Embedding, a severe type of self-harm

Reuters, Wednesday 11 May 2011

In a new study this week, doctors describe a form of self-injury among teenagers called self-embedding, which involves inserting objects into the skin or muscle

self harm

The researchers say embedding is on the spectrum of self-harming behaviors, but a much more severe form that appears to be linked to thoughts of suicide and major psychiatric disorders.

"There's clearly a more severe intent to hurt themselves than cutting," said Dr. William Shiels, a radiologist at Nationwide Children's Hospital in Columbus, Ohio and one of the authors of the study.

"Inserting a 16 cm paperclip - not just to do that on one arm, but both arms - the intent that's required to cause that much self harm is significant," he said.

Self-injury, which is often in the form or cutting or burning, is a fairly common behavior, with estimates ranging between 4 and 30 percent of youth who have hurt themselves in some way.

The pain involved in self-harm is thought to provide a sense of psychological relief, and is generally not considered part of a suicide attempt.

Self-embedding is a rare behavior that few doctors have noted, Shiels said.

He and his colleagues had noticed that several patients at his hospital required objects to be removed from their bodies - objects that were intentionally put there.

All the patients were teenagers - most of them girls -- between 14 and 18 years old, and had come to the hospital because they had admitted embedding an object or because they ended up with an infection at the site.

Staples, pencil lead, and paperclips were the most common objects, often inserted into the arm.

One teenager was treated four times for a total of 35 objects - including a crayon and a nail polish wand - stuck into the arm. Another patient pushed a piece of glass into her neck.

All the patients had bipolar disorder, which is a mood disorder marked by cycles of mania and depression. Most of the teens suffered additionally from post-traumatic stress disorder, and others also had depression, borderline personality disorder, or attention deficit-hyperactivity disorder.

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