Co-Occurring Disorders in the Treatment of Nonsuicidal Self-Injury: An Evidence-Informed Approach

Abstract

Co-occurring disorders are common among patients who present for treatment with nonsuicidal self-injury (NSSI). Evidence-based approaches specifically designed for the treatment of NSSI are limited, although interest in this area of research is growing. An evidence-informed model for the treatment of NSSI and co-occurring disorders is presented here to stimulate interest in addressing co-occurring disorders in the treatment of NSSI. Case examples are presented to highlight the complexity of treating NSSI and co-occurring disorders and to illustrate a model of treatment at the acute level of care. The case examples also underscore the need for clinical researchers to address co-occurring disorders when developing treatments specifically for NSSI.

Temporal Associations Between Disordered Eating and Nonsuicidal Self-Injury: Examining Symptom Overlap Over 1 Year

“…Although previous clinical observations suggest that NSSI and DE may be negatively related (e.g., Washburn, Gebhardt, Styer, Juzwin, & Gottlieb, 2012), with one behavior increasing as the other 3 Given the small number of males in the sample, we repeated all of our analyses with the females only. The pattern of results remained consistent, and thus analyses for the full sample are presented.…”

Nonsuicidal Self-Injury: Management on the Inpatient Psychiatric Unit

“…Three models of care have been empirically tested and were reviewed: the Safewards Model (Bowers et al, 2015), the Oakwood Young People’s Centre (Livesey, 2009), and the Alexian Brothers Self-Injury Recovery Model (Washburn, Gebhardt, Styer, Juzwin, & Gottlief, 2012). These models share commonalities of removing sharp objects, potential ligature points and materials, pens, and limiting access to certain toiletries such as nail files, aerosol sprays, mouth washes, and tweezers (Cardell, Bratcher, & Quinnett, 2009; O’Donovan, 2007; Sine, 2008).…”

“…The Alexian Brothers Self-Injury Recovery Model addresses NSSI with co-occurring disorders in the inpatient setting and is envisioned as a way to stabilize the patient while in acute care and pave the way for a more successful outpatient treatment by addressing both mental health conditions in an integrated, rather than piecemeal approach (Washburn, Gebhardt, et al, 2012). The model begins with the assumption that both disorders are manifestations of the same underlying vulnerabilities, although the possibility that they are independent disorders is determined at the outset.…”

Adolescência e autolesão: psicodiagnóstico como proposta de compreensão e intervenção a partir de um caso clínico

“…analisaram os estudos encontrados entre 1998 e 2016 e constataram a prevalência entre 7,5 a 46,5% para o comportamento ao longo da vida. No que diz respeito à pré-adolescência, os números estimados foram entre 7,5% e 8%, aumentando entre 12% e 23% para adolescentes (Washburn, 2012).…”

“…No entanto, parece inegável que a prevalência do comportamento autolesivo esteja aumentando (Washburn, 2012), haja vista a grande quantidade de pesquisas recentes que o categorizam, em nível mundial, como um problema de saúde pública e, portanto, foco de atenção de políticas sociais e da prática profissional (Stewart et al, 2017;Plener, Munz, Allroggen, Kapusta, Fegert & Groschwitz, 2015a;Selby, Bender, Gordon, Nock, & Joiner, 2012;Rodav, Levy, e Hamdan, 2014;Somer, Bildik, Kabukçu, Basay, Güngör, Basay & Farmer, 2015;Giletta, Scholte, Engels, Ciairano & Prinstein, 2012;Muehlenkamp, Claes, Havertape, Plener, 2012).…”