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Is NSSI a Disorder?

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A "Condition for Further Study"

The short answer is no, NSSI is not a disorder; however, in 2013, the American Psychiatric Association included Nonsuicidal Self-Injury Disorder (NSSI-D) as a condition for further study in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). ISSS was consulted during the development of the proposed criteria for NSSI-D, where concerns and benefits of the diagnosis were discussed. 

There are currently six diagnostic criteria, and ISSS members continue to be involved in research to improve the reliability and validity of these criteria.

Criterion A

The first criterion relates to the frequency of self-injury. To meet this criterion, self-injury must have occurred on at least five days during the previous 12 months.

Criterion B

The second criterion relates to the reasons for engaging in self-injury. To meet this criterion, self-injury must have occurred for one or more of the following reasons:

  • To reduce negative thoughts or emotions

  • To manage interpersonal difficulties

  • To induce a positive state

Criterion C

There are several components captured by the third criterion. To meet this criterion, self-injury must meet one of more of the following​

  • Be preceded by:

    • negative thoughts/emotions

    • conflict with others

  • Involve preoccupation with self-injury that is difficult to resist

  • Involve recurrent thoughts about self-injury

Criterion D

This is an exclusion criterion, and stipulates that the self-injurious behaviours must not be socially sanctioned. Therefore, behaviours that cause injury but are socially acceptable, such as piercing or body modification, are excluded.

Criterion E

As with other disorders outlined in the DSM, to meet this criterion, the self-injury must cause distress or interfere with an individual's quality of life.

Criterion F

As with other disorders outlined in the DSM, to meet this criterion, the self-injury must cause distress or interfere with an individual's quality of life.