Is NSSI a Disorder?

The short answer is no, NSSI is not a disorder; however, in 2013, the American Psychiatric Association published the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), which included Non-Suicidal Self-Injury Disorder (NSSI-D) as a condition for further study. ISSS was consulted on the development of proposed criteria for NSSI-D. 

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 or 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

To meet the final criterion, self-injury must not be explained by another psychological disorder.

How Prevalent is NSSI-D?

In with the suggestions put forth in the DSM-5, a lot of research has been conducted to determine how common NSSI-D might be. What the data show us so far is that