DSM-5 suicidal behavior disorder: a systematic review of research on clinical utility, diagnostic boundaries, measures, pathophysiology and interventions

The authors developed the Self-Injurious Thoughts and Behaviors Interview (SITBI) and evaluated its psychometric properties. The SITBI is a structured interview that assesses the presence, frequency, and characteristics of a wide range of self-injurious thoughts and behaviors, including suicidal ideation, suicide plans, suicide gestures, suicide attempts, and nonsuicidal self-injury (NSSI). This initial study, based on the administration of the SITBI to 94 adolescents and young adults, suggested that the SITBI has strong interrater reliability (average kappa = .99, r = 1.0) and test-retest reliability (average kappa = .70, intraclass correlation coefficient = .44) over a 6-month period. Moreover, concurrent validity was demonstrated via strong correspondence between the SITBI and other measures of suicidal ideation (average kappa = .54), suicide attempt (kappa = .65), and NSSI (average kappa = .87). The authors concluded that the SITBI uniformly and comprehensively assesses a wide range of self-injury-related constructs and provides a new instrument that can be administered with relative ease in both research and clinical settings. (PsycINFO Database Record (c) 2007 APA, all rights reserved).

Background Self-injurious thoughts and behaviors (SITBs) are common in adolescents. While there is no standardized interview in German to assess SITBs to date, the Self-Injurious Thoughts and Behaviors Interview (SITBI) is widely used in English-speaking countries. However, the SITBI has not been validated for the assessment of the recently issued DSM-5 Section 3 diagnoses of nonsuicidal self-injury (NSSI) and suicidal behavior disorder (SBD) yet. In the present study the psychometric properties of the German version of the SITBI (SITBI-G) were assessed. We also evaluated whether SITBI-G is a reliable and valid instrument to establish diagnoses of NSSI and SBD. Methods A clinical adolescent sample (N = 111, f/m = 73/38, age range = 12-19 years) was recruited from the inpatient units of three departments of child and adolescent psychiatry in Germany. All participating patients were interviewed by using the SITBI-G, and DSM-5 criteria of NSSI and SBD were operationalized from the SITBI-G data. Additionally, participants were given the Self-Harm Behavior Questionnaire (SHBQ), and SITBI-G was retested in a subsample. Results The SITBI-G shows moderate to good test-retest reliability, a very good interrater reliability, and a good construct validity. The results demonstrate that diagnoses of NSSI and SBD can be established using the SITBI-G, achieving moderate to good test-retest reliabilities and very good to perfect interrater reliabilities. Conclusions Overall, the good psychometric properties of SITBI-G are comparable to the original version of the interview. Therefore, SITBI-G seems to be highly appropriate to assess SITBs, including the new DSM-5 Section 3 diagnoses NSSI and SBD in research and clinical contexts. Electronic supplementary material The online version of this article (doi:10.1186/s12888-014-0265-0) contains supplementary material, which is available to authorized users.