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Taylor Burke, PhD, from Harvard Medical School and Massachusetts General Hospital discusses the psychological effects of scars resulting from self-injury and self-harm. Season 2 | Episode 31 Podcast/ Season 2 | Episode 31 The Psychology of Self-Injury Scarring Nov 25, 2022 with Dr. Taylor Burke The Psychology of Self-Injury Scarring with Dr. Taylor Burke 00:00 / 01:04 How are scars from nonsuicidal self-injury (NSSI) different than physical scars that are unintentional or result from non-self-inflicted wounds ? What psychological effects can result from daily reminders of one's own decision to self-harm? Is there an association between NSSI scars and suicidal thoughts and behaviors? In this episode, Dr. Burke discusses the mixed relationship that many people who self-injure have with the scars they bear from NSSI and how some may feel the need to hide their scars even from themselves. Learn more about Dr. Burke and her work by clicking here or visiting the Mood & Behavior Lab (MABL) at www.moodandbehaviorlab.org . Follow her on Twitter @TaylorABurkePhD . Below are some of her publications and papers referenced in this episode: Burke, T. A., Ammerman, B. A., Hamilton, J. L., Stange, J. P., & Piccirillo, M. (2020). Nonsuicidal self-injury scar concealment from the self and others . Journal of Psychiatric Research, 130 , 313-320. Burke, T. A., Olino, T. M., & Alloy, L. B. (2017). Initial psychometric validation of the nonsuicidal self-injury scar cognition scale . Journal of Psychopathology and Behavioral Assessment, 39 , 546–562. Burke, T. A., Hamilton, J. L., Cohen, J. N., Stange, J. P., & Alloy, L. B. (2016). Identifying a physical indicator of suicide risk: non-suicidal self-injury scars predict suicidal ideation and suicide attempts . Comprehensive Psychiatry, 65 , 79–87. Bachtelle, S. E., & Pepper, C. M. (2015). The physical results of nonsuicidal self-injury: The meaning behind the scars . The Journal of Nervous and Mental Disease, 203 (12), 927-933. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their " Best 20 Clinical Psychology Podcasts " and by Welp Magazine in their " 20 Best Injury Podcasts ." Previous Next

Nathan Peterson, LCSW, from OCD and Anxiety Counseling in Allen, Texas, explains the difference between Self-Harm OCD and nonsuicidal self-injury as well as Exposure and Response Prevention (ERP) for harm OCD. Season 3 | Episode 38 Podcast/ Season 3 | Episode 38 Self-Harm OCD vs. Nonsuicidal Self-Injury Jun 30, 2023 with Nathan Peterson Self-Harm OCD vs. Nonsuicidal Self-Injury with Nathan Peterson 00:00 / 01:04 Approximately 1-4% of people throughout the world experience obsessive-compulsive disorder (OCD). Individuals with OCD are more likely than those without OCD to engage in nonsuicidal self-injury (NSSI), and recent research has shown that, among those who self-injure, having a diagnosis of OCD predicts more severe self-injury. In this episode, licensed clinical social worker and OCD expert Nathan Peterson explains how he differentiates nonsuicidal self-injury (NSSI) from Self-Harm OCD, which is just one of many subtypes of OCD and one in which a person experiences intrusive thoughts or mental images of violence toward oneself. He then walks us through how he uses Exposure and Response Prevention (ERP) for Self-Harm OCD in therapy. Learn more about Nathan and his therapy practice OCD and Anxiety Counseling here . He has nearly 100k subscribers on YouTube ( @ocdandanxiety ) where his videos receive thousands and thousands of views. You can also follow him on Instagram ( @ocdandanxietyonline ), Twitter ( @ocdandanxiety1 ), and Facebook . Click here to take his online "Do I Have Harm OCD? Test." Below are additional resources about OCD and/or NSSI: Browning, M. E., Lloyd-Richardson, E. E., Schneider, R. L., Faro, A. L., Muehlenkamp, J. J., & Claudio-Hernandez, A. (2022). Obsessive compulsive disorder and co-occurring nonsuicidal self-injury: Evidence-based treatments and future research directions . The Behavior Therapist, 45(6), 199-208. International OCD Foundation at https://iocdf.org/ . Winston, S. M., & Seif, M. N. ( 2017). Overcoming unwanted intrusive thoughts: A CBT-based guide to getting over frightening, obsessive, or disturbing thoughts . New Harbinger. Baer, L. (2012). Getting control: Overcoming your obsessions and compulsions (3rd ed.) . Plume. To learn more about how medication can help address OCD (most often in tandem with ERP but not discussed in this episode), click here . Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their " 20 Best Clinical Psychology Podcasts " and also featured in Audible's " Best Mental Health Podcasts to Defy Stigma and Begin to Heal ." Previous Next

2023 - 2024 Home / Collaborative Research Program / Understanding recovery... Understanding NSSI recovery Mentor/s: Penny Hasking & Stephen Lewis 2023 - 2024 Project Overview Data have been collected in Australia and Canada to assess the utility of Lewis & Hasking’s NSSI recovery framework. This person-centred approach reflects the lived experience of NSSI rather than focusing on NSSI cessation. This includes assessing: ongoing thoughts and urges to self-injure, expectations about disclosure, the nature and extent of scarring, resilience, self-efficacy and optimism. We have both qualitative and quantitative data and the final project can be decided with the candidate. Application Deadline: June 11 2023 Apply Now Previous Next

Ruth Tatnell, PhD, from Deakin University in Melbourne, Australia describes how the COVID-19 pandemic and first lockdown affected rates of self-injury and self-harm. Season 3 | Episode 33 Podcast/ Season 3 | Episode 33 Did Self-Injury Increase During the COVID-19 Lockdown? Jan 27, 2023 with Dr. Ruth Tatnell Did Self-Injury Increase During the COVID-19 Lockdown? with Dr. Ruth Tatnell 00:00 / 01:04 Early in the pandemic there was a lot of talk about how the initial lockdown and stay-at-home orders would affect people’s mental health, including risk for suicide and nonsuicidal self-injury (NSSI). In this episode, Dr. Ruth Tatnell answers questions about the pandemic's effects on rates of self-injury: Did the initial lockdown of the COVID-19 pandemic increase self-injury urges and behaviors like many people thought would happen? And do we know if self-harm has increased, decreased, or stayed the same since the first lockdown of the pandemic? Learn more about Dr. Tatnell and her work at Deakin University here , and connect with her on LinkedIn here . Below is her publication discussed in this month's episode as well as additional articles referenced in our interview: Tatnell, R., Terhaag, S., & Melvin, G. (2023). Covid-19 lockdown and non-suicidal self-injury: A Mixed methods analysis of NSSI during Australia's national lockdown . Archives of Suicide Research . Online ahead of print. Tanaka, T., & Okamoto, S. (2021). Increase in suicide following an initial decline during the COVID-19 pandemic in Japan . Nature Human Behaviour, 5 (2), 229–238. Read about the Harvard Happiness Study published in The Atlantic here . Read about the Cigna loneliness study here and their tips for addressing loneliness here . Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their " Best 20 Clinical Psychology Podcasts " and by Welp Magazine in their " 20 Best Injury Podcasts ." Previous Next

Home / Awards / Invited Fellow / Dr. Jennifer J. Muehlenkamp Dr. Jennifer J. Muehlenkamp Previous Dr. Jennifer J. Muehlenkamp is a Professor at the University of Wisconsin - Eau Claire (United States), where she is known to collaborate with almost anyone. As the first to formally propose that NSSI is a phenomenon deserving of clinical and research attention in its own right, Jennifer has had a great and long-lasting impact on the field. Her research focuses on the development, functions, and prevention of NSSI, as well as the roles of stigma, body image, and identity in emotional well-being. Dr. Muehlenkamp’s work has been instrumental in developing validated assessment tools and community-based prevention programs that reach students, educators, and clinicians. Beyond her research, she is an inspiring teacher and mentor known for her compassion, thoughtfulness, and dedication to bridging the gap between science and the lived realities of distress and recovery. A founding member of ISSS, Jennifer is encouraging and innovating, and she represents the kind of academic many of us aspire to be. Next ISSS Fellow | 2021

Home / Awards / Invited Fellow / Dr. James J. Gross Dr. James J. Gross Previous Dr. James J. Gross is the Ernest R. Hilgard Professor of Psychology at Stanford University (United States), where he directs the Stanford Center for Affective Science and the Stanford Psychophysiology Laboratory . A pioneer in emotion regulation, he has published over 650 works cited more than 250,000 times, shaping research across psychology and neuroscience. Dr. Gross is also an award-winning teacher and mentor, recognized with Stanford’s highest teaching honor, multiple mentoring awards, and national mentorship prizes. He has received research honors from the APA, the Society for Psychophysiological Research, the Social and Affective Neuroscience Society, and the Grawemeyer Award, as well as honorary doctorates from institutions in Belgium, the Netherlands, and Hong Kong. He is co-founding President of the Society for Affective Science, Founding Co-Editor-in-Chief of Affective Science , and a Fellow of multiple leading scientific organizations. Known for his intellectual rigor and transformative impact, Dr. Gross continues to advance the science of emotion while inspiring students, colleagues, and the global research community. Next ISSS Fellow | 2026

Two paragraph summary Research on Self-Injury in Daily Life Dr Glenn Kiekens Two paragraph summary Previous Next Featured Member Home / Special Interest Groups / Research on Self-Injury in Daily Life / Member Spotlights Question Answer

Local Chapters Collaboration / Local Chapters Local Collaborations with a Mission The ISSS Local Chapters is a new collaboration initiative fostering local connections within our international organization. The goal of these chapters is to facilitate local collaboration on research, clinical practice, reflection, and advocacy. Through these Chapters, we aim to promote innovation and impact through diverse connections that lead to improvements in the lives of those who have lived/living experience of self-injury. Below you can find active ISSS Local Chapters. If you don't see one in your area, consider starting one! Head to our contact form to let us know you are interested. Location Lead Contact Scandinavia Philip Ulstrup Hartvig phart@regionsjaelland.dk

Drs. Greg Lengel, Maria Zetterqvist, Amy Brausch, and Jason Washburn explain why they now advocate for nonsuicidal self-injury and self-harm to be considered a clinical specifier rather than a disorder in the Diagnostic & Statistical Manual of Mental Disorders (DSM). Season 5 | Episode 64 Podcast/ Season 5 | Episode 64 DSM Update: Nonsuicidal Self-Injury Disorder, or a Clinical Specifier? Aug 29, 2025 DSM Update: Nonsuicidal Self-Injury Disorder, or a Clinical Specifier? 00:00 / 01:04 In this episode, four of the top experts in researching and treating nonsuicidal self-injury (NSSI) talk about the research behind NSSI Disorder, the evolution of how they now think about NSSI within the context of the DSM, and why they now advocate for an NSSI specifier rather than an NSSI Disorder in the DSM. They also delineate their proposed criteria for self-harm as a specifier and both the positive and negative consequences of doing so. Below are papers referenced in this episode: Lengel, G. J., Muehlenkamp, J. J., Zetterqvist, M., Ammerman, B. A., Brausch, A. M., & Washburn, J. J. (2025). Non-suicidal self-injury: proposal to shift designation from disorder to a clinical specifier . The Lancet Psychiatry . Online advanced publication. Shaffer, D., & Jacobson, C. (2009). Proposal to the DSM-V childhood disorder and mood disorder work groups to include non-suicidal self-injury (NSSI) as a DSM-V disorder . American Psychiatric Association , 1-21. Muehlenkamp, J. J. (2005). Self-injurious behavior as a separate clinical syndrome . American Journal of Orthopsychiatry, 75 (2), 324–333. Brausch, A. (2019). Diagnostic classification of nonsuicidal self-injury . In J. J. Washburn (Ed.), Nonsuicidal self-injury: Advances in research and practice (pp. 71-87). Routledge. NONSUICIDAL SELF-INJURY SPECIFIER (PROPOSED CRITERIA): A. The specifier should be used when the nonsuicidal self-injury (NSSI) behavior is characterized by the following: The individual intentionally engages in NSSI behavior to inflict bodily damage or pain The individual's NSSI behavior is recent, such that it occurred at least once during the past month The individual’s NSSI behavior is repetitive, such that it occurred on about 5 or more days in an individual’s lifetime Note: culturally specific NSSI behavior (e.g., piercings and tattoos) and harm that is habitual (e.g., scab picking, nail biting, and hair pulling) should not be considered to be NSSI unless the behavior is explicitly for the purposes of causing damage or pain to one’s body. The NSSI specifier can still be applied if the behavior occurs under the influence of substances, as long as the behavior meets the required features. Coding note: use code Z91.52 for individuals with a previous history of NSSI when all criteria except for recency are met (A2). Previous Next

2023 - 2024 Home / Collaborative Research Program / NSSI in Chinese Adolescents NSSI and other life-threatening behaviours among adolescents in China Mentor/s: Moye Xin 2024 - 2025 Project Overview Affiliation: Xhaanxi Normal University, China Project Description: My research interests mainly focus on a combination with Life-threatening behaviors (e.g., NSSI and suicidal behaviors) among other minorities (e.g., adolescents and young adults at risk) and gender study, then try to figure out the mechanism of them, with the perspective of social science and psychological methodology, meanwhile, cooperating with international platforms, if possible. Applicants should have the following skills: Basic skills of data analysis, literature review and a little bit of mind of innovation Junior researcher responsibilities: Collecting literatures and revelant data, drafting manuscripts based on their own research interests Anticipated outcome(s) for junior researcher: Able to start your own research by choosing frontiers of research field, and start to write basic literature reviews and do some basic data analysis. Time commitment: 3 days per week for 1 year Application Deadline: June 1, 2024 Apply Now

About Self-Injury Who Self-Injures and Why? Resources / About Self-Injury / Who Self-Injures and Why? "A kaleidoscope of people & reasons" People of all ages, genders, sexualities, ethnicities, and social classes self-injure, though there are factors that may increase the likelihood that an individual will self-injure. Age Current research suggests that self-injury most commonly begins between ages 12 and 15 (Plener et al., 2015), with a second onset peak in early adulthood, around age 20 (Ghandi et al., 2018). Some people first start to self-injure before the age of 12 and some first self-injure much later in life. An age of onset before 12 is associated with more severe self-injury over a longer period of time (Muehlenkamp et al., 2019). Typically rates of self-injury increase through early-mid adolescence and decline in later adolescence. Sex, gender, and sexuality A 2015 meta-analysis of 116 studies showed that girls and women are slightly more likely to self-injure than boys and men, with this gender difference particularly evident in clinical samples. Self-injury is also more common among individuals identifying within the LGBTQIA+ community, with rates 2-3 times that of heterosexual/cisgender individuals (Liu et al., 2019). Culture and race A majority of research to date has focussed on samples comprising mostly Caucasian individuals from Western societies. This has lead to a significant gap in our understanding of NSSI among individuals in underrepresented cultural and racial groups. Current knowledge suggests that self-injury is present across cultures and races. A review by Gholamrezaei et al. (2015) showed there may be differences in age of onset and function, but the differences are complicated by social and economic factors, often brought about by racism. Psychological profile A meta-analysis (Fox et al., 2015) found that risk factors for self-injury include depression, hopelessness, abuse, personality and eating disorders, and impulsivity. People who engage in self-injury report being more sensitive to interpersonal stress or conflict, and experiencing greater difficulty expressing and regulating their emotions. That being said, most people who engage in self-injury do not have a mental illness. Trauma and hardship Experiences of trauma can leave lasting psychological damage resulting in instrusive thoughts, flashbacks, painful emotional states, and dissociation. Self-injury may be used by individuals facing these experineces, as it can be an effective strategy for escaping unwanted experiences and ending dissociation (Smith et al., 2014). Whilst people who have experienced trauma are more likely to engage in self-injury (Liu et al., 2018), it is a myth that all people who self-injure have experienced childhood trauma. Poverty is an additional risk factor for self-injury, with individuals from impoverished backgrounds more likely to self-injure than individuals whose socioeconomic needs were met (Liu, 2021). Why People Self-Injure Self-injury can be difficult to understand, as it appears to go against humans' innate desire to avoid harm. However, the reasons someone might injure themselves on purpose are often similar to the reasons people engage in other behaviours. Individuals who have self-injured often report more than one reason for their self-injury, and their reasons may change over time. The functions of self-injury can be classified into two broad categories: intrapersonal and interpersonal. Self-injury for intrapersonal reasons is more common than for interpersonal reasons (Taylor et al., 2018). Intrapersonal Functions Intrapersonal reasons have to do with an individual's internal state, including thoughts and emotions. There are three main intrapersonal functions: Emotion regulation. The most commonly reported reason to engage in self-injury is to manage emotional experiences. This includes escaping an unwanted emotions or inducing a desired emotion. Typically, these emotions are "negative", such as anger, frustration, sadness, and loneliness, but "positive" emotions such as excitement or pride have also been reported. Thought regulation. This is closely linked to emotion regulation, as our thoughts and emotions are connected. Individuals may use self-injury to control or quieten unwanted thoughts, such as self-criticism or suicidal ideation. Self-punishment. While self-punishment appears to serve an emotion regulation purpose, self-injury for this reason is usually tied to feelings or shame or thoughts about oneself being "flawed" or "bad". Interpersonal Functions Interpersonal functions have to do with an individual's connection with others, and include three main reasons: Communicating distress. Sometimes individuals may not know how to explain their distress to others and use self-injury as a way to communicate their feelings. Social influence. There may be several motivations underlying self-injury as a way to influence others. An individual may engage in self-injury to keep people away from them, to demonstrate their belonging to a social group, to elicit care, or to encourage a change in behaviour. Punishment. Sometimes a person may engage in self-injury as a way to punish another person for something they have or have not done. In these instances, the self-injury is typically communicating distress and serving an emotion regulation function as well. References Fox, K. R., Franklin, J. C., Ribeiro, J. D., Kleiman, E. M., Bentley, K. H., & Nock, M. K. (2015). Meta-analysis of risk factors for nonsuicidal self-injury. Clinical Psychology Review , 42 , 156-167. https://doi.org/10.1016/j.cpr.2015.09.002 Gandhi, A., Luyckx, K., Baetens, I., Kiekens, G., Sleuwaegen, E., Berens, A., Maitra, S., & Claes, L. (2018). Age of onset of non-suicidal self-injury in Dutch-speaking adolescents and emerging adults: An event history analysis of pooled data. Comprehensive Psychiatry , 80 , 170-178. https://doi.org/10.1016/j.comppsych.2017.10.007 Gholamrezaei, M., De Stefano, J., & Heath, N. (2015). Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. International Journal of Psychology , 52 , 316-326. https://doi.org/10.1002/ijop.12230 Liu, R. R. (2021). The epidemiology of non-suicidal self-injury: Lifetime prevalence, sociodemographic and clinical correlates, and treatment use in a nationally representative sample of adults in England. Psychological Medicine , 53 , 274-282. https://doi.org/10.1017/S003329172100146X Liu, R. T., Scopelliti, K. M., Pittman, S. K., & Zamora, A. S. (2018). Childhood maltreatment and non-suicidal self-injury: A systematic review and meta-analysis. The Lancet - Psychiatry , 5 , 51-64. https://doi.org/10.1016/S2215-0366(17)30469-8 Liu, R. T., Sheehan, A. E., Walsh, R. F. L., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. Clinical Psychology Review , 74 , Article 101783. https://doi.org/10.1016/j.cpr.2019.101783 Muehlenkamp, J. J., Xhunga, N., & Brausch, A. M. (2019). Self-injury age of onset: A risk factor for NSSI severity and suicidal behavior. Archives of Suicide Research , 23 , 551-563. https://doi.org/10.1080/13811118.2018.1486252 Plener, P. L., Schumachers, T. S., Munz, L., & Groschwitz, R. C. (2015). The longitudinal course of non-suicidal self-injury and deliberate self-harm: A systematic review of the literature. Borderline Personality Disorder and Emotion Dysregulation , 2 , Article 2. https://doi.org/10.1186%2Fs40479-014-0024-3 Smith, N. B., Kouros, C. D., & Meuret, A. E. (2014). The role of trauma symptoms in nonsuicidal self-injury. Trauma, Violence, and Abuse , 15 , 41-56. https://doi.org/10.1177/1524838013496332 Taylor, P. J., Jomar, K., Dhingra, K., Forrester, R., Shahmalak, U., & Dickson, J. M. (2018). A meta-analysis of the prevalence of different functions of non-suicidal self-injury. Journal of Affective Disorders , 227 , 759-769. https://doi.org/10.1016/j.jad.2017.11.073

About Self-Injury Is NSSI a Disorder? Resources / About Self-Injury / Is NSSI a Disorder? "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 emotion 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. References Zetterqvist, M. (2015). The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature. Child and Adolescent Psychiatry and Mental Health , 9 , Article 31. https://doi.org/10.1186/s13034-015-0062-7