Conditions for Further Study 803
Comorbidity
Suicidal behavior is seen in th e context of a variety of mental disorders, most commonly bipo-
lar disorder, major depressive disorder, schizo phrenia, schizoaffective disorder, anxiety dis-
orders (in particular, panic disorders asso ciated with catastrophic content and PTSD
flashbacks), substance use disorders (especially  alcohol use disorders) , borderline personality
disorder, antisocial personality disorder, eating disorders, and adjustment disorders. It is
rarely manifested by individual s with no discernible pathology,  unless it is undertaken be-
cause of a painful medical condition with the in tention of drawing attention to martyrdom for
political or religious reasons, or in partners in  a suicide pact, both of which are excluded from
this diagnosis, or when third-party informants  wish to conceal the nature of the behavior. 
Nonsuicidal Self-Injury
Proposed Criteria
A. In the last year, the individual has, on 5 or more days, engaged in intentional self-inflicted
damage to the surface of his or her body of a sort likely to induce bleeding, bruising, or pain
(e.g., cutting, burning, stabbing, hitting, excessive rubbing), with the expectation that the
injury will lead to only minor or moderate physi cal harm (i.e., there is no suicidal intent). 
Note:  The absence of suicidal intent has either been stated by the individual or can be
inferred by the individual’s repeated engagement in a behavior that the individual
knows, or has learned, is not likely to result in death.
B. The individual engages in the self-injurious behavior with one or more of the following
expectations:
1. To obtain relief from a negative feeling or cognitive state.
2. To resolve an interpersonal difficulty.