(PS8-33) Discrepancies in Self-reporting NSSI Engagement in Adolescents

Abstract Text: Nonsuicidal self-injury (NSSI) involves deliberate harm to one's own body, without suicidal intent. Roughly 22% of adolescents around the globe engage in these behaviors (Xiao et al., 2022). The most common methods for adolescents include banging/hitting, punching, and pulling hair. Despite the prevalence of these behaviors, research has found discrepancies in self-report of these behaviors, specifically when comparing within-person responses on different measures of self-harm. Notably, both adolescents and young adults have reported higher prevalence rates on behavioral checklists compared to single-item measures (Aspeqvist et al., 2024; Robinson & Wilson, 2020). These findings highlight the need to explore factors influencing self-report discrepancies among adolescents. The current study investigated the consistency of NSSI endorsement in a community sample of adolescents using two different measures. We also examined the relationship between demographic variables and the likelihood of reporting discrepant responses. Our sample included 456 adolescents (M age = 13.19) who were recruited from middle and high schools in the Southcentral U.S. Most participants identified as female (53%), heterosexual (89%), and White (85%). NSSI and self-harm history were assessed using two different measures: The Self-Harm Behavior Questionnaire (SHBQ; self-report) and the Inventory of Statements About Self-Injury (ISAS; behavioral checklist). Responses to items on these measures were compared for consistency. From the SHBQ, the item used for NSSI engagement asked “Have you ever purposely hurt yourself without wanting to die?” On the ISAS, participants are given a list of NSSI methods with the instructions: “Please estimate the number of times in your life you have intentionally (i.e., on purpose) performed each type of non-suicidal self-harm." Endorsement of any NSSI method was coded as a positive history of NSSI. Demographic variables such as gender (male and female) and age group (early adolescence: 10-13, middle adolescence: 14-17) were also examined. Roughly 17% of adolescents reported NSSI engagement on the SHBQ, however, more than 30% of adolescents reported NSSI engagement on the ISAS. The most common NSSI methods were interfering with wound healing (e.g., picking scabs; 14.8%), pulling hair (11.4%), and cutting (10.6%). Chi-square analyses found that the type of measure was significantly associated with the likelihood of self-reporting NSSI prevalence, χ2 (1) = 173.22, p < .001. Gender was not associated with the likelihood of reporting discrepant responses, χ2 (1) = 0.538, p = .463, nor was age group, χ2 (1) = 0.098, p = 0 .754. Our results indicated that 53 participants would be misrepresented in the data, depending on which measure was used to identify NSSI history. It is possible that some adolescents have engaged in NSSI; however, due to the wording on the SHBQ item, thought they didn't meet criteria and responded ‘no.’ Alternatively, adolescents may misinterpret the checkbox items on the ISAS, in that they have engaged in these behaviors before but not to deliberately harm themselves. It could also be that the list of NSSI methods on the ISAS helps with recall of all instances and types of NSSI, while the SHBQ does not.