Understanding Factors Relevant to Self-Injurious Behavior in a High-Risk Secure Psychiatric Sample: Developing the Theory-Driven Measure of Self-Injurious Behavior Engagement

A measure for the assessment of self-injurious behavior is developed. Commencing with a Delphi composed of 33 experts: detached experts (academics), experts by exposure (staff), and experts by experience (patients), the Theory-driven Measure of Self-Injurious Behavior Engagement is outlined. This is then examined in two samples: high-secure psychiatric male patients (n = 76) and high-secure psychiatric nursing staff (n = 100; 50 men, 50 women). We predicted that all components of the Theory of Planned Behavior and the capacity, belongingness, and burdensomeness elements of the Interpersonal Psychological Theory of Suicidal Behavior would be confirmed as important inclusions. Results initially showed the importance of including intention, perceived behavioral control, affect, capacity, and burdensomeness. The role of environmental and individual factors, such as coping, was captured as additional variables of value. However, the structure of items differed between patients and staff. Being valued consistently represented a core consideration, as did capacity and affect. Directions for future research are indicated.