Screen for Nonsuicidal Self-injury (SNSI) Items	During the past year?
			If yes, how many times?
Have you ever intentionally cut yourself (e.g., on your wrists, legs, or torso)?	No	Yes	1	2	3	4	5+
Have you ever intentionally burned yourself (e.g., with a lighter or cigarette)?	No	Yes	1	2	3	4	5+
Have you ever intentionally scratched yourself to the point that you bled, or it left a mark?	No	Yes	1	2	3	4	5+
Have you ever intentionally bitten your cheeks, lips, or other parts of your body to the point of bleeding or breaking the skin?	No	Yes	1	2	3	4	5+
Have you ever intentionally stuck sharp objects (e.g., needles, pins, staples) into your skin?	No	Yes	1	2	3	4	5+
Have you ever intentionally banged your head against walls or objects to the point of bruising or bleeding?	No	Yes	1	2	3	4	5+
Have you ever intentionally punched or hit yourself to the point of bruising or bleeding?	No	Yes	1	2	3	4	5+
Have you ever intentionally punched or hit walls or objects to the point of bruising or bleeding?	No	Yes	1	2	3	4	5+
Have you ever intentionally prevented wounds from healing?	No	Yes	1	2	3	4	5+
Have you ever done anything else to intentionally hurt or mutilate your body on purpose that resulted in tissue damage (e.g., bruising or bleeding)? Please specify: ________________________________________________________	No	Yes	1	2	3	4	5+

Scoring: “No” = 0, “1” = 1, “2” = 2, “3” = 3, “4” = 4, “5+” = 5. Items are summed for a total score (range 0 – 50). Scores >1 indicate high-risk for Nonsuicidal Self-Injury Disorder. Note: if method(s) specified in last item are not examples of nonsuicidal self-injury (e.g., suicide attempt), item to be scored as a “No” = 0.