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Diagnostic Assessment

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Identifying, Assessing, and Treating Self-Injury at School

Part of the book series: Developmental Psychopathology at School ((DPS))

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Abstract

Determining whether an individual is engaging in NSSI, and to what degree, is the first essential step in developing effective treatment strategies. Thus, the purpose of this chapter is to discuss the diagnostic assessment of NSSI. Topics in this chapter include the roles of diagnosis and classification, a review of various classification/diagnostic models of NSSI, guidelines for differentiating NSSI from suicidal behavior, a brief discussion of some popular assessment practices that have limited utility, and finally a description of recommended assessment practices for assisting in effective diagnostic decision making. Other assessment issues, such as psychoeducational classification issues and linking assessment to intervention, will be discussed in Chapter 6. However, before examining pertinent issues in the diagnostic assessment of self-injury, it is necessary to discuss the importance of the initial response to any student possibly engaging in NSSI.

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References

  • Achenbach, T. M. (2001). Child behavior checklist for ages 6–18. Burlington, VT: Research Center for Children, Youth, and Families.

    Google Scholar 

  • Bardos, A. N. (1993). Human figure drawings: Abusing the abused. School Psychology Quarterly, 8, 177–181.

    Article  Google Scholar 

  • Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York: New American Library.

    Google Scholar 

  • Berman, A. L., Jobes, D. A., & Silverman, M. M. (2006). Adolescent suicide: Assessment and intervention (2nd ed.). Washington, DC: American Psychological Association.

    Google Scholar 

  • Chandler, L. A. (2003). The projective hypothesis and the development of projective techniques for children. In C. R. Reynolds & R. W. Kamphaus (Eds.), Handbook of psychological and educational assessment of children: Personality, behavior, and context (pp. 51–65). New York: Guilford Press.

    Google Scholar 

  • Cloutier, P., & Humphreys, L. (2009). Measurement of nonsuicidal self-injury in adolescents. In M. K. Nixon & N. L. Heath (Eds.), Self-injury in youth: The essential guide to assessment and intervention (pp. 115–142). New York: Routledge.

    Google Scholar 

  • Connors, R. E. (2000). Self-injury: Psychotherapy with people who engage in self-inflicted violence. Northvale, NJ: Jason Aronson.

    Google Scholar 

  • Dawes, R. M. (1994). House of cards: Psychology and psychotherapy built on myth. New York: Free Press.

    Google Scholar 

  • D’Onofrio, A. A. (2007). Adolescent self injury: A comprehensive guide for counselors and health care professionals. New York: Springer.

    Google Scholar 

  • Dowdy, E., Mays, K. L., Kamphaus, R. W., & Reynolds, C. R. (2009). Roles of diagnosis and classification in school psychology. In T. B. Gutkin & C. R. Reynolds (Eds.), The handbook of school psychology (4th ed., pp. 191–209). New York: Wiley.

    Google Scholar 

  • Farberow, N. L. (Ed.). (1980). The many faces of suicide: Indirect self-destructive behavior. New York: McGraw-Hill.

    Google Scholar 

  • Favazza, A. (1987). Bodies under siege. Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  • Favazza, A. (1996). Bodies under siege: Self-mutilation and body modification in culture and psychiatry (2nd ed.). Baltimore, MD: Johns Hopkins University Press.

    Google Scholar 

  • Favazza, A. (1998). The coming of age of self-mutilation. The Journal of Nervous and Mental Disease, 186, 259–268.

    Article  PubMed  Google Scholar 

  • Garb, H. N. (1996). Taxometrics and the revision of diagnostic criteria. American Psychologist, 51, 553–554.

    Article  Google Scholar 

  • Gittelman-Klein, R. (1986). Questioning the clinical usefulness of projective psychological tests for children. Developmental and Behavioral Pediatrics, 7, 378–382.

    Google Scholar 

  • Goin, M. (2003). The “suicide prevention contract:” Dangerous myth. Psychiatric News, 18, 3.

    Google Scholar 

  • Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the deliberate self-harm inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253–263.

    Article  Google Scholar 

  • Hughes, J. N., & Baker, D. B. (1991). The clinical child interview. New York: Guilford Press.

    Google Scholar 

  • Jablensky, A. (1999). The nature of psychiatric classification: Issues beyond ICD-10 and DSM-IV. Australian and New Zealand Journal of Psychiatry, 33, 137–144.

    Article  PubMed  Google Scholar 

  • Joiner, T. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Joiner, T. (2009). Suicide prevention in schools as viewed through the interpersonal-psychological theory of suicidal behavior. School Psychology Review, 38, 244–248.

    Google Scholar 

  • Kettlewell, C. K. (1999). Skin game. New York: St. Martin’s Griffin.

    Google Scholar 

  • Knoff, H. M. (2003). Evaluation of projective drawings. In C. R. Reynolds & R. W. Kamphaus (Eds.), Handbook of psychological and educational assessment of children: Personality, behavior, and context (pp. 91–158). New York: Guilford Press.

    Google Scholar 

  • Lightfoot, C. (1997). The culture of adolescent risk-taking. New York: Guilford Press.

    Google Scholar 

  • Linehan, M. M., Comtois, K. A., Brown, M. Z., Heard, H. L., & Wagner, A. (2006). Suicide attempt self-injury interview (SASII): Development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury. Psychological Assessment, 18, 303–312.

    Article  PubMed  Google Scholar 

  • McConaughy, S. H. (2005). Clinical interviews for children and adolescents: Assessment to intervention. New York: Guilford Press.

    Google Scholar 

  • McDonald, C. (2006). Self-mutilation in adolescents. Journal of School Nursing, 22, 193–200.

    Article  PubMed  Google Scholar 

  • Meehl, P. E. (1995). Bootstraps taxometrics: Solving the classification problems in psychopathology. American Psychologist, 50, 266–275.

    Article  PubMed  Google Scholar 

  • Menninger, K. (1966). Man against himself. New York: Harcourt, Brace Janovich. (Original work published 1938).

    Google Scholar 

  • Merrell, K. W., Ervin, R. A., & Gimpel, G. A. (2006). School psychology for the 21 st century: Foundations and practices. New York: Guilford Press.

    Google Scholar 

  • Miller, D. N. (2010). Assessing internalizing problems and well-being. In G. Gimpel-Peacock, R. Ervin, E. Daly, & K. W. Merrell (Eds.), Practical handbook of school psychology (pp. 175–191). New York: Guilford Press.

    Google Scholar 

  • Naglieri, J. A. (1993). Human figure drawings in perspective. School Psychology Quarterly, 8, 170–176.

    Article  Google Scholar 

  • Nock, M. K., Holmberg, E. B., Photos, V. I., & Michel, B. D. (2007). The self-injurious thoughts and behaviors interview: Development, reliability, and validity in an adolescent sample. Psychological Assessment, 19, 309–317.

    Article  PubMed  Google Scholar 

  • Pattison, E. M., & Kahan, J. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140, 867–872.

    PubMed  Google Scholar 

  • Ponton, L. E. (1997). The romance of risk: Why teenagers do the things they do. New York: Basic Books.

    Google Scholar 

  • Ross, R. R., & McKay, H. R. (1979). Self-mutilation. Lexington, MA: Lexington Books.

    Google Scholar 

  • Seligman, M. E. P. (1992). Helplessness: On depression, development, and death. New York: Freeman.

    Google Scholar 

  • Shapiro, S. (2008). Addressing self-injury in the school setting. The Journal of School Nursing, 24, 124–130.

    Article  PubMed  Google Scholar 

  • Shneidman, E. S. (1985). Definition of suicide. New York: Wiley.

    Google Scholar 

  • Shneidman, E. S. (1996). The suicidal mind. New York: Oxford University Press.

    Google Scholar 

  • Simeon, D., & Favazza, A. (2001). Self-injurious behaviors: Phenomenology and assessment. In D. Simeon & E. Hollander (Eds.), Self-injurious behaviors, assessment and treatment (pp. 1–28). Washington, DC: American Psychiatric Publishing.

    Google Scholar 

  • Sroufe, L. A. (1997). Psychopathology as an outcome of development. Development and Psychopathology, 9, 251–268.

    Article  PubMed  Google Scholar 

  • Walsh, B. W. (2006). Treating self-injury: A practical guide. New York: Guilford Press.

    Google Scholar 

  • Walsh, B. W. (2007). Clinical assessment of self-injury: A practical guide. Journal of Clinical Psychology: In Session, 63, 1057–1068.

    Article  PubMed  Google Scholar 

  • Walsh, B. W., & Rosen, P. M. (1988). Self-mutilation: Theory, research, & treatment. New York: Guilford Press.

    Google Scholar 

  • Heath, N. L., & Nixon, M. K. (2009). Assessment of nonsuicidal self-injury in youth. In M. K. Nixon & N. L. Heath (Eds.), Self-injury in youth: The essential guide to assessment and intervention. New York: Routledge.

    Google Scholar 

  • Nafisi, N., & Stanley, B. (2007). Developing and maintaining the therapeutic alliance with self-injuring patients. Journal of Clinical Psychology: In Session, 63, 1069–1079.

    Article  PubMed  Google Scholar 

  • Dieter, P. J., Nicholls, S. S., & Pearlman, L. A. (2000). Self-injury and self-capacities: Assisting an individual in crisis. Journal of Clinical Psychology, 56, 1173–1191.

    Article  Google Scholar 

  • Miller, D. N., & Eckert, T. L. (2009). Youth suicidal behavior: An introduction and overview. School Psychology Review, 38, 153–167.

    Google Scholar 

  • Jobes, D. A. (2003). Manual for the collaborative assessment and management of suicidality – revised (CAMS-R). Unpublished manuscript.

    Google Scholar 

  • Rudd, M. D., Mandrusiak, M., & Joiner, T. E. (2006). The case against no-suicide contracts: The commitment to treatment statement as a practice alternative. Journal of Clinical Psychology, 62, 243–251.

    Article  PubMed  Google Scholar 

  • Fergusson, D. M., & Horwood, J. (1995). Predictive validity of categorically and dimensionally scored measures of disruptive childhood behaviors. Journal of Clinical Child and Adolescent Psychology, 32, 396–407.

    Google Scholar 

  • Caron, C., & Rutter, M. (1991). Comorbidity in child psychopathology: Concepts, issues, and research strategies. Journal of Child Psychology and Psychiatry and Allied Disciplines, 32, 1063–1080.

    Article  Google Scholar 

  • Kamphaus, R. W., & Frick, J. P. (1996). Clinical assessment of child and adolescent personality and behavior. Needham Heights, MA: Allyn & Bacon.

    Google Scholar 

  • Favazza, A., & Rosenthal, R. (1990). Varieties of pathological self-mutilation. Behavioral Neurology, 3, 77–85.

    Google Scholar 

  • Reynolds, W. M., & Mazza, J. J. (1993). Suicidal behavior in adolescents: Suicide attempts in school-based youngsters. Unpublished manuscript.

    Google Scholar 

  • Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.

    Google Scholar 

  • Merrell, K. W. (2008a). Helping students overcome depression and anxiety: A practical guide (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Merrell, K. W. (2008b). Behavioral, social, and emotional assessment of children and adolescents (3rd ed.). Mahwah, NJ: Lawrence Erlbaum.

    Google Scholar 

  • Brock, S. E., & Clinton, A. (2007). Diagnosis of attention-deficit/hyperactivity disorder (AD/HD) in childhood: A review of the literature. The California School Psychologist, 12, 73–91.

    Google Scholar 

  • Miller, D. N., & Nickerson, A. B. (2006). Projective assessment and school psychology: Contemporary validity issues and implications for practice. The California School Psychologist, 11, 73–84.

    Google Scholar 

  • Hosp, J. L., & Reschly, D. (2002). Regional differences in school psychology practice. School Psychology Review, 31, 11–29.

    Google Scholar 

  • Shapiro, E. S., & Heick, P. F. (2004). School psychologist assessment practices in the evaluation of students referred for social/behavioral/emotional problems. Psychology in the Schools, 41, 551–561.

    Article  Google Scholar 

  • Wilson, M. S., & Reschly, D. J. (1996). Assessment in school psychology training and practice. School Psychology Review, 25, 9–23.

    Google Scholar 

  • Kennedy, M. L., Faust, D., Willis, W. G., & Piotrowski, C. (1994). Social-emotional assessment practices in school psychology. Journal of Psychoeducational Assessment, 12, 228–240.

    Article  Google Scholar 

  • Hojnoski, R. L., Morrison, R., Brown, M., & Matthews, W. J. (2006). Projective test use among school psychologists: A survey and critique. Journal of Psychoeducational Assessment, 24, 145–159.

    Article  Google Scholar 

  • Lilienfield, S. O., Wood, J. M., & Garb, H. N. (2000). The scientific status of projective techniques. Psychological Science in the Public Interest, 1, 27–65.

    Google Scholar 

  • Yalof, J., Abraham, P., Domingos, B., & Socket, B. (2001). Re-examining the Rorschach test in school psychology practice. The School Psychologist, 55, 97, 100–102, 110–112.

    Google Scholar 

  • Batsche, G. M., & Peterson, D. W. (1983). School psychology and projective assessment: A growing incompatibility. School Psychology Review, 12, 440–445.

    Google Scholar 

  • Motta, R. W., Little, S. G., & Tobin, M. I. (1993). The use and abuse of human figure drawings. School Psychology Quarterly, 8, 162–169.

    Article  Google Scholar 

  • Salvia, J., & Ysseldyke, J. E. (2001). Assessment in special and remedial education (8th ed.). Boston, MA: Houghton Mifflin.

    Google Scholar 

  • Miller, D. N., & Nickerson, A. B. (2007a). Projective techniques and the school-based assessment of childhood internalizing disorders: A critical analysis. Journal of Projective Psychology and Mental Health, 14, 48–58.

    Google Scholar 

  • Mash, E. J., & Hunsley, J. (2005). Evidence-based assessment of child and adolescent disorders: Issues and challenges. Journal of Clinical Child and Adolescent Psychology, 34, 362–379.

    Article  PubMed  Google Scholar 

  • Kerr, M. M., & Nelson, C. M. (2002). Strategies for addressing behavior problems in the classroom (4th ed.). Upper Saddle River, NJ: Merrill Prentice-Hall.

    Google Scholar 

  • Eckert, T. L., Dunn, E. K., Guiney, K. M., & Codding, R. S. (2000). Self-reports: Theory and research in using rating scale measures. In E. S. Shapiro & T. R. Krachochwill (Eds.), Behavioral assessment in schools: Theory, research, and clinical foundations (2nd ed., pp. 288–322). New York: Guilford Press.

    Google Scholar 

  • Lloyd, E. E., Kelley, M. L., & Hope, T. (1997). Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates. Poster presented at the Annual Meeting of the Society for Behavioral Medicine, New Orleans, LA.

    Google Scholar 

  • Nixon, M. K., Cloutier, P. F., & Aggarwal, S. (2002). Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 41, 1333–1341.

    Article  Google Scholar 

  • Gutierrez, P. M., Osman, A., Barrios, F. X., & Kopper, B. A. (2001). Development and initial validation of the self-harm behavior questionnaire. Journal of Personality Assessment, 77, 475–490.

    Article  PubMed  Google Scholar 

  • Sansone, R. A., Wiederman, M. W., & Sansone, L. A. (1998). The self-harm inventory (SHI): Development of a scale for identifying self-destructive behaviors and borderline personality disorder. Journal of Clinical Psychology, 54, 973–983.

    Article  PubMed  Google Scholar 

  • Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005). Non-suicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. Journal of Youth and Adolescence, 34, 447–456.

    Article  Google Scholar 

  • Zlotnick, C., Shea, M. T., Recupero, P., Bidadi, K., Pearlstein, T., & Brown, P. (1997). Trauma, dissociation, implusivity, and self-mutilation among substance abuse patients. American Journal of Orthopsychiatry, 67, 650–654.

    Article  PubMed  Google Scholar 

  • Osuch, E. A., Noll, G. G., & Putnam, F. W. (1999). The motivations for self-injury in psychiatric inpatients. Psychiatry, 62, 334–346.

    PubMed  Google Scholar 

  • Alexander, L. A. (1999). The functions of self-injury and its link to traumatic events in college students. UMI ProQuest Digital Dissertations, 24. (preview, 9932285).

    Google Scholar 

  • Friedberg, R. D., & McClure, J. M. (2002). Clinical practice of cognitive therapy with children and adolescents: The nuts and bolts. New York: Guilford Press.

    Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2004). Behavior assessment system for children (2nd ed.). Circle Pines, MN: AGS.

    Google Scholar 

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Authors and Affiliations

  1. University at Albany State University of New York, 1400 Washington Avenue, Albany, NY, 12222, USA

    David N. Miller

  2. Department of Special Education, Rehabilitation, School Psychology and Deaf Studies, California State University, Sacramento 6000 J Street, Sacramento, CA, 95819-6079, USA

    Stephen E. Brock

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  1. David N. Miller
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Correspondence to David N. Miller .

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Miller, D.N., Brock, S.E. (2010). Diagnostic Assessment. In: Identifying, Assessing, and Treating Self-Injury at School. Developmental Psychopathology at School. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-6092-4_5

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