Differences in Features of Non-Suicidal Self-Injury According to Borderline Personality Disorder Screening Status

Abstract

Given that non-suicidal self-injury (NSSI) disorder is being considered for the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is important to consider how NSSI occurs with and without borderline personality disorder (BPD). Participants were 480 undergraduates who completed online questionnaires and were assigned to 4 groups based on NSSI and BPD status. Analyses revealed BPD-positive self-injurers had higher self-punishment, anti-suicide, and anti-dissociation functions of NSSI and higher rates of cutting and burning than BPD-negative self-injurers. Furthermore, difficulty in emotion regulation, not distress tolerance, was most critical in distinguishing between groups. Differences between BPD-positive and BPD-negative self-injurers provide preliminary support for NSSI as a distinct disorder. However, more research in this area is needed.

Keywords:

• Borderline Personality Disorder
• distress tolerance
• DSM-5
• emotion regulation
• non-suicidal self-injury

Notes

Note. Descriptions of criteria for NSSI disorder taken from www.dsm5.org.

¹Analyses were also conducted using an Extreme Groups Approach (EGA) for the MSI-BPD measure. However, because results of analyses were similar with or without the use of EGA, the results presented are using the full sample.

Note. All ANCOVA analyses include gender and ethnicity as covariates. “NSSI+” indicates meeting criteria based in part on proposed DSM-5 Non-Suicidal Self-Injury Disorder. “BPD−” and “BPD+” indicates a positive or negative screening status for Borderline Personality Disorder, indicated by a score of < 7 or ≥ 7 on the McLean Screening Instrument for Borderline Personality Disorder, respectively.

^a All function subscale scores range from 0 to 6 with higher scores indicating higher endorsement of that function.

^* p < .05,.

^** p < .01.

.

^a Significance levels cannot be evaluated but would reach p < .05 in univariate context.

*p < .05.

**p < .01.

Note. Subscript indicates significant group differences. “NSSI−” and “NSSI+” indicates meeting or not meeting criteria based in part on proposed DSM-5 Non-Suicidal Self-Injury Disorder, respectively. “BPD−” and “BPD+” indicates a positive or negative screening status for Borderline Personality Disorder, indicated by a score of < 7 or ≥ 7 on the McLean Screening Instrument for Borderline Personality Disorder, respectively.

²Roy-Bargmann step-down analyses also were conducted with DTS as the higher-priority variable. Results of these analyses showed that DTS scores made a significant contribution to the composite of the DVs that best distinguishes between NSSI and BPD groups. However, step-down analyses showed DERS also was significant in making a distinction among the four groups (after adjusting for DTS and covariates). These findings, in combination with results presented in the main text, further suggest that although distress tolerance is linked to NSSI and BPD screening status, emotion regulation may play a larger role in differentiating among these groups.

Additional information

Notes on contributors

Katherine L. Bracken-Minor

Katherine L. Bracken-Minor, Department of Psychology, The University of Memphis, Memphis, Tennessee, USA. Katherine Bracken-Minor is now at Fellowship Health Resources, Inc., Raleigh, North Carolina.

Meghan E. McDevitt-Murphy

Meghan E. McDevitt-Murphy, Department of Psychology, The University of Memphis, Memphis, Tennessee, USA. Katherine Bracken-Minor is now at Fellowship Health Resources, Inc., Raleigh, North Carolina.