While most of us hate it when we slice our finger or accidentally cut ourselves with something sharp, there are children – as young as seven years old- that are deliberately cutting themselves as a way to cope with emotional pain.
A recent study based in Denver and central New Jersey, examined self-injury in young children. Although the study was small, researchers and independent experts say the results are credible and should raise awareness about a disturbing problem.
Benjamin Hankin , was the lead researcher and an associate psychology professor at the University of Denver.
The study involved 665 kids, including 197 third-graders, and was published online Monday in the journal Pediatrics. The researchers had local schools send letters to families requesting that their children participate in the study. About two-thirds of families agreed; there were no differences among those who chose not to participate that might skew the results, Harkin said.
Overall, almost 8 percent of the third-graders, or 15 kids, said they had ever intentionally hurt themselves by cutting, burning or poking their skin with sharp objects, hitting themselves, or other methods. These children included eight year-olds and some as young as seven. About two-thirds of the children had done it more than once.
Many kids, even the youngest ones, find that causing physical pain helps them cope with emotional stress, Hankin said. Some researchers believe physical pain releases feel-good hormones called endorphins that can be calming.
There is no one reason why children cut themselves, and the reasons why the children who participated in the study cut themselves were not included in the report. But experts say children and adolescents are trying to get rid of stress and anxiety. Self-injurers report that they feel empty inside, over or under stimulated, unable to express their feelings, not understood by others, have been bullied, and are fearful of relationships.
Self injury includes: 1) cutting; 2) scratching: 3) picking scabs or interfering with wound healing; 4) burning; 5) punching self or objects; 6) infecting oneself; 7) inserting objects in body openings; 8) bruising or breaking bones; 9) some forms of hair pulling, as well as other various forms of bodily harm. The behaviors, which pose serious risks, may be symptoms of a mental health problem that can be treated.
The diagnosis for mental health problems should be determined by a licensed psychiatric professional. There are treatments for self-injurers and include both outpatient and inpatient options. Medications and cognitive/ behavioral therapies are often recommended.
Among older children studied, 4 percent of sixth-graders and almost 13 percent of ninth-graders said they had self-injured — rates consistent with those seen in other studies.
The rate among third-graders echoes observations made by elementary school teachers, and similar numbers of older kids in other studies have said that they started before the age of 10, said Cornell University researcher Janis Whitlock. She was not involved in the current research.
Among older kids, those who hurt themselves are at risk for suicide attempts, although most self-injuring kids don't cause serious harm, said Wendy Lader, president of a St. Louis-based treatment center and clearinghouse for self-injury information.
Children with autism or a major psychiatric disorder that might feature self-injury were excluded from the study.
The children studied were racially and ethnically similar to the general U.S. population, but the study wasn't nationally representative. Similar results were found in both locations, which strengthened the findings, Hankin said.
David Rosen, MD, MPH, is professor of pediatrics at the University of Michigan and director of the Section for Teenage and Young Adult Health at the University of Michigan Health Systems in Ann Arbor.
He offers parents these tips on what to watch for:
- Small, linear cuts. "The most typical cuts are very linear, straight line, often parallel like railroad ties carved into forearm, the upper arm, sometimes the legs," Rosen tells WebMD. "Some people cut words into themselves. If they're having body image issues, they may cut the word 'fat.' If they're having trouble at school, it may be 'stupid,' 'loser,' 'failure,' or a big 'L.' Those are the things we see pretty regularly."
- Unexplained cuts and scratches, particularly when they appear regularly. "I wish I had a nickel for every time someone says, 'The cat did it,'" says Rosen.
- Mood changes like depression or anxiety, out-of-control behavior, changes in relationships, communication, and school performance. Kids who are unable to manage day-to-day stresses of life are vulnerable to cutting, says Rosen.
As a parent, we don’t want to see our child suffer or hurt his or her self, but many parents are simply unaware of “cutting” and what it’s all about. If you’d like to learn more about children and self-injury there are many good articles on the web. You can also talk to your pediatrician. One online resource is: www.kidshelp.com.