Self Mutilation: A Teen Issue
Children as young as 7-years-old report cutting and burning themselves in non-suicidal self-injury or hurting oneself without the intent to die.
Children as young as 7-years-old report cutting and burning themselves in non-suicidal self-injury (NSSI), researchers reported.
The practice -- defined as hurting oneself without the intent to die -- has largely been studied in adolescents and young adults, according to Andrea Barrocas, MA, of the University of Denver, and colleagues.
But even in the third grade, a survey showed that nearly 8% of participants reported some form of NSSI, Barrocas and colleagues wrote in Pediatrics online.
In keeping with previous data on self-injury, the rates surged from childhood into adolescence, especially among girls, the researchers reported.
Understanding the issue, especially among children, is important because the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) may include a psychiatric diagnosis of NSSI, the authors noted.
To investigate, they recruited a community sample of third-, sixth- and ninth-graders, ages 7 to 16, and, using a structured clinical interview, asked if they had ever deliberately injured themselves and if so, how.
There were 665 study participants -- 366 girls and 299 boys -- comprised of 197 third-graders, 247 sixth- graders, and 221 ninth-graders. The majority (62.2%) were white and 77% reported living in two-parent households.
Overall, 8% of the 665 students said they had injured themselves over their lifetime. Based on the behavioral method in their lifetime, 45.3% of all respondents said they had cut themselves while 47.2% said they had hit themselves. A little over 13% said they had burned themselves and 15.1% reported sticking objects into their skin to cause pain.
The rates varied by grade and by sex, Barrocas and colleagues reported. Analyses revealed a significant interaction effect of grade by gender (P<0.001, odds ratio 1.466) on NSSI engagement.
Among third-graders, the rate for self-injury reports was 7.6%. Among those in grade six it was 4%, while among the ninth-graders it was 12.7%.
Among boys, rates of NSSI were roughly comparable from grade to grade and declined with increasing age: 8%, 7%, and 5% among the third-, sixth-, and ninth-graders, respectively.
But among the girls, the rates jumped sharply in grade nine to 18.9%, from 2.1% in grade six and 6.8% in grade three (P=0.002), they reported.
"Ninth-grade girls seem most at risk, as they engage in NSSI at three times the rate of boys," the authors stated.
Methods of self-injury also varied by sex and grade, the researchers found. Specifically:
- Most girls who reported self-injury (63.6%) said they cut or carved their skin.
- Among boys who reported self-injury, 55% said they hit themselves.
- Among the third and sixth graders who reported the practice, 60% and 50%, respectively, said they hit themselves.
- Among ninth graders, 70.4% reported cutting and carving skin.
- Overall, 18.9% reported using other methods, such as biting, pulling hair, running into walls, and throwing themselves into sharp objects.
Although the adolescents in the group (ninth grade) reported higher lifetime rates of NSSI, the take-home message is that younger children also engage in the behavior, Barrocas and colleagues commented.
They cautioned that only 8% of the participants reported NSSI, so that the findings should be replicated in larger samples. As well, the low base rate suggests that differences by sex should be interpreted with caution, they said.
Barrocas and colleagues also noted that they combined participants who reported multiple occasions of self-injury with those who reported a single instance.
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