IV The Need for Continued Long-Term Outcomes Research
Nonsuicidal Self-Injury. Old Problem, New Disorder, Limited Data
CATHERINE R. GLENN, ADAM C. JAROSZEWSKI, ALEXANDER J. MILLNER, JACLYN C. KEARNS, AND MATTHEW K. NOCK
Nonsuicidal self-injury (NSSI) refers to the direct and deliberate destruction of body tissue without suicidal intent. People have engaged in NSSI for thousands of years, but only recently has NSSI been the focus of systematic research and proposed as a distinct clinical syndrome. NSSI disorder is included as a “condition requiring further study” in DSM-5. Research over the past few decades has revealed important information about the prevalence (more common in adolescents and potentially higher rates now than in previous decades), form (most common behaviors are skin-cutting, burning, and severe scratching), and function of NSSI (most common motivation is to reduce negative emotional states). However, the field knows much less about the causes of NSSI, its short- and long-term course, and how to treat and prevent this complex behavior. In terms of etiology, a great deal of research has focused on cross-sectional correlates and distal risk factors for NSSI, but much less is known about the proximal triggers for NSSI and underlying mechanisms that may explain why individuals choose to engage in NSSI specifically, rather than a range of other self-destructive or adaptive behaviors. Our limited understanding of causal mechanisms has hindered the development of effective interventions and preventions for NSSI. Although some interventions and psychiatric medications have shown potential promise, there are no well-established treatments—psychological or pharmacological—for NSSI in adolescents or adults. This chapter reviews the current state of knowledge about NSSI and recommends the types of research needed to move the field forward, including long-term outcome studies.