Clinical Guidance: Emotion Dysregulation in Nonsuicidal Self-Injury
The combination of a serotonin reuptake inhibitor and dialectical behavioral therapy often helps patients with nonsuicidal self-injury build self-soothing strategies to enhance emotion regulation. Mentalization therapy also holds promise. The typical time of onset for nonsuicidal self-injury is adolescence or young adulthood, a period notable for emotional challenges corresponding with important brain changes. Cullen et al. (p. 828) identify parental antipathy and criticism as important factors in development of nonsuicidal self-injury, and family therapy may be a helpful adjunct. Common coexisting disorders include depression, anxiety, borderline personality disorder, substance abuse, eating disorders, and developmental disorders.