Scientific Study: Self-Harm Prevalence, Injury Types, Mental Health

This report presents a scientific investigation into the prevalence of self-harm among teenagers and young adults, exploring its association with mental health conditions such as depression and anxiety. The study analyzes data from various research articles to understand the types of injuries inflicted and the underlying psychological factors contributing to self-harm. It highlights the increasing rates of self-harm hospitalizations, particularly among young women, and discusses the role of factors like academic pressure, social media, and mental health disorders. The report also touches upon the interventions and treatment approaches for self-harm, including psychological therapies and social support, emphasizing the importance of addressing co-occurring issues like substance abuse. The investigation concludes by underscoring the need for continued research and comprehensive strategies to prevent self-harm among vulnerable populations.

Running head: Scientific investigation
Scientific investigation
Name of the Student
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Author Note

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Abstract
The rate of hospitalizations due to self-harm is increasing among the teenagers and young
adolescents which can be as a result of a number of factors including psychosocial, social,
psychological, cultural and familial factors. Previous researches have suggested the relationship
of self-harm with mental disorders and mental health conditions like depression, anxiety,
psychosis and other related conditions that are considered to be risk factors of self-harm. This
paper, thus aims to conduct a scientific investigation on the prevalence of self-harm, types of
injures and its association with mental health conditions. This study also gives an overview of
the interventions or the treatment approaches of self-harm targeting the study populations.

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Introduction
Self-harm is a well-known and a major communal problem with an increasing rate of
self-injuries that can also lead to suicide among teenagers and adolescents. Important risk factors
contributing to self-harm include genetic susceptibility and other psychosocial, psychiatric,
familial, social and cultural factors. Adolescents exhibiting self-harm attitude or behavior must
be assessed properly and monitored in order to understand the risk factors and the major
contributors to their self-harm. However, there are challenges while developing a deeper
understanding of the factors contributing to self-harm and there is not plenty of evidences on the
efficiency of psychosocial or pharmacological management of self-harm, specifically in relation
to the effectiveness of antidepressants (Hawton, Saunders and O’Connor 2012).
Self-harm is considered to be a deliberate and harmful act of injuring oneself by means of
carving, scratching, marking, cutting, burning or abrasions, biting, hitting, bruising, piercing and
others. The psychology behind attempting self-injurious actions are critical to understand,
however, it is believed to be because of some mental illnesses like depression, bipolar disorder,
psychosis, posttraumatic stress disorder (PTSD) and other related mental conditions. Thus, in
order to prevent these behaviors among teenagers and adolescents, it is important to access the
patient’s psychological condition and collect all information such as past medial history, past
mental history and social history in order to get a comprehensive understanding of the major
contributors of self-harm and develop and implement strategies to treat each individual mental
disorders like depression, anxiety and others (Brown and Plener 2017).

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Methods
The scientific investigation has been conducted by searching the relevant articles from
databases like Pub Med, CINAHL and Google Scholar by using some basic keywords. A total of
25 articles were found to be relevant in this area. However, only 17 articles were chosen for
conducting this scientific survey based on the inclusion criteria. 8 articles were excluded since
they did not meet the minimum criteria required to carry out the investigation. Articles that did
not have conclusive research findings and lack an abstract have been excluded. Each of the
articles gathered were evaluated by reading their abstracts, research question and the hypothesis
and the publishing year and then used in the study to get the current findings. Some of the
keywords used in the research are “self-harm”, “self-harm among teenagers”, “self-harm among
adolescents”, “Prevalence of self-harm”, “management of self-harm”, “self-harm treatment”,
“Self-injury”, “ Self injury types and methods”, “Self-harm and mental illness”.
Study population: The study population chosen for conducting this scientific investigation is
teenagers between 15-19 years of age and young adults between 20-24 years of age. The
rationale behind choosing the sample population can be defined in terms of prevalence. It has
been found that the population belonging in this age ground are more susceptible to self-harm
because of a variety of factors including an increased academic pressure, peer pressure, a poor
social image, and social isolation, lack of satisfaction of their lives, poor financial conditions,
distress, anxiety, depression, substance abuse and mental illnesses. One of the prime factors for
the maximum prevalence among the study population is substance abuse. Evidences show that
substance abuse is more common in adolescents and becomes an important reason behind their
self-harm behaviors.

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Results
By conducting the scientific investigation it has been found that females are more
vulnerable to self-harm in comparison to that of the male population. The sample population set
for the study was teenagers and adolescents since the prevalence of self-harm among this
population is the most. Self-harm has detrimental consequences, however, in some studies the
participants have expressed a great sensation of relief following self-harm that satisfied them
(Ogden and Bennett 2015). The strong relationship of mental illness with that of the tendency of
self-harm is grounded on strong and conclusive research findings. Impulsivity is found to be a
common aspect of self-harm (Chamberlain, Redden and Grant 2017). Upon a thorough
investigation, impulsiveness is found in the borderline personality disorder diagnostic criteria.
Impulsivity can lead to certain actions that are unnecessary, risky and have detrimental effect on
an individual (Chamberlain, Redden and Grant 2017). Therefore, by preventing such deliberate
and impulsive actions, self-harm can be managed. Some of the psychological therapies include
problem solving therapy, psychodynamic interpersonal therapy and CBT. Social support is also
an important and effective non-pharmacological intervention for these individuals (Washburn et
al. 2012).
Discussion
Over the past 10 years, the number of children and youth self-harming has increased
dramatically. The rapid upward spike in under-18s admitted to hospital after poisoning, cutting,
or hanging themselves is much more noticeable among girls, while significant increases have
also occurred among boys. Experts said the increase could be caused by various factors such as
pressure to succeed at school, the detrimental effects of social media, breakdown in the family,

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and increasing inequality in recent years, the fear of children's corporate image, the history of
abuse and sexual abuse as well.
Prevalence of Self-harm among the study population
After self-harming, last year, some 19,000 Children and young adolescents were treated n
the England and Wales hospitals, a figure which, according to a leading charity for children, has
increased sharply in recent years.
Alarmingly, 14 percent increase over the last three years, an additional 2,400 cases, is
indicated by the National Society for the Prevention of Cruelty to Children (NSPCC), which has
collected data from hospitals through freedom of information applications. In the midst of their
physical pain and suffering, children are lined with increasing numbers of beds with children
who have taken aggressive and dramatic measures (The National Society for the Prevention of
Cruelty to Children (NSPCC) 2019).
Several common methods of self-harm or injury include intentionally cutting, hitting or
burning themselves, hurting themselves that has potential detrimental effects on health. The self-
injury behaviors need are not always be suicidal, however, a repetitive self-harming behavior can
lead to suicide (Zetterqvist 2014).
The incidence of self-harm among the population being studied are at an alarming rate in
which women are more susceptible. Although, the self-harming behaviors are common in both
the genders but the incidence among women is higher to that that of the male population. Self-
injurious behavior have been found predominantly among the women and interestingly, these
behaviors have been found to be related to mental illnesses (Zetterqvist 2014).

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Deliberate self-harm (DSH):
Deliberate self-harm (DSH) among young population is increasingly prevalent.
Simultaneously, DSH diagnosis and help are often affected by their poor adherence. Suicide is an
important problem for public health globally and a leading cause of mortality for teenagers. On
the contrary to other age groups in most countries, this is particularly severe because suicide
rates do not decrease in this age group. A deliberative self-damage, which involves all non-fatal,
self-inflicted injury, regardless of motive, is one of the common risk factors for suicide. DSH
mainly affects mainly young people as the prevalence can be seen as around 10%. There is no
single factor that can explain the reason behind young people harming themselves purposefully.
There have been a number of risk factors that include psychiatric disorders, depression,
behavioral issues, low self-esteem, social isolation, abuse, bad childhood / parenthood, questions
over sexual orientation, impulsivity and suicide / self-reduction communities. Furthermore,
hopelessness is a key risk factor, the severity of which can influence planned treatment. The self-
reported reasons for self-injustice are a desire to die, obtain relief, or punish oneself from an
awful state of mind. DSH has increased in recent years among young people. Several
explanations were suggested, including increased stress for young people, increased consumption
of alcohol and drugs, easier access to medication and social DSH behavior. DSH implies
considerable costs for health care services and society, but due to its multifaceted nature it is
challenging to estimate the direct cost of self-harm. The indirect costs are not known but are
probably substantial due to the high prevalence of DSH in the community (Idenfors, Kullgren
and Renberg 2015).
Self-harm and depression in young adults and teenagers are extremely concerning. In
several Western countries, self-harm behavior in youth increases and suicide is the world's

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second largest cause of death in 10-24 year-old people. A first self-harm episode is defined as
self-injury without regard to suicide–as a young adult can indicate long-term problems in
adulthood like high threat of future health problems, social difficulties and marginalization of the
labor market. The risk of suicide is almost ten times that of the general population following self-
harm among 15 to 24 year-olds. However, depression, generalized depressive disorder and
adular drugs are identified in young age after self-harm, although only an insignificant
population or a limited selection of mental illnesses have been examined to date in the form of
long-term follow-up.
Even though there is an increased risk of a further negative outcome, most self-harming
young people tend to be healing and their self-harm activity declines at an adult level. The most
vulnerable persons need to be identified in this heterogeneous group. Several high-quality studies
have described risk factors for suicide followed by self-harm among young people, but mainly in
geographic or numerically limited samples (Beckman et al. 2016).
In the last two decades the number of teenagers who have been hospitalized for self-harm
has almost increased, and doctors say that social media stresses lead to the disturbing trend. In
2017, self-harm hospitalizations in the United Kingdom reached 13463, down from 7327 girls
who were treated in the United Kingdom in 1997, according to health minister James
O'Shaughnessy's report. NSPCC reported delivering about 15,000 self-harm counseling sessions
last year–around four hundred and twenty-two per day (The National Society for the Prevention
of Cruelty to Children (NSPCC) 2019).
Coexistent harmful behavior with self-harm
Certain harmful habits, including substance or alcohol abuse, sleep and food-disordering
activities, have appeared to co-include self-harm in a research. In comparison to self-injury, a

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study has found that the people who participated in that study experienced a variety of other
forms of harm. The highest incidence of eating disorders was the abuse and misuse of alcohol
and drugs. In addition, women saw themselves as self-hazardous in numerous other ways. This
included overwork, diet, violence, excessive and frequent risk management and tobacco
(National Collaborating Centre for Mental Health UK 2012).
Self-harm consequences: physical and psychiatric
Many articles have reported physical and psychological significances following an
episode of self-harm. Their opinions about themselves are usually ambiguous. They talked about
how self-harm relieved their pain and gave them a sense of satisfaction and liberation. At the
same moment, after an incident of self-harm, others pointed to internal feelings of guilt and
shame.
In a recent study done by Gordon et al. (2010) 106 participants having a history of self-
harm accomplished surveys on their emotional responses in their latest self-harm episode. It has
been observed that after the most recent self-harm incident, people with more repeated episodes
of self-harm feel calmer and more comfortable, calmer and more vigilant and indicated that
reoccurrence may make self-harm worse (Gordon et al. 2010).
In some other literature, the physical consequences of self-injury were also evident, in
combination with the psychological consequence of self-harm. The feeling of physical pain was
one of the most protruding physical effects of self-harm. Several researches looked into pain
experiences in adolescents and self-harming young people. Some had no discomfort whatsoever
and the others experienced a drop in pain. Some clarified that a certain level of pain had to be
met before they could reconcile (Horne and Csipke 2009).

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Stigma and self-harm misconceptions
Another trend arising from some literatures was the varied reactions or responses of
others to self-harm, as well as stigma and misconceptions linked to self-harm. There were also
different reactions from other people to their self-injury and there were some women who gave
quite supportive answers, while others had fairly negative reactions. To a degree, the responses
of others seem to decide if women remain vulnerable to self-harm, and likely seek support for
such conduct.
Often, the ambition behind self-harm is to achieve a detached state that endorses an
insightful distraction from physical and/or psychological distress. Fascinatingly, self-harm can
also be used, as a way of escaping from any disconnected state, or from any experience of de-
realization or depersonalization out of a flashback. The strong physicality of the emotional states
that leads to it cannot be disputed if anyone reads about the subjective experience of anyone who
harms themselves.
Suspension is manifested, in spite of a perceived need to weep or shout, or as the
immovability distinctive of a major depression or paralyzing fear. There is no longer any kind of
stress that can be discharged or can cause expressive behavior (Horne and Csipke 2009).
Relationship between self-harm and mental disorder:
Self-harm is explicitly listed among the borderline personality disorder diagnostic
criteria, and is also linked to a many mental health conditions which are not listed as diagnostic
criteria. The borderline personality disorder is not unique to self-harm: elevated self-harm rates is
found, for instance, when it comes to depression, anxiety, drug usage as well as gambling (Plener
et al. 2015). Psychological disorders are extremely prevalent in people experiencing self-harm in
medical settings. For example, 92 percent in a group of people in the general hospitals with a

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self-harm were suffering from other underlying psychological disorders, with the commonest
types of diseases involving mood, anxiety disorders as well as substance use. Furthermore, since
self-harm can occur in a series of mental disorders, it is better to reflect upon different types of
self-harm instead of categorically. Investigation on possible self-harm dimensions and the
relative strength of the links between self-harm dimensions, psycholoical disorders and
individuality and neuropsychological impulsivity measure is considered to have clinical
importance (American Psychiatric Association 2013). One important aspect of self-harm is
impulsiveness, which means actions which are unnecessarily hurried, risky and ultimately
harmful to the person. Impulsive self-harm is described in the borderline personality disorder
diagnostic criteria. Self-harm can be considered impulsive because it can be risky and damaging
without anticipation. Impulsive behaviors (e.g. self-harm or substance intakes), categorical
mental disorders (e.g., presentation or absence of ADHD, substance use disorder, gambling
disorder), dimension psychopathology (rats of the symptoms similar to ADHD or game-play
problem), or personality can be examined. Impulsiveness can be evaluated with the help of
neuropsychological tests, like in the absence of pre-potent answers (response inhibition) or risky
gambling decision-making (Chamberlain, Redden and Grant 2017).
Psychiatric conditions are the most commonly known risk factor for self-harm,
particularly depression, anxiety and alcohol abuse disorders. Associations between physical
disease and self-harm, especially in young people, are less well established. Among earlier adult
trials, depressive and persistent physical conditions were associated, like asthma, Type I diabetes
mellitus, epilepsy as well as cancer (Singhal et al. 2014).
Studies have acknowledged ns supported the strong relationship between the tendencies
to attempt self-harm with that of the mental disorder or condition. Scientific evidences have

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proven that people having mental disorders are more likely to harm themselves. Some studies
have shown that self-harm is elicited by certain mental disorders including depression, anxiety
and other related condition that are aroused mainly by social isolation, substance abuse and
others. Therefore, people who have a strong tendency of attempting self-harm, there is a
maximum possibility that they are suffering from mental disorder (Knorr et al. 2016).
Studies have found that a repetition of self-harming behaviors can increase the risk for
suicide. Self-harm or self-injury can be fatal often or can lead to detrimental effects on
individuals. Therefore, adolescents who have an increased tendency of attempting actions
pertaining to self-harm must be treated to avoid these actions on priority basis (Wu et al. 2013).
Management and treatment of self-harm:
Self-harm treatment is taken part across a variety of care and social programs involving
children, young people and adults. The treatment of several psychiatrical disorders and problems,
including borderline personality disorder and substance abuse, is also a critical factor. Self-harm
treatment may be done through distinct autonomous psychological or adjunctive therapy that
works in conjunction with standard treatment, such as letter contact, postcard, telephone or crises
cards. The environment for treatment, for instance at home, or in community mental health
environments, is also important. Who receives care must also be taken into account. Traditional
and community mental health services play a substantial role in current treatment and
specialized, multidisciplinary self-harm teams are becoming increasingly popular in secondary
care. Interventions to self-harm might emphasize on behavior itself or approach relationships,
cognitions and social factors more holistically. Interventions may be provided in groups or
individually. In this group of users, in which some clinicians consider difficult to deal with,
psychological participation is very necessary. There may be some benefit of discriminating

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between those who have a precarious commitment to themselves and those with long periods of
self-harm (National Collaborating Centre for Mental Health (UK) 2012).
The fact that social rejection or isolation, a higher burden of stress and ideation of suicide
leading to self-harm are grounded on strong and conclusive evidences. These actions or
behaviors pertaining to self-harm or self-injury can be moderated by social support (Wu et al.
2013). Studies have found that an adequate social support can modify or alter help seeking
behaviors in the individuals having tendency to harm themselves, for regulating individual
response to individual stressors and also for preventing anxiety and depression. Social support is
also found to affect directly on both mental health and also on the undesirable effects of life
events. Additionally, social support is also found to play a central role in improving social
function and thus, declining the severity of the mental disorder, subsequently decreasing the risk
of self-harm among the study population (Harandi, Taghinasab and Nayeri 2017).
Psychological management of self-harm among the study population
Among the various other psychological interventions adopted to manage or treat mental
illness and disorder, problem-solving therapy, psychodynamic interpersonal therapy and CBT are
found to be more effective in treating these mental conditions. It is also important to conduct the
primary, yet fundamental assessments to get the depression score and severity of the individuals
that will guide the treatment process (Washburn et al. 2012).
Pharmacological management of self-harm among the study population
Some of the psychopharmacological effects on self-harm as suggested by the evidences
include SSRIs like fluoxetine, atypical antipsychotics like aripiprazole and ziprasidon, opioids
like buprenorphine, SNRIs like venlafaxine and opioid antagonists like naltrexone (Turner,
Austin and Chapman 2014).

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Conclusion
The incidence of self-harm is increasing promptly among the young adolescents as a
result of various factors including academic pressure, poor financial or low socio economic
condition, substance abuse, traumatic life events, and sexual abuse or due to mental illness.
Although, the signs and behaviors of self-harm are evident in both the genders, women
population have shown an increased prevalence to self-harm or injury that have potential harmful
consequences. Adolescents and teenagers presenting with self-harming behaviors, though, do not
exhibit any severe psychopathology, it is still needed to have a detailed psychiatric assessment
including monitoring suicidal ide and the risk factors. Evidences have supported the strong
relationship between self-harm and mental disorder. It has been found that individuals with
mental disorder are more expected to have self-harming behaviors. Adolescents suffering from
mental distress, anxiety or depression are more susceptible to exhibit self-harming behaviors that
have detrimental consequences.

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