College Students May Hide Self-Harm

College Survey: 17% of Students Have Ever Deliberately Hurt Themselves

Reviewed by Louise Chang, MD on June 06, 2006
From the WebMD Archives

June 6, 2006 -- A history of deliberate self-harm may not be uncommon among college students, a new Internet survey shows.

The survey, published in June’s issue of the journal Pediatrics, included 2,875 students at two unnamed universities in the Northeastern U.S. The results:

  • 17% of participants reported having ever hurt themselves deliberately.
  • 75% of students who had ever harmed themselves report doing so more than once.
  • More than 1 in 3 students (36%) with a self-harm history said no one knew about it.

The survey also shows that students with a history of self-harm were more likely to be women, bisexual, or questioning their sexual orientation, and to report ever considering or attempting suicide.

A history of repeated self-harm was also linked to higher levels of psychological distress, one or more signs of eating disorders, and a history of suffering physical, sexual, or emotional abuse.

About the Study

The researchers included Janis Whitlock, PhD, MPH, of Cornell University’s Family Life Development Center and human development department.


Whitlock’s team mailed postcards to 8,300 randomly chosen students at two universities, inviting them to take the Internet survey in the spring of 2005.

The survey was taken by about 3,000 students. The researchers only included those with complete data, for a grand total of 2,875 responses. Ideally, the researchers would have liked more students to have taken the survey.

Women made up more than half of participants (about 56%). Most participants were from the U.S. and were 18-20 years old. More than half were white, followed by Asian-Americans.

Asking About Self-Harm

In their report, Whitlock and colleagues define self-injurious behaviors as those “in which an individual inflicts harm to his or her body purposefully, for reasons not recognized or sanctioned socially and without the obvious intention of committing suicide.”

Survey questions probed how often -- if ever -- students had ever done any of 16 forms of self-harm, including cutting, pinching, punching, scratching, or burning themselves, as well as ripping or pulling their skin or hair.


The students reported whether anyone -- including doctors or therapists -- knew about their self-harm. The survey also covered suicidal thinking, suicide attempts, eating disorders, abuse, and psychological distress.

The researchers wanted to gather as much information as possible about the students’ history of self-harm and any traits linked to self-harm.

Secret Self-Harm

Seventeen percent -- 490 students -- reported deliberately hurting themselves at some point in their lives.

About seven in 10 of those students said they had deliberately hurt themselves more than once.

Self-harm in the past year was rarer. About 7% of students reported deliberately hurting themselves in the year before the survey.

Self-harm was often secret. Nearly 40% of students reporting a history of self-harm said no one knew about their self-harm.

Students who had ever deliberately hurt themselves and told someone were more likely to have confided in a mental healthmental health professional (21%) than a doctor or other medical worker (3%).

Abuse Noted

Students with a history of repeated self-harm were more likely than their peers to note history of physical, sexual, and/or emotional abuse, the study shows.


Self-harm was also linked to higher levels of psychological distress and past suicidal thoughts or suicide attempts. However, two-thirds of students with a history of self-harm reported never having considered or attempted suicide.

The results may not apply to other groups of teens and young adults, the researchers note.

Because self-harm often goes hidden, doctors may want to routinely ask adolescents and young adults about it during checkups, Whitlock and colleagues write. They call for more research into the root causes, detection, and prevention of self-injurious behaviors.

SOURCE: Whitlock, J. Pediatrics, June 2006; vol 117: pp 1939-1948.

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