SAN DIEGO – About 11% of ninth graders reported acts of deliberate self-harm in the form of cutting or burning themselves one to three times in the previous year, while an additional 4% reported performing such behavior more than four times in the previous year, results from a large German study show.
In addition, girls were more likely than boys to perform acts of deliberate self-harm, Dr. Romuald Brunner reported during a poster session at the annual meeting of the American Academy of Child and Adolescent Psychiatry.
The study also found that young people who performed acts of deliberate self-harm scored significantly higher on the Youth Self Report subscales of somatic complaints; anxiety and depressive symptoms; and delinquent behavior, compared with their counterparts who did not report committing self-harm.
“The adolescents who practice deliberate self-harm only a few times a year have emotional and behavior problems,” Dr. Brunner said in an interview. “It suggests that we can rule out [self-harm] as a phenomenon of fashion. It's really linked to emotional problems.”
In what he said is the largest study of its kind, he and his associates performed a cross-sectional survey of 5,759 ninth graders in the Rhein-Neckar area in Germany between October 2005 and January 2006. Their mean age was 15 years, and half were female.
To assess the frequency of self-harm, the researchers administered parts of the German version of the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Occasional deliberate self-harm was defined as performing self-mutilative acts by cutting or burning themselves one to three times in the previous year. The repetitive deliberate form was defined as performing such behavior four or more times in the previous year.
The Youth Self Report was used to assess respondents' emotional and behavioral disturbances.
Of the 5,759 students, 630 (10.9%) reported occasional forms of deliberate self-harm in the previous year, while an additional 229 (4.0%) reported repetitive forms of deliberate self-harm.
Compared with boys, girls were 1.60 times more likely to report occasional forms of deliberate self-harm and 2.64 times more likely to report repetitive forms of deliberate self-harm.
The major forms of emotional problems linked to deliberate self-harm on the Youth Self Report were somatoform problems; anxiety and depressive symptoms; and delinquent behavior. The ninth graders who performed self-injurious behavior “demonstrate externalizing problems and internalizing problems,” said Dr. Brunner, of the center for psychosocial medicine in the department of child and adolescent psychiatry at the University of Heidelberg, Mannheim, Germany. “It's an interesting finding.”
He and his associates also observed a significant correlation between cigarette smoking and the risk of deliberate self-harm in girls but not in boys.
“There's no link between smoking in male adolescents and self-injurious behavior,” he said.
“Smoking in girls has another meaning. Perhaps it's linked to a higher grade of impulsive behavior. Girls with a more impulsive style are more prone to smoke,” he added.
Dr. Brunner also reported that most of the adolescents who reported taking drugs did not practice self-harming behavior.
“They regulate their emotion in other [ways], but they don't use this form,” he said. “This was a very surprising finding.”
'We can rule out [self-harm] as a phenomenon of fashion. It's really linked to emotional problems.' DR. BRUNNER