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The Tacoma, Wash., mom knew something was up with her 11-year-old daughter when the girl kept leaving school with stomach aches that disappeared as soon as she got home. But she didn't know how bad things had gotten until the school called one day two years ago to tell her the sixth grader was sobbing and threatening to hurt herself.
“I told the principal 'I'll be right there,” says Abby, a 34-year-old special education teacher from Tacoma, Wash., whose last name is being withheld to protect her daughter. "When I got there, they'd already called the paramedics. That's when she told me, 'Mom, I've been cutting myself.'”
Abby was shocked to learn her daughter had been using the family's steak knives to deliberately cut herself on half dozen occasions. But, as it turns out, her story isn’t as unusual as we'd like to think.
A sobering new study of 665 kids between the ages of 7 and 16, found that a full 9 percent of girls and almost 7 percent of boys surveyed have engaged in self-injurious behaviors such as cutting, banging their heads or hitting themselves.
In fact, researchers found that kids as young as 7 were harming themselves as a way of dealing with unbearable psychic pain. The study of kids in third, sixth and ninth grades found that 7.6 percent of 3rd graders and 12.7 percent of 9th graders surveyed engaged in what researchers called nonsuicidal self-injury.
"Most people think of kids in elementary school as happy-go-lucky,” says Benjamin Hankin, an associate professor of psychology at the University of Denver and the co-author of the study. “They don’t expect kids this young to be having these kinds of problems.”
And, says Hankin, there are signs that self-injurious behaviors may be on the rise among younger kids. While there aren’t hard statistics, “anecdotally, you talk to parents, teachers, and other professionals and they say that it’s definitely on the rise,” he adds.
Many experts believe that kids who turn to cutting and other forms of self-injury inherited a predisposition to anxiety, depression and other emotional issues. The cutting is a way of dealing with the emotional pain.
Hankin has other research that points to a mix of genetic and environmental factors.
“Our data would suggest that the majority of these kids are experiencing really significant environmental stress, such as peer bullying, peer exclusion, gossip, and relational aggression,” he says.
Abby says that after talking to her daughter, who was adopted, about her cutting behavior, she learned that the girl was being bullied at school.
"She hung out with another girl who wasn't the most popular and she and this girl got made fun of and bullied," she says. "Our daughter had talked to the principal and her teachers, done what she was taught to do, but it wasn't working. And we didn't know the whole story. She had an abusive background with her birth family and stuffing her feelings is second nature with her."
Dealing with the pain
For the new study, Hankin and his colleagues found that until ninth grade, boys were almost as likely as girls to injure themselves. But at ninth grade there was a dramatic shift with girls three times as likely as boys to start harming themselves as a way of coping with stress.
Experts interviewed by msnbc.com said they weren’t surprised by the findings.
Kids are feeling pain and they don’t know how to deal with it, says Dr. Jonathan Pletcher, clinical director for adolescent medicine at the Children’s Hospital of Pittsburgh at the University of Pittsburgh Medical Center.
"It’s a way of coping with stress and anxiety – of inner discordant feelings,” Pletcher goes on. “In a young teen it’s hard to find the words to describe how they’re feeling. They come at this through a process of experimentation. Then cutting becomes a ritual that they build their days around. It’s a way of dealing with all the stress and negative feelings that accumulate during the day.”
While, as the study shows, some kids start younger, cutting and other types of self- injury often begins in middle school, says Dr. Mark DeAntonio, a clinical professor and director of inpatient child and adolescent services at the Resnick Neuropsychiatric Hospital at the University of California, Los Angeles.
“It’s a very overwhelming time of their lives,” he explains. “And they develop this as a way of self-soothing. I know it’s a little hard for adults to get their heads around the idea that self-injury can be self-soothing, but I’ve talked to a lot of adolescents and what they say is that it distracts them from psychic pain. And the physical pain is a lot easier to cope with than the emotional pain. It centers them.”
The self-injury doesn’t have to be dramatic. Some kids will just use a nail file to scratch themselves on the ankle or abdomen, Pletcher says. “It’s a way of calming down the nerves,” he explains.
Because the physical pain can distract the nervous system, it can lead to calmer emotions, Pletcher says. And because of that, cutting can be a bridge to help kids deal with life until they get the help to develop better coping skills. Experts warn that parents should never just ignore this kind of behavior, hoping it will eventually go away on its own.
“The biggest mistake a parent can make is assuming they know why the kid is doing it and not challenging the adolescent to say why and what’s going on,” DeAntonio says.
Copy-cat cutting
Sometimes, though, the cutting may not be about a deeper meaning.
“In our American society there is a cultural fad quality to it,” DeAntonio says. “'If you’re not doing this then you’re not a real teenager.' Some feel they have to do it as a rite of passage.”
And sometimes, it’s a case of copy-cat, experts say.
“One kid may be doing it and their peers find out and then they may emulate it,” says Dr. Steve Pastyrnak, division chief of pediatric psychology at the Helen Devos Children’s Hospital in Grand Rapids, Mich. “In that case it’s probably a little bit of nature and nurture going on.”
That might at least partly explain cases where cutting seems to run in a family.
One San Antonio mom discovered two of her daughters were cutting themselves more than a decade ago, at ages 12 and 13.
"My older girl would cut herself on her wrists and then cover it up with bracelets and my younger girl would do her hip," says Patricia, a mother of six whose last name is being withheld to protect her daughters’ privacy. "Our older daughter was more outward with the signs. She was more rebellious and more testing of authority but our younger girl didn't show those signs until ninth grade. She was following our older daughter."
She says she finally saw the marks on her older daughter's wrists and confronted her about it, trying to find out why she was doing it. Once she discovered the 12-year-old was cutting herself as well, she became even more vigilant.
Both Patricia and Abby sought therapy for their daughters, who they say no longer cut themselves.
If parents suspect their child is cutting, they should have a conversation to try to find out exactly how dangerous the situation is and if the child needs help, says Hankin. If that's out of the question, however, he suggests parents try to get them to talk to someone else.
“What we would encourage you to do is to follow your gut,” he says. “And if you don’t want to have a conversation about this with your child, then let them have it with the pediatrician or a nurse or a school counselor. They can comfort the child with the fact that the conversation is confidential so the child is more likely to talk. A lot of kids worry that their parents are going to get mad.”
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