j_sjcapp-2014-003_tab_003
| Cut yourself (cutting) | Yes | No |
| Burned yourself | Yes | No |
| Scratched yourself | Yes | No |
| Hit yourself | Yes | No |
| Other | ______________________________________________________ | |
j_sjcapp-2014-003_tab_004
| Once | 1-5 times | 6-20 times | b20 times |
j_sjcapp-2014-003_tab_005
| Have you ever deliberately starved yourself and/or deliberately vomited when having eaten too much? | Yes | No |
| Have you ever drunk so much alcohol that you blacked out? | Yes | No |
| Have you ever taken drugs (amphetamine, LSD, heroin, or the like)? | Yes | No |
j_sjcapp-2014-003_tab_001
| Sex | Male | Â | Female | (put a mark) |
| Grade | 1.g | 2.g | 3.g | Â |
j_sjcapp-2014-003_tab_002
| Â | Yes | No |