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Initial Psychometric Validation of the Non-Suicidal Self-Injury Scar Cognition Scale

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Abstract

Given the growing literature on the detrimental psychological consequences of NSSI, it is surprising that scarce research has focused on the permanent physical consequences of NSSI, scarring to one’s tissue (Burke et al. Psychiatry Research 228, 416–424, 2015; Lewis The Journal of Nervous and Mental Disease, 204(1), 33–35 2016). Indeed, with recent research suggesting that upwards of half of those with a history of NSSI bear scarring as a result of the behavior (Burke et al. Comprehensive Psychiatry, 65, 79–87 2016), the psychological implications of scarring are important to understand. Given preliminary literature suggesting that the vast majority of individuals who bear NSSI scars ascribe a great deal of meaning to their scarring, and that this meaning varies widely, a psychometrically sound scale is needed to comprehensively and systematically assess NSSI scar-related cognitions. The present study examined the psychometric properties of the Non-Suicidal Self-Injury Scar Cognition Scale (NSSI-SCS). A sample of 110 undergraduates with at least one scar from NSSI completed the NSSI-SCS as well as measures of concurrent and divergent validity. Exploratory Factor Analysis was conducted to determine the factor structure of the NSSI-SCS. Results indicated that a five-factor solution offered the best fit for the data. Psychometric analyses support the validity of the NSSI-SCS given evidence of concurrent validity, divergent validity, and reliability. Future research should examine the test-retest reliability of the NSSI-SCS, as well as its sensitivity to change, particularly in the context of treatment research.

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Acknowledgements

Preparation of this manuscript was supported by a National Science Foundation Graduate Research Fellowship to Taylor A. Burke and a National Institute of Mental Health Grant MH101168 to Lauren B. Alloy.

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Correspondence to Taylor A. Burke.

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Conflict of Interest

Taylor A. Burke, Thomas M. Olino and Lauren B. Alloy declare that they have no conflict of interest.

Funding

This study was unfunded.

Experiment Psrticipants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

Appendix 1. Non-Suicidal Self-Injury Scar Cognition Scale (NSSI-SCS)

Appendix 1. Non-Suicidal Self-Injury Scar Cognition Scale (NSSI-SCS)

Instructions: Please think about your scar(s) from intentionally hurting yourself without suicidal intent.

How true has each statement been for you over the past 2 weeks?

Very slightly or not at all

A little bit

Moderately

Quite A bit

Extremely

1. My scar(s) represent how strong I am emotionally.

1

2

3

4

5

2. My scar(s) represent how strong I am physically.

1

2

3

4

5

3. My scar(s) bring back memories of things that I don't want to remember.

1

2

3

4

5

4. My scar(s) make me think about how weak I used to be.

1

2

3

4

5

5. My scar(s) make me feel proud that I got through a very tough time.

1

2

3

4

5

6. My scar(s) remind me that I am weak.

1

2

3

4

5

7. My scar(s) make me feel afraid.

1

2

3

4

5

8. My scar(s) make me feel shame.

1

2

3

4

5

9. My scar(s) remind me of stressful things that happened to me in the past.

1

2

3

4

5

10. My scar(s) make me embarrassed in front of other people.

1

2

3

4

5

11. My scar(s) make me feel tough, like I can get through anything

1

2

3

4

5

12. My scar(s) make me feel like I am weak.

1

2

3

4

5

13. I think about my scar(s).

1

2

3

4

5

14. My scar(s) make me feel hopeless.

1

2

3

4

5

15. My scar(s) make me think about my failures and mistakes.

1

2

3

4

5

16. I think that people stare at my scar(s)

1

2

3

4

5

17. My scar(s) make me feel like I want to kill myself.

1

2

3

4

5

18. My scar(s) make me feel unattractive.

1

2

3

4

5

19. My scar(s) make me feel like I could kill myself if I wanted to.

1

2

3

4

5

20. My scar(s) make me feel hopeful about my future.

1

2

3

4

5

21. My scar(s) make me feel like I can't handle the future.

1

2

3

4

5

22. My scar(s) make me feel like I can't change anything, like I'm stuck.

1

2

3

4

5

23. I think that people judge me because of my scar(s).

1

2

3

4

5

24. I think that I would have better relationships if I didn't have any scar(s).

1

2

3

4

5

25. I think that my scar(s) make me unique.

1

2

3

4

5

26. My scar(s) make me feel less afraid of dying.

1

2

3

4

5

  1. Items 13, 21, and 24 were excluded from the final scale

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Burke, T.A., Olino, T.M. & Alloy, L.B. Initial Psychometric Validation of the Non-Suicidal Self-Injury Scar Cognition Scale. J Psychopathol Behav Assess 39, 546–562 (2017). https://doi.org/10.1007/s10862-017-9595-9

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