FFFSelf-Injury In Adolescents

No. 73; January 2019

Self-injury is the act of deliberately harming body tissue, at times to change a way of feeling. Self-injury is seen differently by groups and cultures within society. The behavior has become more popular lately, especially in adolescents. The causes and severity of self-injury can vary. Some forms may include:

  • Carving
  • Scratching
  • Branding
  • Marking
  • Picking and pulling skin and hair
  • Burning/abrasions
  • Cutting
  • Biting
  • Head banging
  • Bruising
  • Hitting
  • Tattooing
  • Excessive body piercing

Some adolescents may self-mutilate to take risks, rebel, reject their parents' values, state their individuality, or merely be accepted. Others may injure themselves out of desperation or anger to seek attention, to show their hopelessness and worthlessness, or because they have suicidal thoughts. These children may suffer from serious psychiatric problems such as depression, psychosis, posttraumatic stress disorder (PTSD), and bipolar disorder. Additionally, some adolescents who engage in self-injury may develop borderline personality disorder as adults. Some young children may resort to self-injurious acts from time to time but often grow out of it. Children with developmental delays and/or autism spectrum disorder as well as children who have been abused or abandoned may also show these behaviors.

Why do adolescents self-injure?
Self-injury is a complex behavior and symptom that results from a variety of factors. Adolescents who have difficulty talking about their feelings may show their emotional tension, physical discomfort, pain, and low self-esteem with self-injurious behaviors. Although some teenagers may feel like the steam in the pressure cooker has been released following the act of harming themselves, others may feel hurt, anger, fear, and hate. The effects of peer pressure and contagion can also influence adolescents to injure themselves. Even though fads come and go, most of the wounds on the adolescents' skin will be permanent. Occasionally, teenagers may hide their scars, burns, and bruises due to feeling embarrassed, rejected, or criticized about their physical appearance.

What can parents and teenagers do about self-injury?
Parents are encouraged to talk with their children about respecting and valuing their bodies. Parents should also serve as role models for their teenagers by not engaging in acts of self-harm. Some helpful ways for adolescents to avoid hurting themselves include learning to:

  • Accept reality and find ways to make the present moment more tolerable
  • Identify feelings and talk them out rather than act on them
  • Distract themselves from feelings of self-harm (for example, counting to ten, waiting 15 minutes, saying "No!" or "Stop!," practicing breathing exercises, journaling, drawing, thinking about positive images, using ice and rubber bands)
  • Stop, think, and evaluate the pros and cons of self-injury
  • Soothe themselves in a positive, non-injurious way
  • Practice positive stress management
  • Develop better social skills

Evaluation by a mental health professional may assist in identifying and treating the underlying causes of self-injury. Feelings of wanting to die or kill themselves are reasons for adolescents to seek professional care immediately. A child and adolescent psychiatrist can also diagnose and treat the serious psychiatric disorders that may accompany self-injurious behavior.


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The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 9,400 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

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