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Journal of Mental Health Counseling
Volume 32/Number 3/July 2010/Pages 288-289
SPECIAL SECTION ON NONSUICIDAL SELF-INJURY (NSSI)
Introduction to the Special Section on
Nonsuicidal Self- Injury (NSSI)
Heather C. Trepal
We are pleased to present this special section of the
Journal of Mental Health
Counseling
on the topic of nonsuicidal self-injury (NSSI). Recent research sug-
gests that NSSI is common, particularly among adolescents (Nock & Prinstein,
2005) and college students (Whitlock, Eckenrode, & Silverman, 2006).
Although over the past decade research on NSSI in both clinical and nonclini-
cal populations has progressed, mental health counselors continue to search for
best practices in diagnosing and treating clients who self-injure.
We now know much more about both the compound risk factors and the
motivations that may relate to self-injury (Lloyd-Richardson, 2010), and it is
recognized that the relationship between diagnosis and NSSI is complex.
Although self-mutilation is listed in the current edition of the
Diagnostic and
Statistical Manual of Mental Disorders
(DSM-IV-TR; American Psychiatric
Association [APA], 2000, p. 710) as one potential diagnostic criterion for bor-
derline personality disorder (BPD), both researchers and counselors (Ross &
Heath, 2003; Trepal & Wester, 2007; Whitlock et al., 2006) have provided evi-
dence to support moving beyond the BPD diagnosis when attempting to under-
stand and assess these behaviors.
The four articles in this issue share common themes regarding conceptual
and diagnostic considerations for NSSI and represent current research in terms
of psychopathology, first-hand experiences of self-injury, and the relationship
Heather C. Trepal is affiliated with the University of Texas at San Antonio. Correspondence con-
cerning this article should be directed to Heather Trepal, Associate Professor, Counseling,
DB 4.314, University of Texas at San Antonio, One UTSA Circle, San Antonio TX 78249. E-mail:
heather. trepal@utsa. edu.
288
Beesley and Stoltenberg I ADULT CHILDREN OF ALCOHOLICS
289
between diagnosis and gender. First, Kerr and Muehlenkamp present research
on psychopathology symptoms in female college students. The authors main-
tain that although there has been much research on NSSI and BPD, there is also
evidence that suggests examining the relationship of NSSI to other disorders.
They attempt to explore symptoms shared by various disorders that have been
associated with NSSI.
Next, Kakhnovets, Young, Pumell, Huebner, and Bishop describe self-
reported experiences of self-injury before, during, and after episodes in both
frequent and occasional self-injurers. This examination of personal experiences
of NSSI offers mental health counselors an insider's insight into these behav-
iors that may enhance their ability to conceptualize and appropriately diagnose
and treat them. Healey, Trepal, and Emelianchik-Key then examine how gen-
der and diagnosis of NSSI intersect. They remind us that gender expectations
play an important role in clinical conceptualization. The intersection of client-
gendered behavior with clinician-gendered expectations has been found to raise
questions about clinical decision making and NSSI that may affect diagnosis
and treatment. Finally, Hoffman and Kress explore ways to manage risk for
clients and counselors when adolescents self-injure.
Because NSSI has been proposed as a new diagnostic category in the next
issue ofthe DSM (APA, 2010), this is a critical time for researchers and clini-
cians to come together to share what they know about these behaviors. We hope
that this issue of the
JMHC
will be useful to mental health counselors as they
work with clients who self-injure.
REFERENCES
American Psychiatric Association (APA). (2000).
Diagnostic and statistical manual of mental dis-
orders
(4th ed., text rev.). Washington, DC; Author.
American Psychiatric Association. (2010).
Non-suicidal self-injury.
Retrieved June 18, 2010, from
http;//www.dsm5.org/ProposedRevisions/Pages/proposedrevision.aspx?rid=443
Lloyd-Riehardson, E. E. (2010). Non-suicidal self-injury in adolescents.
The Prevention
Researcher, 17,
3-7.
Nock, M. K., & Prinstein, M. J. (2005). Contextual features and behavioral functions of self-muti-
lation among adolescents.
Journal of Abnormal Psychology, ¡14,
140-146.
Ross, S., & Heath, N. L. (2003). Two models of adolescent self-mutilation.
Suicide and Life-
Threatening Behavior, 33,
277-287.
Trepal, H., & Wester, K. (2007). Self-injurious behaviors, diagnoses, and treatment methods; What
mental health professionals are reporting.
Journal of Mental Health Counseling, 29,
363-375.
Whitlock, J., Eckenrode, J., & Silverman, D. (2006). Self-injurious behaviors in a college popula-
tion. Peí/ío/r/c^,
¡17,
1939-1948.
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Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the
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