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New Test Assesses Self-Injurious Thoughts

Tuesday, May 22, 2007
By Michelle Rizzo

NEW YORK (Reuters Health) - A new behavioral test that does not rely on the patient to express his or her thoughts appears to identify those who are at risk of cutting and other self-injurious behaviors, a new study shows.

"People have engaged in self-injurious behavior for thousands of years, and a dilemma as old as the problem itself is that the only method we have of assessing thoughts of self-injury is to ask a person if he is thinking about hurting himself," Dr. Matthew K. Nock explained in an interview with Reuters Health.

The problem is that people often do not want to tell others about their self-injurious thoughts or plans, he continued, "because they are embarrassed, they do not want to be stopped, or possibly because they are unaware of the severity of their self-injurious thoughts."

Nock, of Harvard University, Boston, and colleagues tested a new method of assessing peoples' self-injurious thoughts using their reaction time on a brief computerized test showing images and words related to self-injury.

A total of 89 subjects, average age 17 years, were included in the study. Of these, 53 had a recent history of non-suicidal self-injury and 36 were not self-injurious, according to the report in the medical journal American Journal of Psychiatry.

The new test revealed significant differences in the responses of people who had recently engaged in non-suicidal self-injury compared with those who had not.

"What we have is the first evidence of a behavioral measure of self-injurious thoughts," Nock said. "The potential implications of this line of research are enormous."

For instance, the investigator continued, "this test ultimately could be used in emergency rooms, doctor's offices, and other health care settings to help clinicians identify those who are most at risk for self-injury."

It could also be used to assess the effectiveness of treatment, "and to make decisions about whether a person should be admitted or discharged from hospital care," he added.

"We are currently studying slightly modified versions of this test that assess thoughts about death and suicide," Nock commented.

SOURCE: American Journal of Psychiatry, May 2007.
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