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Instead of cutting, some teens insert objects in skin

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As many as 20% of adolescents and young adults are believed to intentionally injure themselves, usually by cutting, as a response to emotional pain or trauma. But the number of ways people self-injure seems to be growing, perhaps spurred by Internet communication.

One researcher has identified a new phenomenon he calls ‘self-embedding disorder.’ In a study presented today at the annual meeting of the Radiological Society of North America. Dr. William E. Shiels II says he has removed such items as unfolded paper clips, wood slivers, metal staples, needles, pencil lead and stones from the arms or legs of teenagers. An expert in extracting foreign objects from the body, Shiels described 19 episodes of self-embedding injury in 10 girls ages 15 to 18 and found some common characteristics. Ninety percent of the girls had self-injured before and most had attempted suicide or had thought about it. Forty percent had a history of sexual abuse. Most had other psychiatric disorders, such as bipolar disorder, depression, post-traumatic stress disorder or borderline personality.

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Self-injury often takes the form of cutting, burning, biting or hair pulling. However, Shiels warned his colleagues to look for mysterious wounds that don’t heal. Patients rarely admit that they’ve inserted objects into their skin, he says.

‘They come in with swelling and say they fell or something,’ said Shiels, chief of radiology at Nationwide Children’s Hospital in Columbus, Ohio, in an interview. ‘I have spoken to doctors at five different hospitals and every one of them has seen this, but they didn’t know what to call it.’

Shiels, who developed an expertise in removing foreign objects from the body while working at military hospitals, said more research is needed on why people self-injure and how to prevent and treat it. Parents and healthcare providers should be aware of the high rates of self-injury and that some children and teens are discussing it on the Internet. In one of his cases, he said, a girl was coached by another teenager through Internet communication on how to insert objects in the skin.

‘We need to interrupt this cycle of self-harm,’ he said. ‘But parents often don’t see the behavior evolving . . . Adolescence seems to be increasingly more difficult for some children to handle.’

The Los Angeles Times Health section will present an in-depth look at self-injury later this week online and on Monday in the Health section.

-- Shari Roan

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