Over 40% of Youths With Eating Disorders Cutting and Burning Self – Stanford Study

From ScienceDaily…

Self-mutilation cutting behaviors over 40% in eating disordered youths

ScienceDaily (Oct. 7, 2010) — An alarming number of adolescents already battling eating disorders are also intentionally cutting themselves, and health-care providers may be failing to diagnose many instances of such self-injury, according to a new study from Stanford University School of Medicine and Lucile Packard Children’s Hospital.

The researchers found that 40.8 percent of patients with eating disorders in their study had documented incidents of intentionally harming themselves, most often by cutting and burning. What’s more, the study suggests that inadequate clinical screening might mean the count should be much higher.

“These are very high numbers, but they’re still conservative estimates,” said the study’s lead author, Rebecka Peebles, MD, who was an instructor in pediatrics at Stanford when the research was conducted and is joining the faculty at Children’s Hospital of Philadelphia.

Peebles noted that clinicians aren’t routinely asking about this activity. “We ask 97 percent of children 12 years and up if they smoke cigarettes; we need to get that good with screening for self-injurious behavior,” she said.

The study is to be published online Oct. 8 in the Journal of Adolescent Health. Its senior author is James Lock, MD, PhD, professor of psychiatry and behavioral sciences and of pediatrics. He is also psychiatric director of the Comprehensive Eating Disorders Program at Packard Children’s Hospital.

To conduct the study, the researchers examined the intake evaluation records of 1,432 patients, ages 10-21, who were admitted to the hospital’s eating disorders program from January 1997 through April 2008. Just over 90 percent of all the patients were female, three-quarters of them white, with a mean age of 15. Among the 40.8 percent identified to be physically harming themselves, the mean age was 16. Many of these patients had a history of binging and purging, and 85.2 percent of the self-injurers were cutting themselves.

The researchers also discovered that slightly fewer than half the charts showed that health-care providers had asked patients if they intentionally injured themselves. If patients aren’t asked, they are unlikely to volunteer such information, said Peebles.

Those who were questioned tended to fit previously published profiles of a self-injurer: older, white, female, suffering from bulimia nervosa, or with a history of substance abuse. “The question is, ‘Are we missing other kids who are not meeting this profile?'” Peebles said. “This is part of why we wanted to look at this. If you see an innocent-looking 12-year-old boy, you don’t even think of asking about self-injurious behavior. We need to get much better about universal screening.”

Peebles noted that the profile itself might be flawed. If health-care workers only ask a certain type of patient about a behavior, the profile that emerges will necessarily reflect that bias, she said.

The study did not examine the reasons behind such acts but Peebles said her clinical experience suggested patients “are trying to feel pain.”

“Patients describe a feeling of release that comes when they cut or burn themselves,” she said. “They’ll cut with a razor or a scissor blade. Sometimes we’ve even had kids who will take the tip of a paper clip and gouge holes. To burn themselves, they’ll heat up a metal object and press it to their skin, or they’ll use cigarettes.”

Physicians and other health-care providers at Packard’s Comprehensive Eating Disorders Program now question all new patients about self-injurious behavior. Studies have shown that between 13 and 40 percent of all adolescents engage in some form of self-injury, which is also associated with a higher risk of suicide.

“In clinical practice, kids are fairly open when you engage with them,” Peebles said. “They’ll come in wearing long sleeves, or hiding the marks on their inner thighs. But then when you ask them, they are usually willing to discuss the behavior.”

For full article, click here.

Please Note: This article is not intended to provide medical advice, diagnosis or treatment.

I’ve witnessed cutting behaviors on the rise in my practice, particularly in those with borderline personality disorder and eating disorders. I recall it was shock when I first encountered cutting with one of my own family  members nearly 20 years ago. Now I’m seeing it much more frequently. In fact, some high school students are trying to help friends on their own with cutting behaviors. In one case, a high school student who was cutting was encouraged to go to her parents for help. The parent responded by yelling at the child ‘You can’t feel that way. We have a $2 million house. You have everything you could ever want. That’s ridiculous!’

Sometimes cries for attention are really cries for attention and need to be listened to with compassion. Then address them by seeking out professional help.

John Schinnerer Ph.D.

Founder Guide to Self, Inc.

For a free copy of John’s award-winning book on emotional management, visit http://www.GuideToSelf.com. You can get an instant PDF copy in exchange for your name and email address!

 MLA Stanford University Medical Center (2010, October 7). Self-injury behavior not recognized in many youths with eating disorders. ScienceDaily. Retrieved October 8, 2010, from http://www.sciencedaily.com­ /releases/2010/10/101007184116.htm

Student Rehab – 12 Step Program for the Digitally Addicted

It’s August 12th! Less than 2 weeks left before school starts!

You know what time it is!

Time for Back to School Rehab!

Teacher: ‘So students, did everyone have a wonderful Summer?

Okay, glad to hear it.

Now I know you’ve spent the past 3 months playing video games, tweeting and texting on your phones, and fondling the remote control mindlessly, so it’s time for some brief solution-focused group therapy.

How many of you can focus on one thing for longer than 3 seconds?

How many of you have heard of a handheld wireless tool called a ‘book?’

Award-winning book Guide To Self: The Beginners Guide to Managing Emotion and Thought

Let’s see a show of hands please….hold them up. Okay, 2 of you.

In that case, let’s talk about addiction.

Johnny, I need you to stop moving your thumbs.


Yes, just use your thoughts, dear. Really, you can stop fidgeting using your mind!

I know it’s difficult, dear. Just give it a try.

The withdrawals from your iPhones, video games and laptops seem just as bad as nicotine detox.

Addiction is when you can’t stop thinking about where your next fix is coming from. So if all you can think about is getting home to fire up WOW or COD, you just might be addicted!

Call of Duty (COD)

Addiction is when you spend all your energy focusing on how your going to get your next fix. So if you are counting the seconds from first period to the end of the school day while worrying about playing Angry Birds on the iPhone, you just might be addicted!

Remember, quitting technology cold turkey can be brutal.

So if you need a fix during the school day, we were just got in some brand new Kindles. You can use them in the meantime to quiet those nasty eye twitches and finger tics.

Alright. I’m glad we had the chance to have this little chat. There’s the school bell.





John Schinnerer Ph.D.

A Positive Psychology Approach to Teaching? What Teachers Make by Taylor Mali

Uplifting video poetry/performance art – ‘What Teachers Make’ by Taylor Mali.

You MUST check this short inspirational video out. Fantastic! Well done, Taylor!

If I don’t see you first, have a relaxing and interesting spring break!

On your mind,


John Schinnerer, Ph.D.
Positive Psychology Coach
Guide To Self, Inc.

Is Wrestling A Socially Acceptable Way for Male Siblings to Fulfill Their Need for Touch?

I find this idea of covert intimacy among males fascinating as well. I wonder if one of the functions of sibling rough-housing and wrestling fulfills the function of covert intimacy and allowing brothers to touch one another in a masculine, socially permissible way. 

Brothers fight for a number of reasons….

  • They fight to get their parent’s attention, and the parent is limited in time, attention and patience, so they are fighting for a limited ‘commodity.’
  • They wrestle due to jealousy: “He got a new game. I did not. They love him more than they love me.”
  • They rough-house as a result of teasing, which is one way to test the power of words on behaviors: “He said I was a…” “But he called me a little .. first!”
  • They get in each other’s face partly as a result of socialization. We live in a competitive society which frequently reinforces the idea that winning is better than losing.  “I had it first.” “I can beat you at…. I am better than you.”
  • Perhaps, another reason to add to the list is that, in some manner, wrestling and rough housing allow boys to fulfill their need for touch in an acceptable way (that is, acceptable to society, not so much to their parents!).

 From Close Relationships: A Sourcebook by Clyde Hendrick, Susan Hendrick, p. 307…

‘Swain (1989) coined the phrase ‘closeness in the doing’ to describe men’s friendships. More than two thirds of the men studied by Swain pointed to activities other than talking when asked to describe their most meaningful times with friends. Swain’s study, as well as research by others (Monsour, 1992; Sherrod, 1989; Williams, shows that playing and watching sports and doing other things together are what male friends cite most often as the basis of camaraderie and closeness. Because men typically are not socialized to engage in expressive communication, male friends are less likely to talk intimately about problems than to help each other out by suggesting diversionary activities such as going out for drinks or watching games (Cancian, 1987; Riessman, 1990).

Although men might care deeply about their male friends, they are less likely than women to express those feelings explicitly. Instead, they tend to engage in what Swain (1989) referred to as ‘covert intimacy’, which signals intimacy indirectly and often nonverbally. Affectionate punches, backslapping, and friendly teasing are examples of displays of covert intimacy. Based on a series of men’s friendships, Floyd (1997b) concluded that men are not less affectionate than are women but that men ‘simply communicate affection in different more ‘covert’ ways, so as to avoid the possible ridicule that more overt expression might invite (see also Floyd, 1995, 1996, 1997).’  

Have a terrific Thursday!

John Schinnerer, Ph.D.Guide To Self, Inc.

Positive Psychology Coach

Older Brothers Related to Greater Aggression in Younger Siblings – Per UC Davis

I’ve been heading up a book club on adolescent boys at the local high school here. One of the topics that comes up frequently is aggression and fighting between adolescent brothers (as well as some reports of aggression outside the family). As I’m getting updated on the latest research on this topic, I thought I’d share some of the best studies with you. Hope you enjoy them!

Source:  UC Davis News Service

DAVIS — Children who grow up with an older brother tend to become more aggressive as they move through adolescence, while those with a younger sister tend to become less so, according to a new study by researchers at UC Davis. The study appears in the latest issue of the journal Child Development.

“Siblings contribute unique opportunities for children and adolescents to practice certain types of aggressive behaviors, including teasing, threatening and fighting,” said lead author Shannon Tierney Williams, who conducted the research as a postdoctoral researcher in Human and Community Development at UC Davis. “And because boys consistently demonstrate higher rates of aggression than girls, it may be that adolescents are affected more strongly by the aggression of brothers.”

Williams and her colleagues conducted annual assessments of sibling pairs from 451 rural Iowa families — 902 adolescents in all — from 1989 through 1992. Each assessment involved a home visit, during which parents and kids completed a set of questionnaires in which siblings rated their own aggressive behaviors and parents described economic pressures on the family. Families were also videotaped, without researchers in the room, as they discussed household issues and tried to resolve a real-life family conflict. The videotapes were then analyzed for clues to family hostility, coercion, warmth and support.

The researchers found that on average, aggression increased over time in adolescents with an older brother but remained stable in those with an older sister.

For the older sibling, aggression decreased when the younger sibling was a girl but remained stable when the younger sibling was a boy.

“By having younger sisters, who typically exhibit lower levels of aggressive behaviors, particularly early in adolescence, older siblings may have fewer chances to practice their aggressive behavior,” Williams said.

Parental hostility and family economic stress also played a role in adolescent aggression, the researchers found.

The findings suggest that efforts to address adolescent aggression should involve siblings and families, Williams said.

Her co-investigators were Katherine Jewsbury Conger, an assistant professor of human and community development at UC Davis, and Shelley Blozis, an assistant professor of psychology.