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Depress Anxiety. 2018 Jul;35(7):629-637. doi: 10.1002/da.22754. Epub 2018 Apr 26.

The DSM-5 nonsuicidal self-injury disorder among incoming college students: Prevalence and associations with 12-month mental disorders and suicidal thoughts and behaviors.

Author information

1
Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium.
2
School of Psychology, Curtin University, Perth, Australia.
3
Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
4
Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium.
5
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
6
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
7
School of Education, Boston University, Boston, MA, USA.
8
Harvard Medical School, Department of Health Care Policy, Harvard University, Boston, MA, USA.
9
Department of Psychology, Harvard University, Cambridge, MA, USA.
10
Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA.

Abstract

BACKGROUND:

Approximately one in five college students report a history of nonsuicidal self-injury. However, it is unclear how many students meet criteria for the recently proposed DSM-5 nonsuicidal self-injury disorder (NSSI-D). In this study, we used full NSSI-D criteria to identify those students most in need of clinical care.

METHODS:

Using data from the Leuven College Surveys (n = 4,565), we examined the 12-month prevalence of DSM-5 NSSI-D in a large and representative sample of incoming college students. We also explored the optimal frequency threshold as a function of interference in functioning due to NSSI, and examined comorbidity patterns with other 12-month mental disorders (i.e., major depressive disorder, broad mania, generalized anxiety disorder, panic disorder, and alcohol dependence) and suicidal thoughts and behaviors (STB).

RESULTS:

Twelve-month NSSI-D prevalence was 0.8% and more common among females (1.1%) than males (0.4%). The proposed 5+ diagnostic threshold was confirmed as yielding highest discrimination between threshold and subthreshold cases in terms of distress or disability due to NSSI. A dose-response relationship was observed for NSSI recency-severity (i.e., 12-month NSSI-D, subthreshold 12-month NSSI-D, past NSSI, no history of NSSI) with number of 12-month mental disorders and STB. NSSI-D occurred without comorbid disorders for one in five individuals, and remained associated with severe role impairment when controlling for the number of comorbid disorders.

CONCLUSIONS:

These findings offer preliminary evidence that DSM-5 NSSI-D is uncommon among incoming college students, but may help to improve the deployment of targeted resource allocation to those most in need of services. More work examining the validity of NSSI-D is required.

KEYWORDS:

DSM-5; college students; mental disorders; nonsuicidal self-injury; suicide

PMID:
29697881
DOI:
10.1002/da.22754
[Indexed for MEDLINE]

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