Self-Harm Predicts Suicide Risk
> 11/27/2007 2:06:47 PM

Thousands of young people choose to injure themselves every day - their behavior often borders on the pathological and may stem from any number of cumulative stressors: difficult relationships, negative self-assessments and the hopelessness that comes with chronic clinical depression. Acts like intentional cutting and burning are not suicide attempts, and most patients move through their self-harm periods to emerge as stronger adults, but for some young people, these acts only amount to the first steps in a recurring and potentially tragic scenario that only grows more intense with time. The practice of intentionally injuring oneself cannot be dismissed as a perverse teenage "hobby" or a silent histrionic cry for attention - self-harm almost always serves as evidence of much more pervasive problems, and it may predict serious suicide attempts.

In order to assess the subsequent behavioral patterns of patients who harm themselves, researchers at England's University of Oxford examined the medical histories of more than 5,000 individuals admitted to hospitals for injuries deemed to be self-inflicted. Each of these patients was between the ages of 15 and 24 when first admitted at some point in a 20 year period stretching from 1978 to 1997.

141 patients died between the study's initiation and the year 2000, and 81 of those deaths were determined to be suicides - an alarmingly high 57.4%. Many were attributed to respiratory, circulatory and cardiovascular afflictions, and studies have also noted these conditions to be more common among victims of the chronic, severe depression so common to self-harm cases. Overall risk of early death among this sample was more than four times greater than that of the general population. While far more women injure themselves (estimates run as high as 66-85%), men commit suicide at considerably higher rates, and nearly 2/3 of the patients who died during the study were men.

Distinguishing self-harm incidents from full suicide attempts very rarely proves difficult; among those who physically injure themselves, cutting is by far the most common method at nearly 90%, and the wounds inflicted are almost always superficial, but the scars and other, invisible marks they leave can last a lifetime. Patients also frequently re-open the same wounds. Most of those who harm themselves do not do so openly, wounding themselves in areas of the body that are covered by clothing or otherwise easy to hide. Individuals at risk can therefore be difficult to spot if the efforts to conceal their behaviors are sufficient enough to hide the signs from those closest to them.

Traits common to self-harm patients include depression, eating disorders, drug and alcohol abuse and a lack of interest in intimate relationships, but the central unifying characteristic of self-harm patients is the deep-seated disdain with which they view themselves. This tragic contempt may stem from any number of sources, but the inverted aggression, the disabling weight that follows them every day must be relieved in some way. While therapy and medication can certainly help counteract states of emotional instability and temper the extremity of the distress experienced by these patients, the most effective way to remedy the situation is for their loved ones to reinforce to them that they are worthy individuals able to love and be loved. This most basic form of emotional support may prove to be the difference between recovery and tragedy.

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