Self-Harm Specifics – ADD girls at greater risk
Sunday, February 10, 2013 10 Comments
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In the What Kind of World do YOU Want? series
Part III of an article on Self-Injury & CUTTING
Intenational Self-harm Awareness Day – March 1
There are NO graphic photos or descriptions, BUT if you self-injure, make SURE you are emotionally protected so that reading this article will not precipitate an episode. Have a list of substitute strategies available to self-soothe in healthier ways – you are stronger than you think, nobody’s perfect and I’m on your side!
The Cycle of Self-Harm
by Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
CLICK HERE for Part II: SI/Anxiety link
is the Problem?
Self-harm, or Self-Injury [SI] can be found with greater frequency in certain disorder-populations than its incidence in the population as a whole.
It has been listed in the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders [DSM-IV-TR] as a symptom of borderline personality disorder.
However, according to a 2007 journal-published study it is also found in otherwise high-functioning individuals who have no underlying clinical diagnosis.
(Klonsky, E.D.,”Non-Suicidal Self-Injury: An Introduction” – Journal of Clinical Psychology &
“The functions of deliberate self-injury: A review of the evidence” – Clinical Psychology Review)
Acording to Klonsky, patient populations with other diagnoses who are more likely to be drawn to self-harm as a coping strategy include individuals with the following disorders:
- substance abuse and eating disorders
- post-traumatic stress disorder
- some of the personality disorders, and
as you might expect if you read the previous section of this article,
- ANXIETY disorders
There is disagreement between experts as to whether SI is part of the symptom profile included in these diagnoses, or whether it is actually a separate diagnosis that is comorbid with a number of other diagnoses.
Self-harming behaviors are not confined to the human population either. Animals under significant stress (and sometimes as a side-effect of certain medications) will also self-injure. For example, birds will pull out feathers as far as their beaks will reach, dogs lick or bite themselves raw, and monkeys exhibit many of the human forms of self-injury, with the exception of cutting, etc.
MORE than cutting
In addition to the subtance-related addictions, a list of other self-harming behaviors found on the LifeSIGNS website includes, among many others, the following activities as self-injury:
- Burning and Branding
- Pulling out hair
- Head & body banging / intentional bruising, including bone breaking
- Pricking and scratching (raw)
- Ingesting, including chronic self-medicating, overdosing (chronic or acute),
self-poisoning, swallowing objects intended to cause harm
An article written by Wedge (real name), an SI sufferer and advocate from
the LifeSigns website (linked HERE) might encourage you to take statistics
with enough grains of salt to empty the salt bins in a pretzel factory.
His article aptly underscores what I have frequently said about ADD statistics: they are helpful to guestimate the size of the forest, but don’t depend on the tree-count to build your abode!
Statistics rarely indicate anything so much as the fact that an issue has come to public awareness to a significant enough degree that somebody was able to secure funding for a study or a survey.
Since SI researchers have used different definitions, metrics and population samples for data collection, it is especially difficult to know exactly what the composite numbers represent. There are some areas of agreement about trend, if not metrics (i.e., that SI in children seems to have been increasing since the 1980s), and one statistic that is relatively encouraging:
It has been estimated, extrapolating from an average of studies of non-clinical,
adolescent populations, that we can expect to see a lifetime prevalence of
between 15-20% (higher in clinical populations).
So it is possible to become an ex-cutter eventually, and at least 80-85% get there.
For what it’s worth, however, below are a few other statistics I’ve found sprinkled around the web, attempting to quantify the extent to which self-harm as a coping strategy is prevalent, along with a few other metrics attempting to make sense of the phenomenon:
• England: 3 teens self-harm per hour
• Australia: 24,087 teens were hospitalized for self harm in 2003-2004
• United States: 3,000,000 Americans self-harm
• Cutting is reported most often in girls/women between the ages of 13 and 30
(Wikipedia reports 12-24, other studies estimate that 1 in 200 girls have cut themselves, and one source reports that cutting usually begins between the ages of 10 and 16)
• 90% of SI sufferers begin self-harming behaviors in their teen years or younger
(almost 50% began at the age of 14 and continue into their 20’s and beyond;
13% of 15 to 16-year-olds have deliberately harmed themselves. )
• Almost 50% of SI sufferers have reported being sexually abused
Starting to Stop – repeatedly
No matter how badly the individual who self-harms wants to stop, SI is a condition in which stop-start relapses are common – it’s part of the pathway toward wellness that anyone who wants to offer help and support MUST accept without censure if you want to avoid becoming part of the problem.
Perhaps counterintuitive to many of you reading, the “just say no” approach will increase,
not decrease, these self-injury behaviors – so JUST SAY NO to speaking that phrase anywhere within earshot of anyone who has come to you for understanding and support.
There are a number of different methods that can be used to help an SI sufferer gradually move to less dramatic and harmful ways to cope. The underlying reasons for the SI in the first place changes how you approach the trajectory toward wellness.
Also from Wikipedia:
“The motivations for self-harm vary and it may be used to fulfill a number of different functions.
These functions include self-harm being used as a coping mechanism which provides temporary relief of intense feelings such as anxiety, depression, stress, emotional numbness or a sense of failure or self-loathing and other mental traits including low self-esteem or perfectionism.“
That’s quite a large basket into which they’ve thrown a number of disparate “motivations.”
I want to make sure that you note the “emotional numbness” function cited above.
In the next part of this article, where we will look briefly at a few theories about WHY individuals cause intentional harm to themselves, we will distinguish between the different types of SI, and will take a look at SI as a strategy to manage depersonalization and derealization.
The link between ADD and SI
One possible risk factor bears mention NOW, illuminated in the recently reported results of the 10-year UC Berkeley study of 233 girls: those with ADD-Combined Type seem to be at significantly greater risk for both SI and Suicide
Subjects, which included both those with ADD and controls, were between 6 and 12 years old when the study began, now between the ages of 17 and 24, with a 95% study retention rate at the ten year mark. The results were published in the Journal of Consulting and Clinical Psychology in August, 2012.
Of the girls diagnosed with ADD-Combined Type, 51% reported self-harming, compared to 29% of girls with Inattentive ADD, and a significantly lower 19% of the control group.
Results regarding suicide were also surprisingly disproportionate: 22% of the girls diagnosed with ADD-Combined Type reported at least one suicide attempt within the past 10 years, compared with 8% in the Inattentive group and 6% of the controls.
So it would seem, from this ten year study, that over half of girls with ADD-Combined Type self-harm — which is over two and a half times the likelihood of a teen without ADD, and one and three-quarters times more likely than a teen with Inattentive ADD.
They are also almost four times more likely to attempt suicide than non-ADD teens and pre-teens, and three times more likely than girls with Inattentive ADD.
There were no significant differences regarding substance use, though young women in both ADD groups reported continuing ADD symptoms, greater incidences of other psychiatric problems, and a greater rate of use of psychiatric services.
- Read the American Psychological Association’s Press Release HERE
- Download a pdf of the Journal Published study HERE
Coming up in this article: I will continue to explain more about what’s going on, how ADD complicates the problem, what relatives and friends can do and say to make a positive difference, and what you might be tempted to do and say that will escalate the problem. I will also unpack what’s helpful and what’s not with The Butterfly Project.
Scroll down for “Regular” Related Content links, Self-Harm links immediately below
(Items **enclosed with stars** include visuals – if you self-harm, make SURE you are in an emotional place where viewing them will not precipitate an incident before you click)
- Alternatives to self-harm. (there’s loads here!) (mentalhealthdiaries.wordpress.com)
- Multi-webpage article on self-injury – Mayo Clinic
- **Pain and deliberate self-harm** (The Wellcome Trust) excellent article (*photo at top*)
- **Lucie Russell: Understanding self-harm is first step to ending it **(scotsman.com)
- **Self-Inflicted: A Documentary on IndieGoGo** (wired.com)
- **The butterfly project – Cutting: Part 3** (parentingandstuff) (*butterfly visuals*)
- Mirror (alanonfury — 1st person account of cutting)
- **Cut the Pain Away **
(video with music – VERY well done, painful to watch, but no graphically realistic cutting)
Help Wanted: If you are one of the relatively few individuals who is already dealing with this issue in a proactive fashion and want to add links to your articles on the topic in the comments section below, please DO. PLEASE link back, so that we can ALL help spread the word.
1st-person insights from cutters, recovering cutters and ex-cutters are welcome.
I will approve links to related content posted in the comments section as soon as I can verify that they are not link-spam (or shaming). If and when links reach a sufficient number to do so, I will compile and list in a separate “Self-Harm Related Content” post (similar to the one for sleep struggles and disorders).
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What Kind of World Articles & Related Inspiration:
- What Kind of World Do You Want?
(#1 in the Series, with links to the others at bottom of post)
- ABOUT Values and The Goose Story
- Creating Community Together
- I Have a Dream (Aspiring to Optimal Functioning)
- Anger & Advocacy
Related articles around the ‘net
- Study Examines Parental Behaviors That Create Anxious Children(medicalnewstoday.com)
- Bathtub Revelations on Stress. (breakingthecontract.com)
- Anxiety, you’re not the boss of me. (ireport.cnn.com)