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While association between alcohol consumption and harm is assessed mainly by individual-level data, aggregate time series data sometimes provide a feasible alternative.
This makes clear that harms are assessed relative to some baseline.
Suicide and self-harm are assessed with the Suicide and Self-Harm Inventory (SSHI) [ 3].
Cannabis related harms are assessed using a set of questions adapted from the Adolescent Cannabis Problems Questionnaire [ 50].
Self-harm was assessed by two questions taken from the Avon Longitudinal Study of Parents and Children (ALSPAC) study (Life of a teenager 16+ assessment; (see http://www.alspac.bris.ac.uk).ac.uk
These differences may be due to the way self-harm was assessed since single item measures tend to produce lower rates than multiple item questionnaires [ 32].
For each clinical intervention under study, the balance of benefits and harms is assessed, and a grade of recommendation is classified as strong or weak.
12 Furthermore, studies reporting harms were assessed using the 15-item McMaster Quality Assessment Scale of Harms (McHarm) tool, 13 which focuses on how harms are defined, collected and reported.
Self-harm was assessed using the Self-Harm Behavior Questionnaire (SHBQ) [ 37], which is a self-report measure to assess the lifetime prevalence of self-harming behaviours including NSSI ('Have you ever hurt yourself on purpose?
Self-harm was assessed using the following question: 'In the last [reference period], have you ever deliberately hurt yourself or done anything that you knew might have harmed you or even killed you?' The reference period was the past year for wave 3 and 4 and past 6 months for the remaining waves.
33 Furthermore, it has been recommended that the intent to harm another by the perpetrator and the report of harm by the victim are assessed at the same time.
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