Reconsidering important outcomes of the nonsuicidal self‐injury disorder diagnostic criterion A

Abstract

Objective: The nonsuicidal self-injury (NSSI) disorder diagnostic criteria have been the focus of empirical study.However, Criterion A (i.e., required frequency and timeframe) has received relatively limited attention. The current study aimed to examine the relationship between past 12-month NSSI frequency and eight NSSI behavior features among individuals with past 12-month and 1-month NSSI.Method: Participants were 723 undergraduate students reporting at least 1 past 12-month NSSI act and completed online questionnaires. Decision trees and structural equation model trees were utilized to examine the relationship between NSSI frequency and behavior features.Results: Results highlight several potential subgroups: high (i.e., greater than 49 acts), moderate-to-high (i.e., 19-48 acts), low-to-moderate (i.e., 7-18 acts), and low (i.e., fewer than 6 acts) frequency subgroups.Conclusions: Findings suggest that increasing the NSSI disorder criterion A frequency cutoff or requiring at least one past month NSSI act may better demarcate individuals with more severe NSSI behavior. K E Y W O R D S exploratory data mining, nonsuicidal self-injury frequency, nonsuicidal self-injury severity, NSSI disorder

Nonsuicidal Self-Injury Disorder in Adolescents: Clinical Utility of the Diagnosis Using the Clinical Assessment of Nonsuicidal Self-Injury Disorder Index

“…This could potentially increase utility in clinical samples. One such attempt was made by Muehlenkamp et al (18), who investigated differences between groups with low (1-4), moderate (5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24) and high (≥25) NSSI frequency.…”

“…Since the criteria were published, they have been subject to discussion (e.g., 6,8,[16][17][18][19]. Based on recent empirical data, revisions of the criteria have been suggested, including proposals that a dimensional approach to the disorder would be more beneficial (8).…”

“…The validity of criterion A has been examined and debated. Recent studies suggest that the cutoff level needs to be increased and/or the time period needs to be decreased to better delimit individuals with more severe NSSI (16)(17)(18). Furthermore, severity needs to be taken into account (16)(17)(18).…”

“…Recent studies suggest that the cutoff level needs to be increased and/or the time period needs to be decreased to better delimit individuals with more severe NSSI (16)(17)(18). Furthermore, severity needs to be taken into account (16)(17)(18). Currently, no distinction is made based on severity between five incidents of less serious damage to body tissue by scratching, for instance, and five episodes of severe cutting that need to be stitched.…”

Investigating the DSM-5 criteria for non-suicidal self-injury disorder in a community sample of adolescents

“…Namely, studies that evaluated criterion A found mixed evidence as to whether engaging in NSSI for five days in the past year is a clinically meaningful and valid benchmark (Ammerman et al, 2019;Muehlenkamp et al, 2017). It has been suggested that the current fivedays-specifier is too lenient and possibly over-diagnoses those who experiment with NSSI or intermittently engage in the behaviour (Muehlenkamp and Brausch, 2016).…”