Survey warns youth hurt themselves to deal with mental stress
A new Canadian study suggests a significant number of young people deliberately hurt themselves, not as an attempt at suicide but as a way of coping with mental stress.
Study co-author Dr. Mary K. Nixon said the survey of youth in Victoria, B.C., is fairly limited but the results underscore the need for a wider national look at what she says is a little understood problem.
"This is the first sort of true population-based survey we're aware of in North America, actually," said Nixon, a Victoria psychiatrist whose clinical practice includes children who "self-harm."
"Obviously it's only local so the need for a broader look at this problem, I think, is important."
The survey of Victoria youth aged 14 to 21 found 16.9 per cent of those interviewed — about one in six — reported self-harming behaviours, from cutting, scratching, hitting and burning to taking excessive amounts of medication or illegal drugs.
The study published Monday in the Canadian Medical Association Journal said 77 per cent of those who reported non-suicidal self-harm were female and 40 per cent admitted doing it more than three times.
The survey of 568 young people done in 2005 found most who admitted self-harm also reported depressive mood symptoms and other problems, and many had families with money problems.
"The results of our study suggest that non-suicidal self-harm is common," the report concluded.
The report's authors say their results jibe with similar surveys in North America and Europe, including two Canadian studies of students in big-city schools that found self-harm rates of 13.9 and 15 per cent.
They suggested, however, that the problem may be under-reported, either because surveyed teens had not yet tried it or were unwilling to admit doing it.
'Prevalent problem,' researchers say
Nixon said the mental health community has been aware of the problem for many years but the study warns that those dealing with kids should be vigilant for signs of self-harm.
While the research, carried out in conjunction with the University of Victoria and the Children's Hospital of Eastern Ontario, so far does not suggest it's increasing, this study hints at its scope.
"I think what we're finally doing is a study that's saying this is a prevalent problem," she said.
It's important to recognize that self-harm is not simply a way for kids to get attention, Nixon said.
"It's not necessarily either an acting-out behaviour of a misbehaving teenager," she said. "A lot of these kids clearly are having difficulties."
While many look for help or support from friends, most don't seek outside help for treatment, the study found.
Nixon, who heads the national research network for self-injury, said there's a vast knowledge gap not only about who is vulnerable to self-harm but also why such a "maladaptive coping mechanism" is attractive enough for some to do it repeatedly.
Self-injury potentially addictive
"This is where we want to do more research," she said."One of the things we want to look at is the reward system in the brain … In some of these people, where they do it repetitively, it does seem to have addictive potential.
"When you cut the skin you may induce pain initially … but the kids I see will report that it releases tension, it makes them feel something or it makes them feel numb. It could be many, many things."
Researchers speculate that self-injury may release natural opiates in the brain, the same kind of "feel-good" chemicals that drive fitness fanatics.
"One wonders if there's some kind of reinforcing mechanism at a biological level and we need to explore that, obviously," Nixon said.
She said that while some self-harming kids do build up to suicide attempts, many do not.
"Some kids will actually use non-suicidal self-harm as a means to manage their suicidal ideation (thinking) and prevent acting on suicide thoughts," she said. "Other individuals who do this don't experience any suicidal ideation whatsoever."