Brie Urie couldn't believe what she was seeing.

"She walked into class in jeans and a T-shirt with a bandana around her bleach-blonde hair," said Brie Urie, a BYU freshman studying art, speaking of a close friend. "I didn't think too much about it until I saw her arm - carved into it, with what I later found out to be a kitchen knife, were the letters H.A.T.E. She must have been deeply troubled to do something like that to herself."

Disturbingly, Urie's story about her friend is all too common in American. A recent study concluded college students and young adults are increasingly turning to alternative methods of stress relief by participating in self-abusive behaviors such as cutting and burning, among other methods.

The issue is alarming health experts and gaining a second look to determine what drives young adults to injure themselves, as well as ways to prevent it. While the Internet, specifically chat rooms and instructional sites, can play a key factor in perpetuating this behavior, parent communication and therapeutic outlets can act as a counterbalance and help individuals heal the physical and emotional wounds associated with self-injury.

Janice Whitlock, director of the Cornell Research Program on Self Injurious Behavior in Adolescents and Young Adults, initiated the study because self-injury occurs much more than what the public generally recognizes.

The study found one in five college students participates in self-abuse. According to Self-Abuse Finally Ends Alternatives, or S.A.F.E. Alternatives, an advocacy group to stop self-destructive behavior, "Self injurious behavior is defined as deliberate, repetitive, impulsive, non-lethal harming of one's body" and is typically a symptom of underlying distress or trauma, such as sexual or emotional abuse. However, it could be caused by other stressful life circumstances.

"Some people might not deal well with everyday stresses and can therefore develop negative coping behaviors," Whitlock said.

Urie, a pre-art major, said she discovered one of her close friends from high school was a self-abuser struggling to cope with stresses in her life. She became suspicious after she noticed a cluster of deep scratches on her friend's wrist. While Urie said the girl was never close to suicidal, she recognized her friend was not dealing with the pressure constructively.

"There were a few times she cut her wrists with cuticle scissors - not deep, but enough to break the skin and bleed," Urie said. "She said it was a release of all the pain, anger and stress she was feeling. It was just her way of dealing with her emotions - when it got too much to bear, she would release it through cutting herself."

The study found this behavior to be of a periodic nature in that individuals would act frequently for a period of time and then stop for weeks, months or even years before starting again.

"There isn't a sub-group where it becomes habitual," Whitlock said. "But it becomes a crutch, much like alcohol."

This, she said, is because self-injury has a drug-like quality in that the body releases endorphins to dull the pain associated with an injury, often giving the abuser a temporary sense of relief from their emotions.

The study also found this search for release had no socioeconomic, gender or racial trends.

"It goes through all groups and all races," Whitlock said.

Among the self-abusers in the study, 45 percent were male and 55 percent were female, a statistical finding consistent with other existing literature showing slight or no gender difference regarding this self-abusive behavior. The finding negates society's tendency to feel women are more prone to these destructive behaviors than men, a feeling which possibly results because of the prevalence of other self-destructing behaviors such as eating disorders among young girls and women.

"I think people associate self injury and eating disorders but we have not found any evidence of that," Whitlock said. "It is just nicely hidden."

Whitlock said the misconception could come because women are more likely to disclose their behaviors to others, not because men are immune.

An Internet analysis supplementing the self abuse study validated Whitlock's assertion: it showed the higher prevalence of Internet support tended to be in young, adolescent girls. However, it was not absent among boys.

The side-study looked at the number and availability of Web sites and discussion boards catering to the topic.

Whitlock said while it is impossible to verify the exact age of the message board authors, the users described themselves to be teenagers or young adults and the context of their messages seemed appropriate by discussing typical adolescent topics of parents, friends and appearances.

The Internet study grew from a comment made by a self-abuser participating in the self-injury study that indicated the Internet could be a factor in spreading the behavior.

"People who self-injure typically feel they discovered it on their own," Whitlock said. "One thing message boards have done is allow people to share behavior that is very isolating to feel more accepted."

This interaction leads individuals to believe they are not alone and their behavior is an acceptable way to deal with their emotions.

The study found more than 400 message boards, increasing to more than 500 since the study was completed.

As a way to better understand the culture of the boards, researchers categorized and factored in the nature of the messages. They found 28 percent were supportive in nature. Twenty percent were dedicated to trigger and motivation discussions and 9 percent involved concealment tips, while 6 percent of the postings shared techniques.

Despite this increase in Internet activity, privacy is critical to these individuals and they will go to great lengths to keep it their behavior a secret from parents and friends.

Chrissy Bulloch, a BYU freshman from Ladera Ranch, Calif., studying marriage, family and human development, said a girl in her high school class would try to hide the scars creatively so as not to draw attention.

"She wore a ton of bracelets on her left arm," Bulloch said. "She would make a thread bracelet for every guy that she kissed so she had 3 inches of bracelets up her wrist."

Bulloch said the girl would cut her wrist under her bracelets to hide the scar tattoos she'd give herself in the shape of stars and her initials.

Because of the underground and private nature of self-abuse, it is a behavior completely invisible to most adults.

"Adults have no clue - especially [those] over 30 to 35 years old," Whitlock said. "But they need to know because they need to be able to recognize what is happening and they need to be someone that these people can turn to for help."

Whitlock said a key factor regarding an adult's ability to provide support will be how they respond when a self-abuser opens up about their behavior. She said it is crucial not to overreact.

"Don't react with shock but don't react with horror either," she said. "Focus on the stress or lack of feeling that is leading to the injuries. In most cases, they are not hurting themselves because they hate themselves - they are hurting themselves because they have pent up emotions or lack of emotions. It's about feeling better, not hating yourself and committing suicide."

Even though self-abusers take initiative to hide their behaviors, the study found through interviews they were all glad their problems were discovered.

"Every person interviewed said that if someone were to find out about it and if that person went to an adult, who they believed could help, they were always unhappy about it, but every single one of them said that they were ultimately glad they were betrayed that way," Whitlock said. "They realized that people truly cared and they finally had a connection with other people."

Karen Conterio, administrative director of S.A.F.E. Alternatives, said it is especially important for parents to make that connection. She pointed out children aren't as isolated as parents want to believe them to be. Parents need to realize the influences on their children and be aware of who they are hanging out with, and the best way to find out is to talk with them.

"If parents can do that, it will go so far," she said. "Don't be shy about sharing your own thoughts and feelings with your kids."

Conterio recommended talking about current events and issues that affect youth today. She said to bring it up at dinner, family nights or even in the car and ask if they know people who injure themselves or are involved in other harmful practices. She recommended talking about why it is harmful and how they could be a positive influence for that person.

By creating a comfortable environment of communication, children will be more likely to open up and talk to their parents about these issues and other pressures in their lives, she said.

"Parents are mentors for their kids; it is important for them to set that standard," she said.

However, while communication is a crucial factor and the catalyst to change, the road to recovery is not a journey that can be forced, experts say. Through an interview process corresponding with the study, participants were asked what factors led them to change their way of thinking and thus their behavior. In a dominant response, participants said there is nothing someone on the outside can do to make self-abusers stop; the desire has to come from within.

Whitlock added the person has to take an active role in his or her life.

"Punitive taking things away from them doesn't work," she said. "They have to decide they don't want to cope this way anymore."

The participants also reported stopping because of the impact on people they love.

"Though it is an individual choice, it affects everyone and therefore becomes a family affair," Conterio said.

"But there is hope; people do in fact get better. It is not a disease, it is a symptom of underlying issues."

Depending on the severity and extent of self-injury, common resources for recovery include a combination of therapy and behavioral changes. While some injurers say it is as simple as changing their environment until the desire to hurt themselves passes, others may require a more proactive approach such as therapy where patients can deal with the core issues and then learn new behaviors to cope with the stress.

Whether it is to stop the behavior or deal with the underlying issues, hotlines and programs are available throughout the country to help both individuals and their families recover from the emotional traumas of self-abuse.

Wendy Schneider, producer for "Cut," a self-harm documentary to be released this fall, said she hopes to bring attention to this underground epidemic.

"What I am learning in this film is how little others know about it," Schneider said. "Teens know a lot about it, but parents, teachers and most counselors don't."

Because few resources regarding this subject exist, she said she felt it was important to do a film that introduced self-injury in a way that showed a teen's perspective. Friends, parents and adults can use it as an educational tool to better understand what is driving this behavior and thus know how to help the individual. She said she has found that teens really want to be heard.

"I am not the clinical counselor. I am just the filmmaker that is really trying to bring the stories of teens out into the open a little bit," she said. "I am trying to help validate a teen's experience. I am trying to show a wide perspective with respect to self injury and why certain teens do it."

-Symptoms of Self-Injury:

Inappropriate dress for seasons

Excessive wrist coverings

Clusters of marks/scars at different points on the body

Consistent bandages/ injuries

Odd paraphernalia or cutting materials atypical locations

-Help Resources:

S.A.F.E. Alternatives

1800-Don't-Cut

www.selfinjury.com

Local college/community counseling center