Should Nonsuicidal Self-Injury Be a Putative Obsessive-Compulsive-Related Condition? A Critical Appraisal

Abstract

Non-suicidal self-injury (NSSI) has many behavioral and cognitive features that would make it appear to be closely tied to obsessive-compulsive disorder (OCD). Obsessive-compulsive related disorders (OCRDs) have been described in the literature as conditions that share a common phenomenology, neurobiology, and treatment response. We reviewed the literature describing the degree that NSSI is similar to, and distinct from, OCRDs based on these hypothesized common areas. We conclude with recommendations for conceptualization that draws partly on that from the OCRD literature and from cognitive-behavioral models of rumination.

The association between nonsuicidal self-injury and the emotional disorders: A meta-analytic review

“…Given increasing evidence that NSSI commonly presents with disorders other than BPD, as well as enduring uncertainty about where to place NSSI disorder in the DSM (e.g., McKay & Andover, 2012), a more precise understanding of the relationship between NSSI and the range of psychiatric conditions is needed. The "emotional disorders" are one disorder grouping that may warrant particular attention in this line of research.…”

“…Thus, NSSI often serves functions equivalent to the attempts to avoid negative emotional experiences that maintain the emotional disorders. Indeed, the association of avoidant coping strategies characteristic of emotional disorders (e.g., rumination, thought suppression) with engagement in and severity of NSSI is now well-established (e.g., Bentley, Sauer-Zavala, & Wilner, in press;Borrill, Fox, Flynn, & Roger, 2009;Hilt, Cha, & Nolen-Hoeksema, 2008;Howe-Martin, Murrell, & Guarnaccia, 2012;McKay & Andover, 2012;Najmi, Wegner, & Nock, 2007;Nolen-Hoeksema, Wisco, & Lyubomirsky, 2008;Voon, Hasking, & Martin, 2014).…”

Exploratory Analysis of Behavioral Impulsivity, Pro-inflammatory Cytokines, and Resting-State Frontal EEG Activity Associated With Non-suicidal Self-Injury in Patients With Mood Disorder

“…Participants who engage in NSSI often report difficulties in controlling unwanted urges. In that sense, NSSI has many behavioral and cognitive similarities with obsessive-compulsive disorder (OCD) (37). In a mouse model, elevated TNF-α signaling led to OCD-like behavior (38).…”

Dose-dependent clozapine-induced skin picking and self-injurious behaviour in treatment-resistant schizophrenia

“…This patient from the neighbouring nation developed skin-picking above the clozapine dose of 350 mg/day and improved with the addition of a selective serotonin reuptake inhibitor escitalopram 12 . It is argued that non-suicidal self-injury is closely related to obsessive-compulsive disorder 13 . Non-suicidal self-injury involves deliberate harm to the body without suicidal intent and includes cutting, scratching, skin picking, and burning 13 .…”

“…It is argued that non-suicidal self-injury is closely related to obsessive-compulsive disorder 13 . Non-suicidal self-injury involves deliberate harm to the body without suicidal intent and includes cutting, scratching, skin picking, and burning 13 . Diagnostic criteria for psychogenic excoriation have been proposed and published earlier.…”