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Izvestia Journal of the Union of Scientists - Varna. Medicine and Ecology Series

First results from the application of ISAS and ABASI/ABUSI in a study of non-suicidal self-injury in high school students from Varna

Raya Dimitrova, Galina Radkova, Zlatislav Stoyanov, Petar Petrov


Non-suicidal self-injury (NSSI) is a growing phenomenon observed in the Western world, as well as in Bulgaria. The proper understanding and characterization of the behavior requires the use of highly informative and reliable instruments. However, at the time of the study, there are no nationally accepted standards and no available comprehensive instrument in Bulgarian for the assessment of NSSI. The current pilot study attempts to approbate the informativeness of the Bulgarian versions of two instruments new to Bulgaria, which are commonly used in other countries - Inventory of Statements About Self-injury (ISAS) and Alexian Brothers’ Assessment of Self-Injury/Alexian Brothers’ Urge to Self-Injure (ABASI/ABUSI). We studied a non-clinical population of high school students in Varna, aged between 14 and 18 years. A total of 142 correctly answered scales were analyzed. Preliminary assessment suggests that the scales provide valid information to characterize the main method of self-injury, reason for self-injury, behavior immediately prior to self-injury and risk factors. Cutting was suggested to be the predominant method of self-injury, while the most common reasons for self-injury were self-punishment and affect regulation. A correlation between experienced emotional and verbal abuse and enduring and long-lasting thoughts about self-injury was also noted.


non-suicidal self-injury, ISAS, ABUSI, ABASI, adolescents

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Baetens I, Claes L, Muehlenkamp J, Grietens H, Onghena P. Non-suicidal and suicidal self-injurious behavior among Flemish adolescents: A web-survey. Arch Suicide Res Off J Int Acad Suicide Res. 2011;15(1):56–67.

Hamm MP, Newton AS, Chisholm A, Shulhan J, Milne A, Sundar P, et al. Prevalence and effect of cyberbullying on children and young people: A Scoping review of social media studies. JAMA Pediatr. 2015;169:770–777.

Hargus E, Hawton K, Rodham K. Distinguishing Between Subgroups of Adolescents Who Self‐Harm. Suicide Life Threat Behav. 2009;39(5):518–537.

ISSS [International Society for the Study of Self-Injury (ISSS) (n.d.) About self-injury. Retrieved from]

Klonsky ED, Glenn CR, Styer DM, Olino TM, Washburn JJ. The functions of nonsuicidal self-injury: converging evidence for a two-factor structure. Child Adolesc Psychiatry Ment Health, 2015, 9:44.

Klonsky ED, Glenn CR. Assessing the functions of non-suicidal self-injury: psychometric properties of the Inventory of Statements About Self-injury (ISAS) J Psychopathol Behav Assess. 2009;31(3):215–219.

Muehlenkamp JJ, Gutierrez PM. Risk for Suicide Attempts Among Adolescents Who Engage in Non-Suicidal Self-Injury. Arch Suicide Res. 2007;11(1):69–82.

Nock MK, Joiner TE, Gordon KH, Lloyd-Richardson E, Prinstein MJ. Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Res. 2006;144(1):65–72.

Ross S, Heath N. A Study of the Frequency of Self-Mutilation in a Community Sample of Adolescents. J Youth Adolesc. 2002;31(1):67–77.

Soloff P, Lis J, Kelly T, Cornelius J, Ulrich R. Self-mutilation and suicidal behavior in borderline personality disorder. J Pers Disord. 1994;8:257–267.

Styer D. M., Washburn J. J. Self-Injury in Students. Simple Answers to Complex Questions. Alexian Brothers Press, 1sth Ed, 2014.

Washburn JJ, Potthoff LM, Juzwin KR, Styer DM. Assessing DSM-5 nonsuicidal self-injury disorder in a clinical sample. Psychol Assess. 2015;27:31–41.

Whitlock J., Muehlenkamp J., Purington A., Eckenrode J., Barreira P., Baral Abrams G., Marchell T., Kress V., Girard K., Chin C., Knox K. Nonsuicidal self-injury in a college population: general trends and sex differences. J Am



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