THE SELF-HARM INVENTORY (SHI) - DEVELOPMENT OF A SCALE FOR IDENTIFYING SELF-DESTRUCTIVE BEHAVIORS AND BORDERLINE PERSONALITY-DISORDER

Intentional self-harm behavior is an important clinical phenomenon tha t appears highly related to borderline personality disorder (BPD). Sel f-harm behavior in the context of borderline personality probably exis ts along a continuum from graphic, self-harm behavior to milder forms of self-sabotaging behavior that might be viewed as self-defeating. Re latively little attention has been paid to developing a sell-report me asure of intentional self-harm, particularly as a screening device for detecting BPD. In Study 1,an initial list of self-harm behaviors enco untered in clinical practice was narrowed to those behaviors related t o BPD in a sample comprised of adults from both a mental health and no n-mental health setting. All participants (N = 221) underwent a semist ructured diagnostic interview for BPD. Using a cut-off score of 5 on t he resulting 22-item Self-Harm Inventory (SHI). 83.7% of research part icipants were correctly classified as having BPD or not. In Study 2, w omen(N = 285) sampled from an outpatient medical setting completed the SHI and a widely used self-report measure of BPD. The SHI cut-off sco re resulted in correct classification of 87.9% of the individuals. In Study 3, using a sample of adults involuntarily hospitalized for psych iatric reasons (N = 32). the SHI performed at least as well as another self-report measure of BPD in diagnosing participants (the final diag nosis was based on a semistructured interview). The results are discus sed with regard to potential advantages and utility of the SHI and nee d for further validation. (C) 1998 John Wiley Et Sons. Inc.