New Facet of Self Harm

Self-Embedding

By Tiffany Sharples, from Time Magazine--link is here, with other links to photographs and x-rays


At a recent medical conference in Chicago, a team of radiologists from Nationwide Children's Hospital presented intriguing X-ray evidence of a psychological phenomenon — what they believed was a new form of self-injury among teens and adolescents. Eleven out of 505 patients whom the team had treated in more than a decade had inserted objects — from chunks of crayons to unfolded paper clips — under their skin in a behavior the Nationwide team labeled "self-embedding."

All of Nationwide's patients were young females, but when the researchers, including Dr. William Shiels II, the hospital's chief of radiology, turned to medical literature for other examples of self-embedding, they found very few — and those were among adults, primarily males. Shiels and his colleagues asked around at the hospital, but not even mental-health specialists had heard of it, nor had many of their colleagues outside the hospital. "As a profession in general, psychologists were not aware that this was happening," Shiels says.

At the time of the conference, however, a Chicago Tribune reporter uncovered two more instances of self-embedding in an Illinois town — two teen girls had deliberately inserted pencils into their skin and broken off the tips — lending credence to the possibility that self-embedding was a growing trend, albeit off the radar. "We know it's elsewhere," says Shiels, who is creating a protected database for medical professionals worldwide to track the behavior. "It just hasn't been discussed and it hasn't been studied."

Shiels' team stumbled on the peculiar practice largely by chance. In 2007, a premed student named Adam Young, then 21, was compiling data during his summer internship at Nationwide. Part of his responsibilities included maintaining a database of patients who had been treated by the hospital's radiology department using Image Guided Foreign Body Removal, a technique that was developed by Shiels during his Army days to help remove foreign objects like shrapnel from soft tissue. Shiels' method was less invasive than surgery, which often requires an incision of 2 to 3 inches and can lead to damage in surrounding tissues or organs; the new method requires a quarter-inch incision and uses a combination of ultrasound and fluoroscopy — live X-ray — to carefully guide forceps to the object, steering clear of the body's vital structures during extraction. The scar is also much smaller, "about the size of a freckle," Shiels says.

While Young was cataloging the hospital's data on procedures involving Shiels' technique, which Shiels first introduced to the hospital in 1995, Young realized that some of the patients hadn't injured themselves accidentally. Unlike the majority of people who came in for treatment — for stepping on a piece of glass or being impaled by a particularly large splinter — these patients' wounds were self-inflicted. "I started to see three or four instances where the foreign-body cases were not accidental," he says. "I started to think it was a little strange and mentioned it to Dr. Shiels."

Young went back to school in the fall, and two or three more patients came to Nationwide with similar wounds. For Shiels and Young, it became clear that they were on to something. The following summer, Shiels, Young (who graduated from Miami University in Ohio) and three others worked their way through the data, unearthing cases of self-embedding going back to 2005. They also discovered that the majority of patients who harmed themselves in this way did so more than once — the average recurrence was three times — and that the materials embedded under the skin varied dramatically in size, from several unfolded staples embedded into a hand to a 6.3-in. unfolded paper clip inserted into a bicep.

Once they were aware of the trend, Shiels and his colleagues analyzed the patients' medical records, finding consistent histories of self-injury and mental-health problems. There are numerous psychological and emotional factors that drive people to self-harm, but according to Harvard psychology professor Matthew Nock, who specializes in the study of self-injurious behavior and edited a book on the subject, Understanding Non-Suicidal Self-Injury (due March 2009), many do it for two broad reasons: to regulate their emotions and to communicate with others. "Self-injurers experience greater physiological arousal in response to stress, show poor ability to tolerate distress, and have greater deficits in social problem-solving skills," Nock explains, meaning that people self-injure to distract themselves from other emotional pain, to counter feelings of numbness or to let people know that they're suffering.

The Nationwide team's findings sparked a frenzy on the Internet, with stories cropping up one after the other and chatter lighting up on blogs. But as the news spread, globally even, some mental-health professionals grew wary. Without discounting the severity of the problem — particularly among adolescent girls — some experts felt the headlines declaring self-embedding a new "disorder" went too far. Characterizing it as a disorder rather than a symptom of one may miss the mark, says Dr. John Campo, chief of child and adolescent psychiatry at Nationwide Children's and one of the specialists consulted by Shiels. "Young people with a variety of different psychiatric diagnoses may engage in this behavior," says Campo, and proclaiming it as its own condition may deter comprehensive mental-health care to identify the true nature of the problem.

Nock believes self-embedding is a dangerous evolution, but says it is not unique. "I view this as a more severe variation of self-injury," he says. An analysis of the data Nock has compiled in his years of research reveals that some 10% to 20% of adolescents who injure themselves have inserted objects beneath their skin. None of those patients reported leaving the objects there, however, and only two out of 12 patients who reported doing so had to seek medical treatment as a result. "The fact that kids are inserting things under their skin is not necessarily new," Nock says, adding that those who leave the objects embedded are probably in a very small minority.

The dangers of this form of self-injury are obvious, and serious. Creating any wound in the skin can lead to infection, but when foreign objects are inserted deep into tissue, the risk is amplified. "The infections aren't just at the site," Shiels says. "You can get a deep muscle infection or a bone infection," or if you hit arteries, veins, nerves or tendons while driving something into the soft tissue, you can cause tears or other damage. Beyond those risks, there is also the possibility that objects can travel once inside the body, approaching vital organs. "They pose significant risk, not only during insertion, but also if they're not removed," Shiels says.
The other major concern among mental-health specialists is that publicizing the behavior could exacerbate the problem. In a study of self-injury among adolescents conducted earlier this year, Nock found that 38% of teens who injured themselves learned of the practice from friends, while 13% first heard about it through the media. It's a bit of a catch-22, says Nock. "On the one hand, it's very helpful and useful for health professionals to communicate with each other and learn how to proceed when they see [these cases]," he says, "but we know that media coverage of self-injurious behavior influences rates of self-injurious behavior."

As studies show a surge in self-injury in recent years, "we've also seen increased media reports," Nock says. "It could be the media is catching up, but the opposite is also true: as kids hear more about it, it enters into the realm of behaviors in which they can engage."


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Internet addiction becomes growing concern

The symptoms of Internet addiction are stark but the causes elusive: a teenager begins gaming on the Internet in the early evening and is still feverishly pecking away when the sun comes up.

Another goes to online chat rooms and e-mail sites for 12 hours at a stretch, or even 24.

A third stops eating or eats in front of the screen. Or stops washing. Their identities become twisted up, like strands of DNA, with computer characters.

"It is clear right now that there are people who really, really struggle with what we can easily define as Internet addiction. What that number is we don't know," said Louise Nadeau, a professor at the University of Montreal's psychology department who is researching the issue.

She is one part of a growing cadre of academics examining the social and psychological problems that have sprung from the explosive growth of the World Wide Web.

But drawing any conclusions or projections is a mug's game, said Nadeau, because researchers have barely delved into the issue.

She estimates that in Quebec one quarter of one per cent of those who seek addictions counselling are hooked on the web -- outnumbered by far by those trying to overcome drug or alcohol problems.

"That's really not a lot," said Nadeau. "But then there was no advertising for (Internet addiction treatment), so the people who did ask for it were really in distress."

The problem, she said, is defining Internet addiction and determining where to draw the line between avid computer user and addict.

A child who spends 12 consecutive hours a day on the web may be addicted or may just lack parental supervision, said Nadeau. And does a compulsive online gambler or porn site surfer have an Internet problem or a gambling/sexual disorder?

"Are we at the step in this province where we can advertise our addiction (treatment) service? I'm not sure we're there," said Nadeau.

"But (Internet addiction) is something new that wasn't there 15 years ago."

Cyber addictions have been the subject of a number of recent studies and test cases.

In Britain, psychologist David Lewis recently spearheaded a survey of 2,100 subjects that found close to half experienced stress and anxiety -- detected by measuring heart rates and brainwave activity -- when unable to go online, a phenomenon that has been dubbed "discomgoogolation." It also suggested that half of Britons are on the Net between one and four hours a day and 87 per cent rely on it as their primary source of information.

Karyn Gordon, a Toronto-based teen coach and author of Dr. Karyn's Guide to the Teen Years, says she has counselled some adolescents whose "entire social life is in cyberspace."

Addiction to video games is "a huge problem," particularly with boys, she said in an interview when her book was launched earlier this year.

"I don't think video games are bad and should be banned," but parents need to set limits for their children, Gordon said.

Having games is "a privilege, and with any privilege there needs to be responsibility and boundaries around that."

If it reaches the point of addiction, parents should seek professional help, she said.

"Yes, there are some parents that can handle it (on their own), but really a lot of times I find it almost just gets a lot worse."
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source: London Free Press

Video Game Addiction

Studies show that the excitement of video games makes playing them addictive. Parents of preteens hardly find this surprising.
Ask any preteen how they love to spend their spare time, and chances are you'll get an earful about video games. But why do they love them so? Are they addictive? According to some studies it would appear that the excitement of video games causes the brain to release a chemical that is, in essence, addictive. For any parent who has seen the fervor by which some kids play video games, this news is no surprise.

What makes these games so addictive? Media literacy specialist, Dr. Charles Ungerleider explains that "they're very compelling with increasing complexity, so a child becomes more facile, yet wants to know more and apply new skills." While wanting to improve their game isn't a problem in itself, it becomes one if video games are "taking a youngster away too much from other activities," says Ungerleider. "Then the parent has to intervene and limit the amount of time the youngster spends with the video game."

Professor of Computer Science, Maria Klavee feels video games, if not too violent, can "offer some real opportunities for puzzle solving, strategic and critical thinking". But she adds that it's important that video and computer games are played in moderation. Klavee says parents should "provide a selection of activities, not just the ones that have the most action or are addictive. Choose some that involve problem solving or good story lines. Also aim for a balance in your child's life. Sports are important, reading's important. Just think of computer games as one more component in a child's exploration of what's out there in society."

As for addiction? Ungerleider believes that "a parent can prevent youngsters from becoming addicted to too much TV or too many video games by establishing a pattern of selective viewing or by using video game material early in a child's life so that by the time a youngster gets to be an adolescent and there's very little surveillance or control, it's less likely to occur."

Finally, Ungerleider remind parents that "if a youngster becomes addicted to video games it can be a problem and the parent does need to intervene and provide attractive alternatives."

Adapted from The Parent Report Radio Show. Any advice or information contained herein should never be a substitute for professional and/or medical advice, diagnosis and treatment. For more information please review Terms of Service. Source: http://www.theparentreport.com/resources/ages/preteen/kids_culture/130.html

Anger Management in Children

Anger Management in Children

Anger, a normal emotion, can transform into something painful and ugly. First thoughts of anger issues may bring about images of a couple fighting, a parent abusing a child, a teenager lashing out at a teacher or a parent. Rarely will images of angry children come to mind. Unfortunately children, at very young ages, have to deal with feelings of anger and rage. This is a truth which is often difficult to understand or manage.

Children, young children especially, aren't normally aware of how they feel. When a child becomes upset or mad they simply show these emotions through their behavior. A good example of this might be the little boy in the supermarket who throws a tantrum because he's upset. Many parents have had to deal with similar situations. It is unfortunate that often times these occurrences are overlooked or dismissed because they are "just children". Anger management in children is as important, or perhaps even more important than anger management in adults.

A child requires instruction and guidance from their coming into the world to their entry into adulthood. The things they learn throughout their young lives are likely to form the person they become as an adult. For this reason anger management in children with difficulties controlling their temper is extremely important. Finding ways to teach anger management in children might present challenges.

There are programs designed specifically for children with anger management issues. Finding one that works for a particular child might require testing many methods. Not all children will respond to the same treatments for anger management in children. Because a child cannot always relate their feelings surrounding angry outburst, finding the right approach may take some time. Until the issue is resolved or at least controlled, it is imperative to continue the search.

Young children may respond well to worksheets, games and fun activities. All of these can be used effectively to teach anger management in children. Developing programs which incorporate each of these might be the best route to take. A child completing a worksheet, coloring sheet or participating in games and activities with underlying messages regarding anger management, may not even realize they are working on their problem. Making the activity fun doesn't mean that the anger issue has to be left out. Choosing fun activities which teach healthy interaction and decision making might be good for anger management in children. Teaching them to take turns and helping them to learn that they can't always be the best or the winner would definitely make a difference when confrontational situations arise. Little activities which instill values and positive thinking would be beneficial for anger management in children.

If a child is old enough to talk about their anger problem, encouraging them to share their feelings is important. Suggesting they talk to someone who they feel comfortable with and trust is a good idea regarding anger management in children. Asking them to write or draw about their emotions may be able to help disclose their underlying issues, whether fear, hurt or sadness. Teaching them to ask for help when they feel threatened or angry would certainly help the child with a problem. The important detail to realize when considering anger management in children are they are just "children". Their minds are not equipped to handle big people situations and so they will require a more careful approach.

Avoid Alcohol for a Better Body and Mind

What is alcohol?

Alcohol is nothing but a natural fruit juice. It is a health drink also. There are many types of alcohol. But the one which is useful to human being is ethyl alcohol. It is also known as grain alcohol since it is prepared from starch grains. Ethyl alcohol is the alcohol of wine beer, whisky and similar beverages. It is often simply referred as “alcohol”. Most of the alcohol is prepared when grains, fruits or vegetables are fermented.

What is fermentation?

The process of conversion of sugars into ethyl alcohol under the influence of yeast is known as fermentation. The raw materials of ethyl alcohol are cane juice, beets, dates, molasses, fruit juices which contains sugar, substances which contain starch such as potatoes, rice, barley and maize.

Why should you avoid commercial alcohol?

Denatured Alcohols

It is commercial ethyl alcohol to which small amounts of very poisonous substance have been added. So, commercial alcohol contains methyl alcohol which is poisonous. The manufacture and sale of ethyl alcohol is under strict government control. Heavy excise duty is levied on sale of alcoholic beverages. For industrial purpose ethyl alcohol is duty free in some of the countries.

Alcoholic Beverages

The largest use of ethyl alcohol is considered as a beverage. Wine contains about 12% ethyl alcohol. Beers contain about 4%. Whisky and Brandy contains about 40-50% ethyl alcohol. The alcoholic content of a beverage is indicated by a measure known as proof spirit.

How does it affect your health?

When you drink alcoholic beverages, the ethyl alcohol finds its way in your blood. When you consume 0.8% you will feel steady. If it is 2% you feel giddiness, 3% not able to walk, 4% you may fall down. When it reaches 5% it may leads to death

Why do people like to have it?

Due to some curiosity people like to drink it. They feel that it is good and reduces stress. Some times to people drink to relax themselves.

A Step By Step Method for Alcohol Detox

Alcohol detox may be defined as a phase of medically supervised and monitored withdrawal from alcohol at the same time the alcohol is detached from the body.

Alcohol detoxification depends on your age, medical status and alcohol intake history. In the case of a young man who drinks a lot and looks for 7 days treatment after his last consumed alcohol, he may not need detoxification ahead of starting medication for alcoholism. The most common drugs employed for this purpose are the benzodiazepines, which are followed by barbiturates.

What are benzodiazepines?

Benzodiazepines, diazepam, oxazepam or lorazepam are the most common drugs used to minimize symptoms of alcohol withdrawal. There are a number of treatment methods in which it is employed. The choice of benzodiazepine depends upon the situation.

Chlordiazepoxide is preferred in case of uncomplicated withdrawal of alcohol.
Diazepam or Lorazepam are available for persons who are not able to take medicines safely by mouth.
Oxazepam and Lorazepam is considered best for patients who have cirrhosis

What is the proper medication for alcohol detox and withdrawal?

Alcohol detox can cause suffering and pain and it can be life threatening. Detox from alcohol, otherwise known as withdrawal, may lead to various problems. The symptoms of acute alcohol detox and withdrawal start to emerge within 6 to 48 hours. Proper medication for alcohol detox and withdrawal is to lessen the discomfort of the patient and avoid the development of severe symptoms. Admission in hospital gives the safest situation for alcohol detox and withdrawal.

What is common procedure to detox?

Most doctors are contented to prescribe for alcohol detox. A common procedure for detox is as follows.

Your doctor may prescribe a high dosage medication for the first day so that you discontinue drinking alcohol.
Then the dosage will be reduced gradually over the next five to seven days. Usually this avoids or reduces the nasty withdrawal symptoms.
You should accept not to consume any alcohol in the course of alcohol detoxification. In order to make sure that you are not drinking alcohol, a breathalyzer may be used.
Usually your doctor or nurse will monitor you more often at the time of detox.

While under going detox, support from friends or family may be of great help. The work of receiving the prescription and providing the detox medicine is shared with a friend or family member.

The Risks of Teen Drinking and Drug Use