Self-harm study of Miss. youth finds highest rate in African-American males

A study of Mississippi youth who deliberately hurt themselves, and one of the first to examine self-harm across several demographics, found behaviors such as hitting, burning, biting, banging and cutting extend to African-American teens, boys in particular.

“Often times when people think of cutting or other self-harm, they imagine a white girl. No one thinks of an African-American boy,” said Dr. Kim Gratz, a UMMC psychologist who conducted the study.

“This study shows that there are youth in different racial and ethnic groups struggling with this behavior.”

The study’s authors define deliberate self-harm as behavior that breaks or bruises the skin but is done without suicidal intent. However, it is associated with higher risk of suicide.

Understanding the demographics of deliberate self-harm can help health professionals target prone teens and develop better prevention programs. As well, knowing which groups are most at risk can help teachers, parents and school administrators catch the behavior early, when treatment is most effective.

The researchers surveyed 1,931 students in grades 6-12 anonymously. Students were from one of six Mississippi schools in low-income areas. Results showed 39 percent, or 751 students, reported they had engaged in some form of deliberate self-harm.

Of those, 53 percent said they did so more than five times. And 78 percent of the 751 said they used more than one method.

By demographics, African-American boys were the most likely to engage in deliberate self-harm, followed by white girls. African-American youth in middle school reported higher rates of self-harm than their white peers. In high school students, however, rates were higher among white youth, a demographic group that showed significantly lower rates in middle school.

“Contrary to what may be popular belief, this study shows that African-American boys are struggling with this behavior at significant rates. And, compared with other groups, they seem to be engaging in this behavior at a younger age,” said Gratz, associate professor in the School of Medicine Department of Psychiatry and Human Behavior.

That makes identifying and treating it all the more important, she said, since earlier intervention yields better results. And in locations with limited mental-health resources, knowing who may be at greatest risk for self-harm is particularly important.

“What our findings say in particular is that if you’re trying to identify youth most at risk for self-harm, it may be helpful to focus attention on white girls and African-American boys.”

The journal Personality Disorders: Theory, Research and Treatment published the study in its January 3 issue.

What sets apart this investigation, Gratz said, is that no previous self-harm studies included a large enough African-American group to draw statistically relevant conclusions about the risk for this behavior across demographics.

Study co-author Dr. John Young, University of Mississippi assistant professor of psychology, works on the Behavioral Vital Signs project, a collaboration between Mississippi Children’s Home Services, Ole Miss and UMMC.

The project has collected and presented data in 86 schools about individual student-body behavioral ecology and social well-being. It provided self-harm data to Gratz.

“The fact that a lot of a lot of African-American males were doing these things has been extremely illuminating to the schools when we present them the information,” Young said. “Schools tend to engage the information in a different way when it’s something shocking or illuminating, versus when it’s information they’ve heard before.”

Young said such surveys and studies can help schools respond to mental health needs and, in the long term, influence educational policy.

The study also found a relationship between borderline personality features and the likelihood students will engage in deliberate self-harm.

Borderline personality disorder is driven by emotion disregulation, or difficulties managing emotions effectively—especially during distress— resulting in some of the symptoms of borderline personality disorder such as anger outbursts, arguments and impulsive or destructive behaviors.

Gratz said established treatments for borderline personality disorder – such as dialectical behavior therapy, where patients learn skills for regulating emotions and tolerating distress, may work for many youth engaging in self-harm.

“(The) findings highlight the importance of continuing to examine deliberate self-harm and its correlates among more diverse groups of at-risk youth,” she said.