The presence of an eating disorder in teens has been linked to an alarming high rate of other self-harm tactics, such as cutting.
The findings of research conducted at the Stanford University School of Medicine and Lucile Packard Children’s Hospital, the study also revealed that many healthcare providers regularly fail to diagnose instances of self injury.
Out of 1,432 eating disorder patients examined between the ages of 10 and 21, the study revealed that nearly 41 percent had documented incidents of intentionally harming themselves, most often by cutting and burning.
Also of notable concern was the fact that researchers believed inadequate clinical screening could mean that the count is much higher.
“These are very high numbers, but they’re still conservative estimates,” said the study’s lead author, Rebecka Peebles, MD, who was an instructor in pediatrics at Stanford when the research was conducted and is joining the faculty at Children’s Hospital of Philadelphia.
The sample of patients was drawn from intake evaluation records of patients admitted to the hospital from January 1997 through April 2008. Just over 90 percent of all the patients were female, three-quarters of them white, with a mean age of 15.
Of those identified to be inflicting self harm, the average age was 16, and 85.2 percent of this identified group were cutting themselves.
The findings also revealed that 52.8 percent of those engaging in self harm also engaged in purging, and a little more than 26 percent participated in binge eating.
Researchers voiced concern that less than half of the charts documented a healthcare provider asking patients if they had intentionally injured themselves. Most who were asked already had a history of self injury or fit the profile of a self-injurer in that they were older, white females suffering from bulimia nervosa or a history of substance abuse.
This profile may be flawed, according to Peebles, who added that if healthcare workers only ask certain types of questions, the profile will reflect their bias.
“If patients aren’t asked, they are unlikely to volunteer such information,” said Peebles. “The question is, ‘Are we missing other kids who are not meeting this profile?’”
Peebles added that the industry needs to get much better about universal screening.
While the study did not examine the underlying reasons for inflicting self harm, Peebles said her clinical experience suggested patients “are trying to feel pain.”
“Patients describe a feeling of release that comes when they cut or burn themselves,” she said. “They’ll cut with a razor or a scissor blade. Sometimes we’ve even had kids who will take the tip of a paper clip and gouge holes. To burn themselves, they’ll heat up a metal object and press it to their skin, or they’ll use cigarettes.”
Research suggests that between 13 and 40 percent of all adolescents engage in some form of self-injury. This behavior is also linked to a higher risk of suicide.
Funded by the Stanford Child Health Research Program, the study’s other author is Jenny Wilson, MD, who was a resident in pediatrics when the study was conducted.
The study was published online Oct. 8 in the Journal of Adolescent Health.