High rate of self-harm seen among college students

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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