Cited by 259Suicide and Self-Harm StudiesPersonality Disorders and PsychopathologySubstance Abuse Treatment and Outcomes

Treating Nonsuicidal Self-Injury: A Systematic Review of Psychological and Pharmacological Interventions

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Turner, Brianna J, Austin, Sara B, Chapman, Alexander L·2014·The Canadian Journal of Psychiatry

Abstract

Objective: Nonsuicidal self-injury (NSSI), the deliberate, self-inflicted damage of bodily tissue without the intent to die, is associated with various negative outcomes. Although basic and epidemiologic research on NSSI has increased during the last 2 decades, literature on effective interventions targeting NSSI is still emerging. Here, we present a comprehensive, systematic review of existing psychological and pharmacological treatments designed specifically for NSSI, or including outcome assessments examining change in NSSI. Method: We conducted a systematic search of PsycINFO, MEDLINE, and ERIC databases to retrieve relevant articles that met inclusion criteria; specifically, uncontrolled and controlled trials that 1) presented quantitative outcome data on NSSI, and 2) clearly differentiated NSSI from suicidal self-injury (SSI). Consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, definition of NSSI, we excluded studies examining populations with developmental or intellectual disabilities, or with psychotic disorders. Results: Several interventions appear to hold promise for reducing NSSI, including dialectical behaviour therapy, emotion regulation group therapy, manual-assisted cognitive therapy, dynamic deconstructive psychotherapy, atypical antipsychotics (aripiprazole), naltrexone, and selective serotonin reuptake inhibitors (with or without cognitive-behavioural therapy). Nevertheless, there remains a paucity of well-controlled studies investigating treatment efficacy for NSSI. Conclusions: Structured psychotherapeutic approaches focusing on collaborative therapeutic relationships, motivation for change, and directly addressing NSSI behaviours seem to be most effective in reducing NSSI. Medications targeting the serotonergic, dopaminergic and opioid systems also have demonstrated some benefits. Future studies employing controlled designs as well as a clear delineation of NSSI and SSI will improve knowledge regarding treatment effects.

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  • Turner et al.'s (2014) systematic review of non-suicidal self-injury concluded that structure and collaboration were the most effective components of treatment, but did not identify a clear front runner in psychological interventions.

    “In their systematic review of non-suicidal self-injury, Turner et al. (2014) concluded that structure and collaboration were the most effective components of treatment, but did not identify a clear front runner in psychological interventions.”

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Cited by

Sorted by citations

Authors
Turner, B. J., Austin, S. B., & Chapman, A. L.
Affiliations
Simon Fraser University (CA)
Corresponding author
Turner, Brianna J
Venue
The Canadian Journal of Psychiatry
Published
2014-11
Volume
59
Issue
11
Pages
576-585
ISSN
  • 0706-7437 (ISSN-L)
  • 1497-0015
OpenAlex
W2226199416
Cited by
259
References
109
Citations by year
2026: 17 · 2025: 30 · 2024: 31 · 2023: 36 · 2022: 23 · 2021: 37 · 2020: 19 · 2019: 13 · 2018: 15 · 2017: 15 · 2016: 17 · 2015: 3 · 2014: 1 · 2013: 1 · 2012: 1
FWCI
1.81
Type
journal article
Language
en
Open access
Locations
  • The Canadian Journal of Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • American Psychological Association
  • Michael Smith Health Research BC
  • Health Canada
  • Canadian Institutes of Health Research
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
non-suicidal self-injury, suicidal self-injury, psychological intervention, pharmacotherapy, dialectical behavior therapy, atypical antipsychotics, aripiprazole, naltrexone, selective serotonin reuptake inhibitors, cognitive behavioral therapy, treatment efficacy
MeSH terms
Adolescent, Adult, Borderline Personality Disorder, Combined Modality Therapy, Humans, Psychotherapy, Psychotherapy, Group, Psychotropic Drugs, Suicide, Attempted, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Self-Injurious Behavior, Outcome Assessment, Health Care, Young Adult, Theory of Mind

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