Biased reporting of past self-injurious thoughts and behaviors: A literature review

Accurate assessment of suicide risk is critical for clinical practice, empirical advances, and informing public policy. In this narrative review of the literature, we compiled evidence from longitudinal studies that identify reporting bias of past self-injurious thoughts and behaviors (SITB) and examined possible correlates of inconsistent reporting. We conducted an extensive literature search, including 19 longitudinal samples or subsamples who reported the presence of current or past SITB at an initial but not at a subsequent assessment (yes/no inconsistent reports). The median was 33%, and the weighted mean was 39% (95% CI, 37%–41%) for the prevalence of inconsistent reporting of SITB across the longitudinal samples. Importantly, inconsistent reports were linked with less internalizing psychopathology and more adaptive functioning. The type of sample recruited and assessment interval may also be relevant factors to consider. Variability of sample characteristics and methodology made it challenging to draw firm conclusions across studies but provide information about critical sources of bias. Results suggest considerable caution for clinical, empirical, and policy decision-making based on lifetime reports of suicide and encourage a continued consideration for identifying potential reporting biases for SITB. •Suicide assessments may include inconsistent reports of thoughts and behaviors.•Reviewing the literature we found prevalence of inconsistent reporting was 33%.•Inconsistent reports may be associated with adaptive functioning and less psychopathology.