Abstract
Nonsuicidal self-injury disorder (NSSID) is a condition in need of further study, especially in adolescent and clinical populations where it is particularly prevalent and studies are limited. Twenty-nine clinical self-injuring adolescents were included in the study. The Clinical Assessment of Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess prevalence of NSSID. The NSSID diagnosis criteria were met by 62.1% of adolescents. The impairment or distress criterion was least often met. Criteria B and C (assessing reasons for NSSI and cognitions/emotions prior to NSSI) were confirmed by 96–100% of all participants. Adolescents with NSSI in this clinical sample had several comorbidities and high levels of psychopathology. NSSID occurred both in combination with and independently of borderline personality disorder traits as well as suicide plans and attempts. Those with NSSID had a significantly higher cutting frequency than those not meeting full NSSID criteria. Other NSSI characteristics, comorbidity, psychopathology, and trauma experiences did not differ between groups. CANDI was a feasible tool to assess NSSID in adolescents. It is important to use structured measures to assess the validity of the NSSID diagnosis across development in both community and clinical samples. The clinical utility of the NSSID diagnosis is discussed.
Highlights
Nonsuicidal self-injury (NSSI), i.e., deliberately injuring one's own body tissue without suicidal intent [1], is a significant mental health problem among adolescents
Originally developed for adults, Clinical Assessment of Nonsuicidal Self-injury Disorder Index (CANDI) was a helpful measure in assessing Nonsuicidal self-injury disorder (NSSID) and NSSI characteristics in this clinical adolescent sample, and well suited for this purpose
Cutting frequency significantly discriminated those with NSSID from those with NSSI not meeting full criteria
Summary
Nonsuicidal self-injury (NSSI), i.e., deliberately injuring one's own body tissue without suicidal intent [1], is a significant mental health problem among adolescents. There is a need for studies that examine the feasibility of structured measures to assess NSSID, especially in psychiatric adolescent populations, in order to validate and document NSSID prevalence across development, to identify risk and facilitate treatment planning. The aim of this explorative pilot study was to investigate the feasibility of assessing DSM-5 NSSID criteria using the structured interview CANDI in a clinical sample of adolescents by examining whether a more severe group could be identified by comparing demographics, NSSI characteristics, psychopathology, and trauma experience of those with an NSSID diagnosis to those with NSSI not meeting full NSSID criteria
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