title: Assessing DSM-5 nonsuicidal self-injury disorder in a clinical sample.
abstract: The entry for nonsuicidal self-injury (NSI) disorder in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) provides a criterion-based definition of clinically relevant NSI. NSI disorder is currently classified in the DSM-5 as a condition requiring further study. The present study aimed to examine the reliability, validity, and clinical utility of a self-report measure of NSI disorder, the Alexian Brothers Assessment of Self-Injury (ABASI). The sample included 511 patients admitted to an acute care treatment program designed to treat NSI. Patients were administered the ABASI as part of a clinical assessment and routine outcome evaluation. The sample included a broad age range, as well as sufficient numbers of males and Hispanics to examine sociodemographic differences. The ABASI demonstrated adequate internal consistency and test-retest reliability, and the factor structure reflects NSI disorder criteria. Among patients being treated for NSI, 74% met criteria for NSI disorder. No differences in the rate of NSI disorder were observed by sex, ethnicity, or age. Although NSI disorder is associated with a worse presentation of self-injurious behavior, NSI disorder provides limited clinical utility as a dichotomous diagnosis, at least when compared with common NSI characteristics such as number of methods of NSI and the urge to self-injure. Instead, findings support a dimensional approach to NSI disorder. Analyses of specific symptoms of NSI disorder indicate concerns with Criterion B as currently defined by the DSM-5. Recommendations for a more parsimonious revision of NSI disorder are discussed.
authors.affiliation: Center for Evidence-Based Practice, Alexian Brothers Behavioral Health Hospital.
authors.forename: Jason J
authors.initials: JJ
authors.lastname: Washburn
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine.
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Potthoff
authors.affiliation: Self-Injury Recovery Services, Alexian Brothers Behavioral Health Hospital.
authors.forename: K R
authors.initials: KR
authors.lastname: Juzwin
authors.affiliation: Self-Injury Recovery Services, Alexian Brothers Behavioral Health Hospital.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Styer
mesh_terms: D000328:Adult; D000368:Aged; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D015203:Reproducibility of Results; D057566:Self Report; D012647:Self-Assessment; D016728:Self-Injurious Behavior / Q000175:diagnosis* / Q000523:psychology*