The Self-Injury Trauma (SIT) Scale: a method for quantifying surface tissue damage caused by self-injurious behavior

Area of Science:

• Psychiatry
• Clinical Psychology
• Forensic Psychology

Background:

• Self-injurious behavior (SIB) presents a significant clinical challenge.
• Accurate classification and quantification of SIB-related tissue damage are crucial for effective treatment and risk assessment.

Purpose of the Study:

• To introduce and validate the Self-Injury Trauma Scale (SITS) for classifying and quantifying surface tissue damage resulting from SIB.
• To assess the interrater reliability of the SITS in differentiating SIB based on injury characteristics.

Main Methods:

• Development of the Self-Injury Trauma Scale (SITS) with specific criteria for topography, location, type, number, and severity of injuries.
• Interrater reliability analysis conducted on 50 pairs of independently scored records using the SITS.
• Calculation of mean (median) percentage agreement for overall scoring and specific injury parameters.

Main Results:

• High interrater reliability was achieved for the SITS, with overall agreement at 97% (98%).
• Excellent agreement was observed for injury location (99%), type (96%), and severity (94%).
• Reliability for number of injuries was 89%, and summary scores (Number Index, Severity Index, Estimate of Current Risk) showed high agreement (90-100%).

Conclusions:

• The Self-Injury Trauma Scale (SITS) is a reliable tool for classifying and quantifying surface tissue damage from self-injurious behavior.
• The scale's high interrater reliability supports its utility in clinical and research settings for consistent SIB assessment.
• The SITS facilitates differentiation of SIB based on objective injury characteristics, informing treatment and risk management strategies.