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

Glenn Kiekens*, Penelope Hasking, Laurence Claes, Philippe Mortier, Randy P. Auerbach, Mark Boyes, Pim Cuijpers, Koen Demyttenaere, Jennifer G. Green, Ronald C. Kessler, Matthew K. Nock, Ronny Bruffaerts

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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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.

Original languageEnglish
Pages (from-to)629-637
Number of pages9
JournalDepression and Anxiety
Issue number7
Early online date26 Apr 2018
Publication statusPublished - Jul 2018


Eli Lilly and Company, Grant/Award Number: IIT-H6U-BX-I002; Fonds Wetenschappelijk Onderzoek, Grant/Award Numbers: 1114717N, 11N0514N, 11N0516N; King Baudouin Foundation United States, Grant/Award Number: 2014-J2140150-102905 In the past 3 years, Dr. Kessler received support for his epidemiological studies from Sanofi Aventis, he was a consultant for Johnson & Johnson Wellness and Prevention, Shire and Takeda, and served on an advisory board for the Johnson & Johnson Services Inc. Lake Nona Life Project. Dr. Kessler is a co-owner of DataStat, Inc., a market research firm that carries out healthcare research. The other authors report no biomedical financial interests or potential conflicts of interest.

FundersFunder number
King Baudouin Foundation United States2014-J2140150-102905
Eli Lilly and CompanyIIT-H6U-BX-I002
Fonds Wetenschappelijk Onderzoek11N0516N, 1114717N, 11N0514N


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


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