The thought that young people engage in the phenomenon health professionals refer to as “nonsuicidal self injury” – or NSSI – scares the pants off us parents. These behaviors, including cutting or carving, piercing or puncturing one’s skin, burning oneself and hitting oneself, are unsettling and make parents worry that something worse is right around the corner.
As its name implies, NSSI involves hurting oneself without intention of killing oneself, often to relieve negative thoughts or feelings. The phenomenon has been fairly well documented among adolescents. But research published Monday in the journal Pediatrics finds that younger children engage in NSSI, too. The study, though small, offers a glimpse at the different ways these behaviors present themselves in girls and boys ages 7 to 16 in grades 3, 6 and 9.
A total of 665 children participated in the study. They were asked whether they’d engaged in any self-harming activities and, if they had, what kind and how often. They were also evaluated to determine the degree to which they felt distress.
The study found that 53 children, 8 percent of the sample, had engaged in self-harm at least once in their lives. Seventeen of the 53 reported having done so only once; the remaining 36 had done so more than once. Overall, 9 percent of girls and 6.7 percent of boys reported engaging in NSSI; broken down by age level, 7.6 percent of third-graders, 4 percent of sixth-graders and 12.7 percent of ninth-graders reported engaging in such behaviors.
Overall, girls were more likely to report having cut or carved their skin, while boys more commonly reported having hit themselves. And children in the two younger grades most commonly reported hitting themselves, while those in ninth grade mostly reported cutting themselves.
Gender differences didn’t emerge until the children moved into adolescence. But by the time they were in ninth grade, 19 percent of girls but just 5 percent of boys reported engaging in NSSI behaviors.
The authors note that this information is especially important in light of the likelihood that NSSI will be included as a psychiatric diagnosis in the forthcoming DSM V, the fifth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, known as the “bible” of psychiatric disorders. Inclusion in that document, which is due to be published in May 2013, guides treatment (and influences insurance coverage for that treatment) of such disorders.
Of the young people in the study who reported having engaged in NSSI, 1.5 percent met at least one of the proposed DSM criteria for the disorder, including having engaged in NSSI behaviors at least five times during the past year and having done so for some purpose (to put a stop to bad feelings, for instance, or to attract help). In keeping with the proposed criteria, those who had engaged in NSSI at least five times in the past year had high levels of distress.