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Teen Cutting, Self-harm, Self-injury (SI)

Self-injury (SI), Cutting, Self-harm Overview

Self-harm refers to a person's harming their own body on purpose. Other terms for self-harm are "self-abuse" or "cutting." Overall, a person who self-harms does not mean to kill himself or herself. Self-harm tends to begin in teen or early adult years. Some people may engage in self-harm a few times and then stop. Others engage in it more often and have trouble stopping the behavior. Self-harm is related to trauma in that those who self-harm are likely to have been abused in childhood.

How Common is Self-Harm/Cutting? << back to top
The rates of self-harm vary widely, depending on how researchers pose their questions about it. It is estimated that in the general public, 2% to 6% engage in self-harm at some point in their lives. Among students, the rates are higher, ranging from 13% to 35%. Rates of self-harm are also higher among those in treatment for mental health problems. Those in treatment who have a diagnosis of Post Traumatic Stress Disorder (PTSD) are more likely to engage in self-harm than those without PTSD.

Characteristics of Self-Harmers/Cutters << back to top
A systematic review of the literature on correlates of self-harm found that self-harmers, as compared to others, have more frequent and more negative emotions such as anxiety, depression, and aggressiveness. Links between self-harm and dissociation, low emotional expressivity, and low self-esteem have also been found. The evidence on whether self-harm is more common in females or males is mixed. Individuals who self-harm appear to have higher rates of PTSD and other psychological problems.

Self-harm may be most often related to trauma exposure in childhood rather than adulthood. A number of studies have found that individuals who engage in self-harm report unusually high rates of histories of:

• Childhood sexual abuse
• Childhood physical abuse
• Emotional neglect
• Insecure attachment
• Prolonged separation from caregivers

Childhood sexual abuse appears especially frequently in the histories of those who self-harm. In one sample of individuals who self-harmed, 93% reported a history of childhood sexual abuse. Some research has looked at whether particular characteristics of childhood sexual abuse place individuals at greater risk for engaging in self-harm as adults. More severe, more frequent, or a longer duration of sexual abuse was associated with an increased risk of engaging in self-harm in one's adult years .

Why do People Engage in Cutting/Self-Injury? << back to top
While there are many theories about why individuals harm themselves, the answer to this question may vary from individual to individual. One study specifically examined the reasons given for the behavior in a sample of self-harmers. The top two reasons were "To distract yourself from painful feelings" and "To punish yourself." When factor analysis was applied the responses, nine factors were found:

• Decrease dissociative symptoms, especially depersonalization and numbing
• Reduce stress and tension
• Block upsetting memories and flashbacks
• Demonstrate a need for help
• Ensure safety and self-protection
• Express and release distress
• Reduce anger
• Disfigure self as punishment
• Hurt self in lieu of others

Treatment for Cutting, Self Harm, Self Injury << back to top
Self-harm is a problem that many people are embarrassed or ashamed to discuss. Often, individuals try to hide their self-harm behaviors and are very reluctant to seek needed psychological or even medical treatment.

Psychological Treatments

Because self-harm is often associated with other psychological problems, it tends to be treated under the umbrella of a co-occurring disorder like PTSD, substance abuse, or borderline personality disorder. There is evidence, however, suggesting more improvement when the self-harming behavior is the primary focus of treatment. A randomized controlled trial looked at the effects of adding a short cognitive behavioral therapy (CBT) intervention focused on self-harm to treatment as usual in a sample of self-harmers. Treatment as usual included medications or psychotherapy not specific to self-harm. The group that received the self-harm CBT showed a significant reduction in self-harming behaviors, as compared to the group receiving only treatment as usual (12).

Pharmacological Treatments
It is possible that psychopharmacological treatments would be helpful in reducing self-harm behaviors, but this has not yet been rigorously studied. As yet, there is no consensus regarding whether or not psychiatric medications should be used in relation to self-harm behaviors. This is a complicated issue to study because self-harm can occur in many different populations and co-occur with many different kinds.

Most people with deep emotional pain or distress need to work with a counselor or mental health professional to sort through strong feelings, heal past hurts, and to learn better ways to cope with life's stresses. Although cutting can be a difficult pattern to break, it is possible. Getting professional help to overcome the problem doesn't mean that a person is weak or crazy.

Individuals who carry out self inflicted violence often go to extreme lengths to prevent family and friends from discovering their secret. Being vigilant can often uncover early signs that may require further investigation, such as:

• Family members telling you that they are finding razors or knives in strange locations
• Evidence that friends are self-mutilating
• Regularly locking themselves away for long periods in their room or the bathroom
• A reduced social circle or reluctance to attend social events
• Finding sharp objects hidden in the bedroom
• A reluctance to wear clothes such as short-sleeved shirts or shorts
• The appearance of an abnormal number of bruises or scars.

If you discover that your loved one has been self-cutting or otherwise self-mutilating try hard to hide any feelings of disgust. Individuals who self-mutilate often have very low self-esteem. Reacting with horror is likely to exacerbate their low self-image.

Content compiled above is intended for informational use only and it does not endorse or recommend services available in this site.

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What is Cutting/Self-injury (SI)?
How Common is Cutting/Self-harm?
Characteristics of Self-harmers/ Cutters
Why do People Engage in Cutting/Self-injury?
Treatment for Cutting, Self Harm, Self Injury

Help for Teens Who are Cutting
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