Assessing the Functions of Non-suicidal Self-injury: Psychometric Properties of the Inventory of Statements About Self-injury (ISAS) (original) (raw)
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Psychological Assessment, 2014
Research tools for assessing nonsuicidal self-injury (NSSI) epidemiology in community populations are few and are either limited in the scope of NSSI characteristics assessed or included as part of suicide assessment. Though these surveys have been immensely useful in establishing the presence of NSSI and in documenting basic epidemiological characteristics, they have been less useful in describing secondary NSSI features such as NSSI context, habituation, or perceived life impact. The aim of the current study was to examine the reliability of the test scores and validity of test score interpretations in a university population for the Non-Suicidal Self-Injury-Assessment Tool (NSSI-AT), a web-based measure of NSSI designed to assess primary (such as form, frequency, and function) and secondary (including but not limited to NSSI habituation; contexts in which NSSI is practiced; and NSSI perceived life interference, treatment, and impacts) NSSI characteristics for research purposes. Data for these analyses were drawn from 3 samples, all of which were originally part of a 2007 study of randomly selected students from 8 northeast and midwest public and private universities that participated in a web-based study entitled the Survey of Student Wellbeing. Overall, results provide support for the reliability of NSSI-AT test scores (as assessed by test-retest) and validity of NSSI-AT test score interpretations for the behavior and frequency modules (as assessed using concurrent, convergent, and discriminant evidence) in this population. Implications for research as well as next steps are discussed.
One-Year Test-Retest Reliability of the Inventory of Statements about Self-Injury (ISAS)
Assessment, 2011
Nonsuicidal self-injury (NSSI) is a growing public health problem among adolescents and young adults. The Inventory of Statements About Self-Injury (ISAS) is a self-report measure designed to assess NSSI behaviors and functions. The current study examines the one-year test-retest reliability of the ISAS in a sample of young adult self-injurers. Results indicate that the ISAS behavioral and functional scales demonstrate good stability over one year. For the behavioral scales, test-retest correlations ranged from .52 (biting) to .83 (burning), with a median of .68. For the functional scales, test-retest correlations were .60 for the superordinate intrapersonal functions scale and .82 for the superordinate interpersonal functions scale. Regarding individual functions, test-retest correlations ranged from .35 (affect regulation) to .89 (peer bonding), with a median of .59. Findings suggest the ISAS has good test-retest reliability and contributes to the growing literature on the psychometric properties of the ISAS.
The Self-Injury Questionnaire: evaluation of the psychometric properties in a clinical population
Journal of Psychiatric and Mental Health Nursing, 2006
The Self-Injury Questionnaire: evaluation of the psychometric properties in a clinical population This paper presents the findings, from a clinical study, on the reliability and validity of a new measure for intentions in self-harm behaviour, the Self-Injury Questionnaire (SIQ). Eightythree patients, who had presented to an emergency department with an episode of selfharm/suicidal behaviour, were given the SIQ as part of a battery of measures to evaluate differentiation in self-harm intentions based upon a history of childhood physical and/or sexual abuse. The internal consistency for the total scale was strong (α = 0.83). Construct validity demonstrated significant correlations with standardized measures. A principle component analysis of responses yielded a five-factor solution with 'affect regulation' items loading on the first factor. Cronbach's alphas were adequate for each subscale (α = 0.72-0.77). These preliminary findings indicate that the SIQ is a valid and reliable measure for research in an acute self-harming population.
Journal of Abnormal Psychology, 2013
Theoretical and empirical literature suggests that nonsuicidal self-injury (NSSI) may represent a particularly important risk factor for suicide. The present study examined the associations of NSSI and established suicide risk factors to attempted suicide in four samples: adolescent psychiatric patients (n ϭ 139), adolescent high school students (n ϭ 426), university undergraduates (n ϭ 1,364), and a random-digit dialing sample of United States adults (n ϭ 438). All samples were administered measures of NSSI, suicide ideation, and suicide attempts; the first three samples were also administered measures of depression, anxiety, impulsivity, and borderline personality disorder (BPD). In all four samples, NSSI exhibited a robust relationship to attempted suicide (median Phi ϭ .36). Only suicide ideation exhibited a stronger relationship to attempted suicide (median Phi ϭ .47), whereas associations were smaller for BPD (median r pb ϭ .29), depression (median r pb ϭ .24), anxiety (median r pb ϭ .16), and impulsivity (median r pb ϭ .11). When these known suicide risk factors and NSSI were simultaneously entered into logistic regression analyses, only NSSI and suicide ideation maintained significant associations with attempted suicide. Results suggest that NSSI is an especially important risk factor for suicide. Findings are interpreted in the context of Joiner's interpersonal-psychological theory of suicide; specifically, NSSI may be a uniquely important risk factor for suicide because its presence is associated with both increased desire and capability for suicide.
Previous research has found associations between non-suicidal self-injury (NSSI) and suicidal thoughts and behaviors (STBs), yet the nature of this relationship remains equivocal. The goal of the present study was to examine how lifetime NSSI frequency and individual NSSI functions relate to a history of suicidal ideation, plan, and attempt. Data were collected via a large (N¼ 13,396) web-based survey of university students between the ages of 18 and 29. After demographics and psychiatric conditions were controlled for, we found a positive curvilinear relationship between NSSI frequency and each of the suicide outcomes. When examined among those with STBs, bipolar disorder and problematic substance use remained positively associated with risk for suicide attempt, but not NSSI. Analyses of individual NSSI functions showed differential associations with STBs of varying severity. Specifically, nearly every NSSI function was significantly related to suicide attempt, with functions related to avoiding committing suicide, coping with self-hatred, and feeling generation (anti-dissociation) showing the strongest risks for suicide attempt. From both clinical and research perspectives, these findings suggest the importance of assessing multiple reasons for engaging in self-injury.
2012
Understanding the functions of nonsuicidal self-injury (NSSI) has important implications for the development and refinement of theoretical models and treatments of NSSI. Emotional and social vulnerabilities associated with five common functions of NSSI-emotion relief (ER), feeling generation (FG), self-punishment (SP), interpersonal influence (II), and interpersonal communication (IC)-were investigated to clarify why individuals use this behavior in the service of different purposes. Female participants (n = 162) with a history of NSSI completed online measures of self-injury, emotion regulation strategies and abilities, trait affectivity, social problem-solving styles, and interpersonal problems. ER functions were associated with more intense affectivity, expressive suppression, and limited access to emotion regulation strategies. FG functions were associated with a lack of emotional clarity. Similar to ER functions, SP functions were associated with greater affective intensity and expressive suppression. II functions were negatively associated with expressive suppression and positively associated with domineering/controlling and intrusive/needy interpersonal styles. IC functions were negatively associated with expressive suppression and positively associated with a vindictive or self-centered interpersonal style. These findings highlight the specific affective traits, emotional and social skill deficits, and interpersonal styles that may render a person more likely to engage in NSSI to achieve specific goals.
2018
Objective: despite the fact that nonsuicidal self-injury (nSSI) has become an important issue among clinicians and researchers all over the world, in Italy there is still a lack of instruments able to assess it. The objective of this study is to develop and validate the Self-Injurious Thoughts and Behaviors Questionnaire-nonsuicidal (SITBQ-nS), a self-report measuring the whole nSSI spectrum, that is, from ideation to act. Method: SITBQ-nS was administered to 51 adult patients recruited from public mental health services together with the millon clinical multiaxial Inventory (mcmI-III), the Beck hopelessness Scale (BhS), the deliberate Selfharm Inventory (dShI), and the nepean dysphoria Scale (ndS-I). Results: SITBQ-NS demonstrated excellent internal consistency (α=0.983). NSSI thoughts were present in 56.9% of participants, and NSSI behaviors were present in 49% of participants. Similar NSSI functions were found among participants, except for “To end suicidal ideation,” which was m...
Interpersonal Features and Functions of Nonsuicidal Self-injury
Suicide and Life-Threatening Behavior, 2012
Etiological models of nonsuicidal self-injury (NSSI) suggest interpersonal features may be important to understand this behavior, but social functions and correlates have not been extensively studied. This study addresses existing limitations by examining interpersonal correlates and functions of NSSI within a stratified random sample of 1,243 predominantly Caucasian college students (mean age = 21.52, SD = 4.15 years). Participants completed an anonymous online survey assessing NSSI features, perceived social support, and disclosure experiences. Approximately 15% of the students endorsed NSSI. Interpersonal reasons were endorsed proportionally more often for initiating rather than repeating the behavior. Individuals with repetitive NSSI reported significantly lower perceived social support from family members and fewer individuals to seek advice from than single-act and control participants. Fifty-nine percent had disclosed their NSSI, but rarely to mental health professionals. Conversations with others about NSSI were rated as being mostly unhelpful. These results emphasize the importance of interpersonal features and functions of NSSI, suggesting treatments should focus on strengthening interpersonal bonds alongside emotion regulation. Improving responses to disclosures of NSSI is needed to promote communication about this behavior and perceived helpfulness of such conversations.
Prospective Prediction of Nonsuicidal Self-Injury: A 1-Year Longitudinal Study in Young Adults
Behavior Therapy, 2011
Nonsuicidal self-injury (NSSI) has become a significant public health problem. Although numerous studies have examined cross-sectional psychological correlates of NSSI, there has been little research examining predictors of NSSI over time. The present study examined cross-sectional and longitudinal correlates of NSSI in 81 young adult selfinjurers (M age = 19, 74.1% female, 51.9% Caucasian), 51 of whom were followed up 1 year later. At baseline, participants completed self-report measures of NSSI, Axis-I disorders, borderline personality disorder (BPD), and impulsivity, as well as an implicit measure of NSSI attitudes and identity. One year later, participants completed a Timeline Followback Method whereby they indicated their engagement in NSSI over the previous 12 months. Analyses replicated many known cross-sectional correlates of NSSI, including symptoms of several Axis-I disorders and BPD. However, many of these same variables failed to predict the course of NSSI over the 1-year follow-up. The only variables to prospectively predict NSSI were past NSSI (i.e., frequency, methods, and recency of NSSI), participants' behavioral forecast of their engagement in future NSSI, and BPD features. Findings suggest that many cross-sectional corre-lates of NSSI may not be useful for predicting subsequent NSSI. Instead, NSSI severity and BPD features appear to best predict continued engagement in NSSI.
Archives of Suicide Research, 2013
This study clarified the association of maladaptive, potentially self-damaging behaviors with suicidality. Specifically, we examined whether greater frequency (i.e., how often) or greater versatility (i.e., how many ways) of several self-damaging behaviors, including non-suicidal self-injury (NSSI), substance use and disordered eating, increased risk for suicide. Participants who engaged in NSSI (N = 141) completed questionnaires assessing suicidal and self-damaging behavior at baseline and engagement in suicidal behaviors (e.g., ideation, attempts, talking about suicide) three months later. Results suggest that the versatility rather than frequency of self-damaging behaviors is most robustly associated with suicide risk. Engaging in multiple methods of NSSI and using a greater number of illicit substances were positively associated with suicide risk. Further, versatility of NSSI interacted with depression to predict suicide risk at three-month follow-up such that highly depressed participants who engaged in more methods of NSSI exhibited highest risk, whereas those who engaged in more methods with low depression exhibited the lowest risk.