New teen self-mutilating disorder? Embedding sharp objects in body

CHICAGO — Researchers evaluating a new technique for locating and removing objects accidentally embedded in the body said they may have uncovered a new form of self-mutilating behavior in which teenagers intentionally insert objects into their flesh.

Personnel at Nationwide Children's Hospital in Columbus, Ohio, report extracting 52 foreign objects that 10 teenage girls deliberately embedded in their arms, hands, feet, ankles and necks over the past three years, including needles, staples, wood, stone, glass, pencil lead and a crayon.

One patient had inserted 11 objects, including an unfolded metal paper clip more than 6 inches long.

The study, being presented today at the annual meeting of the Radiological Society of North America in Chicago, is the first to report on this type of self-inflicted injury among teenagers, the researchers said. They call the behavior "self-embedding disorder."

Dr. William Shiels, the study's principal investigator and the hospital's chief of radiology, said that uncovering the behavior was unexpected but that researchers are hearing about cases in other cities. The hospital recently set up a national registry to track incidents and conduct research.

Self-injury is a disturbing trend among teenagers, particularly girls.

The size of the problem is unclear because many cases go unreported, but recent studies have reported that 13 to 24 percent of high-school students in the United States and Canada have deliberately injured themselves at least once.

More common forms of self-injury include cutting of the skin, burning, bruising, hair pulling, breaking bones or swallowing toxic substances. In cases of self-embedding disorder, objects are used to puncture the skin or are forced into a wound after cutting.

In the study, the researchers set out to evaluate the use of minimally invasive, image-guided treatment to improve the removal of objects accidentally lodged in the body, such as when a child steps on a shard of glass.

By using ultrasound, they sometimes detected the presence and precise location of objects that would not be visible on X-rays, such as wood, crayons and plastic. The researchers learned later that some items had been intentionally forced into the body.

All the cases in the study involved girls living in foster homes, group homes or mental-health facilities. Many had experienced or witnessed physical or sexual abuse, and most had been diagnosed with depression, anxiety or other mental-health problems.

Until more information is gathered, it cannot be known if teens living outside the homes of their birth families are at higher risk for such behavior, said Dr. Jarrod Leffler, a child psychiatrist at Nationwide Children's.