Latimer Shane, Covic Tanya, Cumming Steven R, Tennant Alan
School of Psychology, University of Western Sydney, Locked Bag 1797 Penrith South DC 1797 NSW, Australia.
BMC Psychiatry. 2009 Aug 19;9:53. doi: 10.1186/1471-244X-9-53.
Deliberate Self-Harm (DSH) is the intentional destruction of healthy body tissue without suicidal intent. DSH behaviours in non-clinical populations vary, and instruments containing a range of behaviours may be more informative than ones with restricted content. The Self-Harm Inventory (SHI) is a widely used measure of DSH in clinical populations (mental and physical health) and covers a broad range of behaviours (self-injury, risk taking and self-defeating acts). The test authors recommend the SHI to screen for Borderline Personality Disorder (BPD) using a cut-off score of five or more. The aim of this study was to investigate the psychometric characteristics of the SHI in non-clinical samples.
The SHI was administered to a sample of 423 non-clinical participants (university students, age range 17 to 30). External validation was informed by the administration of the Depression Anxiety Stress Scales 21 (DASS-21) to a sub-sample (n = 221). Rasch analysis of the SHI was conducted to provide a stringent test of unidimensionality and to identify the DSH behaviours most likely to be endorsed at each total score.
The SHI showed adequate fit to the Rasch model and no modifications were required following checks of local response dependency, differential item functioning and unidimensionality. The scale identified gender and age differences in scores, with females and older participants reporting higher levels of DSH. SHI scores and DASS-21 scores were related.
The recommended cut-off point of five is likely to comprise mild forms of DSH and may not be indicative of psychopathology in a non-clinical population. Rather it may be more indicative of developmentally related risk taking behaviours while a higher cut-off point may be more suggestive of psychopathology as indicated by higher levels of depression, stress and anxiety.
蓄意自伤（DSH）是指无自杀意图地故意破坏健康身体组织。非临床人群中的DSH行为各不相同，包含一系列行为的工具可能比内容受限的工具提供更多信息。自伤量表（SHI）是临床人群（心理健康和身体健康）中广泛使用的DSH测量工具，涵盖了广泛的行为（自我伤害、冒险行为和自我挫败行为）。测试作者建议使用SHI，以五分或更高的临界值筛查边缘性人格障碍（BPD）。本研究的目的是调查SHI在非临床样本中的心理测量特征。
对423名非临床参与者（大学生，年龄范围17至30岁）的样本进行SHI测试。通过对一个子样本（n = 221）进行抑郁焦虑压力量表21（DASS - 21）测试来进行外部验证。对SHI进行拉施分析，以对单维性进行严格测试，并确定在每个总分下最有可能被认可的DSH行为。
SHI显示出对拉施模型的充分拟合，在检查局部反应依赖性、项目功能差异和单维性后无需修改。该量表在得分上发现了性别和年龄差异，女性和年龄较大的参与者报告的DSH水平较高。SHI得分与DASS - 21得分相关。
推荐的临界值五分可能包括轻度的DSH形式，在非临床人群中可能并不表明存在精神病理学问题。相反，它可能更表明与发育相关的冒险行为，而较高的临界值可能更表明存在精神病理学问题，如抑郁、压力和焦虑水平较高所显示的那样。
