Self-Injurious Behavior: Cutting Behavior in Teens

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Introduction

Self-Injurious behavior (SIB) is conduct committed by a person with the intent of causing physical harm to herself or himself. Deliberate self-harm among youths is done through poisoning, cutting, scratching, and overdosing. Adolescents and children with developmental and intellectual disabilities are at more risk of developing cutting behavior. They are usually not aware of their behavior effects, which have serious medical problems such as wound infections, excessive blood loss, and increased feelings of shame. Teens who hurt themselves have intense efforts to avoid suicidal thoughts, extreme anger or disgust, and intense distressing feelings (Černis et al., 2019). This paper expounds on self-injury behavior in teens aged between 10-11 concerning therapy, medication, and treatment.

Self-injury behavior is a critical problem in teenagers that poses great challenges in psychiatric centers. SIB is increasingly becoming prevalent in secondary schools, it accounts for about 2.2 to 15% of the population (Rioult, 2018). Self-harming individuals have a history of verbal, physical, or sexual abuse. The harm is usually a defense against hurting activities taking place in families and live cycles. In the past, self-injury was rarely practiced because it existed in secrecy, however, TV shows and movies have exposed the behavior (Daraganova, 2017). Consequently, drawing attention to the practice, teens aged 9-14 have been provoked to injure themselves as they struggle with self-identity crises.

Emotional abuse is a major cause of self-cutting behavior in children aged 10 and 11, furthermore, overwhelming social problems due to loss or failure also fuel these manners. Distressed individuals inflict pain on their bodies to release anger and gain a sense of relief from various modalities such as anger, tension, depression, and anxiety (Le Breton, 2018). Depression is the most frequent diagnosis of SIB leading to cutting behavior in teens, followed by dysthymia and anxiety disorders respectively.

Adolescents with self-harming tendencies show conduct disorder characterized by disruptive manners, externalizing disorders, aggression, and other behavioral problems. In addition, comorbid disorders as a result of an eating disorder such as anorexia nervosa, drug abuse, and excessive alcohol use are associated with teens with self-injuring inclinations. Risk-taking, loneliness, hopelessness, recklessness, and anger are some of the conditions that aggravate self-mutilative practices. Kids aged 10 and 11 self-inflicts wounds in their bodies as a way to manage strong feelings, emotional pain, relationship problems, and intense pressure.

Age Range of Normal Growth and Development

The normal growth and development phase refers to the age through which school-aged children mature mentally, physically, socially, and emotionally. It ranges from 5 to 12 years of age when several alterations occur (Rioult, 2018). During this period, a child is transitioning to adulthood, thus physical changes such as an increase in weight and height, growth of muscles, bones, and fats, and improvement of balance, strength, and coordination take place.

Emotional and social changes also occur in teens during the normal growth and development phase, acceptance is critical in this stage because a kid may want to fit in socially with other children. In addition, they are eager to socialize with others and appreciate social customs. Mental changes occurring in this growth phase cause kids to develop unknown fears, they also begin to think logically and number easily.

Common Variations that Impact a Child in the Education Settings

Human beings grow continuously from conception to death, however, each individual has a unique developmental trajectory. Biological, parental, and environmental factors effects growth outcomes. In teenagers, behavior emergence is dependent on several internal events such as expectations, self-perception, sensory and neural systems intentions, and goals. The external environments having an impact on children’s growth include societal roles, social influences, and physical environment. Additionally, disabilities and disorders collectively known as neurodevelopmental disabilities cause variation in school-going children.

Disability is an impairment that restricts people from performing some activities in a normal manner. It is broadly classified into two groups, which are physical and learning disabilities. Incapacity in children is characterized by physical anomalies during birth, autism cranial insult, severe learning inability, or motor nonfunctioning in the first year of life. Children with these incapacities are often exposed to discrimination and prejudice at school, this is because they are different from other kids.

The personal development of a child with a disability is influenced by family, personal attributes, level of care given, and social surroundings. However, the level of needs required by a child may increase during puberty and early schooling (Skehan & Davis, 2017). Teens aged ten and eleven are still struggling with self-identity issues. Therefore, teasing and bullying of these disabled adolescents by other teens result in a loss of self-confidence that later affects emotional development.

Learning disability is a disorder that causes variability in early childhood development, which has a significant impact on children’s educational needs. This condition is associated with communication and speech problems, it is triggered by several factors such as genetics, brain injury, brain infection before birth, and brain damage. The inability to express oneself properly leads to behavioral problems such as SIB. Examples of learning disabilities are Down syndrome, autism, and dyslexia. The stigma associated with these disorders results in coping stress and emotional difficulties for both family and the teen. For instance, social isolation due to feeling indifferent is likely to be experienced by the child.

Autism affects how children communicate and relate with the people surrounding them. Autistic kids have difficulties in understanding voice tones and facial expressions, and they often avoid social interaction, which makes them feel lonely and isolated from society. In school-going children and especially teens, this disability affects interaction and development in classrooms and other social settings. Dyslexia has an impact on the ability of a child to learn reading, kids with this problem are usually frustrated. Most of them develop behavioral problems such as dislike for school, undetected dyslexia hindering achievement, and school progress.

Attention deficit hyperactivity disorder is a behavioral and neurological condition that causes learning disabilities. It makes a person have difficulties in screening out distractions, staying on task, and inhibiting developmental outbursts. Teens with learning disabilities are vulnerable to struggles with self-image. This is because they are more aware of the difficulties they face in school. Issues such as low self-esteem, embarrassment, worries, and feelings of being a failure are common in youths with hyperactive disorder.

There are several physical disabilities such as deafness, delayed walking, and visual impairment that cause variation in child development. Cerebral palsy (CP) is the most prevalent form of physical incapacity in early childhood, it affects about 2 per 1,000 babies born in developed countries (Stang et al., 2020). Cerebral palsy is an umbrella term describing a wider group of non-progressive motor impairment disorders, lesions, and brain anomalies that occur in the brain during the early stages of growth. It affects an individual’s posture, movement, and coordination, in children and teens it causes difficulties in language and speech, seizures, and epilepsy. This condition has effects on the child’s emotional wellbeing, which later develops into behavioral problems such as SIB.

Various Techniques or Strategies that Might be Used to Assess Common Developmental Variations

There is no specific diagnosis for self-injury behavior, however, a psychological and physical evaluation is used by mental health professionals for identification. Self-harm culminates from repetitive behavior that leads to obsession and finally routine. The most preferred regions of the body for hurt include elbows, arms, legs, hands, and chest. Thus, signs such as scars and flesh injuries inflicted on the body confirm cutting behavior. Additional tools such as psychological tests and questionnaires are also used for assessment.

Developmental Behavior Checklist and Psychosocial Risk Assessment Instrument also known as HEADS are used to measure the overall emotional and behavioral disturbance in young persons that can lead to SIB (Smith & McGuinness, 2017). An aptitude test is also used to measure a child’s general learning ability. The conduct items scaled in the developmental behavior checklist include disruptive, communication disturbance, anxiety, self-absorbed, and social relating disturbances. Patients exhibiting self-harming tendencies need a meticulous evaluation to ascertain the best management strategies to be applied. A recurrent motif develops; statistical analysis using hurdle models helps in identifying repetitive harming patterns. Deliberate self-injury etiological factors used as diagnosis clues include impulsivity, abuse, poverty, low self-esteem, depression, and influence of intimidation in school.

Disruptive behaviors entail using abusive language, swearing, telling lies, and being stubborn and manipulative. Humming, whining, banging of head, eating non-edible items such as stones and chewing nails are some of the characteristics indicating self-absorption that may lead to self-injury behavior. Communication disturbances are characterized by confusion in using pronouns, repeating what others have said, speaking in whispers, an arrangement of objects, and following order or routine strictly. Anxiety is marked by excess attachment to a familiar person, excessive distress when left alone and being upset over small environmental changes. Socially related disturbances cause the child to be downcast, depressed, or unhappy.

Treatment and Therapies

Treatment of self-injuring behavior is based on the specific issue causing the mental disorder. For instance, borderline personality disorder, depression, or anxiety is treated by a psychiatrist to hinder harm tendencies. Psychotherapy, and psychological counseling aids in the treatment plan to manage and identify self-harm tendencies. Therapies help the patient to learn better stress management skills and emotional regulation. In addition, it also aids in developing health problem-solving skills, boosting self-image, and improving social skills.

Different types of individual psychotherapy that help correct self-injury behavior are cognitive-behavioral therapy (CBT), dialectical behavior therapy, and mindfulness-based therapies. Unhealthy negative beliefs and norms are identified and corrected by adopting new ones through the use of cognitive-behavioral therapy (Frey et al., 2017). Behavioral skill helps the child to develop abilities needed in tolerating distress, regulating emotions, and improving relationships between people. Mindful-based therapies reduce depression, anxiety, and the general well-being of the patient.

In the treatment of physical disabilities, adaptive equipment such as augmentative communication systems (picture boards, and sign language) and powered mobility is critical in creating a significant impact on language, social, and playing skills. It also encourages independent movement. Learning disabilities such as attention deficit hyperactivity disorder are commonly treated using medication, structuring of classroom environments to avoid distractions, and teaching parents to encourage appropriate behavior and set limits.

Other remedies such as family therapy and group therapy are helpful when dealing with self-hurt conduct. There is no specific medication for the treatment of self-injuring behavior, however, the specific mental health disorder causing cutting behavior such as anxiety disorder and depression are treated using antidepressants. Patients admitted with severe injuries may be admitted to the hospitals for psychiatric care and more intensive treatment. Successful intervention therapies develop positive mechanisms for coping that help in improving communication skills and reducing underlying distress.

Ethical, Professional, and Legal Standards for Disabled Teens Aged 10 and 11

According to the American Psychological Association, physicians should obtain informed consent before assessing a child (Stang et al., 2020). Furthermore, parents should be given full information about assessment procedures, potential risks, consequences, and benefits of treatment. All children have a right to be treated carefully and with respect, therefore, the principles of beneficence, autonomy, and justice should be applied when accessing adolescents and children for cutting behavior. Children aged 10 and 11 are developmentally able to voice their concerns. Thus, their opinions, desires, and needs for confidentiality should not be overlooked.

Impact of Faith in Dealing with Teens with Cutting Behavior

My faith tenets provide a moral and ethical framework to be used in the community, it requires one to be compassionate and loving towards other people regardless of their actions. I believe that people should be helped to handle life stressors and troubles, to achieve goodness, and behave well. For teens obsessed with cutting behavior, encouraging them to have self-control and increase their optimism by pointing out their strengths will be my wish. Damaging oneself or others is prohibited in my faith. Therefore, the teen will be discouraged from indulging in detrimental behaviors such as excessive drinking, smoking, and self-harm through cutting.

References

Černis, E., Chan, C., & Cooper, M. (2019). What is the relationship between dissociation and self‐harming behavior in adolescents? Clinical Psychology & Psychotherapy, 26(3), 328-338.

Daraganova, G. (2017). Self-harm and suicidal behaviour of young people aged 14–15 years old. Annual Statistical Report, 2016, 119-120.

Frey, G. C., Temple, V. A., & Stanish, H. I. (2017). Interventions to promote physical activity for youth with intellectual disabilities. Salud Pública de México, 59, 437-445.

Le Breton, D. (2018). Understanding skin-cutting in adolescence: Sacrificing a part to save the whole. Body & Society, 24(1-2), 33-54.

Rioult, C. (2018). Adolescent self-cutting: A form of narcissistic violence. Enfances Psy, (2), 114-124.

Skehan, B., & Davis, M. (2017). Aligning mental health treatments with the developmental stage and needs of late adolescents and young adults. Child and Adolescent Psychiatric Clinics, 26(2), 177-190.

Smith, G. L., & McGuinness, T. M. (2017). Adolescent psychosocial assessment: The HEEADSSS. Journal of Psychosocial Nursing and Mental Health Services, 55(5), 24-27.

Stang, K., Frainey, B., Tann, B., Ehrlich‐Jones, L., Deike, D., & Gaebler‐Spira, D. (2020). Understanding children with cerebral palsy and bullying: A mixed methods approach. Child: Care, Health and Development, 46(3), 303-309.

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