Kids as young as 7 years report self-injury

Children aged as young as 7 years report that they have engaged in nonsuicidal self-injury (NSSI), hurting themselves without the intent to die.

A new study of youngsters in grades 3, 6, and 9 is the first to explore the rate and methods of NSSI in children younger than 11 years and investigate the influence of age and sex on self-injury in children and adolescents.

Researchers interviewed 665 children aged 7 through 16 years using the Self-injurious Thoughts and Behaviors Interview. The overall rate of NSSI was 8%: 9% for girls and 6.7% for boys. Third-graders had a rate of 7.6% compared with 4% for sixth-graders and 12.7% for ninth-graders. Ninth-grade girls had the highest risk of NSSI with a rate of 19%, more than 3 times the rate for ninth-grade boys (5%).

Examining NSSI across age groups reveals that self-injury occurs in young children, not just adolescents and young adults, and increases with age, the researchers say.

Girls and boys reported different NSSI behaviors. Girls most often cut or carved their skin; boys most often hit themselves.

Behaviors also varied by grade. Most third- and sixth-graders hit themselves, whereas most ninth-graders reported cutting or carving skin. Other behaviors included biting, hair pulling, running into walls, and hurling the body against sharp objects.

Nonsuicidal self-injury, which carries a risk for suicidal thought and behavior and can precede more serious psychiatric problems, may be added to the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a new psychiatric diagnosis, the researchers note. In their study, 1.5% of children met some criteria for the proposed diagnosis because they performed NSSI at least 5 times during the past year, injured themselves for a purpose, and reported significant distress.

Possible inclusion of NSSI in the DSM-5 increases the importance of establishing rates of NSSI and self-injury behaviors among children, the researchers say.

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