There's another teenage behavior to alarm American parents. Doctors have come across a little-reported form of deliberate self-injury by teenagers — embedding objects ranging from glass to needles to wood under their own skin.
In recent years, the problem of "self-harm," particularly among teens, has received increasing attention in the media and in medical studies. Self-harm refers to self-inflicted injuries that are not intended to be fatal although there is evidence that people who self-harm are more at risk of suicide.
But a new study of children undergoing radiology treatment at the Nationwide Children's Hospital in Columbus, Ohio, has pointed to another little-recognized form of self-injury where children embed objects under their own skin.
In a report published in the journal Radiologys, researchers from the hospital describe the cases of 11 teenagers who were treated to remove foreign objects deliberately implanted through cuts in their skin.
The patients had implanted a total of 76 objects -- including paper clips, staples, pencil lead and glass fragments -- in what the researchers term "self-embedding behavior." Researcher Dr. William E. Shiels II said this latest report appeared to be the first to describe a series of teenage patients with self-embedding behavior -- and the first to detail the successful removal of the implanted objects with the help of ultrasound and/or fluoroscopic imaging.
He said most parents were unlikely to know self-embedding behavior exists, and the same is true of most doctors.
To date the spotlight has mainly been on the practice of "cutting," where a person uses a razor or knife to make cuts in their skin, often, research suggests, with the goal of using the pain to distract from other emotional pain or feelings.
Shiels told Reuters Health that the goal of reporting on this series of patients was to bring self-embedding behavior to the attention of parents and teachers, as well as pediatricians, ER doctors and radiologists.
The findings come from a review of 600 patients at Nationwide Children's Hospital who were part of a long-term study of using imaging technology to help remove small foreign bodies embedded in patients' soft tissue.
Most of these children had been involved in accidents but Shiels and his colleagues identified 11 patients -- nine girls and two boys aged between 14 and 18 -- who were self-embedding.
All 11 teenagers had a history of mental health conditions, including bipolar disorder, depression, and anxiety disorders.
Shiels said the study illustrates a "clear role" for radiologists for spotting self-embedding behavior.
"We may become the first provider to make a clear diagnosis of it," he said.
Shiels said there were not yet any estimates of how common self-embedding might be but there are some figures on self-harm.
According to a recent research review, studies suggest that 1 percent to 4 percent of adults have deliberately injured themselves but up to 23 percent of teenagers admit to trying self-harm, again most commonly by cutting.
Researchers say it is unclear, whether self-harm is actually becoming more common, or whether adults are more reluctant than teenagers to admit to past or current self-harm.