High rate of self-harm seen among college students

[Celebration]

http://today.reuters.co.uk/news/newsArticle.aspx?type=healthNews&storyID=2006-06-08T150608Z_01_COL850937_RTRIDST_0_HEALTH-SELF-HARM-DC.XML&archived=False

NEW YORK (Reuters Health) - One in six young adults have injured themselves intentionally at least once, according to the largest US survey to investigate the practice among college students.

Self-injurious behavior can include scratching and pinching oneself, cutting, swallowing poison and even breaking bones. People who injure themselves say it helps relieve distress.

"It's a harbinger of distress, in all likelihood, and inability to cope positively," Dr. Janis Whitlock of Cornell University in Ithaca, New York, the study's lead author, told Reuters Health.


"There's a fair degree of consensus that self-injury is fundamentally self-medicative," she added, noting that injuries trigger the release of natural opiates known as endorphins, resulting in an immediate sense of calm.

[LoZoccolo]

1. They should go exercise.

You get the endorphins plus it's good for you. We had a free fitness center we could go to on campus. And technically, doing weight training is just a controlled muscle strain, so if you really want to harm yourself that's the way to go I guess.

[varkam]

8. And vitamins too n/t

:eyes:

[NMMNG]

9. Just what I thought when I saw that

But I held my tongue, so to speak, and posted some facts instead. I always hope that through enlightenment I can dispell stereotypes and misconceptions.

I like your snark though. :thumbsup:

[varkam]

10. Well I was going to post a well thought out response

on self-injurious behavior and how it relates to certain disorders such as Borderline Personality Disorder, but then I saw you took care of that. Then I went for the snark :)

[LoZoccolo]

11. So you'd say that like, 1/6 of college students have a form of BPD?

Or that the kind of behaviour people display in college is always indicative of mental illness?

Would you count everyone who binge-drinks in college as an alcoholic?

I was also adressing this in terms of my own experience with generalized anxiety disorder, so I can play a card and pull out my pain too if you'd like.

[varkam]

12. Look

Cutting or burning yourself is not necessarily indicative of mental illness but should be addressed by a mental health professional. Not everyone in therapy has a mental illness. I would not count all binge-drinkers in college as alcoholics, but unfortunately many of them are and binge-drinking is neither a normal behavior for college students nor is it a healthy one.

I appreciate your motivation and your own experience. I realize that you mean well with your advice, but even if exercise helps in the way you said it would (controlled muscle strain) it's just replacing the knife for the barbells and does nothing to examine the underlying issue. I also appreciate that exercise may have helped you with your GAD, but unfortunately that is your personal experience which should not be generalized to the population as a whole.

on edit: And no, I wouldn't say that 1/6 of college student have BPD. Self-injurious behavior is not unique to that disorder.

[Celebration]

13. exercise can be like a drug

Really, it can have dramatic effects on mood--but maybe not for everyone. It also may not be enough to keep people from injuring oneself, but I would definitely recommend trying it. That does not mean don't try other things as well. Inositol in large amounts might help--also counseling, etc. And then there's the chakra balancing. I just have a feeling that self injurious behaviour is a third chakra (roughly the solar plexus) problem.

[varkam]

14. Stopping the self-injurious episodies

without insight into why they occur does absolutely nothing to help. I agree that exercise is good and can make you feel better and happier - but it does nothing to resolve the issue.

[Celebration]

15. stress reaction

This is a stress reaction, like biting fingernails, pulling hair out, etc. I am sure there are varying degrees of seriousness. The cause could be something hidden, true, that required some sort of psychotherapy. Or, the person, when asked, may be able to readily identify the stressors-- weird and unreasonable college professors, roommate problems, lack of sleep, being homesick, etc. I just think going away to college can be very stressful, and one needs to learn to be able to handle stress. Exercise is a great way to handle stress---probably the best way--and it works physiologically and psychologically. Counseling might be beneficial, of course, but in general I would throw my hat in the exercise ring. A proper diet and sleep are imperitive of course, and it might require counseling to get a college student to acknowledge the importance of ALL of the above! Honestly, I think acupuncture and energy therapies help more with things like this than counseling--but I am speaking from my own personal experience and that of my family.

[varkam]

16. I agree that those things are generally important...

But cutting oneself is not an adaptive way to deal with stress, though it does help with it. Unfortunately, people who do that don't realize that it is a maladaptive way of dealing with the stress of college. I have no doubt the things that you mentioned help with stress; either through actual physiological changes or through the placebo effect.

The point I am getting at is this: the methods that you mention offer zero insight for the individual into the rationale behind the maladaptive behavior. Sure, energy therapies might help to reduce stress, but they don't make you realize (1) how to deal with stress more effectively (and indeed, getting exercise or better sleep might be part of that) or (2) how certain methods of coping with stress end up creating more stress in the long-run. If you want to change the behavior, you need to examine the beliefs that underlie that behavior and not just take them to the gym and tell them that this is better. That teaches the individual nothing.

[Celebration]

17. Counselors

I guess a member of my family has had really lousy luck with counselors--that are expensive, come highly recommended, hard to get an appointment with, etc. I am sure there are good ones. There are some interesting therapies out there like cognitive behaviour therapy, but they may not be available, etc. Anyway in particular this one family member had the whole counseling thing figured out better than the counselors--oh, affirm the beliefs, etc. It was as if she was analyzing the counselor, and generally she was smarter. And some were absolute complete control freaks. Really!! I remember a particularly zany one. Aach!! Then there are the useless ones-- they just chit chat once a week and expect that to work when really the person needs stuff to do in the interim. Then there was the hypnosis guy who turned on the wrong tape, causing a stress reaction!! Along the way there was occasionally some good advice given--keep a journal, etc., but one can read a book and get that advice.

So what helped? Energy therapies, acupuncture, inositol, exercise, sleep, eating right, Buddhist philosophy--all cheaper than talk therapy and way less expensive and stressful. Nobody in my family cut themselves, but there were was maladaptive response to stress. I do think counselors are probably helpful for things like family counseling or marriage counseling, though I wouldn't necessarily trust them.

But what works for one person may not work for another.

[varkam]

18. First off

Since the OP was concerned with college students - any college campus worth a damn offers free psychological counseling to students (so they're not exactly expensive or hard to get an appointment with). I know a lot of people (and patients) who generally think talk therapies are just junk and that they're smarter than the therapist and that the therapist doesn't say anything at all yadda yadda yadda. That's not to say there aren't bad therapists out there; because there are. But that doesn't mean they're all bad, either. Nor does that mean they don't help. Even the "interesting therapies" such as CBT show great results in helping individuals overcome mental illnesses such as depression, anxiety disorders, pain management, and insomnia. Another great treatment program called Dialectical Behavior Therapy incorporates aspects of CBT with zen buddhism - it's pretty much the most efficacious thing around for people with Borderline Personality Disorder.

But what works for one person may not work for another.

Truer words were never spoken. Perhaps alternative therapies really are the key. There isn't a whole lot of research to support that conclusion, so I'm not ready to jump on the wagon just yet. I'm happy that they worked for you and your family to overcome problems, because that's generally what it's all about. But that doesn't mean that you need to discourage individuals from seeking out any treatment option that they wish to pursue (such as counseling). The fact is that counseling works for a great many people, even if it didn't work for you.

[Celebration]

20. free counseling

That is the ticket. Tried that too. It didn't help much but it was free!! And it wasn't the free counselor that was the nutcase!! I am certainly not discouraging anyone from trying it--but if it turns out not to work, I would hope that people don't necessarily believe that more of the same will be better, or allow themselves to feel guilty for dropping the whole idea and instead go another route.

By the way EFT is free (Emotional Freedom Technique). I am not a huge fan personally, but there are a ton of people who love it. And there are some techniques based on the same principles that I really, really love. I would encourage everyone to try it, and see if it helps.

www.emofree.com

And I think I posted before this funny website on how to rid oneself of hatred of Bush-well, it is funny and serious. I think I might have to do EFT night and day for a few millenium to accomplish anything.

http://www.thrivingnow.com/for/Health/be-emotionally-free-of-george-w-bush/

“Even though I still have some of this hate for George W. Bush,
I deeply and completely accept myself.”

“Even though I still have some of this hate for George W. Bush,
I deeply and completely accept who I am.”

“Even though I still have some of this hate for George W. Bush,
I choose to be calm and relaxed.”

Top of the head: “This remaining hate”
Eyebrow: “This remaining hate”
Side of the eye: “This remaining hate”
Under the eye: “This remaining hate”
Under the nose: “This remaining hate”
Chin: “This remaining hate”
Collarbone: “This remaining hate”
Under the arm: “This remaining hate”

[varkam]

21. Mmhmm...

I am certainly not discouraging anyone from trying it...

Oh really?

I guess a member of my family has had really lousy luck with counselors--that are expensive, come highly recommended, hard to get an appointment with, etc. I am sure there are good ones. There are some interesting therapies out there like cognitive behaviour therapy, but they may not be available, etc. Anyway in particular this one family member had the whole counseling thing figured out better than the counselors--oh, affirm the beliefs, etc. It was as if she was analyzing the counselor, and generally she was smarter. And some were absolute complete control freaks. Really!! I remember a particularly zany one. Aach!! Then there are the useless ones-- they just chit chat once a week and expect that to work when really the person needs stuff to do in the interim. Then there was the hypnosis guy who turned on the wrong tape, causing a stress reaction!! Along the way there was occasionally some good advice given--keep a journal, etc., but one can read a book and get that advice.

And what do you think the effect is of the above passage on individuals considering seeking help for their issues? Is it encouraging them to try it?

[Celebration]

22. None of the above

It is simply telling the truth. As I stated, everyone can have different experiences. Our experience was just one.

[varkam]

23. self-delete

[NMMNG]

19. There is far more to Self-injury than a simple stress reaction,

and much more to the act than releasing endorphins. Therefore while exercise is beneficial to everyone, it is not a practical therapy for SIB (compulsive exercising is actually a form of SIB).

Read, for example, some real experiences of individuals who engage in SIB:

Silkyfire: I have felt that the feeling of the blood running down my arm is a symbol of the stress leaving.

<snip>

mammamia: It's important for me to cut veins, in order to see the blood run out. It feels almost like I'm ridding my body of all the bad stuff. I'm getting very weak because of this. It has become very serious; I'll cut 3 or 4 times a day.

<snip>

insight: My experience has been that it was easier to self-injure to prevent memories of past abuse to surface. The emotional pain was what I was afraid of.

<snip>
http://www.healthyplace.com/Communities/self_injury/site/Transcripts/stop_self_injury.htm


These people aren't trying to get an endorphin rush, they are trying to avoid emotional pain and/or achieve catharsis.


SIB also requires intensive, guided therapy. A person who is so out of control that they physically injure themselves in response to emotional pain or exacerbation of mental illness is not capable of handling the issue by him/herself.


Diagnoses. The diagnosis for someone who self-injures can only be determined by a licensed psychiatric professional. Self-harm behavior can be a symptom of several psychiatric illnesses: Personality Disorders (esp. Borderline Personality Disorder); Bipolar Disorder (Manic-Depression); Major Depression; Anxiety Disorders (esp. Obsessive-Compulsive Disorder); as well as psychoses such as Schizophrenia.

Evaluation. If someone displays the signs and symptoms of self-injury, a mental health professional with self-injury expertise should be consulted. An evaluation or assessment is the first step, followed by a recommended course of treatment to prevent the self-destructive cycle from continuing.

Treatment. Self-injury treatment options include outpatient therapy, partial (6-12 hours a day) and inpatient hospitalization. When the behaviors interfere with daily living, such as employment and relationships, and are health or life-threatening, a specialized self-injury hospital program with an experienced staff is recommended.

The effective treatment of self-injury is most often a combination of medication, cognitive/behavioral therapy, and interpersonal therapy, supplemented by other treatment services as needed. Medication is often useful in the management of depression, anxiety, obsessive-compulsive behaviors, and the racing thoughts that may accompany self-injury. Cognitive/behavioral therapy helps individuals understand and manage their destructive thoughts and behaviors. Contracts, journals, and behavior logs are useful tools for regaining self-control. Interpersonal therapy assists individuals in gaining insight and skills for the development and maintenance of relationships. Services for eating disorders, alcohol/substance abuse, trauma abuse, and family therapy should be readily available and integrated into treatment, depending on individual needs.
http://www.nmha.org/infoctr/factsheets/selfinjury.cfm

[gully]

2. Why is this a new trend?

That's what's puzzling to me. What has changed in our society that fosters this "solution?"

[Celebration]

4. Hard to fathom

Maybe once the Opus Dei self mutilation stuff is out there in the human consciousness, people pick up on that subtle energy. I like the exercise idea myself. Maybe eat turkey to raise serotonin levels? I am starting to think that eighteen year olds going away from home to live in dorms, and all the associated pressures, may not be such a great thing for our youth. If things go well though, it is a pretty good thing for parents, I will admit.

[BrklynLiberal]

6. I would be interrested in the corelation between economic status and

the occurrence of this phenomenon..in the college students, that is.

[NMMNG]

24. It's not really new

Self-injurious behavior has been around for a very long time. While it is most commonly seen in individuals with developmental disabilities or more severe forms of mental illness, it is not unheard of for individuals with milder forms of mental illnesses or those without mental illness to engage in SIB.

This study from 2002 noticed an "alarmingly high rate" of SIB among college students:

Risk factors for deliberate self-harm among college students.
by Gratz, Kim L.; Conrad, Sheree Dukes; Roemer, Lizabeth
from American Journal of Orthopsychiatry. 2002 Jan Vol 72(1) 128-140

This self-report study examined the risk factors for deliberate self-harm among 133 college students (67% female, aged 18-49 yrs). Results indicate that insecure attachment, childhood separation, emotional neglect, sexual abuse, and dissociation were significant predictors of self-harm. Substantial gender differences in the risk factors for self-harm behavior were also revealed. Suggestions for future research are provided. (PsycINFO Database Record (c) 2005 APA, all rights reserved)
http://content.apa.org/journals/ort/72/1/128

Cited in: http://www.ncptsd.va.gov/facts/problems/fs_self_harm.html#Anchor-Gratz-30189



U.S. Studies on young adults and SIB have been done at least as far back as 1989:

The few studies which have been conducted in U.S. community samples of young adults and adolescents are limited by small convenience-based samples and vary in estimates of self-injury prevalence from 4% to 38% percent (Briere & Gil, 1998; Favazza, 1996; Gratz, Conrad, & Roemer, 2002; Kokaliari, 2005; Muehlenkamp & Guiterrez, 2004).
http://www.crpsib.com/whatissi.asp



Deliberate self-harm occurs in nonclinical populations as well. Approximately 4% of the general population (14) and 14% of college students (15) have reported a history of deliberate self-harm. A recent study found that as many as 35% of college students report having performed at least one self-harm behavior in their lifetime (16). There is evidence that deliberate self-harm has become more prevalent in recent years. Several studies have found higher rates of self-harm in individuals from younger generations (10, 14, 17, 18).
http://ajp.psychiatryonline.org/cgi/content/full/160/8/1501#R1608BABJFJCJ



I don't know if there's so much of a dramatic increase in the behavior, or if people are just more aware of it than they were before.

[CoffeeCat]

3. Maybe this has always been prevalent...

...just not discussed.

I hadn't ever heard of "self injury" until I started doing it. I began therapy three years ago, for childhood sexual abuse. The emotional pain was so intense, that I thought it would kill me. All of that rage, profound sorrow, helplessness, fear, and pain---flooded me.

The experience was indescribable. I had kept a lid on all of these emotions--for 35 years. Finally feeling them was a relief--but it was brutal.

I would find myself in the kitchen, cutting myself with a knife. I felt like a complete freak for doing this. I wasn't some teenager with multiple piercings, dressed in black (not that there's anything wrong with that!). I was a suburban, stay-at-home mom to two toddlers.

After cutting and scratching myself for a couple of months, I finally divulged this to my therapist. He said this is very common with sexual abuse victims, and that it is coping mechanism; a distraction. I'm sure there is some chemical component to this, because when I would do it--I would feel relief and the emotional pain seemed to subside. Possibly, when you're processing difficult emotions--a physical jolt (like a cut or some other pain), redirects your mind.

I know self injury sounds very bizarre, or like a form of attention getting. I can tell you that I'm a fairly normal, high-functioning person. I was also pretty "normal" when I was going through therapy--but it was just so overwhelming and painful. The abuse left me emotionally unequipped to deal with basic emotion--let alone the flood of trauma that assaulted my senses. I was having flashbacks, nightmares...it was awful.

I'm doing very well now. I have good days and bad days, but nothing like the initial painful stuff. I just thought I would chime in and put a "face" on self injury.

[gully]

5. I've heard it described as "feeling something is better than not feeling."

I'm so sorry that you've been victimized, but thankful your on the path to healing.

thanks for sharing your very personal story.

[NMMNG]

7. More on SIB

Self-harm is also known as self-injury (SI), self-inflicted violence (SIV), self-injurious behavior (SIB), and self-mutilation<3>, although this last term has connotations that some people find worrisome, inaccurate, or offensive. When discussing self-harm with someone who engages in it, it is suggested to use the same terms and words which that person uses, e.g. "cutting".<4> Self-harm is usually dissociated from an attempt at suicide; the person who self-harms is not usually seeking to end his or her own life, but is instead hoping to cope with or relieve unbearable emotional pressure or some kind of discomfort.

snip

People experiencing various forms of mental ill-health can be considered to be at higher risk of self-harming. Key issues are depression <1> <13>, phobias <1>, conduct disorders <14> Substance abuse is also considered a risk factor <5> as are some personal characteristics such as poor problem resolution skills, Impulsivity, hopelessness and aggression. <5>
Abuse during childhood is accepted as a primary social factor <15>, along with troubled parental or partner relationships. <5> <2>. Socio-economic factors such as poverty and unemployment may also contribute. <1>

snip

Many people who self-harm state that self-injury is a way to "go away" or dissociate, separating the mind from feelings that are causing anguish. This may be achieved by tricking the mind into believing the pain felt at the time is caused by self-injury instead of the issues they were facing before: the physical pain therefore acts as a distraction from emotional pain.<4> The sexual organs may be deliberately hurt as a way to deal with unwanted feelings of sexuality.

snip

Alternatively self-injury may be a means of feeling something, even if the sensation is unpleasant and painful. Those who self-injure sometimes describe feelings of emptiness or numbness, and physical pain may be a relief from these feelings. "A person may be detached from himself or herself, detached from life, numb and unfeeling. They may then recognise the need to function more, or have a desire to feel real again, and a decision is made to create sensation and ‘wake up’." <18> A flow diagram of these two theories accompanies this section.

Much more : http://en.wikipedia.org/wiki/Self-harm