts, 0.92 (0.86) vs. 0.74 (0.86) vs. 0.17 (0.44); less time since most recent suicide attempt, 3.9 (1.2) vs. 3.6 (1.4) vs. 4.8 (0.60) NSSID > CC Significantly more individuals with NSSID had mood disorders (25 vs. 10% for dysthymia; 11 vs. 2% for bipolar disorder); cluster A PDs, 6 vs. 0.1% and higher levels of anxiety symptoms, 22.8 (15.2) vs. 14.2 (11.9) |
Washburn et al. [52] | Clinical inpatient, partial hospitalization intensive outpatient adolescents and young adults | NSSID (378) NSSI (133) | Demographics NSSI characteristics Psychopathology Quality of life Functional impairment | NSSID > NSSI Those with NSSID reported significantly more frequent NSSI, 88.72 (104.80) vs. 42.91 (88.31); methods, 4.29 (2.78) vs. 3.21 (3.40); urge, 21.06 (7.86) vs. 16.83 (8.62); higher levels of psychopathology, 2.05 (0.63) vs. 1.74 (0.70); suicide ideation, 1.40 (1.17) vs. 1.08 (1.18); BPD traits, 37.79 (11.35) vs. 33.38 (10.92); higher impairment, 18.03 (9.86) vs. 15.34 (9.79) and lower quality of life, 49.22 (17.79) vs. 55.29 (18.74) |
Ward et al. [43]a
| Clinical outpatient adults | NSSID+/BPD− (65) BPD+/NSSI∓ (24) CC (482) | Treatment variables Clinical impairment at intake and termination Response to treatment | NSSID, BPD > CC Significantly more individuals with NSSID and BPD ended therapy prematurely, 64 vs. 64 vs. 49% and had lower levels of functioning at termination, 3.6 (1.5) vs. 4.2 (1.7) vs. 2.8 (1.4)¬; 63.8 (16.1) vs. 60.5 (15.3) vs. 70.0 (12.8) NSSID > BPD, CC Those with NSSID showed more improvement following therapy with higher global functioning scores at termination compared to intake NSSID > CC Those with NSSID showed a larger decrease on ratings of severity of illness at termination compared to intake |
Zetterqvist et al. [46]b
| School adolescents | NSSID (205) NSSI (883) | Demographics Functions of NSSI NSSI characteristics | NSSID > NSSI Significantly more individuals with NSSID were female, 83.4 vs. 49.9%; lived with only one parent, 32.4 vs. 21.0%; alone or at institution, 13.2 vs. 5.2%; had parents that were unemployed or on long-term sick leave, 26.1 vs. 12.5%; perceived some or serious financial difficulties in the family, 40.9 vs. 20.0%; reported past or present smoking, 72.5 vs. 51.6%; drug use, 24.9 vs. 12.3%; were enrolled in a vocational program, 54.6 vs. 49.7% or individual educational program, 9.8 vs. 5.3%. All functions of NSSI were endorsed by a higher proportion of adolescents with NSSID, especially the automatic functions |
Zetterqvist et al. [44]b
| School adolescents | NSSID (186) NSSI (630) | Maltreatment/adversities Trauma symptoms | NSSID > NSSI Significantly more adolescents with NSSID reported bullying, 62.4 vs. 40.0%; emotional abuse 77.4 vs. 40.8%; physical abuse 38.7 vs. 16.0%; sexual abuse, 36.6 vs. 8.4%; parental chronic adversity 69.4 vs. 53.5% and significantly higher levels of symptoms of depression, 12.71 (5.66) vs. 5.15 (4.44); anxiety, 9.35 (5.91) vs. 5.32 (4.35); anger, 9.35 (5.91) vs. 5.32 (4.35); posttraumatic stress, 14.72 (6.06) vs. 7.53 (5.65) and dissociation, 12.45 (6.29) vs. 6.60 (5.09) |