Accuracy and predictive value of incarcerated adults’ accounts of their self-harm histories: findings from an Australian prospective data linkage study

Rohan Borschmann, Jesse Young, Paul Moran, Matthew Spittal, Kathryn Snow, Kathryn Mok, Stuart Kinner

Research output: Contribution to journalArticle (Academic Journal)peer-review

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Abstract

Background: Self-harm is prevalent in prison populations, and is a well-established risk factor for suicide. Researchers typically rely on self-report to measure self-harm, yet the accuracy and predictive value of self-report in prison populations is unclear. Using a large, representative sample of incarcerated men and women, we aimed to (a) examine the level of agreement between self-reported self-harm history and historical medical records, and (b) investigate the association between self-harm history and medically-verified self-harm after release from prison.
Methods: During confidential interviews with 1315 adults, conducted within six weeks of expected release from prison, participants were asked about the occurrence of lifetime selfharm. Responses were compared with prison medical records and linked both retrospectively and prospectively with ambulance, emergency department, and hospital records, to identify instances of medically-verified self-harm.
Results: Agreement between self-reported and medically-verified history of self-harm was poor, with just 64 of 170 participants (38%) with a history of medically-verified self-harm disclosing any history of self-harm at baseline. Participants with a medically-verified history of self-harm were more likely to self-harm during the follow-up period and, among those with prior medically-verified self-harm, those who disclosed this at baseline were more likely than those who did not disclose to have a subsequent self-harm event.
Interpretation: Self-reported history of self-harm should not be considered a sensitive indicator of prior self-harm, or of future self-harm risk, in incarcerated adults. In order to identify those who should be targeted for prevention, triangulation between multiple and verifiable data sources should be implemented whenever possible.
Original languageEnglish
Pages (from-to)E694-E701
Number of pages8
JournalCMAJ Open
Volume5
Issue number3
DOIs
Publication statusPublished - 11 Sep 2017

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