A new German study finds that 25 to 35 percent of adolescents in the country have intentionally inflicted injuries upon themselves at least once in their lifetime, with some young people self-harming on a regular basis.
These figures give Germany one of the highest prevalence rates for self-harm among European countries. The researchers present the latest evidence on non-suicidal self-injury in adolescents in the current issue of the journal Deutsches Ärzteblatt International. They also discuss the guidelines for treatment.
Non-suicidal self injury is defined as direct, repetitive, socially unacceptable damage to body tissues without any suicidal intent. To this end, young people who self-harm most often cut, scratch, or burn the surface of their skin, for example, or they hit parts of their bodies (such as their head) against objects and injure their skin or bones in this way.
According to study author Paul L. Plener and his coauthors from Ulm University Hospital, non-suicidal self-injury often serves to help manage negative emotional states.
Many people who self-harm say the physical pain helps drown out the emotional pain. Sometimes, injuring oneself stimulates the body’s endorphins or pain-killing hormones, thus raising one’s mood.
A number of risk factors have been identified for people who may self-harm, with the primary ones being bullying, comorbid psychiatric conditions, and abuse and neglect in childhood. In the past few years, neurobiological research has shown that individuals who self-harm often have abnormalities when it comes to coping with stress.
In addition, researchers have found that after repeated acts of non-suicidal self-injury, patients tend to gain a greater threshold for pain, allowing for more intense acts of harm.
The treatment for non-suicidal self-harm is typically some form of psychotherapy which can help patients learn new coping mechanisms for stress. The researchers assert that other mental comorbidities will have to be taken into account during treatment.
But while psychotherapeutic interventions have been shown to successfully reduce the frequency of self-injury, no single therapeutic approach has demonstrated clear superiority. Randomized controlled studies in adolescents have shown small to moderate effects after cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and mentalization-based treatment.
As of yet, no psychoactive drug has been found to possess specific efficacy in the treatment of non-suicidal self-injury.
In the U.S., research has shown that self-injury occurs in approximately 15 percent of teens and as many as four percent of adults. Studies show an even higher risk for self-injury among college students, with rates ranging from 17 to 35 percent.