Self-Injurious Thoughts And Behaviors Interview Research Articles

Risk factors for attempted suicide in non-psychotic patients with suicidal ideation.

In Eastern European countries, suicide rate are among the highest in the world and suicide attempts are among the most important risk factors. The aim of this study is to identify factors associated with suicide attempt (SA) in non-psychotic patients with suicidal ideation (SI). Among 6204 consecutive adult patients (residents of Moscow) with non-psychotic mental disorders (NPMD), 361 individuals aged 18-77 years (median 24 years) were enrolled in the study after screening for lifetime SI with the Self-Injurious Thoughts and Behaviors Interview (SITBI). All participants were assessed for sociodemographic variables, psychiatric diagnosis, family history of mental disorders, history of abuse, sexual behavior, psychiatric treatments, suicide plan, SA, and nonsuicidal self-injury (NSSI). Results of multivariable analyses (MV) are presented as odds ratios (OR) with 95% confidence intervals (CI). 166 patients (46%) reported lifetime SA. In MV, variables associated with SA included smoking (OR 2.1; 95% CI 1.2-3.7), having made a suicide plan (OR 3.4; 95% CI 2.0-5.7), and scars covered by tattoos (OR 5.2; 95% CI 1.5-17.9). History of law violation (OR 2.0; 95% 1.0-4.2) was of borderline significance. Transition from SI to SA in patients with NPMD was associated with smoking, suicide planning, history of law violation and presence of tattoos covering scars.

Preliminary Validation of the Korean Version of the Alexian Brothers Urge to Self-Injure Scale (ABUSI-K)

Background: This study aimed to validate the Korean version of the Alexian-Brothers Urge to Self-injure Scale (ABUSI) for measuring non-suicidal self-injury urges.Methods: Analysis was conducted on a sample of 389 adult men and women who had inflicted self-harm without suicidal intent within three years. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was conducted to confirm the single factor of the scale, and convergent validity was assessed to establish the relationship between ABUSI-K and Negative Urgency (UPPS-P), Self-Criticism/Attacking and Reassurance (FSCRS), and Self-Injurious Thoughts and Behaviors Interview (SITBI).Results: The Korean version of the Alexian-Brothers Urge to Self-Injure Scale (ABUSI-K) showed high internal consistency and, like the original scale, was confirmed to be a single-factor scale measuring the urge to self-injure. Convergent validity with negative urgency, self-criticism/self-attacking and self-reassuring, the NSSI module of self-injurious thoughts and behaviors, and depression and anxiety were also significant, indicating that ABUSI-K’s psychometric benefits are confirmed.Conclusions: The results of this study will provide a multifaceted understanding of self-injury without suicidal intent and the urges that occur before self-injury. They are expected to be useful in clinical interventions for individuals who have engaged in non-suicidal self-injuries.

Evaluating the Psychometric Properties of the Self-Injurious Thoughts and Behaviors Interview-Jail (SITBI-J) Version

ABSTRACT Suicides, and related self-injurious thoughts and behaviors (SITBs), are among the leading public health concerns in American jails. Despite suicide being the leading cause of death in jails, there is little information about the prevalence of SITBs among incarcerated individuals. The Self-Injurious Thoughts and Behaviors Interview (SITBI) was developed to assess the presence, frequency, and characteristics of self-injurious thoughts and behaviors. The SITBI has been implemented and validated in a variety of clinical and research settings, but not among incarcerated individuals. With survey data collected from two samples of incarcerated individuals from Florida and Texas, single-item reliability, graded item response modeling, and validity tests are used to evaluate the psychometric properties of an adapted version of the SITBI, the SITBI-J (Self-Injurious Thoughts and Behaviors Interview – Jail). The SITBI-J demonstrated strong single-item coefficients (coefficient range from rx = .33–.99).: The SITBI-J showed strong construct validity when assessed using convergent tests with Beck’s Hopelessness Scale, and discriminate validity against a theoretically dissimilar measure. Results demonstrate the potential of the SITBI-J for correctional settings. Future research should continue to test and validate the SITBI-J in other jail facilities.

Is the end in the beginning? Child maltreatment increases the risk of non-suicidal self-injury and suicide attempts through impaired personality functioning

BackgroundChild maltreatment is a risk factor for a range of mental disorders later in life, including dangerous self-harm and suicide attempts. A better understanding of the mechanisms underlying this association can inform prevention and intervention. ObjectiveTo investigate personality functioning as a potential mediator of the association of childhood abuse and neglect and self-harm and suicide attempts in the general population. Participants and settingData were drawn from a representative German population sample (N = 2510). MethodsParticipants filled out the Childhood Trauma Questionnaire (CTQ), OPD Structure Questionnaire (OPD-SQS), and items of the Self-Injurious Thoughts and Behaviors Interview (SITBI). In structural equation models, we operationalized impaired personality functioning as the mediator between childhood abuse and neglect and self-harm. ResultsIndividuals with a history of self-harm (combining suicide attempts, N = 47, and non-suicidal self-injury, N = 83) reported more childhood abuse and neglect (d = 1.39, p < .001) and greater impairments in personality functioning (d = 1.64, p < .001) than the rest of the population. The indirect effect via personality functioning accounted for 48.8 % of the total effect of childhood abuse and neglect on self-harm. In more differentiated analyses, emotional abuse showed the strongest association with self-harm. Only physical and sexual abuse had direct effects. ConclusionsThe results specify the relationship between child maltreatment and self-harm by demonstrating that it is partly mediated by basic functions of personality assessed using a dimensional measure. These abilities constitute modifiable risk factors that can be addressed by psychotherapy.

Self-Injurious Thoughts and Behaviors Interview-Korean Version: Psychometric Properties

ObjectiveThere is currently no structured interview tool developed that comprehensively evaluates self-injurious thoughts and behaviors (SITB) in Korea. The Self-injurious Thoughts and Behaviors Interview (SITBI) collectively measures suicidal ideation, plans, gestures, attempts, and non-suicidal self-injuries (NSSI). The SITBI’s reliability and validity have been established with it being widely used in English speaking countries. This study evaluated the psychometric validity of the Korean version of the SITBI (SITBI-K). MethodsThe SITBI’s validity as a diagnostic assessment tool for NSSI and suicidal behavior disorder (SBD), as defined by the Diagnostic and Statistical Manual of Mental Disorders-5th edition, was examined. Analyses were performed on 108 university students reporting experiences of suicidal thoughts and behaviors (female 84.26%, mean age=22.10, ±SD 3.33). Results The SITBI-K displayed excellent interrater reliability, with a credible test-retest reliability at two months. Construct validity examined the correlation between the SITBI-K’s modules and approved the self-report results. Appropriate convergent and discriminant validities were obtained for suicidal ideation, plans, gestures, attempts, and NSSI. Conclusion The SITBI-K showed excellent psychometric validity at a level comparable to the original. Its clinical utility for both NSSI and SBD diagnoses was confirmed.

CALMA, a Mobile Health Application, as an Accessory to Therapy for Reduction of Suicidal and Non-Suicidal Self-Injured Behaviors: A Pilot Cluster Randomized Controlled Trial

The present study was aim to evaluate the acceptability and preliminary effectiveness of a mobile-health application, CALMA, based on dialectical behavioral therapy skills. CALMA was proposed as an adjunct to therapy for the reduction of non-suicidal and suicidal self-injury behaviors. A parallel design was used to compare the intervention group (DBT + CALMA) and the comparison group (DBT). Patients were randomized based on their groups following a randomized cluster design. After treatment, patients completed a follow-up assessment four weeks later. Each cluster was represented by a different DBT Skills Training Group offered weekly at FORO Foundation for Mental Health. Six DBT Skills Training groups were randomized to the intervention or comparison group. Twenty-one individuals met inclusion criteria and eighteen were included in the analysis. Acceptability was measured with the User Experience Questionnaire short version (UEQ-s) and preliminary efficacy with the Self-injurious thoughts and behaviors interview (SITBI). CALMA shows good acceptability to be used as an adjunct to therapy specific to the reduction of suicidal and non-suicidal self-directed violence. Evidence for preliminary efficacy included a high probability of decreased in more behaviors evaluated with the SITBI pre- and post-intervention for the group that received CALMA as compared to the comparison group. Our study provides initial evidence for the effectiveness and acceptability of CALMA. Future studies scaling up this intervention in a larger number of participants are necessary. CALMA may be especially useful in low and middle-income Latin American countries to improve access to evidence-based interventions openly available in Spanish and free to download. Highlights CALMA is a DBT-based app aimed to reduce non-suicidal and suicidal self-directed violence. The app showed good acceptability by users A high probability of decrease in suicidal ideation, suicidal plan, suicidal gesture, thoughts about NSSI and NSSI pre- and post-intervention was observed

Self-Injurious Thoughts and Behaviors Interview-Revised: Development, reliability, and validity.

The Self-Injurious Thoughts and Behaviors Interview (SITBI) is a widely used measure of the presence, frequency, and characteristics of suicide and self-harming thoughts and behaviors. In response to advances in the conceptualization of these outcomes, and the potential for online data collection, we created a revised version of the SITBI (SITBI-R) and tested its psychometric properties via in-person interview and online self-report formats. Across two studies, the SITBI-R demonstrated strong psychometric properties for both assessment formats. In Study 1, outcomes measured via the SITBI-R showed convergent validity with those assessed with the Columbia Suicide Severity Rating Scale, another interview assessing suicidal thoughts and behaviors. The SITBI-R also showed strong alternate-forms reliability across nearly all outcomes assessed via both assessment formats. In Study 2, the SITBI-R showed strong test-retest reliability via the online assessment format. Across both studies, reliability was strongest for more recent outcomes (e.g., past year vs. lifetime) and for more commonly assessed outcomes of suicidal thoughts, plans, and attempts than for other, less commonly assessed behaviors (e.g., suicide gestures, interrupted suicide attempts, and aborted suicide attempts). The results of these two studies suggest that the SITBI-R provides reliable and valid measurement of key self-injurious outcomes both in person and online. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Vínculos afectivos familiares en mujeres adolescentes con conductas autolesivas no suicidas

Las autolesiones no suicidas (ALNS) son consideradas como un problema importante de salud pública debido a que es frecuente en muestras clínicas y no clínicas de adolescentes. En este estudio, las ALNS se relacionan con los vínculos afectivos familiares, por tal motivo, el objetivo de este trabajo es identificar la posible relación entre los vínculos afectivos familiares y la acción de adoptar conductas autolesivas no suicidas en adolescentes de sexo femenino, con edades comprendidas entre los 11 y 14 años. Los instrumentos empleados son Self-Harm Questionnaire (SHQ-E), Self-Injurious Thoughts and Behaviors Interview (SITBI), Inventario de Apego con Padres y Pares (IPPA) y una entrevista semi-estructurada. Los resultados evidencian que no existe relación estadísticamente significativa entre ambas variables, pero permiten identificar métodos empleados en las ALNS, así como niveles de apego parental. Se propone que deben realizarse futuras investigaciones que proporcionen más información sobre factores afectivos relacionados con conductas autolesivas no suicidas en adolescentes.

Coping, stress, and negative childhood experiences: The link to psychopathology, self-harm, and suicidal behavior.

Early life experiences, such as childhood adversities or poor parenting practices, can impact on the ability to cope with stressors across the lifespan. Furthermore, poor coping skills can lead to the development of mental illnesses, self-harm, and suicidal behavior. This study aimed to examine demographic differences in stress levels and to determine if those who had endured negative childhood experiences would be more likely to develop psychological problems and display suicidal behavior when current stress levels were accounted for. The study also explored the link between coping and mental health problems. Finally, it aimed to predict risk and protective factors related to good coping skills. The study utilized data obtained from the Ulster University Student Wellbeing Study, conducted across four university campuses in Northern Ireland in 2015 (n = 716) as part of the World Health Organization World Mental Health (WMH) International College Student Initiative. Mental health problems and early childhood experiences were examined using questions adapted from the WMH Composite International Diagnostic Interview, with self-harm and suicidal behavior measured using the Self-Injurious Thoughts and Behaviors Interview (SITBI). Females, non-heterosexuals, and older students experienced more current stress. When current stress levels were high, childhood adversities and parental overcontrol and overindulgence were related to higher rates of mental health problems, self-harm, and suicidal behavior. Poor coping skills were associated with negative mental health outcomes. Social support and good emotion-regulation strategies were related to effective coping, while parental overcontrol and overindulgence, female gender, and younger age were related to poorer coping. The study highlights the importance of developing good coping skills to deal with life stressors, thereby minimizing the risk of psychological problems and suicidal behavior. The findings provide support for initiatives to help parents improve their parenting skills and other programs to help young people cope with stress, and to develop social networks and adaptive emotion-regulation strategies.

Suicidal Thoughts and Behaviors: Prevalence and Association with Distal and Proximal Factors in Spanish University Students.

We report on the prevalence of suicidal thoughts and behaviors in Spanish university students and their risk and protective factors (distal/proximal; individual/environmental). First-year university students completed an online survey including Self-Injurious Thoughts and Behaviors Interview (SITBI) items, the screening version of the Columbia-Suicide Severity Rating Scale (C-SSRS) along with adversities and positive relationships during childhood/adolescence, recent stressful experiences, and lifetime mental disorders. Nested logistic regression models were estimated and areas under the curve (AUC) compared. A total of 2,118 students completed the survey (mean age=18.8 [SD=1.4]years; 55.4% female). Twelve-month prevalence of suicide ideation (SI) was 9.9%, plans, 5.6%, and attempts, 0.6%. Risk factors of 12-month SI were as follows: parental psychopathology (OR=1.7, 95% CI 1.2-2.5); sexual assault (OR=5.6, 95% CI 1.4-22.1); lifetime mood disorder (OR=5.2, 95% CI 3.5-7.7); and lifetime anxiety disorder (OR=1.7, 95% CI: 1.1-2.5). Childhood positive relationships protected from SI were as follows: peers/others (OR=0.6, 95% CI 0.4-0.9 for the second highest tertile) and family (OR=0.4, 95% CI 0.3-0.7 for the highest tertile). AUC of the final model was 0.82 (SE=0.015). Our results indicate a high prevalence of SI among Spanish university students and identify protective and risk factors from a comprehensive conceptual model.

Predictive models for suicidal thoughts and behaviors among Spanish University students: rationale and methods of the UNIVERSAL (University & mental health) project.

BackgroundSuicide is a leading cause of death among young people. While suicide prevention is considered a research and intervention priority, longitudinal data is needed to identify risk and protective factors associate with suicidal thoughts and behaviors. Here we describe the UNIVERSAL (University and Mental Health) project which aims are to: (1) test prevalence and 36-month incidence of suicidal thoughts and behaviors; and (2) identify relevant risk and protective factors associated with the incidence of suicidal thoughts and behaviors among university students in Spain.MethodsAn ongoing multicenter, observational, prospective cohort study of first year university students in 5 Spanish universities. Students will be assessed annually during a 36 month follow-up. The surveys will be administered through an online, secure web-based platform. A clinical reappraisal will be completed among a subsample of respondents. Suicidal thoughts and behaviors will be assess with the Self-Injurious Thoughts and Behaviors Interview (SITBI) and the Columbia-Suicide Severity Rating Scale (C-SSRS). Risk and protective factors will include: mental disorders, measured with the Composite International Diagnostic Interview version 3.0 (CIDI 3.0) and Screening Scales (CIDI-SC), and the Epi-Q Screening Survey (EPI-Q-SS), socio-demographic variables, self-perceived health status, health behaviors, well-being, substance use disorders, service use and treatment. The UNIVERSAL project is part of the International College Surveys initiative, which is a core project within the World Mental Health consortium. Lifetime and the 12-month prevalence will be calculated for suicide ideation, plans and attempts. Cumulative incidence of suicidal thoughts and behaviors, and mental disorders will be measured using the actuarial method. Risk and protective factors of suicidal thoughts and behaviors will be analyzed by Cox proportional hazard models.DiscussionThe study will provide valid, innovative and useful data for developing prevention programs for youth suicide and for improving early identification for high-risk students. The longitudinal design of this study will improve causal interpretation of analyzed associations, needed for generating and validating predictive models. It will represent the first results about suicidal thoughts and behaviors in the Spanish university population. The World Mental Health Survey collaboration will permit accurate cross-national comparisons.

Clinical Correlates of Non-Suicidal Self-Injury (NSSI) in an Outpatient Sample of Adolescents

Non-suicidal self-injury (NSSI) in adolescents is a major public health concern. The first goal of our study was to describe the characteristics and functions of NSSI and NSSI thoughts in an adolescent outpatient sample. The second goal was to examine which clinical factors discriminate between these two groups of patients. A group of 267 subjects was recruited from the Adolescent Outpatient Psychiatric Services, Jiménez Díaz Foundation (Madrid, Spain) from November 2011 to October 2012. All participants were administered the Spanish version of the Self-Injurious Thoughts and Behaviors Interview (SITBI). A total of 21.7% of patients reported having engaged in NSSI at least once in their lifetime. The most strongly endorsed function for NSSI was automatic negative reinforcement. In comparison with patients in the NSSI Thoughts group and the control group, patients in the NSSI group scored higher in Internalization of Anger and in all the scales comprising the Children's Depression Inventory. Our findings on the prevalence and functions of NSSI are consistent with the literature. NSSI was mainly performed for emotion regulation purposes; specifically, NSSI seems to be used to cope with anger and depression. In addition, internalization of anger might play a significant role in the maintenance of this behavior.

The German version of the self-injurious thoughts and behaviors interview (SITBI-G): a tool to assess non-suicidal self-injury and suicidal behavior disorder

BackgroundSelf-injurious thoughts and behaviors (SITBs) are common in adolescents. While there is no standardized interview in German to assess SITBs to date, the Self-Injurious Thoughts and Behaviors Interview (SITBI) is widely used in English-speaking countries. However, the SITBI has not been validated for the assessment of the recently issued DSM-5 Section 3 diagnoses of nonsuicidal self-injury (NSSI) and suicidal behavior disorder (SBD) yet. In the present study the psychometric properties of the German version of the SITBI (SITBI-G) were assessed. We also evaluated whether SITBI-G is a reliable and valid instrument to establish diagnoses of NSSI and SBD.MethodsA clinical adolescent sample (N = 111, f/m = 73/38, age range = 12-19 years) was recruited from the inpatient units of three departments of child and adolescent psychiatry in Germany. All participating patients were interviewed by using the SITBI-G, and DSM-5 criteria of NSSI and SBD were operationalized from the SITBI-G data. Additionally, participants were given the Self-Harm Behavior Questionnaire (SHBQ), and SITBI-G was retested in a subsample.ResultsThe SITBI-G shows moderate to good test-retest reliability, a very good interrater reliability, and a good construct validity. The results demonstrate that diagnoses of NSSI and SBD can be established using the SITBI-G, achieving moderate to good test-retest reliabilities and very good to perfect interrater reliabilities.ConclusionsOverall, the good psychometric properties of SITBI-G are comparable to the original version of the interview. Therefore, SITBI-G seems to be highly appropriate to assess SITBs, including the new DSM-5 Section 3 diagnoses NSSI and SBD in research and clinical contexts.Electronic supplementary materialThe online version of this article (doi:10.1186/s12888-014-0265-0) contains supplementary material, which is available to authorized users.

Extending the Concurrent Validity of the Self-Injurious Thoughts and Behaviors Interview to Inpatient Adolescents

The Self-Injurious Thoughts and Behaviors Interview (SITBI) was created to address limitations in existing suicide assessments and its validity was evaluated in the original publication. However, this work has not yet been extended to inpatient adolescents, a population in which suicide assessment is crucial. Moreover, information on the psychometric properties of the SITBI has not been provided by other groups beyond the developers of the SITBI. The aim of this study was to examine the concurrent validity of the suicide ideation, attempt, plan, and gesture modules of the SITBI with inpatient adolescents (N = 106, 64.8 % female, M age = 14.63), as an extension to previous validation efforts using this measure. Concurrent validity was examined with established interview-based and self-report measures of suicide ideation and suicide intent. The SITBI demonstrated adequate agreement with other measures, suggesting adequate validity for the suicide ideation, attempt, plan, and gesture modules in a sample of inpatient adolescents.

Measuring engagement in deliberate self-harm behaviours: psychometric evaluation of six scales

BackgroundEngagement in Deliberate Self-Harm (DSH) is commonly measured by behavioural scales comprised of specific methods of self-harm. However, there is a scarcity of information about the degree to which the methods relate to the same DSH construct although such scales are routinely used to provide a DSH total score. This study addresses the shortfall by evaluating the dimensionality of six commonly used behavioural measures of DSH.MethodsThe DSH measures were Self-Injury Questionnaire Treatment Related (SIQTR), Self-Injurious Thoughts and Behaviors Interview (SITBI), Deliberate Self-Harm Inventory (DSHI), Inventory of Statements About Self-Injury (ISAS), Self-Harm Information Form (SHIF) and Self-Harm Inventory (SHI). The behavioural scales contained in each measure were administered to 568 young Australians aged 18 to 30 years (62% university students, 21% mental health patients, and 17% community members). Scale quality was examined against the stringent standards for unidimensional measurement provided by the Rasch model.ResultsAccording to the stringent post-hoc tests provided by the Rasch measurement model, there is support for the unidimensionality of the items contained within each of the scales. All six scales contained items with differential item functioning, four scales contained items with local response dependency, and one item was grossly misfitting (due to a lack of discrimination).ConclusionsThis study supports the use of behavioural scales to measure a DSH construct, justifies the summing of items to form a total DSH score, informs the hierarchy of DSH methods in each scale, and extends the previous evidence for reliability and external validity (as provided by test developers) to a more complete account of scale quality. Given the overall adequacy of all six scales, clinicians and researchers are recommended to select the scale that best matches their adopted definition of DSH.

Traducción y validación de la Self-Injurious Thoughts and Behaviors Interview en población española con conducta suicida

Most of the assesment tools used in our country examine a limited range of suicidal behaviours. In contrast, the Self-Injurious Thoughts and Behaviors Interview (SITBI), developed in the US, assesses a wider range of these behaviours: suicidal ideation, suicide attempt, suicidal gestures, and self-harming behaviours. Given this lack, we think it is necessary to validate the Escala de Pensamientos y Conductas Autolesivas (EPCA), Spanish translation of the SITBI, in the Spanish population.The EPCA interview was administered to 150 inpatients in the Psychiatry Unit- Fundación Jiménez Díaz in order to examine its psychometric properties in a Spanish sample. To assess its test-retest reliability, the EPCA was again administered to those patients who were readmitted to hospital at least six months after the first assessment (n=50). To examine its construct validity, some of the most used assessment tools in this research field were also administered.[corrected] Inter-rater agreement ranged from k=.90 to k=1. Test-retest reliability was good in the case of suicidal ideation, suicide plans and suicide attempts; however, it was lower in the case of self-harming behaviours and suicidal gestures. Our results also support the construct validity of the scale.Our findings back the reliability (both inter-rater and test-retest) and construct validity of the EPCA in the Spanish population.

Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.

The authors developed the Self-Injurious Thoughts and Behaviors Interview (SITBI) and evaluated its psychometric properties. The SITBI is a structured interview that assesses the presence, frequency, and characteristics of a wide range of self-injurious thoughts and behaviors, including suicidal ideation, suicide plans, suicide gestures, suicide attempts, and nonsuicidal self-injury (NSSI). This initial study, based on the administration of the SITBI to 94 adolescents and young adults, suggested that the SITBI has strong interrater reliability (average kappa = .99, r = 1.0) and test-retest reliability (average kappa = .70, intraclass correlation coefficient = .44) over a 6-month period. Moreover, concurrent validity was demonstrated via strong correspondence between the SITBI and other measures of suicidal ideation (average kappa = .54), suicide attempt (kappa = .65), and NSSI (average kappa = .87). The authors concluded that the SITBI uniformly and comprehensively assesses a wide range of self-injury-related constructs and provides a new instrument that can be administered with relative ease in both research and clinical settings.