SELF-INJURY IN ADOLESCENTS
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  1. Children and Divorce
  2. Teenagers with Eating Disorders
  3. Teens: Alcohol and Other Drugs
  4. The Depressed Child
  5. Child Abuse - The Hidden Bruises
  6. Children Who Can't Pay Attention
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  10. Teen Suicide
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  18. Bedwetting
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  20. Making Day Care a Good Experience
  21. Psychiatric Medication for Children and Adolescents Part I: How Medications Are Used
  22. Normality
  23. Mental Retardation
  24. Know When to Seek Help for Your Child
  25. Who can be contacted to seek Help for Your Child
  26. Know Your Health Insurance Benefits
  27. Stepfamily Problems
  28. Responding to Child Sexual Abuse
  29. Psychiatric Medication for Children and Adolescents Part II: Types of Medications
  30. Children and AIDS
  31. When Children Have Children
  32. 11 Questions to Ask Before Psychiatric Hospital Treatment of Children and Adolescents
  33. Conduct Disorders
  34. Children's Sleep Problems
  35. Tic Disorders
  36. Helping Children After a Disaster
  37. Children and Firearms
  38. Bipolar Disorder (Manic-Depressive Illness) in Teens
  39. Children of Parents with Mental Illness
  40. The Influence of Music and Music Videos
  41. Substance Abuse Treatment for Children and Adolescents: Questions to Ask
  42. The Continuum of Care
  43. Discipline
  44. Children and Lying
  45. Lead Exposure
  46. Home Alone Children
  47. The Anxious Child
  48. Problems with Soiling and Bowel Control
  49. Schizophrenia in Children
  50. Panic Disorder in Children and Adolescents
  51. Psychiatric Medications for Children and Adolescents Part III: Questions to Ask
  52. Comprehensive Psychiatric Evaluation
  53. What is Psychotherapy For Children and Adolescents?
  54. Children and Watching TV
  55. Understanding Violent Behavior in Children & Adolescents
  56. Parenting: Preparing for Adolescence
  57. Normal Adolescent Development - Middle School and Early High School Years
  58. Normal Adolescent Development - Late High School Years and Beyond
  59. Children Online
  60. Obsessive-Compulsive Disorder in Children and Adolescents
  61. Children and Sports
  62. Talking to Your Kids About Sex
  63. Gay And Lesbian Adolescents
  64. Foster Care
  65. Children's Threats: When are they serious? 
  66. Helping Teenagers with Stress
  67. Children and The News
  68. Tobacco and Kids
  69. Asperger's Disorder
  70. Posttraumatic Stress Disorder (PTSD)
  71. Multiracial Children
  72. Children with Oppositional Defiant Disorder
  73. Self-Injury in Adolescents
  74. Advocating for Your Child
  75. Pets and Children
  76. Helping Your Teen Become a Safe Driver
  77. Grandparents Raising Grandchildren
  78. When a Pet Dies
  79. Obesity in Children and Teens
  80. Bullying #80
SELF-INJURY IN ADOLESCENTS

Self-injury is the act of deliberately destroying body tissue, at times to change a way of feeling. Self-injury is seen differently by groups and cultures within society. This appears to have 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, however, 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 mental retardation and/or autism may also show these behaviors which may persist into adulthood. Children who have been abused or abandoned may self-mutilate.

Why do adolescents self-injure?
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 they may feel like the "steam" in the "pressure cooker" has been released following the act of hurting themselves, teenagers may instead 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 deformities.

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 acting 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, etc.)
  • 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 emergently. A child and adolescent psychiatrist can also diagnose and treat the serious psychiatric disorders that may accompany self-injurious behavior.

For additional/related information see other Facts for Families: #4 "Depression," #38 "Manic Depressive Illness," #70 "PTSD," #52 "Comprehensive Psychiatric Evaluation," #66 "Helping Teenagers with Stress," #5 "Child Abuse", and #10 "Teen Suicide."

 

Article # 73 Updated 12/99

All Family Resources wishes to thank the (AACAP) for giving us permission to use this article.

The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 6,900 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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