Abstract
There are a number of candidates as useful outcomes in self-harm research - repetition of self-harm; symptom states; quality of life, social participation. Repetition of self-harm has been the predominant choice of researchers, not least because of its status as a risk for eventual suicide. Use of alternatives would respond to the preferences of study participants, but there are substantial methodological constraints. Nonetheless more attention could be given to the use of outcomes other than repetition. Another option is to broaden the approach to evaluation design, incorporating advances in the use of observational data either alone or linked to data from trials.
Highlights
SummaryThere are a number of candidates as useful outcomes in self-harm research – repetition of self-harm; symptom states; quality of life, social participation
In this context achievability means two things: the ability to identify and use individual measures with acceptable properties; and the ability to use those measures with an evaluation design that takes into account the various outcome domains and the heterogeneity of the target population
Owens and colleagues are right to remind us that research into intervention after self-harm has tended to overemphasise repetition at the expense of other outcomes that are important to study participants. Where they are wrong is in attributing the problem to lack of understanding of the nature of self-harm: a more cogent criticism is that we have lacked imagination in thinking about how to overcome the constraints imposed by conventional randomised controlled trials (RCTs) design
Summary
There are a number of candidates as useful outcomes in self-harm research – repetition of self-harm; symptom states; quality of life, social participation. Repetition of self-harm has been the predominant choice of researchers, not least because of its status as a risk for eventual suicide. Use of alternatives would respond to the preferences of study participants, but there are substantial methodological constraints. More attention could be given to the use of outcomes other than repetition. Another option is to broaden the approach to evaluation design, incorporating advances in the use of observational data either alone or linked to data from trials
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