Abstract
BACKGROUND: The "Inventory of Statements About Self-Injury" (ISAS) is one of the most widely used and reliable psychometric tools for assessing non-suicidal self-injury (NSSI) and its motivations. The Russian adaptation of the ISAS, involving patients with nonpsychotic psychiatric disorders, demonstrated high internal consistency and a two-factor structure similar to the original. However, the reliability and suitability of ISAS in a non-clinical population remain unclear. AIM: To adapt the ISAS in Russian, evaluate its psychometric properties, and analyze its factor structure in a sample of Russian university students. METHODS: The psychometric properties and factor structure of the adapted ISAS version were evaluated through an anonymous online survey of Russian university students. Respondents had reported lifetime NSSI and scored above 4 on the ISAS-Functions subscale. Exploratory and confirmatory factor analysis (EFA/CFA) were performed on two randomly formed subgroups to evaluate the factor structure of ISAS. Additionally, the associations between the identified ISAS factors and the presence of suicidal thoughts and attempts over a lifetime and in the week before their participation in the study, as well as seeking psychiatric and/or psychotherapeutic care over a lifetime, were analyzed. RESULTS: The survey included 3,919 participants, of whom 1,149 (29.3%; 88.0% female) reported NSSI, with a median age of 20 (18; 22) years. The Russian ISAS demonstrated high internal consistency (Cronbach's alpha = 0.851). EFA results supported the original two-factor structure. CFA results suggested an alternative three-factor structure of the ISAS, including "Signal", "Regulation", and "Influence" factors. Suicidal attempts were associated with the factors "Regulation" and "Influence", suicidal thoughts with "Regulation" and female gender, and the seeking of psychiatric and/or psychotherapeutic care with "Regulation" and age. CONCLUSION: The adapted ISAS in Russian is a reliable tool with high internal consistency. The study proposed a three-factor structure, indicating a greater heterogeneity of the NSSI phenomenon compared to earlier understandings. The study demonstrated the association between two of the three identified factors with suicidal behavior and thoughts, and the seeking of psychiatric care.