Advancing a temporal framework for understanding the biology of nonsuicidal self- injury: An expert review

Michael Kaess, Jill M. Hooley, Bonnie Klimes-Dougan, Julian Koenig, Paul L. Plener, Corinna Reichl, Kealagh Robinson, Christian Schmahl, Maurizio Sicorello, Mindy Westlund Schreiner, Kathryn R. Cullen

Research output: Contribution to journalReview articlepeer-review

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Nonsuicidal self-injury (NSSI) is a serious clinical problem, particularly for adolescents and young adults. NSSI is a complex behavior that emerges through the intersecting effects of social, psychological, and biological mechanisms. Although the social and psychological contributions to risk for developing NSSI are relatively well understood and have guided the development of effective psychosocial treatments for self-injury, the biological mechanisms underlying NSSI have just begun to come to light. To evaluate and categorize the biological research conducted on the topic of NSSI, we propose a model that distinguishes between trait and state markers. According to this model, risk factors and mechanisms involved in NSSI can be distinguished into both trait and state factors. We review the existing evidence on distal biological traits (predictors) of NSSI, proximal biological traits (correlates) of NSSI, and biological states directly preceding or following NSSI. We conclude by providing recommendations for future research on the neurobiology of NSSI.

Original languageEnglish (US)
Pages (from-to)228-239
Number of pages12
JournalNeuroscience and Biobehavioral Reviews
Early online dateAug 24 2021
StatePublished - Nov 2021

Bibliographical note

Publisher Copyright:
© 2021


  • Neurobiology
  • Nonsuicidal self- injury
  • States
  • Temporal framework
  • Traits

PubMed: MeSH publication types

  • Journal Article
  • Review


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