INVENTORY OF STATEMENTS ABOUT SELF-INJURY (ISAS)
This will help us to establish, among others, the following: Effect-regulation, interpersonal boundaries, self-punishment, self-care, anti-dissociation/feeling-generation, anti-suicide, sensation-seeking, peer-bonding, interpersonal influence, toughness, marking distress, revenge, autonomy. It takes the following stipulated format as per the previous studies by Glenn et al (2013).
SECTION I: BEHAVIORS
This questionnaire asks about a variety of self-harm behaviors. Please only endorse a behavior if you have done it intentionally (i.e., on purpose) and without suicidal intent -i.e., not for suicidal reasons (Glenn et al 2013).
1. Please estimate the number of times in your life you have intentionally (i.e., on purpose) performed each type of non-suicidal self-harm (e.g., 0, 10, 100, 500):
Severe Scratching ____
Biting ____
Banging or Hitting Self ____
Burning ____
Interfering w/ Wound Healing ____ (e.g., picking scabs)
Carving ____
Rubbing Skin Against Rough Surface ____
Pinching ____
Sticking Self w/ Needles ____
Pulling Hair ____
Swallowing Dangerous Substances ____
Others (specify) _______________, ____
Important: If you have performed one or more of the behaviors listed above, please complete the final part of this questionnaire. If you have not performed any of the behaviors listed above, you are done with this particular questionnaire and should continue to the next.
2. If you feel that you have a main form of self-harm, please circle the behavior(s) on the first page above that you consider to be your main form of self-harm.
3. At what age did you:
First harm yourself? ____________
Most recently harm yourself? ____________ (approximate date – month/date/year)
4. Do you experience physical pain during self-harm?
Please cross a choice: YES, SOMETIMES, NO
5. When you self-harm, are you alone? Please circle a choice: YES, SOMETIMES, NO
6. Typically, how much time elapses from the time you have the urge to self-harm until you act on the urge? Please circle a choice:
< 1 hour, 1 - 3 hours, 3 - 6 hours, 6 - 12 hours, 12 - 24 hours, > 1 day
7. Do/did you want to stop self-harming? Please circle a choice: YES, NO
SECTION II: FUNCTIONS
This inventory is to help us better understand the experience of non-suicidal self-harm. Below is a list of statements that may or may not be relevant to your experience of self-harm. Please identify the statements that are most relevant for you (Sadeh et al 2014):
Circle 0 if the statement not relevant for you at all
Circle 1 if the statement is somewhat relevant for you
Circle 2 if the statement is very relevant for you
When I self-harm, I am
Response:
1. calming myself down 0 1 2
2. creating a boundary between myself and others 0 1 2
3. punishing myself 0 1 2
4. giving myself a way to care for myself (by attending to the wound) 0 1 2
5. causing pain so I will stop feeling numb 0 1 2
6. avoiding the impulse to attempt suicide 0 1 2
7. doing something to generate excitement or exhilaration 0 1 2
8. bonding with peers 0 1 2
9. letting others know the extent of my emotional pain 0 1 2
10. seeing if I can stand the pain 0 1 2
11. creating a physical sign that I feel awful 0 1 2
12. getting back at someone 0 1 2
13. ensuring that I am self-sufficient 0 1 2
14. releasing the emotional pressure that has built up inside of me 0 1 2
15. demonstrating that I am separate from other people 0 1 2
16. expressing anger towards myself for being worthless or stupid 0 1 2
17. creating a physical injury that is easier to care for than my emotional distress 0 1 2
18. trying to feel something (as opposed to nothing) even if it is physical pain 0 1 2
19. responding to suicidal thoughts without actually attempting suicide 0 1 2
20. entertaining myself or others by doing something extreme 0 1 2
21. fitting in with others 0 1 2
22. seeking care or help from others 0 1 2
23. demonstrating I am tough or strong 0 1 2
24. proving to myself that my emotional pain is real 0 1 2
25. getting revenge against others 0 1 2
26. demonstrating that I do not need to rely on others for help 0 1 2
27. reducing anxiety, frustration, anger, or other overwhelming emotions 0 1 2
28. establishing a barrier between myself and others 0 1 2
29. reacting to feeling unhappy with myself or disgusted with myself 0 1 2
30. ..allowing myself to focus on treating the injury, which can be gratifying or satisfying 0 1 2
31. making sure I am still alive when I don’t feel real 0 1 2
32. putting a stop to suicidal thoughts 0 1 2
33. pushing my limits in a manner akin to skydiving or other extreme activities 0 1 2
34. creating a sign of friendship or kinship with friends or loved ones 0 1 2
35. keeping a loved one from leaving or abandoning me 0 1 2
36. proving I can take the physical pain 0 1 2
37. signifying the emotional distress I’m experiencing 0 1 2
38. trying to hurt someone close to me 0 1 2
39. establishing that I am autonomous/independent. 0 1 2
In the space below, please list any statements that you feel would be more accurate for you than the ones listed above (Optional):
