NSSI in the DSM-5

Abstract Since the proposal for an NSSI disorder (NSSI-D) in DSM-5, there has been an expanding literature exploring the reliability, validity, and utility of NSSI-D and its proposed criteria. This chapter aims to identify NSSI features that may advance the construct from a behavior subordinated within other mental disorders to an independent diagnosis, and examines historical conceptualizations of NSSI as a clinical behavior and discrete syndrome, the initial proposal to include NSSI-D in DSM-5 and recent and future directions for NSSI-D. The chapter also identifies NSSI features that differentiate the construct from related diagnoses and behaviors (e.g., borderline personality disorder), explores challenges with the current NSSI-D criteria and its categorization in the diagnostic manual, and summarizes arguments for and against NSSI-D.