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Mental Health

Is this Anxiety?



I know a child that is 9yr. old who at night picks her face, especially the chin area, and arms until these sites bleed. She has a couple scars on her face and arms as a result of this behavior. Is this a disorder of some type?????


It is very difficult to know what is the exact source of this behavior without seeing a child and knowing the child's health and family history. Repetitive behaviors are fairly common in young children 2-3 years old, which usually resolve on their own. Other causes of repetitive, self-harm include cognitive delays, obsessive-compulsive disorder, and autism spectrum disorders.

When self-injury persists, those who love the child need to consider whether there is stress and anxiety in the child's life and mental health services are needed. We tend to think children live in a protected and happy bubble, seldom experiencing the stresses many adults experience. This is not at all true. Additionally, children often lack the self-insight and expressive ability to tell an adult how they are feeling.

At nine years of age, it is more concerning than if she was a toddler or early preschooler. There are a number of treatments available to help a distressed or stressed child including cognitive behavioral therapy (CBT), medications for anxiety or depression, talk therapy, behavior modification, and the substitution of another behavior that is not self-injurious for the concerning behavior.
I hope this is helpful information.


Wolraich, Drotar, Dworkin, and Perrin (Eds.) (2008). Developmental and Behavioral Pediatrics: Evidence and Practice. St. Louis: Mosby Elsevier.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University