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INVENTORY OF STATEMENTS ABOUT SELF-INJURY (ISAS) – 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).
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):
Cutting

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

Other

,

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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.
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24 hours > 1 day 7. are you alone? Please circle a choice: YES 6.2.6 hours 6 . Typically. 3. If you feel that you have a main form of self-harm. Do you experience physical pain during self-harm? Please circle a choice: YES SOMETIMES NO SOMETIMES NO 5.12 hours 12 . When you self-harm.3 hours 3 . Do/did you want to stop self-harming? Please circle a choice: YES NO . At what age did you: First harm yourself? Most recently harm yourself? (approximate date – month/date/year) 4. please circle the behavior(s) on the first page above that you consider to be your main form of self-harm. 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 .

… demonstrating that I am separate from other people 0 1 2 Response Key: 0 – not relevant. … ensuring that I am self-sufficient 0 1 2 14. … letting others know the extent of my emotional pain 0 1 2 10. … creating a physical sign that I feel awful 0 1 2 12. … releasing emotional pressure that has built up inside of me 0 1 2 15. Please identify the statements that are most relevant for you:    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. … getting back at someone 0 1 2 13. … doing something to generate excitement or exhilaration 0 1 2 8. … punishing myself 0 1 2 4. … bonding with peers 0 1 2 9. … giving myself a way to care for myself (by attending to the wound) 0 1 2 5. Below is a list of statements that may or may not be relevant to your experience of self-harm. … avoiding the impulse to attempt suicide 0 1 2 7. … causing pain so I will stop feeling numb 0 1 2 6.INVENTORY OF STATEMENTS ABOUT SELF-INJURY (ISAS) – SECTION II. … creating a boundary between myself and others 0 1 2 3. I am … Response 1. … calming myself down 0 1 2 2. … seeing if I can stand the pain 0 1 2 11. 2 – very relevant . FUNCTIONS Name: Date: Instructions This inventory was written to help us better understand the experience of non-suicidal self-harm. 1 – somewhat relevant.

… expressing anger towards myself for being worthless or stupid Response Key: 0 – not relevant. 2 – very relevant 0 1 2 .16. 1 – somewhat relevant.

… signifying the emotional distress I’m experiencing 0 1 2 38. … fitting in with others 0 1 2 22. I am … 17. … pushing my limits in a manner akin to skydiving or other extreme activities 34. … creating a sign of friendship or kinship with friends or loved ones 0 1 2 0 1 2 35. … demonstrating that I do not need to rely on others for help 0 1 2 27. or other overwhelming emotions 0 1 2 28. . … trying to feel something (as opposed to nothing) even if it is physical pain 19. … creating a physical injury that is easier to care for than my emotional distress 18. … entertaining myself or others by doing something extreme 0 1 2 21. demonstrating I am tough or strong 0 1 2 24. … responding to suicidal thoughts without actually attempting suicide 0 1 2 0 1 2 0 1 2 20. … establishing a barrier between myself and others 0 1 2 29. … allowing myself to focus on treating the injury. … getting revenge against others 0 1 2 26. frustration. … proving to myself that my emotional pain is real 0 1 2 25. … seeking care or help from others 0 1 2 23. … reacting to feeling unhappy with myself or disgusted with myself 0 1 2 30. which can be gratifying or satisfying 31. … trying to hurt someone close to me 0 1 2 39. anger. … proving I can take the physical pain 0 1 2 37.“When I self-harm.. … establishing that I am autonomous/independent 0 1 2 . … keeping a loved one from leaving or abandoning me 0 1 2 36. … making sure I am still alive when I don’t feel real 0 1 2 0 1 2 32. … reducing anxiety. … putting a stop to suicidal thoughts 0 1 2 33..

even if they do not necessarily apply to you: . please list any statements that you feel would be more accurate for you than the ones listed above: (Optional) In the space below.(Optional) In the space below. please list any statements you feel should be added to the above list.

19. 20. 33 Peer-Bonding – 8. 37 Revenge – 12. 31 Anti-Suicide – 6. 32 Sensation-Seeking – 7. 36 Marking Distress – 11. 30 Anti-Dissociation/Feeling-Generation – 5. 39 Scores for each of the 13 functions range from 0 to 6. 35 Toughness – 10. 24. 29 Self-Care – 4. . 18. 28 Self-Punishment – 3.ITEMS COMPRISING EACH OF 13 FUNCTIONS SCALES Affect Regulation – 1. 34 Interpersonal Influence – 9. 15. 21. 38 Autonomy – 13. 16. 23. 14. 22. 25. 17. 26. 27 Interpersonal Boundaries – 2.

B. & Willoughby. & Downey.. & Klonsky. (2013). O. 31.A. Basay. 215-219.G. Bildik.. Interpersonal and intrapersonal functions of deliberate self-harm (DSH): A psychometric examination of the Inventory of Statements About Self-injury (ISAS) scale. & Klonsky. Journal of Clinical Child & Adolescent Psychology. Rafaeli.R. C. (2009) Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS). C. One-year test-retest reliability of the Inventory of Statements About Self-injuiry (ISAS).G. (2013). B. L. K. Glenn.. Turkish Journal of Psychiatry. Nonsuicidal self-injury and suicidal behavior: A latent class analysis among young adults. 375-378.M.G. T. Assessment. E.. 496-507.Studies Validating and Using the ISAS Psychometric properties of ISAS Section I (Behaviors) are reported in: Klonsky. . & Ozbaran. Journal of Psychopathology and Behavioral Assessment. 44. A. K. T. Meade. Behavior Therapy. e59955. & Tennant. T. & Glenn.D.D.. Glenn. 18. 30. 24-35. Psychometric properties of ISAS Section II (Functions) are reported in: Klonsky. PLOS One. R. 22-27. C. Identifying clinically distinct subgroups of selfinjurers among young adults: A latent class analysis. 8(3).. (2011). (2008).D. (2013). 529-540.R. (2013). Zaki. O. Somer. (2013).. E. Additional psychometric studies of the ISAS: Kortge... & Olino. G. Other studies using part or all of the ISAS (list not comprehensive): Hamza.F. Non-suicidal self-injury disorder: An empirical investigation in adolescent psychiatric inpatients. T. Kabukcu Basay. E. 76. E. Behaviour Change. Coifman. 42.D. The validity and reliability of the Turkish version of the Inventory of Statements About Self-injury. Berenson. E. Journal of Consulting and Clinical Psychology. Emotion differentiation as a protective factor against nonsuicidal self-injury in Bordelrine Personality Disorder. C.

Personality and Individual Differences. 242-254. E. 25-29.. (2010). & Klonsky. T. Behavior Therapy. 751-762. 1-8. 40. C. G. Prospective prediction of non-suicidal self-injury: A one-year longitudinal study. 66. & Klonsky. Klonsky. C. (2011). 166-170.R.D. (2011). Is non-suicidal self-injury an "addiction"? A comparison of craving in substance use and non-suicidal self-injury. 80. Functions of non-suicidal self-injury among young women in residential care: A pilot study with the Swedish version of the Inventory of Statements About Self-injury (ISAS).R.D.. C. Psychological Medicine. E. Glenn. 67-75.D. C. 46.D. E.D. Glenn.R. 19811986. & Klonsky. 73-77. E. Klonsky. C. Glenn. E. Emotional reactivity in nonsuicidal self-injury: Divergence between self-report and startle measures. E. Glenn. Blumenthal.R.D. & Klonsky. sociodemographics. C. Motivation and Emotion. (2010). T. & Klonsky.. S. A. 42. (2011).. Social context during non-suicidal self-injury indicates suicide risk. 183-189. Glenn. Journal of Clinical Psychology. E. 197. Glenn. & Klonsky. Weinberg. (2009). E. Personality Disorders: Theory. Lindholm.D. (2012). 41. Research. 36..D. A multimethod analysis of impulsivity in nonsuicidal self-injury. The effects of self-injury on acute negative arousal: A laboratory simulation.E. 1. & Hajcak. (2011).D.Victor. Psychiatry Research. The role of seeing blood in non-suicidal self-injury. topography.. and functions.R. International Journal of Psychophysiology. . and Treatment. Non-suicidal self-injury in United States adults: Prevalence. Cognitive Behaviour Therapy. (2012).R.