Brain changes indicative of mental disorder seen in girls who self-harm, study finds

COLUMBUS, Ohio — The teenage years are fraught with emotions. Girls who experience heightened levels of anxiety, depression and hostility are more likely to self-harm. And now a new study tells us that these self-injurious behaviors, such as cutting, may do more than harm just the body: they also indicate potentially detrimental changes in the brain.

Researchers with The Ohio State University have discovered a biological change in the brain volume of girls who self-harm. The reductions seen in the brain scans of these girls are similar to what is seen in adults with borderline personality disorder (BPD), a severe and hard-to-treat mental illness.

Self-harming is also associated with a heightened risk of suicide. Researchers say these findings serve as a warning for a swarm of potential bad outcomes.

Highlighted areas show brain regions where researchers saw reductions in brain volume in girls who self-injure.

“These girls are at high risk for eventual suicide. Self-injury is the strongest predictor of suicide outside of previous suicide attempts,” says lead study author Theodore Beauchaine, a professor of psychology with the university, in a news release. “But there’s most likely an opportunity here to prevent that. We know that these brain regions are really sensitive to outside factors, both positive and negative, and that they continue to develop all the way into the mid-20s.”

Incidences of self-harm affect about 20 percent of adolescents, Beauchaine says, and the age it begins continues to move downward. “Girls are initiating self-injury at younger and younger ages, many before age 10,” he notes.

For this study, 20 teenage girls with a history of severe self-injury and 20 girls without any history of self-harm underwent magnetic resonance imaging (MRI). Researchers compared the brain volumes of the participants in both groups. The MRIs showed definite reductions in brain volume in the insular cortex and inferior frontal gyrus, the same parts of the brain involved in BPD. Both conditions are more common among females.

The girls were asked about their emotions before the brain scans, and researchers say the results of the MRI tests matched what would be expected based on their answers. Brain volume losses have also been well-documented in people who have experienced abuse, neglect or trauma, according to Beauchaine.

“A lot of people react to girls who cut by saying, ‘She’s just doing it for attention, she should just knock it off,’ but we need to take this seriously and focus on prevention,” says Beauchaine. “It’s far easier to prevent a problem than to reverse it.”

Researchers say this study does not prove that the changes in brain volume are either a cause for or a result of self-harm. More studies are needed to determine how structural differences in the brain and self-harm are related and how those changes might later lead to BPD or other mental disorders.

They also caution that these findings are not saying that every girl who harms herself will later develop BPD. But the results do send a strong message that more needs to be done to prevent, identify and treat self-harm in girls, starting at younger ages.

“If we can learn more about how adults with psychiatric disorders got there, we are in a much better position to take care of people with these illnesses, or even stop them from happening in the first place,” Beauchaine says. “Self-injury is a phenomenon that’s increasing, and that’s less common outside of the United States. It’s saying something about our culture that this is happening, and we should do whatever we can to look for ways to prevent it.”

The study was published November 5, 2018 in the journal Development and Psychopathology.