Self-injury: Even little boys and girls do it

By ninth grade, 19% of girls -- almost one in five --own up to hurting themselves intentionally, mostly by cutting or carving their skin, but also by burning, biting, cutting or hitting themselves. Some report they will throw themselves against sharp objects or pull their own hair to cause pain.

That’s more than three times higher than the rate of self-injury among ninth grade boys.

But self-injurious behavior, which increasingly is seen as a silent cry of emotional pain, is not unique to teenage girls: 7.6% of third graders -- 8- and 9-year-old boys and girls -- also reported to researchers that they intentionally harm themselves. At third grade, boys were slightly more likely to report engaging in self-injurious behavior. About 60% of the 6.7% of boys who harm themselves report that they hit themselves.

Hospital emergency departments release some 60% of patients who show evidence of self-harming behavior without a psychiatric evaluation, reported the authors of the study, which appeared Monday in the journal Pediatrics. Researchers debate whether self-harming behavior is directly linked to later suicide attempts. But the psychiatric profession is set to adopt “non-suicidal self-injury” as a recognized mental disorder in its latest edition of the “diagnostic and statistic manual,” which guides psychiatrists in diagnosis and treatment.

The fact that “non-suicidal self-injury” is prevalent among a surprisingly large minority of kids, and because mental disturbance that begins in childhood is highly correlated with chronic obesity and substance abuse, “routine health examinations, including assessment of [non-suicidal self-injury] may be warranted,” the study authors concluded. Early identification of the behavior could help avert a lifetime of mental woes that can lead to suicide attempts, they added.

The study, conducted by a group of researchers from Rutgers University and University of Denver, also underscores that self-harm does not always appear as burn marks or scars on the arms or body. Boys, in particular, were far more likely to engage in self-injurious behaviors the consequences of which might be harder to detect, including hitting oneself.

That led the researchers to suggest that physicians or mental health professionals screening young people for self-injury should ask about such behaviors in more open-ended ways, rather than to limit their inquiries about cutting, carving, burning or hitting oneself.