ArticleBJPsych open2020
Measuring outcomes in trials of interventions for people who self-harm: qualitative study of service users' views.
Article in BJPsych open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 8 syntheses or guidelines pooled it.
- Reducing self-harm in adolescents: the RISA-IPD comprehensive synopsis.Health technology assessment (Winchester, England) · 2026Pooled it
- Psychosocial interventions for self-harm and suicide prevention in liaison psychiatry: an overview of systematic reviews.BMC psychiatry · 2025Pooled it
- Professionals' attitudes towards people with intellectual disabilities who self-harm: A literature review.Journal of intellectual disabilities : JOID · 2022Pooled it
- Adapting a codesign process with young people to prioritize outcomes for a systematic review of interventions to prevent self-harm and suicide.Health expectations : an international journal of public participation in health care and health policy · 2022Pooled it
- Non-restrictive interventions to reduce self-harm amongst children in mental health inpatient settings: Systematic review and narrative synthesis.International journal of mental health nursing · 2022Pooled it
- Psychosocial interventions for self-harm in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Interventions for self-harm in children and adolescents.The Cochrane database of systematic reviews · 2021Pooled it
- Pharmacological interventions for self-harm in adults.The Cochrane database of systematic reviews · 2021Pooled it
- Trial
- Umbrella review of psychosocial and ward-based interventions to reduce self-harm and suicide risks in in-patient mental health settings.BJPsych open · 2025Review
- Article
- Is a smartphone application (BlueIce) acceptable and safe for university students who self-harm: an open study.BMJ open · 2024Article
- Transition to suicide ideation and attempt among emergency room patients.BJPsych open · 2024Article
- Young adults looking back at their experiences of treatment and care for nonsuicidal self-injury during adolescence: a qualitative study.Child and adolescent psychiatry and mental health · 2024Article
- Psychotherapeutic approaches: hopefully, globally effective.Frontiers in psychiatry · 2024Article
- Self-Injurious Behavior in Child and Adolescent Psychiatry Inpatient Units: Actual Aspects of the Complex Care Provision.Acta medica Lituanic · 2024Article
- Evaluation of a national clinical programme for the management of self-harm in hospital emergency departments: impact on patient outcomes and the provision of care.BMC psychiatry · 2023Article
- Developing Suicide Prevention Tools in the Context of Digital Peer Support: Qualitative Analysis of a Workshop With Multidisciplinary Stakeholders.JMIR formative research · 2023Article
- "Frontiers in psychiatry · 2022Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundPatients often have very different ideas from clinicians about what they want treatments to achieve. Their views on what outcomes are important are not always reflected in trials.
aimsTo elicit the views of people who self-harm on the most commonly used outcome measures and to identify the outcomes that matter to them.
methodWe conducted in-depth interviews with 18 people with histories of self-harm, recruited from hospital and community settings. We conducted thematic analysis using a framework approach and used visual mapping to arrive at our final analysis and interpretation.
resultsParticipants' accounts contained a number of challenges to the validity and meaningfulness of current trial outcome measures. Five broad issues emerged: (a) relationship between frequency and severity of self-harm; (b) behavioural substitution; (b) self-management skills; (d) the role of self-harm as survival tool and affect regulator, and (e) strategic self-presentation. We show how these affect the visibility and measurability of commonly used outcomes. The outcomes that mattered to participants focused on positive achievements in three domains: (a) general functioning and activities of everyday living; (b) social participation, and (c) engagement with services. Participants conceptualised these as both measures and means of sustained improvement.
conclusionsOur findings suggest that current self-harm trial science rests on flawed assumptions about the relationship between mental states and behaviours and about our ability to measure both. Greater understanding of the outcomes that matter to people who self-harm is needed to inform both intervention development and trial design.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.