Validation and Assessment of the Self-Injurious Behavior Scale for Tic Disorders (SIBS-T)

Abstract

Background: self-injurious behavior (SIB) is a well-known phenomenon in patients with
chronic tic disorders (CTD). To investigate prospectively symptomatology, frequency, and
associated symptoms/phenomena of SIB in adults with CTD, we developed and validated the
Self-Injurious Behaviour Scale (SIBS).

Methods: we performed an online survey using SoSciSurvey. Patients completed the SIBS
and a variety of assessments for tics and comorbidities. We investigated SIB frequency, internal consistency of the SIBS, and carried out an exploratory factor analysis (EFA).

Results: We enrolled n=123 adult patients with CTD (n=82 males (66.7%), mean age =36.5
(SD=14.18)). SIB was reported by n=103 patients (83.7%) as assessed by SIBS with a mean
age at onset of 15.2 years (SD=8.46). The most frequently reported SIB were
beating/pushing/throwing and were found in 79.6% of cases. Patients with SIB had significantly higher tic severity measured with the Adult Tic Questionnaire (ATQ) (p=0.002, d=0.78) as well as higher severity of psychiatric comorbidities such as obsessive-compulsive symptoms (OCS) (p<0.001, d=0.51), attention deficit/hyperactivity disorder (ADHD) (p<0.001, d=0.86), and anxiety (p=0.001, d=0.74). In addition, patients with SIB had significantly lower quality of life (p=0.002, d=0.76). Pearson correlations demonstrated significant associations between SIB and severity of tics (p<0.001, r=0.35), depression (p=0.005, r=0.28), ADHD (p=0.008, r=0.26), and borderline personality traits (p=0.014, r=0.24). Consequently, higher SIBS also correlated with greater impairment of quality of life (p<0.001, r=0.40). The internal consistency of the SIBS was good (α = 0.88). The EFA confirmed a single factor underlying the SIBS.

Conclusions: SIB is a common comorbidity in patients with CTD and occurs in more than 80%
of patients. From our data, it is suggested that SIB are a subtype of complex tics rather than
OCS. The SIBS showed good internal consistency and construct validity and is the first self assessment that can be used to measure SIB in patients with CTD.

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