Should nonsuicidal self-injury be a putative obsessive-compulsive-related condition? A critical appraisal.

McKay et al. (2012) looked at whether skin-picking, hair-pulling and other body-focused habits belong in the same box as self-cutting or burning. They read every paper that compared nonsuicidal self-injury (NSSI) to obsessive-compulsive-related disorders (OCRDs).

The team asked: do these behaviors share triggers, brain patterns and relief feelings? They wrote a critical map instead of running new lab work.

The review found partial overlap. Both NSSI and OCRDs give quick relief from tension and show similar brain reward circuits. Yet NSSI is often linked to emotion storms, while OCRDs chase sensory 'just-right' feelings.

Because the fit is only half-complete, the authors warn against parking NSSI in the OCRD chapter. They offer a hybrid frame: borrow OCRD tools for body-focus, but keep CBT emotion skills for the urge to self-punish.

Boudreau et al. (2015) add a treatment angle. Their review shows opioid blockers cut self-injury in half of adults with severe ID. Dean’s paper never mentions meds; together they tell us drugs can help the body-focused side while you shape emotional coping.

Goodwin et al. (2012) sharpen definitions. They stress that repetitive SIB in ID is different from teen NSSI. Reading both reviews side-by-side keeps you from mixing apples and oranges when you pick targets.

McGonigle et al. (2014) give a quick scale, the RSSIQ, that spots why people want to stop. Pair it with Dean’s hybrid model: use RSSIQ scores to decide whether to lean on OCRD habit reversal or CBT mood skills.

BCBAs often see clients who bite, pick or cut. This paper says do not force the behavior into one box. Start with functional analysis. If the payoff is sensory perfection, try habit reversal and exposure like you would for OCRDs. If the payoff is emotional escape, add CBT mood logs and distress-tolerance chains. Write both routes in the plan and track which one sticks.