A study of the frequency of self-mutilation in a community sample of adolescents

By: Shana Ross and Nancy Heath

Previous Research

Self-mutilation (SM) behaviors in adolescents have being gaining attention recently but there is currently very little research that analyzes self-mutilation (as defined by this study) specifically. Preliminary research points to a possible growing trend of self-mutilation behaviors among adolescents there is little empirical research to support such a claim. The authors categorize previous research into four groups.

1. Studies that explore the prevalence of self-harm behaviors in high school students

2. Studies of individuals who were referred to the emergency room following an episode of self injury.

3. Studies conducted on clinical samples of adolescents.

4. Studies that look at self-mutilation across a wide age range.

Problems with Previous Studies

-There is little research much of which is case studies.

-There is no generally agreed upon definition of self-mutilation. Self-mutilation has been used equivocally with terms like self-injurious behavior, deliberate self-harm, parasuicide, and self-wounding.

-Most research has been done in clinical settings with people who have personality disorders or other psychological problems which makes it difficult to translate results to more normative populations.

Current Study

Definitions of Self-Mutilation:

-“Any incident where an individual had attempted to deliberately alter or destroy body tissue without suicidal intent.”

Goals:

1. Investigate the frequency of self-mutilation in a sample of high school students.

2. Investigate the relationship between self-mutilation, anxiety and depression.

Method

Two high schools were chosen to participate in the study. One high school was in an urban area which consisted of ethnically diverse student population mostly of the lower middle class. The other high school was in a suburban area which consisted mainly of Caucasian students most of which were from the upper middle class. The two schools were chosen to gain a representative estimate of the prevalence of self-mutilation behaviors.

-Grades 7-11 were approached in the urban high school to participate in the study.

-Grade 9 and 10 were asked to participate in the suburban high school.

-A total of 440 students agreed to participate in the study.

-231 students from the urban school.

-209 students from the suburban school.

The students were given a questionnaire to determine whether they had ever self-mutilated previously. Students who responded that they had hurt themselves on purpose participated in a semi-structured interview.

Questionnaire

-Instructions were read to the students by the examiner who told the students that the survey was to gain knowledge about the students how deal with stress. The students read through the responses and marked down whether they had used the presented behaviors to cope with stress and how often. The responses ranged from adaptive behaviors (e.g. exercise, talking to a friend) or destructive behaviors (e.g. drinking, fighting)

A comparison group was randomly assigned which matched the students who indicated that they had hurt themselves for grade, gender and race. The members of the group who indicated that they had hurt themselves and the members of the comparison group were given the Beck Anxiety Index (BAI). In another session the self-mutilators were given the Beck Depression Index (BDI).

Semi-Structured Survey

The semi-structured interview was organized so that researchers could clarify what the students meant when they responded that they had engaged in self-mutilation and to obtain more specific information. The interview was conducted in three parts.

1. Demographic information

-Family and living situation

2. Clarification about self-mutilation

-How students self-mutilate

-How often

3. Feelings prior, during and after self-mutilating

Results

Following the interview 13% of the students deemed to have self-mutilated. In the suburban school 14.8% of the students were deemed self-mutilators. The overall prevalence for self mutilation was 13.9%.

Race

-77% Caucasian

-5% Black

-6.5% Asian

-3.3% Hispanic

-8.2% Other Minority

Living Situation

-59% of self-mutilators came from homes where their parents were married.

-36% came from homes where parents were separated or divorced.

-5% came from homes with a widowed parent.

Gender

-64% Girls

-36% Boys

Practices

-41% Skin Cutting

-32.8% Self-Hitting

-6.5% Pinching

-5% Scratching

-5% Biting

-3.3% Burning

Frequency

-13.1% More than once a day

-27.9% Couple times a week

-19.6% Couple times a month

-18% Single occasion

-19.6% Episodic

-64% Indicated that they no longer self-mutilate

Onset

-11.5% Grade 9

-59% Grade 7 or 8

-24.6% Grade 6 or younger

-4.9% Could not remember when the behavior began

The results of the Beck Anxiety Index and the Beck Depression Index showed that the students who engaged in self-mutilation show significantly more anxiety and depressive symptomatology compared to the students who did not self-mutilate.