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Adolescent self-cutting elsewhere than on the arms reveals more serious psychiatric symptoms

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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the most pronounced association between self-cutting on other places than the arms was found with YSR subscales withdrawn/depressed, social problems and thought problems, and dissociation (A-DES).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.

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Authors and Affiliations

  1. Department of Psychiatry, Kuopio University Hospital, P.O. Box 1777, 70211, Kuopio, Finland

    Eila Laukkanen & Tommi Tolmunen

  2. Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland

    Eila Laukkanen

  3. Savo Vocational College, Health and Social Services, P.O. Box 87, 70100, Kuopio, Finland

    Marja-Liisa Rissanen

  4. School of Health Sciences, Nursing Science, University of Tampere, 33014, Tampere, Finland

    Jari Kylmä

  5. Department of Health Sciences, University of Oulu, P.O. Box 7500, 90014, Oulu, Finland

    Jari Kylmä

  6. Department of Psychiatry, Päijät-Häme Central Hospital, Keskussairaalankatu 7, 15850, Lahti, Finland

    Jukka Hintikka

  7. School of Medicine, University of Tampere, 33014, Tampere, Finland

    Jukka Hintikka

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  1. Eila Laukkanen
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  2. Marja-Liisa Rissanen
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Correspondence to Eila Laukkanen.

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Laukkanen, E., Rissanen, ML., Tolmunen, T. et al. Adolescent self-cutting elsewhere than on the arms reveals more serious psychiatric symptoms. Eur Child Adolesc Psychiatry 22, 501–510 (2013). https://doi.org/10.1007/s00787-013-0390-1

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