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Bojanić L, Turnbull P, Ibrahim S, Flynn S, Kapur N, Appleby L, Hunt IM. Suicide-related internet use among mental health patients who died by suicide in the UK: a national clinical survey with case-control analysis. THE LANCET REGIONAL HEALTH. EUROPE 2024; 44:100991. [PMID: 39040089 PMCID: PMC11262162 DOI: 10.1016/j.lanepe.2024.100991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/13/2024] [Accepted: 06/17/2024] [Indexed: 07/24/2024]
Abstract
Background Suicide-related internet use (SRIU) has been shown to be linked to suicide. However, there is limited research on SRIU among mental health patients, who are at 4 to 7 times increased risk of suicide compared to the general population. This study aims to address this gap by exploring the prevalence of SRIU among mental health patients who died by suicide in the UK and describing their characteristics. Methods The study was carried out as part of the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH). Data were collected on sociodemographic, clinical, suicide characteristics and engagement in SRIU of patients who died by suicide between 2011 and 2021. The study utilised a case-control design to compare patients who engaged in suicide-related internet use with those who did not. Findings The presence or absence of SRIU was known for 9875/17,347 (57%) patients; SRIU was known to be present in 759/9875 (8%) patients. The internet was most often used to obtain information on suicide methods (n = 523/759, 69%) and to visit pro-suicide websites (n = 250/759, 33%) with a significant overlap between the two (n = 152/759, 20%). Engaging in SRIU was present across all age groups. The case-control element of the study showed patients who were known to have engaged in SRIU were more likely to have been diagnosed with autism spectrum disorder (OR = 2.13, 95% CI: 1.43-3.18), have a history of childhood abuse (OR = 1.70, 95% CI: 1.36-2.13) and to have received psychological treatment (OR = 1.43, 95% CI: 1.18-1.74) than controls. Additionally, these patients were more likely to have died on or near a salient date (OR = 2.11, 95% CI: 1.61-2.76), such as a birthday or anniversary. Interpretation The findings affirm SRIU as a feature of suicide among patients of all ages and highlight that clinicians should inquire about SRIU during assessments. Importantly, as the most common type of SRIU can expand knowledge on suicide means, clinicians need to be aware of the association between SRIU and choice of methods. This may be particularly relevant for patients approaching a significant calendar event. Funding The Healthcare Quality Improvement Partnership.
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Affiliation(s)
- Lana Bojanić
- National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Pauline Turnbull
- National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Saied Ibrahim
- National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Sandra Flynn
- National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Navneet Kapur
- National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
- NIHR Greater Manchester Patient Safety Research Collaboration, Manchester, UK
- Mersey Care NHS Foundation Trust, Liverpool, UK
| | - Louis Appleby
- National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
| | - Isabelle M. Hunt
- National Confidential Inquiry Into Suicide and Safety in Mental Health (NCISH), Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
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Chen W, Boggero A, Del Puente G, Olcese M, Prestia D, Jahrami H, Chalghaf N, Guelmami N, Azaiez F, Bragazzi NL. Googling for Suicide-Content and Quality Analysis of Suicide-Related Websites: Thematic Analysis. JMIR Form Res 2021; 5:e29146. [PMID: 34689118 PMCID: PMC8663606 DOI: 10.2196/29146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 08/11/2021] [Accepted: 10/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background Suicide represents a public health concern, imposing a dramatic burden. Prosuicide websites are “virtual pathways” facilitating a rise in suicidal behaviors, especially among socially isolated, susceptible individuals. Objective The aim of this study is to characterize suicide-related webpages in the Italian language. Methods The first 5 most commonly used search engines in Italy (ie, Bing, Virgilio, Yahoo, Google, and Libero) were mined using the term “suicidio” (Italian for suicide). For each search, the first 100 webpages were considered. Websites resulting from each search were collected and duplicates deleted so that unique webpages could be analyzed and rated with the HONcode instrument Results A total of 65 webpages were included: 12.5% (8/64) were antisuicide and 6.3% (4/64) explicitly prosuicide. The majority of the included websites had a mixed or neutral attitude toward suicide (52/64, 81.2%) and had informative content and purpose (39/64, 60.9%). Most webpages targeted adolescents as an age group (38/64, 59.4%), contained a reference to other psychiatric disorders or comorbidities (42/64, 65.6%), included medical/professional supervision or guidance (45/64, 70.3%), lacked figures or pictures related to suicide (41/64, 64.1%), and did not contain any access restraint (62/64, 96.9%). The major shortcoming to this study is the small sample size of webpages analyzed and the search limited to the keyword “suicide.” Conclusions Specialized mental health professionals should try to improve their presence online by providing high-quality material.
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Affiliation(s)
- Wen Chen
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, China
| | - Andrea Boggero
- Department of Educational Science, University of Genoa, Genoa, Italy
| | - Giovanni Del Puente
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences, University of Genoa, Genoa, Italy
| | - Martina Olcese
- Department of Educational Science, University of Genoa, Genoa, Italy
| | - Davide Prestia
- Department of Psychiatry, Istituto di ricovero e cura a carattere scientifico Ospedale Policlinico San Martino, Genoa, Italy
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.,Ministry of Health, Manama, Bahrain
| | - Nasr Chalghaf
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Noomen Guelmami
- Higher Institute of Sport and Physical Education of Kef, University of Jendouba, Jendouba, Tunisia
| | - Fairouz Azaiez
- Higher Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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Huang CY, Tsai CW, Chi YC, Wu KCC, Chen YY. Changes in accessibility of suicide-related information on websites in Taiwan during 2016 and 2019. J Formos Med Assoc 2021; 121:335-341. [PMID: 34024719 DOI: 10.1016/j.jfma.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/20/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND/PURPOSE To the best of our knowledge, no studies have examined longitudinal changes in the accessibility of suicide-related content on Chinese-language websites. We investigated changes between 2016 and 2019 in suicide-related materials likely to be accessed by individuals through websites in Taiwan. METHODS In March 2019, we searched the Taiwanese versions of Google and Yahoo! using six suicide-related terms and compared the results to a search performed in 2016. Website characteristics (e.g., pro- or anti-suicide) generated by various keywords were calculated and compared in 2016 and 2019. RESULTS The number of anti-suicide websites exceeded that of pro-suicide websites in 2016 and 2019. Between 2016 and 2019, the proportion of pro-suicide sites decreased slightly from 16.3% (61 out of 375 sites) to 12.3% (51 out of 417 sites) (p = 0.10). User-generated webpages constituted the primary source of pro-suicide content at both time points. Over the same period, the proportion of pro-suicide information on internet forums decreased from 59.1% to 17.8% (p < 0.001); by contrast, pro-suicide content on news websites increased significantly, from 1.9% to 11.3% (p = 0.005). Searches with the term "painless suicide" were more likely to yield pro-suicide websites and less likely to generate anti-suicide ones than searches with "suicide" in both 2016 and 2019. CONCLUSIONS Harmful suicide-related information circulating on websites remained easily accessible to internet users in Taiwan, particularly through user-generated and news websites. Proper site moderation and implementation of online suicide reporting guidelines are still warranted.
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Affiliation(s)
- Cho-Yin Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chi-Wei Tsai
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan; Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
| | - Ying-Chen Chi
- Department of Healthcare Information and Management, Ming Chuan University, Taoyuan, Taiwan
| | - Kevin Chien-Chang Wu
- Graduate Institute of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei City, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei City, Taiwan.
| | - Ying-Yeh Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan; Institute of Public Health and Department of Public Health, National Yang-Ming University, Taipei City, Taiwan.
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4
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Marchant A, Hawton K, Burns L, Stewart A, John A. Impact of Web-Based Sharing and Viewing of Self-Harm-Related Videos and Photographs on Young People: Systematic Review. J Med Internet Res 2021; 23:e18048. [PMID: 33739289 PMCID: PMC8074996 DOI: 10.2196/18048] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 10/24/2020] [Accepted: 01/17/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Given recent moves to remove or blur self-harm imagery or content on the web, it is important to understand the impact of posting, viewing, and reposting self-harm images on young people. OBJECTIVE The aim of this study is to systematically review research related to the emotional and behavioral impact on children and young people who view or share web-based self-harm-related videos or images. METHODS We searched databases (including Embase, PsychINFO, and MEDLINE) from January 1991 to February 2019. Search terms were categorized into internet use, images nonspecific and specific to the internet, and self-harm and suicide. Stepwise screening against specified criteria and data extraction were completed by two independent reviewers. Eligible articles were quality assessed, and a narrative synthesis was conducted. RESULTS A total of 19 independent studies (20 articles) were included. Of these, 4 studies focused on images, 10 (11 articles) on videos, and 5 on both. There were 4 quantitative, 9 qualitative, and 7 mixed methods articles. In total, 11 articles were rated as high quality. There has been an increase in graphic self-harm imagery over time. Potentially harmful content congregated on platforms with little moderation, anonymity, and easy search functions for images. A range of reactions and intentions were reported in relation to posting or viewing images of self-harm: from empathy, a sense of solidarity, and the use of images to give or receive help to potentially harmful ones suggesting new methods, normalization, and exacerbation of self-harm. Viewing images as an alternative to self-harm or a creative outlet were regarded in 2 studies as positive impacts. Reactions of anger, hostility, and ambivalence have been reported. There was some evidence of the role of imitation and reinforcement, driven partly by the number of comments and wound severity, but this was not supported by time series analyses. CONCLUSIONS Although the results of this review support concern related to safety and exacerbation of self-harm through viewing images of self-harm, there may be potential for positive impacts in some of those exposed. Future research should evaluate the effectiveness and potential harms of current posting restrictions, incorporate user perspectives, and develop recovery-oriented content. Clinicians assessing distressed young people should ask about internet use, including access to self-harm images, as part of their assessment.
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Affiliation(s)
| | - Keith Hawton
- Centre for Suicide Research, University Department of Psychiatry, Oxford, United Kingdom
| | - Lauren Burns
- Swansea University Medical School, Swansea, United Kingdom
| | - Anne Stewart
- Centre for Suicide Research, University Department of Psychiatry, Oxford, United Kingdom
| | - Ann John
- Swansea University Medical School, Swansea, United Kingdom
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5
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Niederkrotenthaler T, Schacherl R, Till B. Communication about suicide in YouTube videos: Content analysis of German-language videos retrieved with method-and help-related search terms. Psychiatry Res 2020; 290:113170. [PMID: 32526517 DOI: 10.1016/j.psychres.2020.113170] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 10/24/2022]
Abstract
Online searches for information on suicide are very common but studies on how the topic is addressed on one of the the most relevant platforms, YouTube, are missing. We performed a content analysis of German-language videos retrieved with the basic term "suicide", a method-related search term ("how to hang yourself"), and a help-related term ("suicide prevention"). We assessed the quality of n=232 randomly selected videos based on media recommendations for suicide reporting. Characteristics of videos retrieved with the method- and help-related search term, were compared to search results for "suicide". Videos retrieved with the help-related term had more potentially protective and fewer harmful characteristics than those retrieved with the other search terms. For example, these videos significantly more often debunked suicide myths and provided contact information to help services. In total, the mean number of harmful and protective characteristics per video were 1.6 and 1.3 for basic searches; 1.7 and 1.0 for method-related searches, and 0.4 and 2.8 for help-related searches, respectively. Videos retrieved in the help-related search were often from help organizations. Only 3% and 8% of videos retrieved with "suicide" and "how to hang yourself", respectively, were age-restricted. Collaborations between suicide prevention and Youtube are warranted to improve the visibility of protective contents and ensure a better implementation of Youtube's own policies regarding self-harm.
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Affiliation(s)
- Thomas Niederkrotenthaler
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria.
| | - Ronja Schacherl
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Benedikt Till
- Unit Suicide Research & Mental Health Promotion, Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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Abstract
Background: Information on methods of suicide is available online, and access to information on methods of suicide appears to contribute to a small but significant proportion of suicides. There is limited documentation of how methods of suicide are being profiled, as well as what content exists in other languages than English. Aim: We aimed to analyze and compare how methods of suicide are profiled on Danish and English-language websites. Method: We applied a categorization and content analysis of websites describing methods of suicide. Sites were retrieved by applying widely used Danish and English-language search terms. Results: A total of 136 English-language websites and 106 Danish-language websites were included for analysis. Websites were more often categorized as prevention or support sites, academic or policy sites, and against suicide sites than dedicated suicide sites (i.e., pro-suicide sites), or information sites. However, information on methods of suicide was available, and 20.1% and 8.9% of the English and Danish-language sites, respectively, suggested that a particular method of suicide was quick, easy, painless, or certain to result in death. Limitations: Only one author coded and analyzed all websites. A further operationalization of the content analysis checklist is warranted to increase reliability. Conclusion: The websites primarily had a prevention or anti-suicide focus, but information on methods of suicide was available, requiring an increased focus on how to diminish the negative effects of harmful online content.
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Affiliation(s)
- Christian Ulrich Eriksen
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark.,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Denmark
| | - Flemming Konradsen
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
| | - Thilde Vildekilde
- Global Health Section, Department of Public Health, University of Copenhagen, Denmark
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7
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Liu X, Huang J, Yu NX, Li Q, Zhu T. Mediation Effect of Suicide-Related Social Media Use Behaviors on the Association Between Suicidal Ideation and Suicide Attempt: Cross-Sectional Questionnaire Study. J Med Internet Res 2020; 22:e14940. [PMID: 32343249 PMCID: PMC7218592 DOI: 10.2196/14940] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/20/2019] [Accepted: 02/03/2020] [Indexed: 01/06/2023] Open
Abstract
Background A limited number of studies have examined the differences in suicide-related social media use behaviors between suicide ideators and suicide attempters or have sought to elucidate how these social media usage behaviors contributed to the transition from suicidal ideation to suicide attempt. Objective Suicide attempts can be acquired through suicide-related social media use behaviors. This study aimed to propose 3 suicide-related social media use behaviors (ie, attending to suicide information, commenting on or reposting suicide information, or talking about suicide) based on social cognitive theory, which proposes that successive processes governing behavior transition include attentional, retention, production, and motivational processes. Methods We aimed to examine the mediating role of suicide-related social media use behaviors in Chinese social media users with suicidal risks. A sample of 569 Chinese social media users with suicidal ideation completed measures on suicidal ideation, suicide attempt, and suicide-related social media use behaviors. Results The results demonstrated that suicide attempters showed a significantly higher level of suicidal ideation (t563.64=5.04; P<.001; two-tailed) and more suicide-related social media use behaviors, which included attending to suicide information (t567=1.94; P=.05; two-tailed), commenting on or reposting suicide information (t567=2.12; P=.03; two-tailed), or talking about suicide (t542.22=5.12; P<.001; two-tailed). Suicidal ideation also affected suicide attempts through the mediational chains. Conclusions Our findings thus support the social cognitive theory, and there are implications for population-based suicide prevention that can be achieved by identifying behavioral signals.
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Affiliation(s)
- Xingyun Liu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beiijng, China.,Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Jiasheng Huang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Qing Li
- Department of Computing, The Hong Kong Polytechnic University, Hong Kong, China (Hong Kong)
| | - Tingshao Zhu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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8
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Chen JI, Mastarone GL, Ambrosino SA, Anzalone N, Carlson KF, Dobscha SK, Teo AR. Evaluation of the Safety and Design of Community Internet Resources for Veteran Suicide Prevention. CRISIS 2019; 40:347-354. [PMID: 30935244 DOI: 10.1027/0227-5910/a000590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background: Recent data show many veterans who die by suicide are not currently engaged in mental health care. Veterans frequently use the Internet for health information and may look online for community resources when in distress. However, little is known about their design characteristics. Aim: To evaluate the design and content of community, veteran suicide prevention websites. Method: Community websites focused on veteran suicide prevention were gathered through Internet searches using standardized search terms. Websites that met the inclusion criteria (n = 9) were evaluated for adherence to suicide safe messaging, usability, readability, and credibility heuristics. Interrater reliability was evaluated using kappa statistics. Descriptive statistics were used to describe website features. Results: Community websites tended to provide help-seeking information, safe messaging, and community activities. However, no websites provided information on lethal means safety or references to signal credibility. Limitations: The sample was small and only included English-language websites, and focused on veteran-oriented, community websites. Conclusion: Community suicide prevention websites focused on veterans could be improved through increased readability, credibility, and provision of lethal means safety information.
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Affiliation(s)
- Jason I Chen
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Ginnifer L Mastarone
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Santisia A Ambrosino
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA
| | - Nicole Anzalone
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA
| | - Kathleen F Carlson
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Oregon Health and Science University-Portland State University School of Public Health, Portland, OR, USA
| | - Steven K Dobscha
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
| | - Alan R Teo
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, US Department of Veterans Affairs (VA), Portland, OR, USA.,Department of Psychiatry, Oregon Health and Science University, Portland, OR, USA
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9
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Horsman G. A Forensic Examination of Online Search Facility URL Record Structures. J Forensic Sci 2019; 64:236-242. [DOI: 10.1111/1556-4029.13818] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 04/17/2018] [Accepted: 04/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Graeme Horsman
- Teesside University Campus Heart, Southfield Rd Middlesbrough TS1 3BX U.K
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11
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Thianthai C. What does social media have to do with health? A case study of Bangkok youths. Int J Adolesc Med Health 2018; 33:/j/ijamh.ahead-of-print/ijamh-2018-0058/ijamh-2018-0058.xml. [PMID: 30205644 DOI: 10.1515/ijamh-2018-0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 05/08/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This qualitative research aims to understand how Bangkok youths perceive social media usage effects on their physical, psychological, social and spiritual health. METHODS A total of 74 Bangkok youths, aged 15-24 years old, divided according to each age and gender group participated in in-depth interviews and mobile phone search observations. Health impact was categorized into the four health aspects through content analysis according to sociological perspectives. RESULTS Bangkok youths view social media to have both positive and negative effects on their health. Increased awareness of negative results was shown with increased age. While younger youths use social media for entertainment, older youths also use social media for self-development. Interests and degree of sensitivity varied among the genders. CONCLUSION Effective health education can only be achieved through future youth-centered research on social media usage based on age, gender and cultural variations.
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Affiliation(s)
- Chulanee Thianthai
- Faculty of Political Science, Chulalongkorn University, 254 Phayathai Road, Bangkok 10330, Thailand
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12
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Marchant A, Hawton K, Stewart A, Montgomery P, Singaravelu V, Lloyd K, Purdy N, Daine K, John A. A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: The good, the bad and the unknown. PLoS One 2017; 12:e0181722. [PMID: 28813437 PMCID: PMC5558917 DOI: 10.1371/journal.pone.0181722] [Citation(s) in RCA: 200] [Impact Index Per Article: 28.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 07/06/2017] [Indexed: 11/18/2022] Open
Abstract
Background Research exploring internet use and self-harm is rapidly expanding amidst concerns regarding influences of on-line activities on self-harm and suicide, especially in young people. We aimed to systematically review evidence regarding the potential influence of the internet on self-harm/suicidal behaviour in young people. Methods We conducted a systematic review based on an electronic search for articles published between 01/01/2011 and 26/01/2015 across databases including Medline, Cochrane and PsychInfo. Articles were included if: the study examined internet use by individuals who engaged in self-harm/ suicidal behaviour, or internet use clearly related to self-harm content; reported primary empirical data; participants were aged under 25 years. New studies were combined with those identified in a previous review and subject to data extraction, quality rating and narrative synthesis. Results Forty-six independent studies (51 articles) of varying quality were included. Perceived influences were: positive for 11 studies (38191 participants); negative for 18 studies (119524 participants); and mixed for 17 studies (35235 participants). In contrast to previous reviews on this topic studies focused on a wide range of internet mediums: general internet use; internet addiction; online intervention/treatment; social media; dedicated self-harm websites; forums; video/image sharing and blogs. A relationship between internet use and self-harm/suicidal behaviour was particularly associated with internet addiction, high levels of internet use, and websites with self-harm or suicide content. While there are negative aspects of internet use the potential for isolation reduction, outreach and as a source of help and therapy were also identified. Conclusions There is significant potential for harm from online behaviour (normalisation, triggering, competition, contagion) but also the potential to exploit its benefits (crisis support, reduction of social isolation, delivery of therapy, outreach). Young people appear to be increasingly using social media to communicate distress, particularly to peers. The focus should now be on how specific mediums’ (social media, video/image sharing) might be used in therapy and recovery. Clinicians working with young people who self-harm or have mental health issues should engage in discussion about internet use. This should be a standard item during assessment. A protocol for this review was registered with the PROSPERO systematic review protocol registry: (http://www.crd.york.ac.uk/prospero/display_record.asp?ID=CRD42015019518).
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Affiliation(s)
- Amanda Marchant
- Medical School, Swansea University, Swansea, Wales, United Kingdom
| | - Keith Hawton
- Centre for Suicide Research, University of Oxford, Oxford, United Kingdom
| | - Ann Stewart
- Oxford Central Child and Adolescent Mental Health Services, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Paul Montgomery
- Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom
| | | | - Keith Lloyd
- Medical School, Swansea University, Swansea, Wales, United Kingdom
| | - Nicola Purdy
- Medical School, Swansea University, Swansea, Wales, United Kingdom
| | - Kate Daine
- Centre for Evidence Based Intervention, University of Oxford, Oxford, United Kingdom
| | - Ann John
- Medical School, Swansea University, Swansea, Wales, United Kingdom
- * E-mail:
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