From the Journals

Self-harm on rise in U.S. among girls aged 10-14



The rate of self-inflicted injuries has increased significantly among young girls since 2009, according to a study of emergency department visits for self-inflicted injuries from 2001 to 2015.

In a research letter, Melissa C. Mercado, PhD, and her associates reached that conclusion based on data from 43,138 emergency department visits for self-inflicted injury among young people aged 10-24 years, which were captured by the National Electronic Injury Surveillance System–All Injury Program (JAMA. 2017;318[19]:1931-3. doi: 10.1001/jama.2017.13317).

From 2001 to 2008, the overall weighted, age-adjusted rate of self-inflicted injury showed no statistically significant trend upward or downward, reported Dr. Mercado of the National Center for Injury Prevention and Control, Atlanta, and her associates. From 2009 to 2015, however, the rate increased by a significant 5.7% per year, reaching 303.7 per 100,000 population in 2015, compared with 201.6 in 2001.

This increase was even more pronounced among girls, rising by 8.4% per year from 2008 to 2015 in all females but by 18.8% per year in those aged 10-14 years. In adolescent females aged 15-19, the rate of self-inflicted injury rose 7.2% per year from 2008 to 2015. In young women aged 20-24 years, the rate rose 2% per year from 2001 to 2015.

Meanwhile, the rates of self-inflicted injury for males were stable across all time periods and age groups.

“Self-inflicted injury is one of the strongest risk factors for suicide – the second-leading cause of death among those aged 10 to 24 years during 2015,” Dr. Mercado and her coauthors wrote.

The most common method of self-inflicted injury for females was poisoning. As with the overall rates of injury in females, the rates of this method of harm were stable until 2007, then increased by 5.3% until 2015. Self-inflicted injuries among females using a sharp object increased by 7.1% each year from 2001 to 2015, but the rates of blunt-object injuries were stable from 2006 to 2015.

The authors wrote that the finding of an increase in self-harm among females was consistent with youth suicide data, which also show an increase after 2006, particularly among girls and female adolescents aged 10-14 years.

Dr. Mercado and her associates called for the implementation of evidence-based, comprehensive suicide and self-harm prevention strategies. “These strategies include strengthening access to and delivery of care for suicidal youth within health systems and creating protective environments, promoting youth connectedness, teaching coping and problem-solving skills, and identifying and supporting at-risk youth within communities.”

The study was conducted under the auspices of the National Center for Injury Prevention and Control, which is part of the Centers for Disease Control and Prevention. The findings, however, do not necessarily represent the views of the CDC. No conflicts of interest were declared.

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