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Call it "self-injury," call it "cutting," but doctors need to recognize it

May 25, 2010 |  4:16 pm

Xray Known as "self-injury," "self-mutilation" or the more direct and simple "cutting," the act of deliberately and physically hurting oneself is surprisingly common and surprisingly varied. And, as such, it needs to be better detected.

So says a Cornell University researcher exploring the phenomenon in a paper published Tuesday in the journal PLoS Medicine.

An estimated 12% to 37% of youths in secondary school are believed to have hurt themselves in such a fashion; 6% to 7% of adolescents say they do it regularly. And though  the behavior isn't intended to be suicidal, the distress that provokes it can ultimately lead to suicide or suicidal thoughts. Further, the actions themselves can lead to accidental suicide.

Paper author Janis Whitlock explores the prevalence of self-injury, the reasons for the behavior, its (still somewhat muddy) connection to suicide, its potential for contagion, the treatments -- and the signs.

She writes in conclusion:

"Because [non-suicidal self-injury] research is nascent, unanswered research questions abound. Those most pressing for clinicians and allied medical health professionals include (a) discerning individuals with [non-suicidal self-injury] history at elevated risk for suicide from those not at elevated risk, (b) effective treatment regimes, (c) effective prevention strategies in school and community settings, and (d) assessment and referral protocols likely to result in effective treatment and abatement of [non-suicidal self-injury] behavior."

We apparently have a long way to go.

Here, staff writer Shari Roan details one radiologist's X-ray evidence of a particular form of self-injury known as embedding: Turning the hurt toward the self

There are many types of self-injury; cutting is but one. Helpguide.org offers this self-injury explainer, with resources. It states (and is worth repeating):

"The person who self-injures may not recognize the connection, but this act usually occurs after an overwhelming or distressing experience and is a result of not having learned how to identify or express difficult feelings in a healthy way."

The paper offers a place for clinicians to start. The Helpguide page is a place for parents and teenagers to start.

-- Tami Dennis

Photo: An X-ray reveals metal pieces in a teenage girl's wrist, left there in a form of self-injury known as embedding. (Here's the accompanying article.)

Credit: Dr. William E. Shiels II

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