Self-harm and personality disorder: Distinct facets of a complex relationship

Self-harm - particularly nonsuicidal self-injury (NSSI) - has long been conceptualized as a core symptom of borderline personality disorder (BPD) and remains a central focus within the emerging domains of early intervention and indicated prevention for personality disorders. Although self-harm and personality pathology are closely intertwined, accumulating evidence indicates that, while they share certain clinical and behavioral characteristics, they should not be regarded as largely overlapping constructs. This distinction underscores the need for caution against an overly narrow emphasis on self-harm during the early identification and treatment of BPD, to avoid oversimplification and to better capture the multifaceted nature of personality pathology. In this presentation, Professor Michael Kaess will provide a comprehensive review of current empirical findings concerning the role of self-harm in early intervention strategies for personality disorders. Specifically, it will explore the utility of self-harm as a potential diagnostic marker, a predictor of risk, a target for therapeutic intervention, and a primary outcome measure in clinical practice. The discussion will culminate in evidence-based clinical recommendations, highlighting the necessity of adopting a holistic, multi-dimensional approach to early detection and intervention that goes beyond self-harm alone.