Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know
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EATING DISORDERS (S WONDERLICH AND S ENGEL, SECTION EDITORS)
Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know Glenn Kiekens 1,2
&
Laurence Claes 1,3
Accepted: 25 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research. Recent Findings While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. Summary It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors. Keywords Non-suicidal self-injury . Eating disorders . Self-injury . Comorbidity . Self-harm
Introduction Non-suicidal self-injury (NSSI) refers to the deliberate and direct damage to one’s body tissue without suicidal intent [1]. Examples of NSSI include behaviors such as cutting, scratching, biting, or burning oneself. Adolescence and emerging adulthood are critical periods for NSSI, with approximately 20% of individuals reporting an onset before the age of 25 [2]. Reported gender differences in the prevalence of NSSI have been inconsistent; however, a recent metaanalysis found higher rates of NSSI in females compared with
This article is part of the Topical collection on Eating Disorders * Glenn Kiekens [email protected] 1
Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000 Leuven, Belgium
2
Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
3
Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
those in males, especially in clinical samples [3]. DSM-5 recently included the Non-Suicidal Self-Injury Disorder (NSSID) as a condition requiring further study [4]. NSSI-D requires NSSI on at least 5 days in the past year, significant distress due to NSSI, as well as several other conditions (e.g., psychological precipitant, intense urges, and the expectation of a favorable outcome following NSSI). Approximately 7% of adolescents and 1% of emerging adults meet diagnostic criteria for 12-month NSSI-D [5, 6]. While the definition
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