Abstract
BACKGROUND: Self-injurious thoughts and behaviors (SITBs) increasingly prevalent among youth, with particularly high rates in China. Existing assessment tools often lack comprehensiveness or cultural adaptation. This study aimed to translate and validate the Self-Injurious Thoughts and Behaviors Interview-Revised (SITBI-R) for Chinese adolescents in clinical settings and evaluate its diagnostic accuracy against DSM-5 criteria and suicide risk assessment protocols. METHODS: A total of 170 adolescents aged 12-19 years were recruited from two psychiatric hospitals. The Chinese version of SITBI-R (C-SITBI-R) was compared with established instruments including the M.I.N.I., self-report scales for non-suicidal self-injury assessment, and DSM-5 diagnostic criteria. Content validity, construct validity, test-retest reliability, interrater reliability, and diagnostic agreement were evaluated. RESULTS: The C-SITBI-R exhibited excellent content validity (I-CVI = 1.00, S-CVI/UA = 1.00) and significant construct validity correlations with validation instruments. Perfect interrater agreement was achieved (all κ and ICC values = 1.00, p < 0.001), while test-retest reliability showed excellent consistency for lifetime presence and timing variables (κs = 0.78-1.00, ICCs = 0.93-1.00, p < 0.001), and moderate to strong agreement for past month frequencies of major SITBs (ICCs = 0.64-0.75, p < 0.001).High diagnostic consistency was observed with DSM-5 criteria for NSSI (κ = 1.00) and SBD (κ = 0.86), and M.I.N.I. suicide risk assessment (κ = 0.94). CONCLUSIONS: The C-SITBI-R demonstrates strong psychometric properties and cultural adaptation for systematic assessment of SITBs among Chinese adolescents. Its strong diagnostic accuracy and clinical feasibility support its implementation in routine psychiatric practice for enhanced identification and management of at-risk youth.