Development and validation of the Self-Harm Screening Inventory (SHSI) for adolescents.

Despite the rapidly increasing rate of non-suicidal self-injury (NSSI) among adolescents, there is a dearth of culturally appropriate psychological measures screening for NSSI among the adolescents in the Asian countries. This study aimed to develop and validate the Self-Harm Screening Inventory (SHSI), a culturally sensitive and suitable scale for screening adolescents for NSSI. In total, 514 Korean adolescents (aged 12-16 years) were recruited nationwide. All participants gave informed consent and completed the online self-report measures on NSSI, depression, anxiety, and self-esteem. Thereafter, preliminary items were developed through a series of steps: literature review, ratings of experts on self-harm and suicide, and statistical analyses. Ten of the 20 preliminary items were eliminated after exploratory factor analysis due to low endorsement and factor loading (less than .70). The final version of the SHSI comprised 10 binary items relating to self-harm behaviors within the past year (e.g., cut my body with sharp objects, hit my body). A confirmatory factor analysis supported a one-factor structure, as hypothesized. The one-factor model had a good model fit (x2(35) = 84.958, p < .001, RMSEA = .053, CFI = .981, TLI = .975, SRMR = .124). The SHSI also had good internal consistency (Cronbach's alpha = .795) and 4-week test-retest reliability (r = .786, p < .01). The SHSI had high correlations with another self-harm related scale, the Self-Harm Inventory (r = .773, p < .01), and moderate correlations with the Child Depression Inventory (r = .484, p < .01) and Revised Children's Manifest Anxiety Scale (r = .433, p < .01). Additionally, the SHSI was negatively correlated with the Rosenberg Self-Esteem Scale (r = -.399, p < .01). The findings indicate that the SHSI is a reliable and valid measure for the screening of self-harm behaviors among adolescents.

Self-Injurious Behavior in Community Youth.

The rapid increase of self-injurious behavior among Korean adolescents, and its reckless spread on social media, has driven the necessity to study this behavior. The present study investigates the characteristics of self-injurious behavior among adolescents in local communities, and the psychological factors affecting such behavior. Questionnaires were administered to 516 sixth graders in elementary school and first to third graders in middle school of both genders, nationwide. They measured the prevalence and characteristics of self-injurious behavior and the relevant psychological factors, such as levels of depression, anxiety, and self-esteem. Furthermore, group differences were assessed for self-injury experience and the characteristics relevant to self-injurious behavior. In addition, this study performs logistic regression to explore the risk factors predicting self-injurious behavior. In all, 166 participants (32.2%) reported self-injury, with a higher rate of self-injury in female students than in male students. Although the study finds high rates of mild forms of self-injury, such as "biting", "pulling hair," and "hitting self", it also finds relatively high reports of more risky methods, such as "cutting or carving". The logistic regression shows a significant effect of the negative self-image sub-factor of depression (CDI) and oversensitivity and physical and sleep problems sub-factors of anxiety (RCMAS) on self-injurious behavior. The rates of self-injury were higher in female participants than in male ones, and adolescents in local communities reported higher rates of mild forms of self-injury than the moderate/severe forms. The results of this study suggest that early screenings and interventions should be conducted through evaluation of self-image and emotional stability of early adolescents to hinder the risk of self-harm.