This article is more than 5 years old. Information may no longer be current.
Self-injury rates in elementary school children comparable to those in adolescents
Click Here to Manage Email Alerts
Children in grade school engaged in nonsuicidal self-injury at a rate that is similar to early adolescents, according to national study results. The self-injury rate was especially high in girls.
“It is important for health care providers to recognize that younger youth, not mainly adolescents, can sometimes hurt themselves intentionally,” study researcher Andrea L. Barrocas, MA, told Healio.com. “However, adolescents engage in this behavior more frequently than younger youth, and of these adolescents, the majority are girls. We hope that pediatricians, who are often the first line of care for many youth, are aware of these statistics.”
Barrocas and researchers from the University of Denver and Rutgers University interviewed a nationally representative sample of 665 children and adolescents aged 7 to 16 years who were in the third, sixth and ninth grades. Nonsuicidal self-injury (NSSI) was measured using the Self-Injurious Thoughts and Behaviors Interview.
NSSI behaviors included:
- Cutting or carving skin.
- Hitting oneself.
- Inserting sharp objects into the skin or nails.
- Burning oneself.
- Picking one’s skin.
The researchers also used the Functional Assessment of Self-Mutilation to determine the purpose of participants’ self-injuries, and the Children’s Depression Inventory to determine whether youth who met the proposed DSM-5 criteria for NSSI had experienced increased distress. NSSI rates by gender and grade were determined by logistic regression analyses.
Results show that 8% of the participants reported engaging in NSSI. Nine percent of girls and 6.7% of boys reported NSSI engagement. Broken down by grade, 7.6% of third-graders, 4% of sixth-graders and 12.7% of ninth-graders engaged in NSSI. The association between gender and grade was significant, according to researchers, who found that girls in the ninth grade (19%) reported significantly greater rates of NSSI than boys (5%) in the same grade (OR=1.466). Girls also reported cutting and carving their skin most often vs. boys who reported hitting themselves more often. According to researchers, 1.5% of the participants met some of the proposed DSM-5 criteria for NSSI diagnosis.
“Knowing that a substantial percentage of youth overall report engaging in NSSI suggests it is a mental health outcome that needs medical evaluation, especially as NSSI might be a precursor for suicidal behavior,” the researchers wrote.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
Back to Top
Suzanne D. Dixon, MD, MPH
The report in Pediatrics on non-suicidal self injury in young children is a real wakeup. We are familiar as pediatricians with cutting and other self harm in the teenage population, but this paper brings these concerns to light in children as young as 7 years of age. We need to pay attention to behaviors such as cutting on oneself and repeatedly hitting oneself, even (and perhaps especially) when this is reported from our youngest patients.
This behavior has meaning as does all behavior in children, and these concerns need further exploration. It is telling us something we need to know, and children find it hard to express what's inside them. Even young children experience the stresses so common in their lives, such as divorce, economic hardship, domestic violence, bullying and exposure to the turmoil and violence in the world through media, in games and in person. It should be no surprise that these forces push kids hard enough to need to engage in self-injury behaviors. We need to follow these youngsters to see how these behaviors evolve over time. I would expect things would get worse without intervention.
Click Here to Manage Email Alerts