http://www.sciencedaily.com/releases/20 ... 135015.htmSource: University of Washington
Posted: June 16, 2006
Physiological Markers For Cutting, Other Self-harming Behaviors By
Teenage Girls Found
Non-fatal, self-inflicted injuries by adolescent and young adult
females are major public health problems and researchers have found
physiological evidence that this behavior may lead to a more serious
psychological condition called borderline personality disorder.
NaNUniversity of Washington psychologists have discovered that
adolescent girls who engage in behaviors such as cutting themselves
have lower levels of serotonin, a hormone and brain chemical, in
their blood. They also have reduced levels in the parasympathetic
nervous system of what is called respiratory sinus arrhythmia, a
measure of the ebb and flow of heart rate along with breathing.
"A low level of this measure of the parasympathetic nervous system
is characteristic of people who are anxious and depressed and among
boys who are delinquent. But this is the first study to show it
among adolescent girls who engage in self-harming behavior," said
Theodore Beauchaine, UW associate professor of psychology.
The findings come from a study that also uncovered sharp disparities
in the number of self-harming events and suicide attempts reported
by the girls and their parents.
The research, headed by Sheila Crowell, a UW psychology doctoral
student, focused on girls because self-harming behavior affects
females far more often than it does males. The study included 23
girls, ages 14 to 18, who engaged in what psychologists call
parasuicidal behavior. Participants were included if they had
engaged in three or more self-harming behaviors in the previous six
months or five or more such behaviors in their lifetime. An equal
number of girls of the same ages who did not engage this behavior
were enrolled as a comparison group.
The adolescents in the parasuicide group reported far more incidents
of self-harming behavior than did their parents. Individuals engaged
in this kind of behavior between 11 and 839 times. Their parents,
however, reported a range of 0 to 205 incidents. Similarly, the
girls reported more than three times the number self-harming
behaviors with intent to die, 310 events versus 90, than their
parents did. However, the girls and their parents were very close on
the number of times an adolescent required medical attention.
Twenty of the girls, or 87 percent, reported at least one attempted
suicide, but Crowell said this number is not that surprising in this
population.
"You need to understand a person's intent and the lethality of their
attempts," she said. "Did they take a small number of Tylenol or
were they holding a loaded gun to their head?"
She noted cutting was the most common self-harming behavior in which
the girls engaged. Eight-two percent of girls used instruments
ranging from paper clips to kitchen knives and razors with the
intent of hurting themselves.
"These attempts have to be taken seriously," said Beauchaine. "These
girls may be really at risk for later suicide, and in the long term
there needs to be studies of the progression of self-harm attempts."
To find physiological markers of self-harming behavior, the UW
researchers showed both groups of adolescents a three-minute film
clip from the movie "The Champ" depicting a boy with his dying
father. Previous studies have shown the film can induce sadness. A
number of different psychophysiological measures were collected from
each of the girls before, while and after viewing the film clip.
Following the viewing a small blood sample was taken to measure
whole-blood serotonin.
The girls who engaged in self-harming behavior had lower levels of
respiratory sinus arrhythmia in their parasympathetic nervous system
while watching the film clip. These measures, the researchers argue,
support the idea that the inability to regulate emotions and
impulsivity can trigger self-harming behavior.
"This research supports the primary theory that borderline
personality disorder is caused by an inability to manage emotions.
These girls have an excessively strong emotional reactions and they
have extreme difficulty in controlling those emotions," said
Beauchaine. "Their self-harming behavior serves to distract them
from these emotions."
Borderline Personality Disorder is far more serious than self-
harming behavior and people with the condition have a very high
suicide rate. An estimated 5.8 million to 8.7 million Americans,
mostly women, suffer from borderline personality disorder. People
with the condition have a multiple spectrum of disorders that are
marked by emotional instability, difficulty in maintaining close
relationships, eating disorders, impulsivity, chronic uncertainty
about life goals and addictive behaviors such as using drugs and
alcohol. They also have major impact on the medical system by being
among the highest users of emergency and in-patient medical services.
Co-authors of the study are Elizabeth McCauley, UW professor of
psychiatry and behavioral science; Cindy Smith a former psychiatrist
at Children's Hospital who is now in private practice; Adrianne
Stevens, an incoming UW psychology graduate student, and Patrick
Sylvers, a former UW student who is now a graduate student at Emory
University. The study, published in the journal Development and
Psychopathology, was funded by Seattle Children's Hospital, the
National Foundation for Suicide Prevention and the National
Institute of Mental Health.
