High rate of self-harm seen among college students

By Anne Harding

NEW YORK (Reuters Health) – One in six young adults have
injured themselves intentionally at least once, according to
the largest US survey to investigate the practice among college
students.

Self-injurious behavior can include scratching and pinching
oneself, cutting, swallowing poison and even breaking bones.
People who injure themselves say it helps relieve distress.

“It’s a harbinger of distress, in all likelihood, and
inability to cope positively,” Dr. Janis Whitlock of Cornell
University in Ithaca, New York, the study’s lead author, told
Reuters Health.

“There’s a fair degree of consensus that self-injury is
fundamentally self-medicative,” she added, noting that injuries
trigger the release of natural opiates known as endorphins,
resulting in an immediate sense of calm.

Whitlock and her colleagues surveyed 2,863 students at two
northeastern US universities, 17 percent of whom said they had
harmed themselves intentionally at least once. While there have
been numerous reports that self-injurious behavior is becoming
more common, Whitlock told Reuters Health, “I don’t think I
expected it to be quite that high.”

Most of the students who reported injuring themselves — 71
percent — said they had done so at least twice. On average,
they had injured themselves for the first time at age 15 or 16,
the team reports in the medical journal Pediatrics.

While 20 percent said they had injured themselves more
severely than they intended and should have gotten medical
help, just 3 percent of the self-injurers had told a physician.
Thirty-six percent said no one knew about their self-injurious
behavior.

Repeat self-injurers were more likely to be female,
bisexual or unsure of their sexual orientation, and were also
more likely to have been abused sexually or emotionally,
Whitlock and her colleagues found. They also were more likely
to have considered or attempted suicide and were more
psychologically distressed.

Given the reluctance of people who injure themselves to get
help, the researchers write, it is “critical” for health
professionals to find ways to recognize, treat and prevent
self-injury. Based on the findings, they add, medical and
mental health providers might make it standard practice to ask
their older adolescent and young adult patients about
self-injurious behaviors.

Signs that a young person may be harming themselves may
include dressing inappropriately for the season, for example
wearing long sleeves and long pants in the summer months, and
wearing adornments that cover the wrists, Whitlock said.

Parents who do discover that their child is injuring him or
herself should try not to react with “horror or incredulity,”
she added. “For a lot of self-injurers there is a high degree
of shame associated with the behavior, and that’s one of the
reasons why they’re so secretive. Adults need to sort of be
aware and know how to respond in a way that’s not judgmental or
reactionary.”

SOURCE: Pediatrics, June 2006.

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