Non-suicidal self-injury: state of the art perspective of a proposed new syndrome for DSM V

Excerpt

Non-suicidal Self-Injury (NSSI) has received an increasing amount of attention over the last years. Although first papers on NSSI date back to the 1960s, it was not until 2002, that the first epidemiological study on adolescents was published, leading to a large body of research that has been growing ever since. Ten years after this seminal study, that showed a high prevalence of NSSI in a non-clinical population [1], we are discussing a new entity, which has been proposed to be included in the DSM V [2] as Non-Suicidal Self-Injury Syndrome. This proposal was the result of seeing a growing number of adolescents, that did not fulfil the criteria for Borderline Personality disorder (the only diagnostic category in DSM IV and ICD-10 that listed NSSI as symptom), but were nevertheless distressed, in need of help and - as recent research showed - at risk for suicide. It has been discussed, whether a new diagnostic entity makes sense, especially with regards to suicide and the relationship between NSSI and suicidality [3‐5]. However, given the high prevalence of adolescents that "use" NSSI as emotional regulation "skill" and clearly distance themselves from suicidality, the inclusion in a classificatory systems seems to make sense in order to foster further treatment and research in an area, that causes a lot of distress in adolescents, research that within the next years will have to focus on trajectories and predictors, since the first promising longitudinal studies, reported specific risk factors [6] and a strong decrease of prevalence in young adulthood [7], both of which needs to be understood more clearly in order to assist therapeutic approaches to treating NSSI. …