How Many Teenage Girls Deliberately Harm Themselves? Nearly 1 in 4, Survey Finds.

The New York Times

Rates of self-injury are even higher in parts of the United States, according to government data. Boys are half as likely to harm themselves.

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An increase in self-injuries, especially among teenage girls, showed up in a survey of 65,000 high school students. CreditYoon S. Byun/The Boston Globe, via Getty Images

Up to 30 percent of teenage girls in some parts of the United States say they have intentionally injured themselves without aiming to commit suicide, researchers have found.

About one in four adolescent girls deliberately harmed herself in the previous year, often by cutting or burning, compared to about one in 10 boys.

The overall prevalence of self-harm was almost 18 percent.

“These numbers are very high for both genders — that surprised me,” said Martin A. Monto, a sociologist at the University of Portland and lead author of the new research.

Dr. Monto and his colleagues drew on data from a risk behavior survey administered by the Centers for Disease Control and Prevention in 2015. Their report, published online in the American Journal of Public Health, included almost 65,000 public high school students in 11 states.

Most previous studies have examined self-harm among adolescents only in developed countries, in general, or in American adolescents admitted to a clinical setting.

Delaware reported the lowest rates of deliberate injury: 6.4 percent among boys and 17.7 percent among girls. The highest rates were found among boys in Nevada (14.8 percent) and girls in Idaho (30.8 percent).

Adolescents of both sexes reported injuring themselves at rates above 20 percent in Idaho, Kentucky, Nevada and New Mexico. Girls reported self-injury at twice the rate of boys in all but two states.

The results varied by race. More than 20 percent of Native American students reported self-harm, followed by Hispanic, white and Asian students. Only 12 percent of black students reported self-injury.

The behavior also declined with age, from 19.4 percent among 14-year-olds to 14.7 percent among 18-year-olds.

There are wide gaps in researchers’ understanding of self-harm, Dr. Monto noted: “Is adolescence more difficult in some states than in others? What does it actually mean to them when they do it? How is the behavior learned and regarded differently in different cultures?”

Adolescent girls who participated in the survey were more likely than boys to report belonging to the L.G.B.T. community and having been sexually assaulted or bullied online. But males were more likely to report smoking and using drugs. All of those factors were at least somewhat linked with purposeful injury.

The C.D.C. only recently began asking adolescents about self-injury, so it is unclear whether there has been a significant uptick in prevalence over generations.

The practice is so widespread across both sexes that addressing it on a case-by-case basis — instead of as a public health problem — may be insufficient, the researchers said.

“Parents who deal with this often think their child is a clinical anomaly,” Dr. Monti said. “It’s certainly not a healthy behavior — it’s harmful. But if your child has done this, the data shows that it doesn’t make them an unusually ill person.”

Advice on Helping Teen Girls Thrive

The Wall Street Journal

Stumped by a teenager’s mood swings? Read the latest research on helping girls between 10 and 15 years old flourish

New research offers insight into helping teenage girls thrive. 

Screaming, slamming doors and careening from one emotional outburst to the next—all can be part of life with a teenage girl.

Although girls approaching their teens are often years ahead of boys in gaining height, language and social skills, those strengths mask some important vulnerabilities.

Questions about helping teen girls thrive are a source of interest for psychologists and neuroscientists, sparking more than three dozen studies in the past year. Here’s a guide to the findings:

Ages 10 to 11: Early signs of puberty set in sooner than many parents expect. Girls begin staying up later and having their first crushes. Many are beset by strong, volatile emotions, ending a period of relative calm from ages 6 to 11, says Lisa Damour, a psychologist and director of the Laurel School’s Center for Research on Girls in Shaker Heights, Ohio.

ILLUSTRATION: ROBERT NEUBECKER

Some girls mature faster and begin menstruating at age 10 or 11, compared with an average of 12 to 13. Early-maturing girls are at higher risk of behavior problems and depression. Girls who look older than their years often attract older peers who may lead them into risky behaviors.

Early-maturing girls who hang out with school friends the same age, rather than older friends from outside school, fare better. Also, those who say they’re close to parents and can talk with them about many things have a better chance of thriving, research shows.

Ages 12 to 13: Girls typically are more skilled than boys at expressing their emotions and interpreting others’ moods at this stage. They’re quicker to grasp nuances of humor.

Girls are also more vulnerable to stress than boys.

ILLUSTRATION: ROBERT NEUBECKER

A stress hormone that has a calming effect on teen males and adults may make teen girls more anxious, based on research on female rats. And teen girls are more sensitive to rejection, showing a sharper rise in stress hormones when trained peers in laboratory simulations exclude them from conversations, according to a 2017 study of 59 children and teens led by Laura R. Stroud, a senior research scientist at Brown University’s Warren Alpert Medical School.

Girls whose parents give them strategies for solving social problems—by suggesting they join a school club to meet peers with similar interests, for example—have stronger friendships, according to a 2017 study which surveyed 123 middle-schoolers and their parents and teachers twice over 10 months.

Girls also need help managing strong emotions, Dr. Damour says. One eighth-grade girl screamed in distress after finding out about a bad grade online, as if “she walked into a mass-murder scene,” the girl’s father told researchers in a 2016 study.

Teenage girls are hardwired for drama, according to Family therapist Colleen O’Grady, author of “Dial Down the Drama.” But there are key ways daughters and mothers can find common ground. She offers tips for keeping the peace on Lunch Break with Tanya Rivero. Photo: iStock

Parents should avoid overreacting. “The No. 1 mistake parents make when their kid is in distress is to jump in to solve the problem,” says Michael Y. Simon, an author and school counselor in New Orleans.

Simply helping a girl name what she’s feeling and talk about it can have an almost magical calming effect, Dr. Damour says. Teens who are able to ask for and receive support and problem-solving help from their mothers at age 13 tend to be more independent and better educated at 25, according to a 12-year study of 184 subjects.

Some girls try to cope by sharing too much or attacking others on social media, which tends to amplify bad feelings. Dr. Damour advises curbing social-media use and guiding girls toward face-to-face activities instead.

Ages 14 to 15: Girls’ interactions with parents can take a negative turn, and some become pessimistic in the face of challenges. Boys offered a chance to win rewards in a Wheel of Fortune-like game became excited and motivated, while girls said the challenge made them anxious, says a 2017 study of 167 teens with an average age of 14.

ILLUSTRATION: ROBERT NEUBECKER

Girls tend to have more negative conflicts with parents than boys. A certain amount of arguing helps teens learn to control themselves and negotiate differences, Mr. Simon says. Parents who can listen with respect and disagree calmly make teens feel as if their opinions matter, helping build a sense of identity.

Some teens, however, unconsciously dump negative feelings on a parent so Mom or Dad will feel bad in their stead, says Dr. Damour, author of “Untangled,” a best-selling book on raising adolescent girls. They also tend to make bad feelings worse by ruminating or brooding over them. Rumination is linked to depression in teen girls, who suffer the malady at nearly twice the rate of boys.

If a girl is ruminating on a problem she can do something about, help her get started on working toward a solution, Dr. Damour says. If it’s something she can’t change, help her find a happy distraction. Preteen and teenage girls posted lasting improvements in feelings of mastery and closeness with others after taking part in a one-week mountain-biking program where they were also coached on goal-setting, self-expression and team-building, according to a 2016 study of 87 girls.

Teen girls who embrace goals that involve helping others also have a higher likelihood of thriving. Such teens tend to have parents who trust them and listen when they talk about problems, says a coming study of 207 girls led by Belle Liang, a professor of counseling and psychology at Boston College.

Write to Sue Shellenbarger at sue.shellenbarger@wsj.com

Appeared in the Apr. 12, 2017, print edition as ‘Teenage Girls: An Expert Guide.’

Teen Girls And Social Media: A Story Of ‘Secret Lives’ And Misogyny

NPR

Nancy Jo Sales interviewed more than 200 teenage girls about their social media and Internet habits while researching her book American Girls.

Knopf

Social media and dating apps are putting unprecedented pressures on America’s teen girls, author Nancy Jo Sales says. Her new book, American Girls, opens with a story about one 13-year-old who received an Instagram request for “noodz” [nude photos] from a boy she didn’t know very well.

“When I was a girl and the things that would come up in your life that were difficult or troubling or whatever — there was always a Judy Blume book for it,” Sales tells Fresh Air’s Terry Gross. But, Sales says, when it comes to responding to an out-of-the-blue solicitation for naked images, “there’s no Judy Blume book for that. There’s nothing for them to turn to, to know, like, ‘How do I react to this?’ ”

In the 2 1/2 years she spent researching her book, Sales interviewed more than 200 teenage girls around the country about their social media and Internet usage. She says girls face enormous pressures to post “hot” or sexualized photos of themselves online, and she adds that this pressure can make the Internet an unwelcoming environment.

“I think a lot of people are not aware of how the atmosphere has really changed in social situations … in terms of how the girls are treated and how the boys behave,” Sales says. “This is a kind of sexism and misogyny being played out in real time in this really extreme way.”


Interview Highlights

American Girls

On how males’ and females’ pictures differ on Tinder

I talked to an 18-year-old girl who is talking about looking at Tinder with her older brother and … she said she was struck by the way in which the boys and men’s pictures were very different than the girls’. Guys tend to have a picture like, I don’t know, they’re standing on a mountain looking like they’ve climbed the mountain, or they’re holding a big fish or they’re doing something manly, or in their car. … But the girls’ pictures … tend to be very different; they tend to be a lot more sexualized.

This is a pressure on social media that goes back, for women and girls, a long time. … I trace the origins back to a site called “Hot or Not” which came out in 2000. … The whole idea of “hotness” has become such a factor in the lives of American girls, unfortunately, because according to many, many studies, including a really landmark report by the American Psychological Association in 2007, this has wide-ranging ramifications for girls’ health and well-being, including studies that link this pressure to sexualize on all kinds of things like rising anxiety, depression, cutting, eating disorders. It’s a thing that I don’t think that boys have to deal with as much.

On boys asking girls for nude photos

I think the fact that so often we’re talking about nudes and sexting is because kids are watching porn. There’s multiple studies that say that they are. We know that they are. They’re curious. They’re going through puberty. They’re watching porn. And yet, nobody really talks about it or talks about the fact that it has an effect on how they behave and what they think about sex and sexuality and how they deal with each other. And there’s really no guidelines for girls about how to react to all of this. …

Some 13-year-old girls in Florida and New Jersey both told me that if they didn’t [send photos] they had been threatened with boys sending rumors about them, sending around a picture that actually wasn’t them and saying it was them. I mean, there’s a kind of thing in adult life that we know about called revenge porn, and that happens among kids as well, unfortunately.

It’s very risky for girls to send nudes because when they do, if they chose to, those photos are not private. They can be shared and very often they are shared. I heard story after story of situations where girls had pictures of themselves sent around to groups of people. It has become such a normal thing to them.

On “slut pages”

A “slut page” is when someone, typically a boy, not 100 percent of the time, but mostly a boy or boys, will collect nude photos of girls in their school or in the area’s schools and post them on a page. I’ve seen them on Facebook or Instagram. It looks like an amateur pornography site — it is an amateur pornography site, I would say — and it’s underage girls and pictures that are sent to someone, very often that they think won’t share them but who does. It’s a nonconsensual sharing of these pictures, and sometimes without their knowledge.

I’ve talked to girls who found out about it through text. Suddenly their phone blows up and they find out, “Oh my god, you’re on this page.” I think it’s very threatening because it’s abuse of a certain kind and it’s harassment, and it’s very often not punished in any way, or even known by adults.

On how porn is affecting sex

It was through talking to girls that I started thinking about porn, and they really enlightened me about the effect that porn was having on their lives, because they would start describing to me interactions that they had with boys. For example, “Send me nudes,” or a boy sending a nude picture of himself. … These things that they’re describing sound violent to me. They say, “[Boys] expect this, and they expect that, and they want you to do this, and they want you to do that.” And these things, they’re all the hallmarks of the most popular online porn.

There’s different things that are sort of popularized in porn. Pornographers have found that they get more traffic, more clicks, more views, whatever, the more extreme that it is. That seems to be the trend that has happened in porn in the last decade or so, right? So there are certain acts or moves or behaviors, whatever, which are filtering their way into the sexual encounters of teenage girls and boys.

Depression Strikes Today’s Teen Girls Especially Hard

NPR

A new study suggests that teen girls experience more bouts of depression than teen boys.

Nicole Xu for NPR

It’s tough to be a teenager. Hormones kick in, peer pressures escalate and academic expectations loom large. Kids become more aware of their environment in the teen years — down the block and online. The whole mix of changes can increase stress, anxiety and the risk of depression among all teens, research has long shown.

But a recent study published in the journal Pediatrics suggests many more teenage girls in the U.S. may be experiencing major depressive episodes at this age than boys. And the numbers of teens affected took a particularly big jump after 2011, the scientists note, suggesting that the increasing dependence on social media by this age group may be exacerbating the problem.

Psychiatrist Ramin Mojtabai and colleagues at Johns Hopkins University Bloomberg School of Public Health wanted to know whether rates of depression among teens had increased over the past decade. They analyzed federal data from interviews with more than 172,000 adolescents. Between 2005 and 2014, the scientists found, rates of depression went up significantly — if extrapolated to all U.S. teens it would work out to about a half million more depressed teens. What’s more, three-fourths of those depressed teens in the study were girls.

The findings are just the latest in a steady stream of research showing that women of all ages experience higher rates of depression compared to men, says psychologist and author Catherine Steiner-Adair. And no wonder, she says — despite gains in employment, education and salary, women and girls are still “continually bombarded by media messages, dominant culture, humor and even political figures about how they look — no matter how smart, gifted, or passionate they are.”

Today’s constant online connections — via texting, Facebook, Instagram and Snapchat, — can exacerbate that harsh focus on looks and other judgments from peers, she says. The uptick in teen depression Mojtabai found after 2011 could be evidence of that.

Mojtabai says girls, in particular, “are more likely to use these new means of communication, so may be exposed to more cyberbullying or other negative effects of this latest social media.”

The effects can feel devastating, says Steiner-Adair.

“We know girls are very vulnerable to defining themselves in comparison to others,” she says. Her young female patients often tell her they get their “entire identity” from their phone, she says, constantly checking the number of “tags, likes, Instagram photos and Snapchat stories.”

Steiner-Adair urges schools to be proactive in trying to reduce teens’ feelings of being “left out” or judged. One tool, she says, might be a course in mindfulness — a form of meditation that has been shown to offer measurable health benefits and can help reduce anxiety and depression.

Such training can help teach kids that their brain “on tech” actually needs a rest, Steiner-Adair says. Mindfulness training teaches the value of solitude and can help practitioners calm the urge to constantly check the phone — a useful skill for people of all ages and gender.

Meanwhile, Mojtabai says, parents and family doctors, as well as teachers and school counselors, should be on the lookout for any behavioral changes in the teens they live and work with that might be signs of depression. Symptoms can include changes in sleep patterns, appetite or energy, or a growing inability to pay attention and concentrate.

Even just one counseling session to evaluate such symptoms, Mojtabai says, can help get teens back on the right track.