Exploring the Characteristics and Functions of Nonsuicidal Self-Injury in Patients with Severe Personality Disorders

Abstract Nonsuicidal Self-Injury (NSSI) is a major public health problem. The present study covered three aspects of this behavior in an outpatient population with severe personality disorders. First, we compared a group that engaged in NSSI to a control group that did not. Second, we looked at the characteristics of the behavior. Third, we explored what the patients think are the reasons for NSSI. 50 (41%) of 121 patients had experienced NSSI during the seven-month data collection period. We found that the NSSI most often occurred in the evening (60%) and while being alone (82%). The most common forms of NSSI were the use of bodily force in some form (48%), followed by cutting (28%) and burning (10%). As triggers for NSSI, pati ents mentioned interaction with others and rising tension. Patients identified with both the ’distraction hypothesis’ and the ’self-punishment hypothesis’ as reasons for NSSI. They reported feeling less nervous and more relieved after NSSI, but also felt guilt about it. Although further research is necessary and the current findings should be interpreted with caution, we conclude based on our findings that it might be helpful for patients with severe personality disorders to be asked by their caregivers on a regular basis whether they use/have used NSSI. We furthermore recommend considering making an adequate crisis prevention plan with the patients who engage in NSSI