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Cited by 34Suicide and Self-Harm StudiesCriminal Justice and Corrections AnalysisHomicide, Infanticide, and Child Abuse

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

Open access
Borschmann, Rohan, Young, Jesse T., Moran, Paul, Spittal, Matthew J., Snow, Kathryn, Mok, Katherine, Kinner, Stuart A.·2017·CMAJ Open
DOI 10.9778/cmajo.20170058PMC PMC5621944
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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 examine the level of agreement between self-reported self-harm history and historical medical records, and 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 6 weeks of expected release from 1 of 7 prisons in Queensland, Australia, participants were asked about the occurrence of lifetime self-harm. 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. Follow-up interviews roughly 1, 3 and 6 months after release covered the same domains assessed in the baseline interview as well as self-reported criminal activity and contact with health care, social and criminal justice services since release. RESULTS: Agreement between self-reported and medically verified history of self-harm was poor, with 64 (37.6%) of 170 participants with a history of medically verified self-harm disclosing a history of self-harm at baseline. Participants with a medically verified history of self-harm were more likely than other participants to self-harm during the follow-up period. Compared to the unconfirmed-negative group, the true-positive (adjusted hazard ratio [HR] 6.2 [95% confidence interval (CI) 3.3-10.4]), false-negative (adjusted HR 4.0 [95% CI 2.2-6.7]) and unconfirmed-positive (adjusted HR 2.2 [95% CI 1.2-3.9]) groups were at increased risk for self-harm after release from prison. 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. To identify those who should be targeted for preventive strategies, triangulation of data from multiple verifiable sources should be performed whenever possible.

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  • Most of the included cross-sectional studies relied on retrospective self-report of self-harm, which might underestimate the prevalence of self-harm in custody.

    “most of the included cross-sectional studies relied on retrospective self-report of self-harm, which might underestimate the prevalence of self-harm in custody.79”

    From Risk factors for self-harm in prison: a systematic review and meta-analysis (2020) · cites this paper as [79]

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  1. Skegg K. Self-harm. Lancet 2005;366:1471-83.

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Authors
Borschmann, R., Young, J. T., Moran, P., Spittal, M. J., Snow, K., Mok, K., & Kinner, S. A.
Affiliations
Griffith University (AU)
ORCID
Venue
CMAJ Open
Publisher
CMA Impact Inc.
Published
2017-09-11
Volume
5
Issue
3
Pages
E694-E701
ISSN
2291-0026 (ISSN-L)
DOI
10.9778/cmajo.20170058
PMC
PMC5621944
OpenAlex
W2755091928
Cited by
34
References
59
Citations by year
2026: 2 · 2025: 3 · 2023: 4 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 3 · 2017: 1
FWCI
4.70
Type
journal article
Language
en
Open access
Locations
  • CMAJ Open (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Explore Bristol Research (publishedVersion, cc-by-nc)
  • Bristol Research (University of Bristol) (submittedVersion, cc-by-nc)
  • UWA Profiles and Research Repository (UWA) (submittedVersion, cc-by-nc)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Research Portal (King's College London) (submittedVersion, other-oa)
  • Griffith Research Online (submittedVersion)
Funders
National Health and Medical Research Council (1104644, 1002463)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
  • Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords
self-harm, incarcerated adults, prison population, self-report accuracy, data linkage, suicide risk, data triangulation, criminal justice

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