Self-Harm Inventory Research Articles

Emotion regulation group therapy for deliberate self-harm: a multi-site evaluation in routine care using an uncontrolled open trial design

ObjectiveEmotion regulation group therapy (ERGT) has shown promising results in several efficacy trials. However, it has not been evaluated outside a research setting. In order to increase the availability of...

Effect of alcohol dose on deliberate self-harm in men and women.

Nonexperimental survey and field research support the notion that alcohol use may be associated with deliberate self-harm (DSH) across the spectrum of lethality, from nonsuicidal self-injury (NSSI) through suicide. Nonexperimental studies, however, provide limited information about potential causal relationships between alcohol consumption and DSH. Two previous experiments showed that a relatively high-dose of alcohol increases the likelihood of engaging in DSH in men, with DSH defined by the self-administration of a "painful" shock (the self-aggression paradigm [SAP]; Berman & Walley, 2003; McCloskey & Berman, 2003). In this study, we examined whether (a) lower doses of alcohol also elicit DSH, (b) this effect occurs for women as well as men, and (c) individual differences in past nonsuicidal self-injury (NSSI) moderate alcohol's effects on DSH. Nonalcohol dependent men and women (N = 210) were assigned either to .00%, .05%, .075%, or .100% blood alcohol concentration (BAC) drink conditions and completed a self-rating scale of NSSI (the Deliberate Self-Harm Inventory [DSHI]; Gratz, 2001). As in previous SAP studies, DSH was operationalized by shock setting behavior during a competitive reaction time (RT) game. Overall, a greater proportion of participants in the .075% and .100% (but not .050%) alcohol conditions self-selected a "painful" shock to administer compared to participants in the placebo condition. NSSI predicted self-administration of painful shocks, but did not moderate the alcohol effect. Results provide experimental evidence to support the notion that interventions for self-harm should include processes to monitor and limit alcohol intake. (PsycINFO Database Record

The Direct and Indirect Self-Harm Inventory (DISH): A new measure for assessing high-risk and self-harm behaviors among military veterans.

The Direct and Indirect Self-Harm Inventory (DISH): A new measure for assessing high-risk and self-harm behaviors among military veterans.

The aggressor at the mirror: Psychiatric correlates of deliberate self-harm in male prison inmates

BackgroundDeliberate self-harm (DSH) causes important concern in prison inmates as it worsens morbidity and increases the risk for suicide. The aim of the present study is to investigate the prevalence and correlates of DSH in a large sample of male prisoners. MethodsA cross-sectional study evaluated male prisoners aged 18+ years. Current and lifetime psychiatric diagnoses were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders - DSM-IV Axis I and Axis II Disorders and with the Addiction Severity Index-Expanded Version. DSH was assessed with The Deliberate Self-Harm Inventory. Multivariable logistic regression models were used to identify independent correlates of lifetime DSH. ResultsNinety-three of 526 inmates (17.7%) reported at least 1 lifetime DSH behavior, and 58/93 (62.4%) of those reported a DSH act while in prison. After multivariable adjustment (sensitivity 41.9%, specificity 96.1%, area under the curve=0.854, 95% confidence interval CI=0.811–0.897, P<0.001), DSH was significantly associated with lifetime psychotic disorders (adjusted Odds Ratio aOR=6.227, 95% CI=2.183–17.762, P=0.001), borderline personality disorder (aOR=6.004, 95% CI=3.305–10.907, P<0.001), affective disorders (aOR=2.856, 95% CI=1.350–6.039, P=0.006) and misuse of multiple substances (aOR=2.024, 95% CI=1.111–3.687, P=0.021). ConclusionsBorderline personality disorder and misuse of multiple substances are established risk factors of DSH, but psychotic and affective disorders were also associated with DSH in male prison inmates. This points to possible DSH-related clinical sub-groups, that bear specific treatment needs.

Elucidating the association between the self-harm inventory and several borderline personality measures in an inpatient psychiatric sample

Objective: The current study evaluated the utility of the self-harm inventory (SHI) as a proxy for and screening measure of borderline personality disorder (BPD) using several diagnostic and statistical manual of mental disorders (DSM)-based BPD measures as criteria.Methods: We used a sample of 145 psychiatric inpatients, who completed the SHI and a series of well-validated, DSM-based self-report measures of BPD.Results: Using a series of latent trait and latent class analyses, we found that the SHI was substantially associated with a latent construct representing BPD, as well as differentiated latent classes of ‘high’ vs. ‘low’ BPD, with good accuracy.Conclusions: The SHI can serve as proxy for and a good screening measure for BPD, but future research needs to replicate these findings using structured interview-based measurement of BPD.

Associations between self-harm and distinct types of impulsivity

ObjectiveThere is an ongoing debate regarding how self-harm should be classified. The aim of this study was to characterize associations between self-harm and impulsivity. MethodTotal 333 adults (mean [SD] age 22.6 (3.6) years, 61% male) were recruited from the general community. History of self-harm was quantified using the Self-Harm Inventory (SHI), which asks about 22 self-harm behaviors. Principal components analysis was used to identify latent dimensions of self-harming behaviors. Relationships between self-harm dimensions and other measures were characterized using ordinary least squares regression. ResultsPrincipal Components Analysis yielded a three factor solution, corresponding to self-injurious self-harm (e.g. cutting, overdoses, burning), interpersonal related self-harm (e.g. engaging in emotionally or sexually abusive relationships), and reckless self-harm (e.g. losing one's job deliberately, driving recklessly, abusing alcohol). Regression modelling showed that all three dimensions of self-harm were associated with lower quality of life. ConclusionsThis study suggests the existence of three distinct subtypes or ‘latent factors’ of self-harm: all three appear clinically important in that they are linked with worse quality of life. Clinicians should screen for impulse control disorders in people with self-harm, especially when it is self-injurious or involves interpersonal harm.

Sleep problems among adolescents: is there a relation with deliberate self-harm and aggression?

Background Adequate sleep during adolescence is important for healthy development and proper daytime functioning. Sleep problems are commonly reported in adolescents, with an estimated prevalence between 17 and 45%. Besides, adolescence period is usually associated with various behavioral problems such as aggression and self-harm. Aims The aim of this study was to evaluate sleep habits and the presence of sleep problems in an Egyptian adolescent sample. Moreover, this study aimed to examine the presence of a relationship between sleep problems and the development of aggression and self-harm among those adolescents. Patients and methods A total of 117 adolescents in the preparatory stage participated in this study. Three self-report questionnaires were used, Child and Adolescent Sleep Checklist, the Deliberate Self-Harm Inventory, and the Aggression Scale, for students for assessment of sleep problems, deliberate self-harm (DSH), and aggression, respectively, among those adolescents. Results A total of 117 adolescents, 51 (43.6%) male and 66 (56.4%) female, participated in this study; their mean age was 13.85±0.81 years. Bedtime problems and daytime problems are more common among adolescents, with higher scores (8.10±3.99 and 6.56±3.61, respectively). Of those, 36 (30.8%) adolescents had a score of 18 or more, and so they were considered to have sleep problems. The participated adolescents had score ranging from 3 to 38 in the Aggression Scale, with a mean±SD of 12.36±8.32. A total of 24 (20.5%) adolescents had engaged in self-harm according to the Deliberate Self-Harm Inventory. Moreover, a significant positive correlation (P Conclusion Bedtime problems and daytime problems were common among the participated adolescents. Moreover, DSH and aggressive behaviors were reported. This study provides evidence that there is a strong relationship between sleep problems and both DSH and aggressive behaviors among those adolescents. Early detection, diagnosis, and treatment of sleep problems and promoting sleep hygiene will, undoubtedly, improve adolescents’ daily functioning and will have good impact on controlling these annoying behavioral problems.

Borderline personality disorder features, emotion dysregulation and non-suicidal self-injury: Preliminary findings in a sample of community-dwelling Italian adolescents.

In order to assess the relationships among borderline personality disorder features, non-suicidal self-injury (NSSI) and emotion dysregulation, 122 community-dwelling Italian adolescents were administered by the Italian translations of the Borderline Personality Features Scale for Children-11, the Deliberate Self-Harm Inventory and the Difficulties in Emotion Regulation Scale (DERS). Regression models showed that both Deliberate Self-Harm Inventory (DSHI) and DERS scores significantly predicted Borderline Personality Features Scale for Children-11 total score; moreover, the DSHI total score significantly predicted the DERS total score. Our findings suggest that borderline personality features in adolescence are moderately, albeit significantly related to NSSI, and that emotion dysregulation does not completely account for the association between borderline personality features and NSSI, although it seems to explain a non-trivial proportion of this relationship. Copyright © 2016 John Wiley & Sons, Ltd.

Comparison of Social Support and Self-Injurious Behaviors in Students with and without Learning Disabilities

Background: Students with learning disabilities, in comparison to normal students, have relatively more problems. Objectives: The aim of the present study is to compare the social support, aggression and self-injurious behaviors in students with and without learning disabilities. Patients and Methods: All students with and without learning disabilities from secondary schools of Ardabil, Iran constitute the research population. Sixty students were randomly selected by cluster sampling. Raven’s IQ Test, Social Support Scale, Aggression Questionnaire and Deliberate Self-harm Inventory were utilized for data collection. The MANOVA test also was applied for data analyzing. Results: The results of the present study indicated that students with learning disabilities, in comparison with normal students, have a inferior perceived social support and a higher rate of aggression as well as a higher self-injurious behavior. Analyses of regression also delineated that social support, physical aggression and verbal aggression can predict self-injurious behaviors in students with learning disabilities. Conclusions: Low social support and high aggression are two important factors which affect self-injurious behaviors in students with learning disabilities.

Prevalence and Correlates of Self-Harm in the German General Population.

The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI) and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women) using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15), the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49%) acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2 = 5.38, p = 0.020). Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4), higher impulsivity scores (BIS-15), and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming behaviors in more depth.

A Comprehensive View of Self-Concept and Its Effect With Respect To Self-Mutilation among the Institutionalized and Non-Institutionalized Adolescents

The objective of this study is to synthesize information from existing literatures on measures of the self-concept among institutionalized and non-institutionalized adolescents with respect to self-mutilation. As for an adolescent is concerned, it is important to develop a positive self-concept and high self-esteem in order to enhance a healthier personality. So the main objectives and focus of this study is to monitor the self-worth of adolescent students and help improve one’s self-concept and thus to develop a sense of healthy personality as an autonomous individual. 985 adolescent students, Kerala, India formed the sample for the study. The Self-Concept Questionnaire ((Kagen, Moore, &amp; Bredekamp, 1995)) and Self-Harm Inventory (Randy A. Sansone, and Lori A. Sansone1998), were used. 2x2x2 factorial ANOVA, Regression Analysis and Correlation technique were used to analyse the data. The findings showed that the levels of self-concept seem to influence the levels of self-mutilating behaviour among the adolescent students.

Attentional Bias Moderates the Link Between Attachment-Related Expectations and Non-suicidal Self-Injury

Insecure attachment is a transdiagnostic risk factor for the development of emotional and behavior problems. In the present study, we investigated the association between attachment-related expectations and non-suicidal self-injury (NSSI) in a sample of 42 university students, taking into account the attentional bias around mother as a mechanism to explain this association. All participants completed the Self-Harm Inventory to assess life-time NSSI and the Inventory of Parent and Peer Attachment and the Attentional Breadth Task. Overall, 28.6 % of the participants engaged in at least one type of life-time NSSI. The results showed that participants who are less able to trust their mother are less likely to communicate with her, which is linked to more life-time NSSI, but only when their attention is more focused on her. Therefore, from a clinical point of view, it is advisable to also focus on the child–parent interaction while preventing or treating NSSI in adolescents and young adults.

Interventions for self-harm in children and adolescents.

Self-harm (SH; intentional self-poisoning or self-injury) is common in children and adolescents, often repeated, and strongly associated with suicide. This is an update of a broader Cochrane review on psychosocial and pharmacological treatments for SH published in 1998 and updated in 1999. We have

A Survey of Medically Self-Sabotaging Behaviors Among Perpetrators of Partner Violence

To the Editor: Up to 18% of women report some type of intimate partner violence in their current or most recent relationship with a male partner (eg, battering, physical assault, and/or sexual assault),1 indicating that a significant minority of men engage in such behaviors. However, little is known about the problematic health behaviors of perpetrators of intimate partner violence, such as engaging in the medically self-sabotaging behaviors of preventing wounds from healing or making medical situations worse. A review of the PubMed database revealed no related articles. In this study, we examined these 2 problematic health care behaviors among this unique population. Method. Participants in this study were adult US men and women who were court-referred to a group educational intervention for the perpetration of partner violence in 1 of 4 different treatment facilities between June and October of 2013. After receiving approval from the executive directors, the recruiter (K.E.) met with 24 different treatment groups, enrolled 193 of 235 participants (82.1%), obtained signed consent forms, and provided surveys for completion in-group and onsite. The survey contained a demographic query as well as the Self-Harm Inventory,2 which assesses the lifetime prevalence of 22 self-harm behaviors. Items 9 and 10 of the Self-Harm Inventory query, “Have you ever intentionally, or on purpose: (9) prevented wounds from healing and (10) made medical situations worse on purpose,” with yes/no response options. Participants were advised to not identify themselves on the surveys. Completed surveys were placed into sealed envelopes and given to the researcher. The project was approved by an institutional review board. Results. Of the 193 participants, 170 were men and 23 were women. All participants checked an age range falling between 18 and 65 years, with most (71.5%) endorsing between 21 and 40 years. As for ethnicity, 43.0% were white, 19.7% black, 14.5% Native American, 11.4% Hispanic, 10.9% other, and 0.5% Asian. Fifteen participants (7.8%) endorsed the item pertaining to preventing wounds from healing. These respondents did not statistically significantly differ from those participants who did not endorse this item in age (F1,191 = 2.53; P < .15) or sex (χ2 = 0.03, P < .87). Twenty-four participants (12.4%) endorsed the item pertaining to making medical situations worse on purpose. These participants did not statistically significantly differ in age from those respondents who did not endorse this item (F1,191 = 0.04; P < .89). However, there was a statistically significant difference in sex among endorsers of this item compared to those who did not endorse this item, with more women reporting having made medical situations worse (29.2%) than women who did not (9.5%) (χ2 = 7.77, P < .01). According to findings, approximately 10% of perpetrators of partner violence report medically self-sabotaging behaviors—a significant minority. These behaviors most likely reflect the aggressive and destructive elements encountered in these individuals. Whether these behaviors are associated with specific psychiatric diagnoses remains unknown. The potential limitations of this study include use of self-report data, relatively small subsamples for comparison, and examination of severe offenders (court-ordered to treatment). However, given the dearth of data in this area, this is the first study to our knowledge to examine problematic health care behaviors among perpetrators of partner violence.

Self-Harming Behavior And Its Relation With Previous Psychological or Psychiatric Care

The study was realized in cooperation with grant support: MUNI/A/0790/2012 "Verifying the psychometric properties of diagnostic tools for screening the incidence and forms of self-harm among school children". This study explores self-harming behavior among adolescents (12-15 years old) and its relation with previous psychological or psychiatric care. There is a connection to the process occurrence type of self-harm between adolescents who have been or are in psychological or psychiatric care and those who were never been. The results can spread our knowledge about self-harm behavior, which is very common teenage phenomenon. Furthermore, it can be used to specify the support for adolescents who do self-harm. In accordance with the research objectives were quantitative, exploratory data, in a one-shot cross-sectional survey using self-report measures. Our sample was 1110 adolescents between 12 to 15 years old. In our sample were 84 adolescents who do or did self-harm. The methods for measuring self-harm included the Self-Harm Inventory (SHI; Sansone, Sansone, &amp; Wiederman, 1995). The main differences were found in occurrence of self-harm behavior between children who have never been in psychological or psychiatric care (20%) and the others (40%). Small differences were found also in different type of self-harm behavior. On the other hand we did not find differences in the self-harm process. There are differences between those adolescents who have never been in psychological or psychiatric care and the others. We hope that the results of this study could help to understand the self-harming behavior, which is currently spreading among adolescents. It could be a useful guide for those, who are working with the youth.

Religiosity/spirituality: Relationships with non-suicidal self-harm behaviors and attempted suicide.

The relationships between religiosity/spirituality (RS) and self-harm behavior, including non-suicidal self-harm behavior (NS-SHB) and suicide attempts/completions, remain of keen interest. Whereas the majority of studies strongly suggest that RS protects against suicide attempts/completions, relationships between RS and NS-SHB have been rarely studied. In this study, we examined RS in relationship to both NS-SHB (six explicit behaviors) and past history of suicide attempts. In a cross-sectional sample of 306 consecutive primary care outpatients, we administered four self-report assessments for RS (extent participant considered self a religious person, extent participant considered self a spiritual person, extent religion is involved in understanding/dealing with stressful situations, Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp-12)) as well as examined seven items on the Self-Harm Inventory: six items reflecting NS-SHB and one item reflecting a past suicide attempt. While two RS items yielded no significant findings (extent participant considered self a spiritual person, extent religion is involved in understanding/dealing with stressful situations), the remaining two items were associated with a lowered risk of self-harm behavior, particularly the FACIT-Sp-12. Some but not all aspects of RS are associated with lowered risk for self-harm. In this study, considering oneself a religious person and reporting a general sense of RS well-being offered the most protective effect to participants, particularly the latter.

Risk Factors and Comorbidities for Occasional and Daily Smoking in European Adolescents: Results of the Seyle Project

Background Smoking among adolescents is still a major public health problem and a global concern. Early onset and long-term smoking are associated with physical and psychological health problems. Objective To identify risk factors and comorbidities for occasional and daily smoking among European adolescents. Methods In the context of the Europe-wide 'Saving and Empowering Young Lives in Europe” (SEYLE) study we surveyed 12,328 youths at the age of 13 to 17 from 11 countries. We applied questions from the Global School-Based Student Health Survey to determine nicotine consumption as well as other risk behaviors. Psychiatric symptoms were assessed by the Strengths and Difficulties Questionnaire, the Becks Depression Inventory-II, the Zung Self-Rating Anxiety Scale, the Deliberate Self-Harm Inventory and the Paykel Suicide Scale. Results On average 30.9% of adolescents reported daily smoking and the onset of smoking was reported by 35.3% between the age of 12 and 13 already. Multinomial logistic regression model showed significant correlations between adolescent smoking and migration background, living in single parent households, no physical activity, parental smoking and physical fights. Further it revealed significant associations of adolescent smoking with alcohol consumption, illegal drug use, anxiety, conduct problems, hyperactivity, suicidal ideation, self-injury and internet-dependence. Conclusion Our data show that adolescent smoking is associated with psychosocial factors, especially family setting and parental behaviors. Further, smoking and psychiatric problems are highly correlated. Therefore, early preventive measures are necessary and essential not only for adolescents but also for their parents.

Connection between Parenting Styles and Self-harm in Adolescence

The aim of this study was to investigate possible associations between parenting styles and the occurrence of self-harm in adolescence, in the context of potential gender differences. In a large-scale survey, we administered a questionnaire asking about basic demographic characteristics, perceived quality of relationships within the respondents’ families, and the occurrence of self-injurious behavior. The questionnaire therefore contained the Self-Harm Behavior Questionnaire (Gutierrez, 2001) and the Self-Harm Inventory (Sansone, Sansone & Wiedermann, 1995), and the Questionnaire for the Assessment of Parenting Styles in the Family (Čáp, 1994). The research sample consisted of 1,466 respondents aged between 11 and 16 years, of whom almost 20% had at least some experience with self-harm. Adolescents living in two-parent families were less likely to harm themselves: Nearly 60% of all adolescents coming from complete families had no experience with self-harm at all. Adolescents from single-parent families, on the other hand, were most frequently found among experimenters and chronic self-harmers – in both groups they constituted more than 20% of respondents. The study yielded interesting findings regarding the quality of respondents’ relationships with parents as well as perceived parenting styles, with self-harm occurring very frequently with weak and inconsistent parenting styles (around 40% each).

Personality Characteristic of Adolescent Self-harmers

Abstract The study, a part of a large-scale project “Validation of tools for screening of self-harm in early adolescents”, explored the associations between the occurrence of self-harm and adolescent personality. Out of the large sample of 1,026 respondents, 43.2% ( n = 443) reported at least one experience with self-harm. The prevalence was somewhat larger in girls ( n = 139, 31.4%) than boys ( n = 102, 23.0%). The average age at the first experience with self-harm was 12.6 years. The questionnaire, administered in a single session, contained the Self-Harm Behavior Questionnaire (Gutierrez, 1998), the Self-Harm Inventory (Sansone, Sansone & Wiederman, 1995), and a Czech adaptation of Eysenck's personality inventory for children B-JEPI (Senka, 1994). The results suggested intriguing gender differences in the associations between self-harm and teenagers’ personalities. Girls scored significantly higher on neuroticism than boys in all self-harm frequency groups. Conversely, boys showed higher levels of psychoticism, regardless of self-harm experience. Both neuroticism and psychoticism correlated positively with the occurrence self-harm, which means that children's personality may play an important role in transition from episodic to recurring self-harm. The interaction effects of either neuroticism or psychoticism and gender on self-harm were not significant, suggesting that the two traits are positively associated with self-harm behaviour in boys and girls more-or-less equally. Although the direction of causality cannot be inferred from the present data, levels of neuroticism and psychoticism can serve as important risk indicators and help target prevention and intervention strategies at young adolescents who are at the highest risk of developing self-harm.

The Role of Job Burnout and Depression in Self-Destructive Behavior of Islamic Republic of Iran's Army Personnel

Aim of the studyThe aim of present study was to investigate the role of job burnout and depression in self-destructive behavior in army personnel of Islamic Republic of Iran. To this end up, a conceptual structural model was examined.Subject or material and methodsParticipants were 215 active duty personnel of the Islamic Republic of Iran Army (age mean=31.07 years; SD=4.71) which they completed Suicide Behavior Questionnaire-Revised (SBQ-R), Self-Harm Inventory (SHI), Beck Depression Inventory-Second Edition (BDI-II-Persian), Maslach Burnout Inventory (MBI).ResultsThe measurement model revealed that all indicators, except self-efficacy, had a significant factor weight on their latent variable, therefore the model revised by omitting it and the modified measurement model showed good fitness according to GFI, AGFI, CFI, IFI, and RMSEA. Structural model results showed burnout has a direct effect on self-destructive behavior (β=0.24), depression has a direct effect on self-destructive behavior (β=0.56); burnout influenced depression indirectly (β=0.56); burnout has indirect (β=0.35) and total effects (β=0.59) on self-destructive behavior. Finally the fitness indices of the structural model showed relatively good fitness.DiscussionBurnout and depression directly increase the tendency to self-destruction among militants. Moreover, findings revealed that job burnout influence self-destruction by intensifying depression.Conclusionssome intervention must be considered to prevent self-destruction among militants