Self-harming behavior common among young women

NEW YORK (Reuters Health) - Nearly one in four young women purposely injure themselves, behavior that is strongly associated with alcohol and drug abuse, suicide attempts, and eating disorders, a new study from Italy shows.

Women between the ages of 18 and 25 enrolled in the study, 24 percent reported performing some type of self-injurious behavior at least once during their adult lives, ranging from skin picking to cutting or burning the skin, Dr. Angela Favaro and colleagues from the University of Padua in Italy found.

It is unknown how prevalence such behaviors are or whether they are associated with indirect self-damaging habits, such as drug or alcohol abuse, Favaro and her team note in the January issue of the Journal of Clinical Psychiatry.

To investigate, Favaro and her team surveyed 934 young women living in two different regions of Padua. The researchers divided self-injurious behavior into two types: compulsive behavior, such as skin picking or nail biting, in which a person resists performing the behavior and experiences relief of tension after doing it; and impulsive behavior, which is performed less frequently and results in gratification from tension release. The researchers considered habits, such as nail biting or hair pulling as self-injurious if they resulted in pain and tissue damage.

There were a total of 228 cases of self-injurious behavior. Compulsive behaviors were the most common, the researchers found, occurring among 21.3 percent of the young women in the study, while 5.2 percent reported impulsive self-injurious behavior.

Among the young women who reported some type of impulsive self-injuring behavior, 39 percent said they had performed such behaviors only once or twice, while 61 percent said they had injured themselves repeatedly.

There appeared to be two subgroups within each group, the researchers found; hair pulling and severe nail biting, reported by about 15 percent of all of the young women in the study; skin picking and self-biting, in about 8 percent; skin cutting, self-hitting, and self-burning, in roughly 4 percent; and head or hand banging and skin scratching, in about 2 percent.

Self-injuring women had higher levels of emotional distress compared to women who didn't report any self injuring behavior, while they also scored higher on an evaluation of lack of familiarity with one's own body, the researchers found.

Women who reported self-injuring behavior were also more likely to report having been raped or sexually molested as children, except for those in the severe hair pulling and nail biting group. Eating disorders were also more common among the women who reported impulsive acts of self-harm.

Favaro and her team note that self-injurious behaviors can be seen as analogous to animals' "pathological grooming behavior."

"This type of behavior typically involves concerns such as the removal of dirt and elimination of danger and, in animals, seems to be activated by traumatic stress," they point out.

Self-injuring behaviors have been tied to many other psychiatric problems as well as distress and dysfunction, and tend to exhibit a chronic course, the researchers add. "These observations make the phenomenon of self injurious behavior a topic that deserves greater attention in the future both in research and in the clinical setting," they conclude.

SOURCE: Journal of Clinical Psychiatry, January 2007.