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Table 2 Group differences when comparing NSSID vs. NSSI; NSSID vs. clinical controls; NSSI vs. BPD

From: The DSM-5 diagnosis of nonsuicidal self-injury disorder: a review of the empirical literature

References Sample and age group Groups being compared (n) Variables Results
Andover [55] Community adults NSSID (14) NSSI (111) NSSI characteristics Impairment/functioning NSSI functions NSSID > NSSI Those with NSSID reported NSSI on significantly more days in the past year, 86.64 (134.47) vs. 6.38 (35.89); that NSSI interfered significantly more with functioning, 28.6 vs. 6.3% and significantly higher levels of automatic functions, 3.79 (1.67) vs. 1.81 (1.88); 5.00 (2.00) vs. 2.41 (2.51)
Bracken-Minor and McDevitt-Murphy [54] College young adults NSSID+/BPD+ (29) NSSID+/BPD− (33) NSSI−/BPD+ (37) Demographics NSSI methods NSSI functions Emotion dysregulation Distress tolerance NSSID+/BPD+ > NSSID+/BPD− Those with BPD reported significantly higher levels of emotion dysregulation, 105.28 (22.95) vs. 88.31 (21.56); self-punishment, 3.90 (2.04) vs. 2.39 (2.12); anti-suicide 2.41 (2.16) vs. 1.06 (1.87) and anti-dissociation, 2.38 (1.86) vs. 1.42 (1.73) functions and significantly more individuals reported cutting, 82.8 vs. 30.3% and burning, 48.3 vs. 24.2%
Glenn and Klonsky [23] Clinical inpatient and partial hospitalization adolescents NSSID (98) CC with and without NSSI (100) Demographics Diagnoses Suicidal thoughts and behaviors Emotion dysregulation Loneliness NSSID > CCd Significantly more individuals with NSSID were female, 86.7 vs. 61%; had an anxiety disorder, 73.5 vs. 41.2%; mood disorder, 66.3 vs. 33.3%; bulimia, 18.3 vs. 0%; BPD, 51.7 vs. 14.9%; suicide ideation, 67.1 vs. 29.2%; suicide attempt, 24.4 vs. 8.6%; more total axis I disorders, 4.23 (2.52) vs. 2.35 (1.76); and significantly higher levels of emotion dysregulation, 117.94 (28.07) vs. 86.62 (29.94) and loneliness, 27.12 (6.66) vs. 22.29 (6.15)
Gratz et al. [53] Community with recurrent NSSI young adults NSSID (40) NSSI (67) Demographics NSSI characteristics NSSI functions Emotion dysregulation BPD pathology Psychiatric diagnoses NSSID > NSSIe Significantly more individuals with NSSID met criteria for BPD, 45.0 vs. 19.4%; bipolar disorder, 20.0 vs. 6.0%; PTSD, 25.0 vs. 10.4%; social anxiety disorder, 37.5 vs. 19.4%; alcohol dependence, 40.0 vs. 17.9%; lifetime substance use disorder 65.0 vs. 37.0% and used burning as NSSI method, 55 vs. 31%; used a significantly greater number of NSSI methods, 6.45 (2.78) vs. 5.14 (2.69); significantly more overall interference and impairment associated with NSSI; significantly higher levels of emotional relief, 3.37 (0.96) vs. 2.73 (0.93) and feeling generation, 3.02 (1.20) vs. 2.24 (1.12) functions; emotion dysregulation, 109.42 (21.79) vs. 94.26 (23.07); symptoms of depression, 18.68 (11.28) vs. 13.99 (9.86); anxiety, 15.12 (9.81) vs. 9.31 (7.23); stress, 20.65 (10.00) vs. 14.20 (8.04) and BPD pathology 76.71 (13.20) vs. 67.89 (11.63)
In-Albon et al. [50] Clinical inpatient adolescents NSSID (41) NSSI without distress/impairment (12) CC (20) Demographics NSSI characteristics NSSI functions Diagnostic correlates Clinical correlates Suicide attempts Smoking NSSID > CC Significantly more individuals with NSSID had major depression, 79.5 vs 30.0%; relatively more individuals with NSSID had PTSD, 28.2 vs. 5%; suicide attempts, 69.2 vs. 20%; significantly higher symptoms of depression, 13.82 (4.56) vs. 8.84 (5.73); 36.32 (12.32) vs. 23.36 (13.11); emotion dysregulation, 123.42 (25.80) vs. 97.79 (24.14); externalizing, 21.31 (11.32) vs. 12.91 (1.74) and internalizing, 33.75 (10.04) vs. 25.28 (9.67) symptoms; borderline symptoms, 186.62 (64.93) vs. 120.47 (76.01) and lower GAF scores, 53.70 (10.17) vs. 59.55 (6.40) NSSID > NSSI Individuals with NSSID had significantly higher levels of automatic functions of NSSI, 2.43 (0.84) vs. 1.54 (0.81); 2.08 (0.71) vs. 1.33 (0.51)
Manca et al. [14] School adolescents NSSID (30) NSSI (24;34;111)c R-NSSI-Q tendencies NSSID > NSSI Individuals with NSSID had significantly higher R-NSSI-Q scores
Odelius and Ramklint [51] Outpatient clinical adolescents and young adults NSSID (18) NSSI (21) NSSI frequency Psychiatric diagnoses Suicide ideation, attempts and risk NSSID > NSSI Those with NSSID had a significantly higher mean number of self-harm methods, 8 vs. 6, and significantly more had a high suicide risk, 50 vs. 29%
Selby et al. [45]a Clinical outpatient adults NSSID+/BPD− (65) BPD+/NSSI (24) CC (482) Demographics Psychiatric diagnosis Global functioning Psychopathology BPD > NSSID, CC Significantly more females, 88 vs. 51 vs. 52% and experience of abuse, 54 vs. 28 vs. 16%, in individuals with BPD BPD, NSSID > CC Significantly more individuals with BPD and NSSID had a depressive disorder, 46 vs. 42 vs. 25%; experience of abuse, 54 vs. 28 vs. 16%; mood swings, 96 vs. 80 vs. 40%; recurrent conflicts with others, 54 vs. 49 vs. 16%; strange beliefs or thoughts, 63 vs. 49 vs. 23%; aggression, 50 vs. 31 vs. 13% compared to clinical controls. Those with BPD and NSSID also had more previous treatment, 3.6 (1.4) vs. 2.9 (1.6) vs. 2.3 (1.6); higher clinical global impression¬, 4.5 (1.0) vs. 4.4 (1.2) vs. 3.4 (1.4); lower GAF scores, 56.8 (13.5) vs. 53.7 (13.3) vs. 64.0 (11.3); higher levels of depressive symptoms, 22.2 (10.2) vs. 24.8 (12.9) vs. 14.3 (10.6); suicide ideation, 6.4 (8.0) vs. 9.2 (11.7) vs. 1.9 (4.1); suicide attempts, 0.92 (0.86) vs. 0.74 (0.86) vs. 0.17 (0.44); less time since most recent suicide attempt, 3.9 (1.2) vs. 3.6 (1.4) vs. 4.8 (0.60) NSSID > CC Significantly more individuals with NSSID had mood disorders (25 vs. 10% for dysthymia; 11 vs. 2% for bipolar disorder); cluster A PDs, 6 vs. 0.1% and higher levels of anxiety symptoms, 22.8 (15.2) vs. 14.2 (11.9)
Washburn et al. [52] Clinical inpatient, partial hospitalization intensive outpatient adolescents and young adults NSSID (378) NSSI (133) Demographics NSSI characteristics Psychopathology Quality of life Functional impairment NSSID > NSSI Those with NSSID reported significantly more frequent NSSI, 88.72 (104.80) vs. 42.91 (88.31); methods, 4.29 (2.78) vs. 3.21 (3.40); urge, 21.06 (7.86) vs. 16.83 (8.62); higher levels of psychopathology, 2.05 (0.63) vs. 1.74 (0.70); suicide ideation, 1.40 (1.17) vs. 1.08 (1.18); BPD traits, 37.79 (11.35) vs. 33.38 (10.92); higher impairment, 18.03 (9.86) vs. 15.34 (9.79) and lower quality of life, 49.22 (17.79) vs. 55.29 (18.74)
Ward et al. [43]a Clinical outpatient adults NSSID+/BPD− (65) BPD+/NSSI (24) CC (482) Treatment variables Clinical impairment at intake and termination Response to treatment NSSID, BPD > CC Significantly more individuals with NSSID and BPD ended therapy prematurely, 64 vs. 64 vs. 49% and had lower levels of functioning at termination, 3.6 (1.5) vs. 4.2 (1.7) vs. 2.8 (1.4)¬; 63.8 (16.1) vs. 60.5 (15.3) vs. 70.0 (12.8) NSSID > BPD, CC Those with NSSID showed more improvement following therapy with higher global functioning scores at termination compared to intake NSSID > CC Those with NSSID showed a larger decrease on ratings of severity of illness at termination compared to intake
Zetterqvist et al. [46]b School adolescents NSSID (205) NSSI (883) Demographics Functions of NSSI NSSI characteristics NSSID > NSSI Significantly more individuals with NSSID were female, 83.4 vs. 49.9%; lived with only one parent, 32.4 vs. 21.0%; alone or at institution, 13.2 vs. 5.2%; had parents that were unemployed or on long-term sick leave, 26.1 vs. 12.5%; perceived some or serious financial difficulties in the family, 40.9 vs. 20.0%; reported past or present smoking, 72.5 vs. 51.6%; drug use, 24.9 vs. 12.3%; were enrolled in a vocational program, 54.6 vs. 49.7% or individual educational program, 9.8 vs. 5.3%. All functions of NSSI were endorsed by a higher proportion of adolescents with NSSID, especially the automatic functions
Zetterqvist et al. [44]b School adolescents NSSID (186) NSSI (630) Maltreatment/adversities Trauma symptoms NSSID > NSSI Significantly more adolescents with NSSID reported bullying, 62.4 vs. 40.0%; emotional abuse 77.4 vs. 40.8%; physical abuse 38.7 vs. 16.0%; sexual abuse, 36.6 vs. 8.4%; parental chronic adversity 69.4 vs. 53.5% and significantly higher levels of symptoms of depression, 12.71 (5.66) vs. 5.15 (4.44); anxiety, 9.35 (5.91) vs. 5.32 (4.35); anger, 9.35 (5.91) vs. 5.32 (4.35); posttraumatic stress, 14.72 (6.06) vs. 7.53 (5.65) and dissociation, 12.45 (6.29) vs. 6.60 (5.09)
  1. BPD borderline personality disorder, CC clinical controls, GAF global assessment of functioning, NSSI nonsuicidal self-injury, NSSID nonsuicidal self-injury disorder, PD personality disorders, PTSD posttraumatic stress disorder, R-NSSI-Q Repetitive Non-Suicidal Self-Injury Questionnaire, ¬higher score indicates more serious illness.
  2. aSame study sample.
  3. bSame study sample.
  4. cIntent uncertain group excluded due to not being applicable in the present fifth version of the Diagnostic and Statistical Manual of Mental Disorders.
  5. dOver and above BPD.
  6. eOver and above BPD except for depressive symptoms, PTSD and social anxiety disorder.