One-Year Consistency in Lifetime Frequency Estimates and Functions of Non-Suicidal Self-Injury in a Clinical Sample.

Daiva Daukantaitė,Sofie Westling,Sophie I Liljedahl,Marjolein Helleman,Reid Lantto

doi:10.3389/fpsyt.2020.00538

Abstract

Non-suicidal self-injury (NSSI), the direct, deliberate destruction of one’s own bodily tissue in the absence of an intent to die, is frequently used for evaluating treatment in clinical care. One instrument for assessing NSSI is the Inventory of Statements About Self-Injury (ISAS). The ISAS is a self-rating measure examining the lifetime frequencies of NSSI behaviors and further exploring NSSI functions. The study aimed to examine the consistency of self-reported lifetime NSSI frequencies and functions (via the ISAS) in a clinical sample of individuals with current self-harm and/or recurrent suicidal behaviors over one year. Fifty-two individuals (84.6% women) completed the ISAS three times over 1 year. We found relatively good test-retest stability for most NSSI behaviors and functions, but the correlation coefficients and frequencies of NSSI behaviors varied substantially. Approximately, 50% of participants reported lower lifetime frequencies of NSSI behaviors at the later time points, with approximately 20% reporting a significant reduction in their lifetime frequencies over one year. This unexpected finding raises concerns about the accuracy of reporting lifetime NSSI frequencies among individuals with multiple psychiatric diagnoses and extensive NSSI behaviors across their lives. Further research is needed to determine more reliable ways of collecting data on the lifetime frequency of NSSI in clinical samples and the accuracy of lifetime NSSI frequency estimates in general.

Highlights

Self-injurious behavior, suicidal or non-suicidal, is a common symptom of many different psychiatric disorders [1]
Some instruments {e.g., Suicide Attempt Self-Injury Interview [SASII; [8]]; Self-Injurious Thoughts and Behaviors Interview [SITBI; [9]]} that assess multiple factors related to selfharm and suicide attempts are designed to be administered in a structured interview format, whereas others—which tend to be less comprehensive [e.g., the Self-Injury Questionnaire, [10]]—use a self-report format, require little time to administer, and are used in both clinical and non-clinical research
We will focus on non-suicidal self-injury (NSSI), a subcategory of Deliberate self-harm (DSH) that represents the direct, deliberate destruction of one’s own bodily tissue in the absence of an intent to die [11]

Summary

Introduction

Self-injurious behavior, suicidal or non-suicidal, is a common symptom of many different psychiatric disorders [1]. Changes in frequency of self-injurious behavior are a common outcome measure in clinical studies and care [2,3,4,5]. Some instruments {e.g., Suicide Attempt Self-Injury Interview [SASII; [8]]; Self-Injurious Thoughts and Behaviors Interview [SITBI; [9]]} that assess multiple factors related to selfharm and suicide attempts are designed to be administered in a structured interview format, whereas others—which tend to be less comprehensive [e.g., the Self-Injury Questionnaire, [10]]—use a self-report format, require little time to administer, and are used in both clinical and non-clinical research. We will focus on non-suicidal self-injury (NSSI), a subcategory of DSH that represents the direct, deliberate destruction of one’s own bodily tissue (e.g., cutting, burning, carving) in the absence of an intent to die [11]. NSSI has been incorporated in the DSM-5, the American Psychiatric Association’s diagnostic system [18], as a “condition for further study” [19,20,21]

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