Is NSSI a Disorder?

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. 

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

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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.

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