Lead researcher Larry K. Brown, MD, of BHCPRC believes that the findings should especially resonate with physicians since they are often the first ones in the medical community to determine if patients have been harming themselves.
"When adolescents come in to seek clinicians, they'll know if a patient self-cuts, but very seldom do clinicians think that he or she is taking sexual risks too," says Brown.
In addition to finding a link to sexual behavior, the study found that self-cutters were significantly more likely to be white, female, and to have histories of sexual abuse.
According to Brown, none of the researchers realized that there would be such a strong relationship between self-cutting and sexual risk. Current theory holds that adolescents who cut do it because they are dissociating, or removing themselves from the trauma of having been sexually abused.
However, the researchers discovered that even when researchers controlled for abuse factors, self-cutting is strongly associated with sexual risk behaviors such as not using condoms.
"Our first thought was that the subjects cut themselves because of previous sexual abuse, but there's much more than that – there's some link between not being able to manage your feelings which leads you to cut yourself and also make it likely that you'll take sexual risks," Brown explained.
Brown believes that the two behaviors – self-cutting and sexual risk - are probably due to a single underlying psychological problem.
"Lack of self-restraint, or the inability to manage strong impulses and emotions may link self-cutting and sexual risk behaviors – in addition, self-cutters may have high rates of other risk behaviors such as suicide attempts, personality disorders or substance abuse."
The study focused on a group of adolescents in intensive psychiatric treatment, and almost half (47%) of the subjects admitted to cutting themselves at least once. Surveys of a more general community have reported the number of self-cutters in adolescents and college students to be around 14%.
In short, teens with abuse history take sexual risks and teens who self-cut take sexual risks. But teens that have been abused and cut take even more sexual risks. "The effect is additive," says Brown.
This research was supported by a grant from the National Institute of Mental Health. The authors, Larry K. Brown, MD, Christopher D. Houck, Ph.D., Wendy S. Hadley, Ph.D., and Celia M. Lescano, Ph.D. are affiliated with the Bradley/Hasbro Children's Psychiatric Research Center, the research arm of Bradley Hospital in East Providence, RI and the department of psychiatry at Brown Medical School.
Founded in 1931 as the nation's first psychiatric hospital for children, Bradley Hospital (www.bradleyhospital.org) remains the premier medical institution devoted exclusively to the research and treatment of childhood psychiatric illnesses. Bradley Hospital ranks in the top third of private hospitals in the country receiving funding from the National Institutes of Health. As an affiliate of Brown Medical School, Bradley employs faculty who are active in clinical research. Its research arm, the Bradley/Hasbro Children's Psychiatric Research Center (BHCPRC), encompasses a wide range of research programs that share a commitment to studying the impact of psychological factors on the growth and development of children and their families. Bradley Hospital is a partner of Lifespan, a health care system based in Providence, RI.
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Psychiatric Services