Revising the Self-Harm Antipathy Scale: validation among staff in psychiatric healthcare in Sweden

Figures & data

Table 1. Participant and population characteristics.

	Sample		Study population*
Variable (n missing)	n	%	n	%
Gender (3)
Woman	440	73.8	2589	72.9
Man	150	25.2	964	27.1
Other	3	0.5	–	–
Age (3)
≤30	67	11.2	536	15.1
31–50	279	46.8	1594	44.9
≥51	247	41.4	1423	40.1
Post-secondary education (11)
No	107	18.0	1424	40.1
Yes	478	80.2	2087	58.7
Main area of work (18)
Outpatient	288	48.3	1605	45.2
Inpatient	223	37.4	1488	41.9
Both of the above	39	6.5	131	3.7
Neither of the above	28	4.7	329	9.3
Work location (9)
Helsingborg	92	15.4	616	17.3
Kristianstad	90	15.1	600	16.9
Lund	171	28.7	787	22.2
Malmo	221	37.1	1235	34.8
Other	13	2.2	315	8.9
Work experience: years within psychiatry (7)
≤10	262	44.0	–	–
11-20	154	25.8	–	–
21–30	65	10.9	–	–
31–40	78	13.1	–	–
≥41	30	5.0	–	–
Self-harm training (8)
No	400	67.1	–	–
Yes	188	31.5	–	–
Work encounters with individuals who self-harm (7)
Never	35	5.9	–	–
A few times per month	191	32.0	–	–
Every week	237	39.8	–	–
Daily	91	15.3	–	–
Several times per day	35	5.9	–	–

*These numbers are slightly distorted, as some individuals have multiple registrations. Dashes indicate that no information was retrievable.

Table 2. Item analysis.

Item number	Item mean	Item SD	Corrected item-total correlation
1	2.44	1.53	0.46
2	6.11	1.39	0.02
3	2.86	1.94	0.35
4	2.05	1.52	0.49
5	1.80	1.21	0.55
6	1.79	1.16	0.46
7	1.31	0.95	0.42
8	3.99	2.08	0.21
9	1.69	1.34	0.35
10	1.55	1.34	0.34
11	1.38	0.97	0.28
12	2.85	1.76	0.38
13	1.52	1.13	0.42
14	2.47	1.47	0.33
15	1.93	1.22	0.52
16	1.56	1.24	0.39
17	1.84	1.31	0.43
18	1.98	1.37	0.51
19	1.54	1.16	0.59
20	1.77	1.17	0.61
21	2.36	1.57	0.41
22	1.95	1.35	0.48
23	1.87	1.19	0.63
24	2.00	1.24	0.55
25	2.24	1.55	0.05
26	2.13	1.45	0.58
27	3.11	1.81	0.63
28	3.44	1.50	0.48
29	1.87	1.43	0.32
30	2.55	1.50	0.50

SD: standard deviation.

Table 3. Item factor loadings for the exploratory factor analysis.

Item	Factor I	Factor II	Factor III
24. I help self-harming clients feel positive about themselves*	0.80
23. I demonstrate warmth and understanding to self-harming clients in my care*	0.74
30. I am highly supportive to clients who self-harm*	0.74
20. I listen fully to self-harming clients’ problems and experiences*	0.67
27. I find it rewarding to care for self-harming clients*	0.66
28. I can really help self-harming clients*	0.66
26. I acknowledge self-harming clients’ qualities*	0.57
21. I feel concern for the self-harming client*	0.47
19. A self-harming client deserves the highest standards of care on every occasion*	0.47
25. I feel to blame when my clients self-harm	0.16
5. When individuals self-harm, it is often to manipulate carers		0.74
15. A self-harming client is a person who is only trying to get attention		0.72
1. People who self-harm are usually trying to get sympathy from others		0.66
6. People who self-harm are typically trying to get even with someone		0.66
9. Self-harm is a serious moral wrongdoing		0.53
7. A self-harming client is a complete waste of time		0.53
4. Self-harming clients do not respond to care		0.52
22. I feel critical towards self-harming clients		0.46
11. People who self-harm lack solid religious convictions		0.45
16. Self-harming clients have only themselves to blame for their situation		0.44
29. I would feel ashamed if a member of my family engaged in self-harm		0.44
10. There is no way of reducing self-harm behaviours		0.33
12. Self-harm may be a form of reassurance for the individual that they are really alive and human*			0.62
8. An individual has the right to self-harm			0.61
17. For some individuals self-harm can be a way of relieving tension*			0.61
18. Self-harming clients have a great need for acceptance and understanding*			0.54
13. Self-harming individuals can learn new ways of coping*			0.53
14. Acts of self-harm are a form of communication to their situation*			0.50
3. A rational person can self-harm*			0.46
2. People should be allowed to self-harm in a safe environment			0.26

^* Statements have been reverse scored. Items below cut-off are in bold type.

Table 4. Item factor loadings for the confirmatory factor analysis based on the EFA model (SHAS-SR-17).

Item	Factor I	Factor II	Factor III
23. I demonstrate warmth and understanding to self-harming clients in my care*	0.76
20. I listen fully to self-harming clients’ problems and experiences*	0.71
26. I acknowledge self-harming clients’ qualities*	0.68
27. I find it rewarding to care for self-harming clients*	0.65
21. I feel concern for the self-harming client*	0.51
5. When individuals self-harm, it is often to manipulate carers		0.78
15. A self-harming client is a person who is only trying to get attention		0.73
6. People who self-harm are typically trying to get even with someone		0.64
1. People who self-harm are usually trying to get sympathy from others		0.64
7. A self-harming client is a complete waste of time		0.47
16. Self-harming clients have only themselves to blame for their situation		0.43
9. Self-harm is a serious moral wrongdoing		0.42
18. Self-harming clients have a great need for acceptance and understanding*			0.70
17. For some individuals self-harm can be a way of relieving tension*			0.67
13. Self-harming individuals can learn new ways of coping*			0.58
14. Acts of self-harm are a form of communication to their situation*			0.53
12. Self-harm may be a form of reassurance for the individual that they are really alive and human*			0.51

^* Statements have been reverse scored.

Table 5. Item factor loadings for the confirmatory factor analysis based on the six-factor model (SHAS-SR-19)**.

Item	Factor I	Factor II	Factor III	Factor IV	Factor V
21. I feel concern for the self-harming client*	0.87
28. I can really help self-harming clients*	0.85
30. I am highly supportive to clients who self-harm*	0.77
26. I acknowledge self-harming clients’ qualities*	0.77
20. I listen fully to self-harming clients’ problems and experiences*	0.68
23. I demonstrate warmth and understanding to self-harming clients in my care*	0.63
10. There is no way of reducing self-harm behaviours		0.91
9. Self-harm is a serious moral wrongdoing		0.91
16. Self-harming clients have only themselves to blame for their situation		0.88
7. A self-harming client is a complete waste of time		0.85
4. Self-harming clients do not respond to care		0.81
6. People who self-harm are typically trying to get even with someone			0.76
1. People who self-harm are usually trying to get sympathy from others			0.75
15. A self-harming client is a person who is only trying to get attention			0.69
5. When individuals self-harm, it is often to manipulate carers			0.62
17. For some individuals self-harm can be a way of relieving tension*				0.76
18. Self-harming clients have a great need for acceptance and understanding*				0.66
12. Self-harm may be a form of reassurance for the individual that they are really alive and human*					0.78
14. Acts of self-harm are a form of communication to their situation*					0.76

^* Statements that have been reverse scored.

^** The presented factor solution is based on the six-factor model of the original SHAS, but was trimmed down to a five-factor solution adjusting for the results of the first CFA.

Table 6. Subscale and wholescale means, SDs and internal consistency for SHAS-SR-17.

Scale level	Mean	SD	Cronbach’s α	McDonald’s Ω
Sympathy and Dedication	11.24	5.30	0.79	0.78
Judgement	12.53	5.71	0.78	0.79
Acceptance and Understanding	10.67	4.92	0.73	0.78
SHAS-SR-17	34.44	12.67	0.86	0.85

SD: standard deviation.

Table 7. Subscale and wholescale means, SDs and internal consistency for SHAS-SR-19.

Scale level	Mean	SD	Cronbach’s α	McDonald’s Ω
Competence Appraisal	14.11	5.87	0.79	0.79
Care Futility	8.16	4.00	0.60	0.61
Client Intent/Manipulation	7.97	4.04	0.79	0.79
Acceptance and Understanding	3.82	2.32	0.66	0.66
Needs Function	5.32	2.71	0.57	0.59
SHAS-SR-19	39.38	13.78	0.86	0.88

SD: standard deviation.