Signs of elaborate acts of self-harm by U.S. teens

CHICAGO Wed Dec 3, 2008 2:27pm EST

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CHICAGO (Reuters) - Some troubled teens are embedding nails, paper clips, bits of rock, glass and even crayons in their bodies as a way to cope with disturbing thoughts and feelings, U.S. researchers said on Wednesday.

They described cases in which teens had forced numerous objects into their arms, hands, feet, ankles and necks in a condition they are calling self-embedding disorder, a step beyond more common forms of self-mutilation.

"We identified a group of 10 patients over a three-year period of time that have this pattern of self-inflicted injury," said Dr. William Shiels, chief of radiology at Nationwide Children's Hospital in Columbus, Ohio. He presented his findings at the Radiological Society of North America meeting in Chicago.

"It's cutting gone to the next level," Shiels said in a telephone interview.

Shiels, who is developing a minimally invasive surgical technique for removing objects accidentally embedded in the skin, saw his first case of what he called self-embedding in 2005, and recently has seen a cluster of cases.

"We had never seen this prior to 2005." he said.

Self injury can involve a number of actions, including cutting of the skin, burning, bruising, hair pulling, breaking bones or swallowing toxic substances.

It is often kept secret, but some studies suggest that 13 to 24 percent of high school students in the U.S. and Canada have practiced deliberate self-injury at least once.

Wendy Lader, a psychologist and co-founder of S.A.F.E. Alternatives, a treatment program for self-injury disorders in Naperville, Illinois, said the practice of self-embedding was not new but it may be on the rise.

"It's not a new manifestation. Whether it's growing, that may be the possibility," Lader said in a telephone interview.

Lader said radiologists will be some of the first people to notice this trend, but she said self-injury was growing in frequency and severity.

Shiels said nine of the patients were female and one was male, all were between 15 and 18 and most had significant psychiatric problems, including depression.

He said the teens described being in an agitated state and said embedding offered a measure of comfort.

"The consistent theme is one of being angry and upset. Some of the patients have had very recent sexual abuse encounters, and they feel no one is taking them seriously," Shiels said.

"Patients will usually have reported behavior that includes cutting and even ingesting things like battery acid and Drano (drain cleaner) before they engage in self-embedding," he said.

"When they reach the point to where they are embedding things in their body, 90 percent have suicidal ideation."

Lader said that was consistent with many cases of self-injury. She said while the act of cutting may not represent a suicide attempt, 90 percent of these patients are suicidal. "They are trying desperately to find ways to cope with life's problems, and suicide is definitely an option," she said.

(Editing by David Storey)

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