June 5, 2006

Self-Injury Epidemic

In the latest incarnation of MTV’s The Real World — still one of the most popular shows for the college-age population — a woman on the cast has some serious scabs on her arms. Throughout the season, she’s had violent arguments with cast mates, often after raucous nights of drinking.

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When she awakens on many a morning after, usually oblivious to her previous night’s travails, the camera frequently catches her picking the unsightly scabs until they bleed. During these injury sessions, she sometimes quietly rocks herself, in a sort of fetal position. Soon after the picking, her eyes seem to spell relief. She’s admitted that she hasn’t let her wounds heal for over three years.

According to a new study, published today in the June issue of Pediatrics, the Real World alum is just one of thousands of college-aged individuals — both males and females — who are engaging in self-injurious behavior, including cutting, biting, bruising, breaking one’s own bones, and ripping off one’s skin or hair. Clinicians and researchers say that there’s a need to promote awareness about this seemingly growing problem, and to treat the underlying causes.

In the survey of 2,875 students at 2 Northeastern universities — the largest U.S. study to date on how common self-injury is among college students — researchers found that about 17 percent of undergraduates and graduate students report that they have cut, burned, punched or harmed themselves in other ways. This number includes 20 percent of women and 14 percent of men. Over 41 percent of of students who reported such behavior said that they began hurting themselves between ages of 17 and 22.

“I wasn’t expecting the percentages to be quite so high,” says Janis Whitlock, lead author of the study and director of Cornell University’s Research Program on Self-Injurious Behavior. “There’s a whole lot of anecdotal evidence and studies that focused on smaller numbers of subjects that indicate this is a growing problem.”

Whitlock is especially concerned that three-quarters of the students engaged in self-injurious behaviors more than once. Those with repeat self-injurious behavior incidents were more likely to have considered or attempted suicide and to report a history of emotional or sexual abuse.

Many are hurting themselves seriously, with 21 percent indicating that they had injured themselves more severely than they expected more than once. And over one-quarter of all repeat self-injurers said that they had hurt themselves so badly that a medical professional should have treated them.

Jaquie Resnick, director of the Counseling Center at the University of Florida, says that the research is on target with her approximately 30 years of observing and treating college students. “More people are presenting with this,” she says. “I’m surprised at how few are actually seeking help.”

Just over 3 percent of the students in the study indicated that a physician knew about their self-injurious behaviors. Over half of repeat self-injurers had ever been to therapy for any reason, and one-quarter reported disclosing or discussing self injuries with a mental health professional.

Whitlock says that two types of mutilators are common: those who feel very numb as a result of some emotional or physical abuse, who want to harm themselves to feel the “pain of being alive”; or those who are feeling an overwhelming amount of negative pressure, who hurt themselves to release the pain. Over time, Whitlock says that the hurting behavior may release addictive endorphins in the brain that help an individual feel that they are coping with his or her problems, when they are really just masking their underlying feelings.

Resnick says that going to a counselor and learning the underlying causes for their behaviors can often help self-injurers. “They’re using it as a way to cope,” she says. “And they can learn how to prevent it—to cope differently.”

Some have argued that Hollywood has helped bring a behavior out of the closet that’s always existed, says Whitlock. In the 2003 film, 13, a teenager is shown sneaking into a bathroom to cut her arms, and Angelina Jolie’s flirtations with blood-letting have been detailed on many an entertainment show. The singer Plumb also offers a song about cutting on her latest album.

“People who are over the age of 35 sometimes can’t wrap their minds around this phenomenon,” says Whitlock. “This is nothing that anyone used to talk about when I was growing up in the 70’s and 80’s. I don’t know of any young people who aren’t aware of it today. In my mind, the cat’s out of the bag.”

Resnick hopes that as more research shows that college-age individuals are not alone that more students, especially males, will feel empowered to seek counseling. “The more that we’re talking and aware about this, the more likely it is that students will seek help,” says Resnick.

Resnick recalls that when she started as a counselor, eating disorders were much less well known than they are today, and students tended to keep them much more hidden from counselors than they do today. “I certainly hope we will see the same progression with self injury.”

— Rob Capriccioso

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