Swedish school survey reports links between sex used as self-harm and distress

This report comes from a correction notice for a research article in European Child & Adolescent Psychiatry. The notice says the original article was missing its abstract and provides the abstract text. That means the available information is limited to the researchers’ brief description of the study and results, rather than the full paper.

The study was part of a national questionnaire survey described as using a representative sample of 3,251 adolescents in their third year of high school in Sweden. Their average age was 18. The students were asked to report whether they had ever engaged in what the authors call “sex as self-injury,” or SASI.

The authors describe SASI as using sexual acts to manage negative emotions, psychological distress, or interpersonal difficulties. They compare the intended emotional function to other forms of self-injury, such as cutting or burning the skin. The source also says there is no standardized definition of SASI, which is an important limitation when interpreting the results.

Overall, 5.7% of students reported having engaged in SASI at least once. The reported proportion was 8.6% among girls, 11.5% among students with a non-binary identity, and 1.9% among boys. It was also reported by 12.9% of sexual-minority students, compared with 4.2% of heterosexual students.

Students who reported SASI said it was mainly connected with trying to regulate emotions or seek validation. The abstract says their experiences could involve sexual situations they viewed as risky, painful, or linked to self-loathing. It does not provide details about how the survey asked these questions or how the researchers defined individual experiences.

The researchers also reported that SASI was associated with several other self-reported experiences. These included non-suicidal self-injury, difficulty regulating emotions, trauma symptoms, and experiences of abuse, especially sexual abuse. The abstract also lists sexual risk-taking experiences, including selling sex, having many sexual partners, a history of chlamydia, and abortion.

An association means that experiences were reported together more often in the survey. It does not show that abuse caused SASI, that SASI led to later victimization, or that any one factor explains an individual student’s experience. The authors suggest SASI may sometimes be a reactive behavior after childhood sexual abuse and may raise the risk of further victimization or exploitation, but the survey design cannot establish those pathways.

The abstract calls for mental-health support, including trauma-focused care and help with emotional regulation. However, this study did not test those approaches. It cannot show whether a particular type of support prevents further harm or improves outcomes.

Important details are not available in the supplied correction notice. It does not report when the survey was conducted, the response rate, the exact survey questions, how measures were scored, or whether the reported links held after accounting for other factors. It also does not provide confidence intervals, which help show how precise survey estimates are.

The findings point to a group of students who may be experiencing substantial distress and overlapping harms. They also underline why careful, nonjudgmental research and support matter. More research using clear definitions and longer-term designs would be needed to understand how these experiences develop and what support is most helpful.