Inner and Outer Circles of Factors Associated with Non-Suicidal Self-Injury (NSSI): A Narrative Review

Abstract: Non-suicidal self-injury (NSSI) is a major concern in the field of public health. In the previous version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), self-injury was only a symptom of borderline personality disorder, but this criterion has recently been seen in people who do not have the diagnostic criteria of borderline personality disorder. The trans-diagnostic approach emphasizes the importance of the factors that precipitate and perpetuate this disorder. The purpose of this research is to review the factors that cause this behavior. Studies were reviewed using Google Scholar, PubMed, Web of Science, and Scopus databases with keywords of NSSI etiology factor and NSSI risk factor. In the present study, factors related to self-injury were studied in two categories: proximal and distal factors. Distal factors include traumatic family and insecure attachment; proximal factors are classified into 4 categories: negative selfrelationship, emotional factors, social factors, and the role of peer groups. Hence, it is better to address risk factors that are related to NSSI for a comprehensive and effective treatment.