TABLE 1. Studies Investigating Consistency in Self-Harm Reports: Across Different Measures or Over Time.
Publication | Country | Sample | Measure | Comparison of different measures | Consistency in reports over time | Other design | Results |
---|---|---|---|---|---|---|---|
Adolescent samples | |||||||
Ougrin and Boege (2013) | United Kingdom | Adolescent inpatients and outpatients n = 100, 12–17 years |
Self-harm | Yes Self-report questionnaire and clinical record (reported during the clinical assessment) |
No | No | 3 (3%) indicated in the clinical record they had self-harmed but did not report self-harm on the questionnaire. 20 (20%) reported at least one episode of self-harm on the questionnaire that was not recorded in the clinical record |
Hart et al. (2013) | United States | Longitudinal community sample of adolescents n = 678, Assessed annually between age 12 and 22 years |
Suicide attempts | No | Yes Also examined characteristics associated with discrepant reporting |
No | 88.5% inconsistently reported a suicide attempt at some point during the study; 65.3% were inconsistent the year following the self-harm event Consistent and inconsistent reporters did not differ on clinical or demographic variables, but consistent reporters had higher lifetime suicidal ideation |
Bjärehed et al. (2013) | Sweden | Adolescent community sample n = 1,052, from grade 7 (mean age 13.7 years) and 8 (mean age 14.7 years) |
Non-suicidal self-injury | Yes Self-report questionnaire and follow-up interview |
No | No | 97 adolescents were selected for interview. 32/66 (48%) participants who reported self-harm on the questionnaire did not disclose self-harm during the follow-up interview. |
Kidger et al. (2012) | United Kingdom | Adolescent community sample n = 4810, 16 years |
Suicide attempts | No | No | Yes Examined suicidal thoughts among those with suicidal self-harm |
Approximately 10% of those who reported wanting to die during the most recent episode of self-harm said they had never had thoughts of killing themselves |
Christl et al. (2006) | Germany | Longitudinal community sample of adolescents/young adults n = 3021, 14–24 years at baseline |
Suicide attempts | No | Yes Also examined characteristics associated with discrepant reporting |
Yes Compared drop-out rates among those with and without suicidal behaviour |
One third of baseline suicide attempters (n = 15/45), did not report a suicide attempt at follow-up 4 years later 81% of discrepant reporters were female and 59% were aged 14–17 at baseline. Greater consistency in reporting was associated with a higher number of psychiatric disorders Those with a suicide attempt at baseline were at least 1.6 times more likely to drop out of the study then those without suicide attempts or ideas |
Ross and Heath (2002) | Not specified | Adolescent community sample n = 440 (from 2 schools), average age 14–15 years |
Self-mutilation (defined as deliberate alteration or destruction of body tissue without suicidal intent) | Yes Self-report screening questionnaire and follow-up interview |
No | No | School sample 1: 38.8% who reported self-harm on the questionnaire were not classified as having self-harmed following the interview (19/49) School sample 2: 24.4% who reported self-harm on the questionnaire were not classified as having self-harmed following the interview (10/41) |
Velting et al. (1998) | United States | Adolescent outpatients n = 48, 12–20 years, mean 15.3 years |
Suicide attempts | Yes Self-report questionnaire and interview Also investigated explanations and characteristics associated with discrepant reporting |
No | No | Discrepancies in reporting were found amongst 50% of the sample (24/48). Discrepancies primarily due to confusion with the operational definition of suicidal behaviour (i.e., confused attempt and ideation or confused attempt and gesture). The discrepant and non-discrepant groups were comparable on measures of suicidal intent, ideation, and hopelessness and on their diagnostic profiles |
O'Sullivan and Fitzgerald (1998) | Ireland | Adolescent community sample n = 88 age 13–14 years |
Suicide attempt | Yes Self-report screening questionnaire and follow-up interview |
No | No | 45 adolescents completed a follow-up interview. 5/7 (71%) participants who reported a suicide attempt on the questionnaire did not disclose self-harm during the follow-up interview. |
Adult samples | |||||||
Eikelenboom et al. (2014) | The Netherlands | Longitudinal cohort of adults with depressive or anxiety disorders n = 1973, aged 18–65 years at baseline, (mean age 42.4 years) |
Suicide attempts | No | Yes Also examined characteristics associated with discrepant reporting |
No | 23% of baseline suicide attempters, did not report their attempt at follow-up 2 years later (63/274) Consistent reporting was associated with a greater number of suicide attempts, and more severe current psychopathology. No differences were found for recency of the event, age, sex, or education |
Morthorst et al. (2011) | Denmark | Patients admitted to hospital following a suicide attempt n = 243, age 12+, mean age 31 years |
Suicide attempts, assessed 1 year after baseline | Yes Self-report (telephone interview) and hospital records |
No | No | Seven suicide attempts listed in the hospital records were not reported by participants. Nine patients reported a suicide attempt that was not listed in the hospital records |
Plöderl et al. (2011) | Austria | Adult community sample n = 1385, age 18–84 years, Mean 37.8 years |
Suicide attempts | No | No | Yes Examined intent to die among those reporting suicidal self-harm |
One quarter (15/60) of individuals reporting a suicide attempt were false positives (lacked intent or attempt aborted) 0.8% (n = 11) were identified as false negatives (reported no suicide attempt on the screen question but reported a self-harm event with intent to die in follow-up questions). 2/11 (18%) false negatives resulted in injuries requiring hospital treatment There were no differences between true positives and false positives regarding age or education or lethality of method |
Linehan et al. (2006) | United States | Adult clinical sample: Five cohorts, three with borderline personality disorder | Self-harm | Yes Self-report interview and 1) therapist notes 2) participant diary cards 3) medical records |
No | No | Agreement with therapist notes (presence/absence of self-harm) was 83% Good agreement with diary cards (mean 4.5 acts at interview vs. mean 4.3 acts on diary cards) 82% of episodes reported by participants as being medically treated had a corresponding medical record. There were no false negatives —all medically treated episodes were reported by participants. |
Nock and Kessler (2006) | United States | Predominately Adult community sample n = 5,877, aged 15–54 years |
Suicide attempts | No | No | Yes Examined intent to die among those reporting suicidal self-harm |
112/268 (42%) of those reporting a lifetime history of suicide attempt reported no intent to die |