An Initial Investigation of the Association Between DSM-5 Posttraumatic Stress Disorder Symptoms and Nonsuicidal Self-Injury Functions

Objective: Despite the well-established link between posttraumatic stress disorder (PTSD) and nonsuicidal self-injury (NSSI), little is known about factors that may lead to self-injury among trauma-exposed individuals. Moreover, no research to date has examined these relations in the context of the newly revised Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) PTSD criteria. Thus, the purpose of the current study was to explore the associations between DSM-5 PTSD symptom clusters (i.e., intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity) and self-injury functions using a small sample of college students. Method: Participants (N = 81) were recruited for a lifetime history of NSSI and trauma exposure. Results: Findings revealed a statistically significant path from PTSD avoidance symptoms to NSSI social functions and from PTSD negative alterations in cognitions and mood symptoms to NSSI intrapersonal functions, even after controlling for relevant covariates. Conclusions: Results of the current study highlight the importance of assessing for NSSI among trauma-exposed individuals. Considering that NSSI is a risk factor for suicidal behavior and potentially a clinically distinct diagnosis, future research should continue to explore these associations using larger, more diverse clinical samples. Clinical Impact Statement This study examined the link between posttraumatic stress disorder (PTSD) symptom clusters and reasons for engaging in nonsuicidal self-injury (NSSI), referred to as a NSSI function. Results indicated that PTSD symptom clusters are differentially related to NSSI functions. Specifically, PTSD negative alterations in cognitions and mood symptoms were associated with engaging in NSSI for intrapersonal (i.e., emotion regulation) functions, whereas PTSD avoidance symptoms were related to NSSI for social functions (i.e., communication, avoidance). These results suggest that PTSD symptom clusters may differentially maintain NSSI behaviors, and highlight the importance of assessing for NSSI among those who experience PTSD symptoms.