title: Adolescent self-cutting elsewhere than on the arms reveals more serious psychiatric symptoms.
abstract: Self-cutting as a form of self-harm is a common and multifaceted phenomenon among adolescents. The aim of this study was to investigate whether the location of self-cutting (arms or other areas of the body) could help to assess the severity of the underlying psychiatric problems. A sample of adolescents who reported self-cutting (n = 440) was drawn from a large sample of community adolescents (n = 4,019). The majority of self-cutting adolescents, 296 (67.2%), reported cutting only the upper arms, while 144 (32.8%) also cut other parts of the body. The data included a structured self-rating questionnaire, questions about self-cutting, the Youth Self-Report (YSR) for adolescents aged 11-18 years, the Beck Depression Inventory, the Toronto Alexithymia Scale and the Adolescent Dissociative Experience Scale (A-DES). The results indicate that self-cutting on other parts of body than the arms was associated with female gender, a wide range of emotional and dissociative symptoms and suicidal ideation. In logistic regression analysis, the most pronounced association between self-cutting on other places than the arms was found with YSR subscales withdrawn/depressed, social problems and thought problems, and dissociation (A-DES). We conclude that self-cutting adolescents, mostly girls, with wounds elsewhere than on the arms present with the most serious psychiatric symptoms. It is important to perform a careful physical examination when an adolescent has unexplained wounds or scars on the arms or on other parts of the body. These adolescents also need a caring and conscientious psychiatric examination and possible psychiatric treatment.
authors: Department of Psychiatry, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland. eila.laukkanen@kuh.fi
authors: Eila
authors: E
authors: Laukkanen
authors: Marja-Liisa
authors: ML
authors: Rissanen
authors: Tommi
authors: T
authors: Tolmunen
authors: Jari
authors: J
authors: Kylmä
authors: Jukka
authors: J
authors: Hintikka
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D002648:Child; D004213:Dissociative Disorders / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D016728:Self-Injurious Behavior / Q000523:psychology*; D011795:Surveys and Questionnaires