Skip to main content Accessibility help

Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adults

  • Eva Duarte (a1), Maria Gouveia-Pereira (a1), Hugo S. Gomes (a2) and Daniel Sampaio (a3)


The present article focuses on the validation of the Questionnaire of Social Representations about the Functions of Deliberate Self-Harm for adults. The understanding of the social representations about deliberate self-harm can be relevant for clinical intervention and prevention. However, there is still a lack of instruments to assess these representations. The basis for this instrument was the translation of the Inventory of Statements About Self-Injury. To complement this instrument, we conducted semi-directive interviews with adults without deliberate self-harm and analysed the Portuguese written press. Results from these studies complemented the questionnaire with new items and functions. Study 1 consisted of an exploratory factor analysis with a sample of 462 adults. Results revealed a two-factor structure of interpersonal and intrapersonal dimensions. After item reduction, the factorial analysis of the independent functions was also acceptable. This structure was then corroborated in Study 2 by a confirmatory factor analysis with a new sample of 474 adults, revealing an acceptable model fit. This questionnaire presents a relatively solid structure and is based on acceptable psychometric properties, which allows its use in future research.


Corresponding author

*Corresponding author: Eva Duarte, CIE-ISPA, ISPA - Instituto Universitário, Rua Jardim do Tabaco 34, 1149-041, Lisboa, Portugal. Email:


Hide All
Arbuckle, J.L. (2013). IBM® SPSS® Amos™ 22 user's guide. Amos Development Corporation. Retrieved from
Arbuthnott, A.E., & Lewis, S.P. (2015). Parents of youth who self-injure: A review of the literature and implications for mental health professionals. Child and Adolescent Psychiatry and Mental Health, 9, 135.
Batejan, K.L., Swenson, L.P., Jarvi, S.M., & Muehlenkamp, J.J. (2015). Perceptions of the functions of nonsuicidal self-injury in a college sample. Crisis, 36, 338344.
Berger, E., Hasking, P., & Reupert, A. (2014). ‘We're working in the dark here’: Education needs of teachers and school staff regarding student self-injury. School Mental Health, 6, 2012012.
Bildik, T., Somer, O., Kabukçu-Başay, B., Başay, Ö., & Özbaran, B. (2013). The validity and reliability of the turkish version of the inventory of statements about self-injury. Turkish Journal of Psychiatry, 24, 4149.
Bresin, K., Sand, E., & Gordon, K. (2013). Non-suicidal self-injury from the observer's perspective: A vignette study. Archives of Suicide Research, 17, 185195.
Brunner, R., Kaess, M., Parzer, P., Fischer, G., Carli, V., Hoven, C.W., … Wasserman, D. (2013). Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries. Journal of Child Psychology and Psychiatry, 55, 337348.
De Stefano, J., Atkins, S., Noble, R.N., & Heath, N. (2012). Am I competent enough to be doing this?: A qualitative study of trainees’ experiences working with clients who self-injure. Counselling Psychology Quarterly, 25, 289305.
Ferrey, A.E., Hughes, N.D., Simkin, S., Locock, L., Stewart, A., Kapur, N., … Hawton, K. (2016). The impact of self-harm by young people on parents and families: A qualitative study. BMJ Open, 6, e009631
Field, A. (2013). Discovering statistics using IBM SPSS Statistics: and sex and drugs and rock ‘n’ roll (4th ed.). London: Sage.
Fox, C. (2011). Working with clients who engage in self-harming behaviour: Experiences of a group of counsellors. British Journal of Guidance & Counselling, 39, 4151.
Glenn, C.R., & Klonsky, E.D. (2011). One-year test-retest reliability of the inventory of statements about self-injury (ISAS). Assessment, 18, 375378.
Gonçalves, S.F., Martins, C., Rosendo, A.P., Machado, B.C., & Silva, E. (2012). Self-injurious behavior in Portuguese adolescents. Psicothema, 24, 536541.
Gouveia-Pereira, M., Gomes, H., Santos, N., Frazão, P., & Sampaio, D. (2016). Relação entre as dinâmicas familiares e os comportamentos suicidários dos adolescentes e pais (Comunicação apresentada no Colóquio Psicanálise). Lisbon, Portugal: ISPA-IU University.
Guerreiro, D.F., Sampaio, D., Figueira, M.L., & Madge, N. (2017). Self-harm in adolescents: A self-report survey in schools from Lisbon, Portugal. Archives of Suicide Research, 21, 8399.
Hasking, P., Rees, C.S., Martin, G., & Quigley, J. (2015). What happens when you tell someone you self-injure? The effects of disclosing NSSI to adults and peers. BMC Public Health, 15, 10391048.
Hawton, K., Saunders, K.E.A., & O'Connor, R.C. (2012). Self-harm and suicide in adolescents. The Lancet, 379, 23732382.
Heath, N.L., Toste, J.R., & Beettam, E.L. (2007). ‘I am not well-equipped’: High school teachers’ perceptions of self-injury. Canadian Journal of School Psychology, 21, 7392.
Heath, N.L., Toste, J.R., Sornberger, M.J., & Wagner, C. (2011). Teachers’ perceptions of non-suicidal self-injury in the schools. School Mental Health, 3, 3543.
Hsieh, H.-F., & Shannon, S.E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15, 12771288.
Jacobson, C.M., & Gould, M. (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature. Archives of Suicide Research, 11, 129147.
Jodelet, D. (1984). Réflexions sur le traitement de la notion de représentation sociale en psychologie sociale. Communication — Information, 6, 1542.
Karman, P., Kool, N., Poslawsky, I.E., & Van Meijel, B. (2015). Nurses’ attitudes towards self-harm: A literature review. Journal of Psychiatric and Mental Health Nursing, 22, 6575.
Kline, R.B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York, NY: The Guilford Press.
Klonsky, E. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27, 226239.
Klonsky, E. (2011). Non-suicidal self-injury in United States adults: Prevalence, sociodemographics, topography and functions. Psychological Medicine, 41, 19811986.
Klonsky, E.D., & Glenn, C.R. (2009). Assessing the functions of non-suicidal self-injury: Psychometric properties of the inventory of statements about self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment, 31, 215219.
Klonsky, E.D., Glenn, C.R., Styer, D.M., Olino, T.M., & Washburn, J.J. (2015). The functions of nonsuicidal self-injury: Converging evidence for a two-factor structure. Child and Adolescent Psychiatry and Mental Health, 9, 19.
Klonsky, E.D., & Muehlenkamp, J.J. (2007). Self-injury: A research review for the practitioner. Journal of Clinical Psychology, 63, 10451056.
Kortge, R., Meade, T., & Tennant, A. (2013). Interpersonal and intrapersonal functions of deliberate self-harm (DSH): A psychometric examination of the inventory of statements about self-injury (ISAS) scale. Behaviour Change, 30, 2435.
Lindgren, B.-M., Oster, I., Aström, S., & Graneheim, U.H. (2011). ‘They don't understand … you cut yourself in order to live.’ Interpretative repertoires jointly constructing interactions between adult women who self-harm and professional caregivers. International Journal of Qualitative Studies on Health and Well-Being, 6, 114.
Long, M., & Jenkins, M. (2010). Counsellors’ perspectives on self-harm and the role of the therapeutic relationship for working with clients who self-harm. Counselling and Psychotherapy Research, 10, 192200.
Madge, N., Hewitt, A., Hawton, K., Wilde, E., Corcoran, P., Fekete, S., … Ystgaard, M. (2008). Deliberate self-harm within an international community sample of young people: Comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study. Journal of Child Psychology and Psychiatry, 49, 667677.
Maroco, J. (2010). Análise de equações estruturais: Fundamentos teóricos, software e aplicações [Structural equation analysis: Theoretical, software and applications]. Pêro Pinheiro: Report Number.
McDonald, G., O'Brien, L., & Jackson, D. (2007). Guilt and shame: Experiences of parents of self-harming adolescents. Journal of Child Health Care, 11, 298310.
McHale, J., & Felton, A. (2010). Self-harm: What's the problem? A literature review of the factors affecting attitudes towards self-harm. Journal of Psychiatric and Mental Health Nursing, 17, 732740.
Meszaros, G., Horvath, L.O., & Balazs, J. (2017). Self-injury and externalizing pathology: A systematic literature review. BMC Psychiatry, 17, 160.
Mojtabai, R., & Olfson, M. (2008). Parental detection of youth's self-harm behavior. Suicide and Life-Threatening Behavior, 38, 6073.
Moscovici, S. (1961). La Psycanalyse — Son Image et Son Public. Paris: P.U.F.
Muehlenkamp, J.J., Brausch, A., Quigley, K., & Whitlock, J. (2013). Interpersonal features and functions of nonsuicidal self-injury. Suicide and Life-Threatening Behavior, 43, 6780.
Muehlenkamp, J.J., Claes, L., Havertape, L., & Plener, P.L. (2012). International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health, 6, 19.
Niwa, K.D., & Mandrusiak, M.N. (2012). Self-injury groups on facebook. Canadian Journal of Counselling and Psychotherapy, 46, 120.
Nock, M.K. (2009). Why do people hurt themselves? New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18, 7883.
Oldershaw, A., Richards, C., Simic, M., & Schmidt, U. (2008). Parents’ perspectives on adolescent self-harm: Qualitative study. The British Journal of Psychiatry, 193, 140144.
Reddy, N., Rokito, L., & Whitlock, J. (2016). What is the link? The relationship between non-suicidal self-injury and social media. Information Brief Series, Cornell Research Program on Self-injury and Recovery. Ithaca, NY: Cornell University.
Rees, N., Rapport, F., Thomas, G., John, A., & Snooks, H. (2014). Perceptions of paramedic and emergency care workers of those who self harm: A systematic review of the quantitative literature. Journal of Psychosomatic Research, 77, 449456.
Rissanen, M.-L., Kylmä, J., & Laukkanen, E. (2008). Descriptions of self-mutilation among Finnish adolescents: A qualitative inquiry. Issues in Mental Health Nursing, 29, 145163.
Swannell, S., Martin, G., Krysinska, K., Kay, T., Olsson, K. & Win, A. (2010). Cutting on-line: Self-injury and the internet. Advances in Mental Health, 9, 177189.
Trewavas, C., Hasking, P., & McAllister, M. (2010). Representations of non-suicidal self-injury in motion pictures. Archives of Suicide Research, 14, 89103.
Wachelke, J.F.R., & Camargo, B.B.V. (2007). Representações sociais, representações individuais e comportamento. Revista Interamericana de Psicología/Interamerican Journal of Psychology, 41, 379390.
Whitlock, J.L., Powers, J.L., & Eckenrode, J. (2006). The Virtual cutting edge: The Internet and adolescent self-injury. Developmental Psychology, 42, 111.
Whitlock, J.L., Purington, A., & Gershkovich, M. (2009). Influence of the media on self injurious behavior. In Nock, M. (Ed.), Understanding non-suicidal self-injury: Origins, assessment and treatment (pp. 139156). Washington. DC: American Psychological Association Press.
Zdanow, C., & Wright, B. (2012). The representation of self injury and suicide on emo social networking groups. African Sociological Review, 16, 81101.


Related content

Powered by UNSILO

Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adults

  • Eva Duarte (a1), Maria Gouveia-Pereira (a1), Hugo S. Gomes (a2) and Daniel Sampaio (a3)


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.