An Analysis of Depression, Self-Harm, and Suicidal Ideation Content on Tumblr

Scrolling for fun or to cope? Associations between social media motives and social media disorder symptoms in adolescents and young adults

Introduction

Although not yet recognized as an official disorder, Social Media Disorder (SMD) has recently received considerable interest in the research. However, relatively little is known about underlying motives for social media use and to what extent motives show differential associations with SMD symptom severity and SMD diagnosis. The overall aim of the present study was therefore to examine motives for social media use in relation to (1) which motives are most common, (2) associations between motives and both SMD symptom severity and SMD diagnosis, and (3) the effects of sex and age.

Methods

Data were collected through a digital survey (n = 1820) and included both high school students (n = 924) and university students (n = 896). Six different motives were assessed, and SMD was measured in relation to both Heavy Involvement and Negative Consequences of social media use.

Results

The results showed that the most common social media use motives were Entertainment, Social Maintenance, and Information and Skills. However, it was the three least common motives - Social Compensation, Self-status, and Escape - that were most strongly associated with SMD symptom severity and SMD diagnosis. These three motives explained as much as 42% of the variance in negative consequences of social media use. Only a few small effects of sex or age were found.

Discussion

Some social media use motives are much more strongly associated with SMD than others are. This could indicate that prevention and intervention programs should target these motives specifically, rather than focusing on social media use in general.

Depression Detection on Social Media: A Classification Framework and Research Challenges and Opportunities

Social media has become a safe space for discussing sensitive topics such as mental disorders. Depression dominates mental disorders globally, and accordingly, depression detection on social media has witnessed significant research advances. This study aims to review the current state-of-the-art research methods and propose a multidimensional framework to describe the current body of literature relating to detecting depression on social media. A study methodology involved selecting papers published between 2011 and 2023 that focused on detecting depression on social media. Five digital libraries were used to find relevant papers: Google Scholar, ACM digital library, PubMed, IEEE Xplore and ResearchGate. In selecting literature, two fundamental elements were considered: identifying papers focusing on depression detection and including papers involving social media use. In total, 50 papers were reviewed. Multiple dimensions were analyzed, including input features, social media platforms, disorder and symptomatology, ground truth, and techniques. Various types of input features were employed for depression detection, including textual, visual, behavioral, temporal, demographic, and spatial features. Among them, visual and spatial features have not been systematically reviewed to support mental health researchers in depression detection. Despite depression's fine-grained disorders, most studies focus on general depression. Recent studies have shown that social media data can be leveraged to identify depressive symptoms. Nevertheless, further research is needed to address issues like depression validation, generalizability, causes identification, and privacy and ethical considerations. An interdisciplinary collaboration between mental health professionals and computer scientists may help detect depression on social media more effectively.

How do teens with a history of suicidal behavior and self-harm interact with social media?

BACKGROUND

This study examines how engagement with depression-related social media content varies by teens who report suicidal ideation, suicide attempts, and nonsuicidal self-injury (NSSI) versus those who had not experienced each behavior.

METHODS

Teens aged 15-17 years old (N = 93) were recruited from social media platforms from October 2016 to August 2018. Participants were asked three open-ended questions about the advantages and disadvantages of networking about depression-related content on social media. We conducted a qualitative analysis to capture themes in responses by question item. Univariate analyses were conducted to compare differences in the frequency of themes endorsed among the behavioral groups versus their counterparts.

RESULTS

Among participants (female, 73%; non-White, 45%; sexual minority, 57%), most (93%, n = 87) endorsed depressive symptoms. Sixty-five percent (n = 60) endorsed suicidal ideation within the past year, who were more likely to indicate unhelpful social interactions (p = .02) as a disadvantage of following depression content than peers who did not endorse suicidal ideation within the past year. Eighty percent (n = 74) endorsed lifetime experience of NSSI, who were more likely to indicate negative impact on relationships (p = .01) from posting depression content than peers who did not experience NSSI. Fifty-eight percent (n = 54) endorsed a lifetime suicide attempt, who were more likely to mention offering solutions (p = .03) to someone posting concerning content than peers who did not endorse a lifetime suicide attempt.

CONCLUSIONS

This study provides diverse and unique perspectives on how engagement with depression-related social media varies by mental health behaviors and informs the use of social media for recruitment and outreach for teens.

Using Web-Based Content to Connect Young People With Real-life Mental Health Support: Qualitative Interview Study

BACKGROUND

Young people experience high rates of mental health problems but make insufficient use of the formal services available to them. As young people are heavy users of the internet, there may be an untapped potential to use web-based content to encourage this hard-to-reach population to make better use of face-to-face mental health services. However, owing to the vast range of content available and the complexities in how young people engage with it, it is difficult to know what web-based content is most likely to resonate with this age group and facilitate their engagement with professional support.

OBJECTIVE

This study aimed to identify the types of web-based content young people identified as more likely to prompt youth engagement with mental health services.

METHODS

This study used a qualitative design conducted within a social constructionist epistemology that recognized the importance of youth empowerment in mental health. Digital interviews using WhatsApp instant messenger were conducted with 37 young people aged 16-23 years who participated as "expert informants" on the priorities and practices of youth in web-based spaces. The data were analyzed using reflexive thematic analysis to identify the types of web-based content that participants believed would encourage young people to reach out to a face-to-face mental health service for support.

RESULTS

The analysis generated 3 main themes related to the research question. First, participants noted that a lack of information about available services and how they worked prevented young people from engaging with face-to-face mental health services. They proposed web-based content that provided clear information about relevant mental health services and how to access them. They also suggested the use of both text and video to provide young people with greater insight into how face-to-face counseling might work. Second, participants recommended content dedicated to combating misconceptions about mental health and negative portrayals of mental health services and professionals that are prevalent in their web-based spaces. They suggested content that challenged the stigma surrounding mental health and help seeking and highlighted the value of mental health services. Finally, participants suggested that young people would be more likely to respond to "relatable" digital stories of using mental health services, recounted in the context of a personal connection with someone they trusted.

CONCLUSIONS

This study offers recommendations for professionals and service providers on how to better engage young people with real-life mental health support using web-based content. Web-based content can be used to challenge some of the barriers that continue to prevent young people from accessing face-to-face mental health services and underlines the importance of including young people's voices in the design of web-based mental health content.

Youth Insight About Social Media Effects on Well/Ill-Being and Self-Modulating Efforts

PURPOSE

We aim to investigate youth insight about how their social media use affects them. We hope to understand if and how they self-modulate their use.

METHODS

Using a text message-based platform, codable survey responses were returned by a minimum of 871 of 1,144 youth aged 14-24 in November, 2020. Youth were asked the following three questions: (1) What advice would you give to young people who are new to social media? (2) Have you ever felt like you need to change your social media use (what you view, time spent, etc.)? Why? (3) Have you ever deleted or thought about deleting your social media account(s)? Why? A codebook was created from the data and two coders independently coded the entirety of the data set using the 18-code codebook. Coders resolved discrepancies in coding patterns together and the frequency of each code was recorded.

RESULTS

Youth showed insight about negative impacts of social media and were especially concerned about safety on social media. A majority of respondents deleted or thought about deleting their social media account or app. Youth were more likely to report wanting to change the amount of time spent on their social media compared to the content they view.

DISCUSSION

Youth are aware of ways in which social media could be negatively impacting them and they have employed methods to modulate their use because of this awareness.

Psychiatric reactions among the non-exposed population who viewed disaster-related short videos: Evidence from the 2021 Henan floods

Media-triggered mental disorders are common when people experience traumatic events. However, few studies have examined the underlying mechanism of how viewing disaster-related short videos triggers psychiatric reactions among non-exposed populations in the context of today's media ecology. Moreover, limited studies have employed psychological network analysis to comprehensively disentangle the associations between diverse forms of media exposure and psychological symptoms. To fill these research gaps, we conducted a survey on a non-exposed population (N = 516) during the 2021 Henan floods to test the effects of short video exposure on its mental status. Short video exposure behaviors were measured under 12 different scenarios, and the participants' mental status (i.e., depression, anxiety, and post-traumatic stress disorder [PTSD]) was measured using the nine-item Patient Health Questionnaire (PHQ-9), seven-item Generalized Anxiety Disorder (GAD-7) scale, and PTSD Check List-Civilian version (PCL-C). We employed both correlation and psychological network analyses to make estimations. The descriptive results revealed that short video exposure behaviors among almost all scenarios were positively associated with the scores of PHQ-9, GAD-7, and PCL-C. The network analysis revealed that both depression and anxiety were associated with the "Support (SVP)" scenario, whereas PTSD was directly linked to the "Help Seeking (SVP)" scenario. Among the three networks, "Help Seeking (SVP)" was the most central among the 12 scenarios of short video exposure. The central symptoms for depression, anxiety, and PTSD were "Concentration," "Relax," and "Reliving Trauma," respectively. The shortest paths between the central short video exposure item and central symptom among the three networks consisted of only two or three steps. This study's findings could assist researchers and policymakers in undertaking novel disaster-related practical activities worldwide.

An Analysis of Young Clients' Communications About Their Suicidality on a Text Message Helpline: "I'm Scared of What I Might Do to Myself"

BACKGROUND

Youth suicide is a major international concern and prevention is a priority. In most cases suicidal behavior would be preceded by a period of suicidal ideation. Although feeling suicidal is recognized as a risk factor for suicide, there is little research which captures young people's own experience of suicidality in a moment of crisis.

AIMS

This study aimed to explore young people's own accounts of their suicidality in the moment in which they experienced it.

METHOD

This qualitative study examined clients' experience of suicidality as communicated during a text message helpline counseling interaction. The data consisted of 125 text transcripts of an interaction during which a client was experiencing suicidality. These were obtained from a New Zealand based youth helpline service. The data was analyzed using thematic analysis.

FINDINGS

The analysis showed that clients' experienced suicidality as a normal part of their life; that it was understood as a form of coping and that it was seen as a legitimate way to communicate distress. Clients described rapid fluctuations in the intensity of their suicidality and a feeling of being out of control. Despite this, they also communicated ambivalence about acting on their suicidality, and a recognition of the need to get help.

CONCLUSIONS

This study offered unique insights into young people's experience of suicidality and opens up opportunities for prevention. It underlines the importance of identifying chronic suicidality early and providing intervention and support prior to a suicidal crisis. The findings point to the potential that text counseling services might have in providing support to young people who are experiencing suicidality in the moment that they need this.

Detecting risk level in individuals misusing fentanyl utilizing posts from an online community on Reddit

INTRODUCTION

Opioid misuse is a public health crisis in the US, and misuse of synthetic opioids such as fentanyl have driven the most recent waves of opioid-related deaths. Because those who misuse fentanyl are often a hidden and high-risk group, innovative methods for identifying individuals at risk for fentanyl misuse are needed. Machine learning has been used in the past to investigate discussions surrounding substance use on Reddit, and this study leverages similar techniques to identify risky content from discussions of fentanyl on this platform.

METHODS

A codebook was developed by clinical domain experts with 12 categories indicative of fentanyl misuse risk, and this was used to manually label 391 Reddit posts and comments. Using this data, we built machine learning classification models to identify fentanyl risk.

RESULTS

Our machine learning risk model was able to detect posts or comments labeled as risky by our clinical experts with 76% accuracy and 76% sensitivity. Furthermore, we provide a vocabulary of community-specific, colloquial words for fentanyl and its analogues.

DISCUSSION

This study uses an interdisciplinary approach leveraging machine learning techniques and clinical domain expertise to automatically detect risky discourse, which may elicit and benefit from timely intervention. Moreover, our vocabulary of online terms for fentanyl and its analogues expands our understanding of online "street" nomenclature for opiates. Through an improved understanding of substance misuse risk factors, these findings allow for identification of risk concepts among those misusing fentanyl to inform outreach and intervention strategies tailored to this at-risk group.

Neurophysiological Markers Related to Negative Self-referential Processing Differentiate Adolescent Suicide Ideators and Attempters

Background

Adolescent suicide is a major public health concern, and presently, there is a limited understanding of the neurophysiological correlates of suicidal behaviors. Cognitive models of suicide indicate that negative views of the self are related to suicidal thoughts and behaviors, and this study investigated whether behavioral and neural correlates of self-referential processing differentiate suicide ideators from recent attempters.

Methods

Adolescents with depression reporting current suicidal ideation and no lifetime suicide attempts (suicide ideators, n = 30) and past-year suicide attempts (recent attempters, n = 26) completed a self-referential encoding task while high-density electroencephalogram data were recorded. Behavioral analyses focused on negative processing bias (i.e., tendency to attribute negative information as being self-relevant) and drift rate (i.e., slope of reaction time and response type that corresponds to how quickly information is accumulated to make a decision about whether words are self-referent). Neurophysiological markers probing components reflecting early semantic monitoring (P2), engagement (early late positive potential), and effortful encoding (late late positive potential) also were tested.

Results

Adolescent suicide ideators and recent suicide attempters reported comparable symptom severity, suicide ideation, and mental disorders. Although there were no behavioral differences, compared with suicide ideators, suicide attempters exhibited greater P2 amplitudes for negative versus positive words, which may reflect enhanced attention and arousal in response to negative self-referential stimuli. There were no group differences for the early or late late positive potential.

Conclusions

Enhanced sensory arousal in response to negative stimuli-that is, attentional orienting to semantic, emotional, and self-relevant features-differentiates adolescent suicide attempters from ideators and thus may signal risk for suicidal behavior.

Characterization of time-variant and time-invariant assessment of suicidality on Reddit using C-SSRS

Suicide is the 10th leading cause of death in the U.S (1999-2019). However, predicting when someone will attempt suicide has been nearly impossible. In the modern world, many individuals suffering from mental illness seek emotional support and advice on well-known and easily-accessible social media platforms such as Reddit. While prior artificial intelligence research has demonstrated the ability to extract valuable information from social media on suicidal thoughts and behaviors, these efforts have not considered both severity and temporality of risk. The insights made possible by access to such data have enormous clinical potential-most dramatically envisioned as a trigger to employ timely and targeted interventions (i.e., voluntary and involuntary psychiatric hospitalization) to save lives. In this work, we address this knowledge gap by developing deep learning algorithms to assess suicide risk in terms of severity and temporality from Reddit data based on the Columbia Suicide Severity Rating Scale (C-SSRS). In particular, we employ two deep learning approaches: time-variant and time-invariant modeling, for user-level suicide risk assessment, and evaluate their performance against a clinician-adjudicated gold standard Reddit corpus annotated based on the C-SSRS. Our results suggest that the time-variant approach outperforms the time-invariant method in the assessment of suicide-related ideations and supportive behaviors (AUC:0.78), while the time-invariant model performed better in predicting suicide-related behaviors and suicide attempt (AUC:0.64). The proposed approach can be integrated with clinical diagnostic interviews for improving suicide risk assessments.

Impact of Web-Based Sharing and Viewing of Self-Harm-Related Videos and Photographs on Young People: Systematic Review

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.

Social Media Use and Deliberate Self-Harm Among Youth: A Systematized Narrative Review

BACKGROUND

Suicide is now the 2^nd leading cause of death among adolescents and young adults. Social media's influence on youth suicidal risk or attenuation of risk is a novel and rapidly expanding topic of research that requires attention from a broad range of mental health services professionals. We aimed to provide an updated review of social media-related risk and protective factors to youth deliberate-self harm (DSH) to guide mental health services professionals in offering care and support to youth vulnerable to suicide.

METHODS

Studies on which primary research was conducted that evaluated young people's use of social media platforms related to DSH were systematically searched via Scopus and identified through expert recommendation and the Association for Computing Machinery's digital library of conference materials. The search focused on the timeframe June 2014 to September 2019, to offer an update since the time the most recent systematic reviews on this topic concluded their literatures searches. Quality was reviewed using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

A total of 38 articles were eligible, and 24 articles rated as high quality were included in a narrative review. Of the included articles, 19 explored DSH risk and 8 explored DSH protection. Most articles reported on cross-sectional quantitative or qualitative studies. Opportunities for both risks and benefits were explored, and potential influences of social media use were considered for subgroups of youth who may be especially vulnerable to suicide.

CONCLUSIONS

In the relatively short period of review, the association between social media use and youth DSH was tested in population-based studies, offering preliminary evidence for suicide prevention and treatment efforts. Further research is needed to understand the contribution of social media use to youth DSH, particularly among youth most vulnerable to suicidal risk.

Each post matters: a content analysis of #mentalhealth images on Instagram

This study examined mental health-related content on a popular visual-based social media platform, Instagram. A content analysis was completed by using the search term '#mentalhealth' on public Instagram posts (N = 758). Our data showed that wellness practices related to mental health (e.g. exercise, healthy eating), anxiety, and depression are the most addressed mental health topics on Instagram. Additionally, posts that mention at least one type of mental health problem seek peer support and engagement from other users at a higher rate compared to posts that do not mention mental health disorder or topic (beyond the search term #mentalhealth). We discussed these findings in detail, as well as their theoretical and practical implications and the limitations of this study. We also suggested avenues for further research to promote evidence-based health communication techniques tailored to current visual-based social media platforms.

Public Health Implications of Image-Based Social Media: A Systematic Review of Instagram, Pinterest, Tumblr, and Flickr

INTRODUCTION

Image-based social media Instagram, Pinterest, Tumblr, and Flickr have become sources of health-related information and tools for health communication. No known systematic review exists that summarizes the existing research and its health implications.

METHODS

We searched EBSCOhost Academic Search Complete, PubMed, and Web of Science in January 2016, April 2017, and November 2017, with the following keywords: Pinterest, Instagram, Tumblr, or Flickr. Only public health-related, peer-reviewed research articles were included (excluding surveys of self-reported social media use).

RESULTS

Sixty-six research articles were included. All 12 experimental studies used Instagram. Of the 54 observational studies, 38 studied Instagram; 12, Pinterest; 7, Tumblr; and 6, Flickr; some studies investigated more than 1 platform. More than half of the included articles were related to mental health and substance abuse (n = 39, 59%). Other topics included chronic diseases, infectious diseases, surgery, injury prevention, pharmacovigilance, sexual and reproductive health, and adolescent psychology with functional magnetic resonance imaging.

DISCUSSION

Public health-oriented research on Instagram, Pinterest, Tumblr, and Flickr is increasing. Most observational studies investigated questions ranging from public perception of diseases or interventions (vaccination) and undesirable media exposure ("echo chamber," distorted body image, underage substance use, and pro-suicide messages) to information dissemination and online engagement (likes and comments). A few studies attempted to use image-based social media as intervention tools, but the results were mainly exploratory.

CONCLUSION

More research is needed to study how social media users discuss health through sharing images online, and how public health professionals can communicate effectively using image-sharing social media.

Responding to depression-related Imgur posts: A content analysis of social support and non-bona fide features in user-generated comments

Objectives

A growing body of health communication scholarship has explored the utility of social media platforms for eliciting social support, although much of this scholarship has focused on Facebook and Twitter. This study contributes to this body of research by identifying support in comments submitted to depression-related Imgur posts. Furthermore, the use of non-bona fide linguistic features (e.g. humor, sarcasm, and irony) is documented for comparison with supportive elements.

Methods

A content analysis was performed of 1530 comments submitted in response to 20 popular Imgur posts about depression, including the emergence of four social support types outlined by the Multi-Dimensional Support Scale—reassuring, empathic, informational, and tangible support—as well as non-bona fide features.

Results

Findings suggest a supportive discourse, with nearly 60% of comments containing some supportive element. Reassuring and informational support emerged most prominently (26.3% and 26.2% of comments, respectively), followed by empathic (22.9%) and tangible (0.3%) support types. Non-bona fide features manifested in 28.8% of comments. Results indicate significant covariation between non-bona fide features and support, as these infrequently co-occurred.

Conclusions

This study’s findings suggest that depression-related messages frequently receive support from Imgur commenters, especially reassuring and informational support. Additionally, this study provides a conceptual framework for future analyses of online social support by integrating non-bona fide communication with established support types. The results of this study could have implications for health professionals and scholars interested in the use of social media platforms such as Imgur, which serves a predominantly young male demographic, for support provision.

Social media, internet use and suicide attempts in adolescents

PURPOSE OF REVIEW

Suicide is the second leading cause of death in youth aged 10-24 years old globally, but detecting those at risk is challenging. Novel preventive strategies with wide influence across populations are required. Interest in the potential for both detrimental and supportive influences of social media/internet use on suicidal behaviour has been growing; however, the relationship remains unclear.

RECENT FINDINGS

A systematic search of articles from database inception up to 25 January 2019 across five databases: Medline, PsycINFO, EMBASE, HMIC and CINAHL revealed nine independent studies investigating social media/internet use and suicide attempts in young people less than 19 years old (n = 346 416). An independent direct association was found between heavy social media/internet use and increased suicide attempts in seven studies (adjusted ORs ranged from 1.03 to 5.10), although adjusting for cyberbullying victimization and sleep disturbance reduced the strength of this association. Two studies found that some social media/internet use, versus no use, may be associated with fewer suicide attempts. There were no studies investigating the relationship between social media/internet use and completed suicide.

SUMMARY

There is an independent association between problematic use of social media/internet and suicide attempts in young people. However, the direction of causality, if any, remains unclear. Further evaluation through longitudinal studies is needed.

The utility of artificial intelligence in suicide risk prediction and the management of suicidal behaviors

OBJECTIVE

Suicide is a growing public health concern with a global prevalence of approximately 800,000 deaths per year. The current process of evaluating suicide risk is highly subjective, which can limit the efficacy and accuracy of prediction efforts. Consequently, suicide detection strategies are shifting toward artificial intelligence platforms that can identify patterns within 'big data' to generate risk algorithms that can determine the effects of risk (and protective) factors on suicide outcomes, predict suicide outbreaks and identify at-risk individuals or populations. In this review, we summarize the role of artificial intelligence in optimizing suicide risk prediction and behavior management.

METHODS

This paper provides a general review of the literature. A literature search was conducted in OVID Medline, EMBASE and PsycINFO databases with coverage from January 1990 to June 2019. Results were restricted to peer-reviewed, English-language articles. Conference and dissertation proceedings, case reports, protocol papers and opinion pieces were excluded. Reference lists were also examined for additional articles of relevance.

RESULTS

At the individual level, prediction analytics help to identify individuals in crisis to intervene with emotional support, crisis and psychoeducational resources, and alerts for emergency assistance. At the population level, algorithms can identify at-risk groups or suicide hotspots, which help inform resource mobilization, policy reform and advocacy efforts. Artificial intelligence has also been used to support the clinical management of suicide across diagnostics and evaluation, medication management and behavioral therapy delivery. There could be several advantages of incorporating artificial intelligence into suicide care, which includes a time- and resource-effective alternative to clinician-based strategies, adaptability to various settings and demographics, and suitability for use in remote locations with limited access to mental healthcare supports.

CONCLUSION

Based on the observed benefits to date, artificial intelligence has a demonstrated utility within suicide prediction and clinical management efforts and will continue to advance mental healthcare forward.

Distress, Suicidality, and Affective Disorders at the Time of Social Networks

PURPOSE OF REVIEW

We reviewed how scholars recently addressed the complex relationship that binds distress, affective disorders, and suicidal behaviors on the one hand and social networking on the other. We considered the latest machine learning performances in detecting affective-related outcomes from social media data, and reviewed understandings of how, why, and with what consequences distressed individuals use social network sites. Finally, we examined how these insights may concretely instantiate on the individual level with a qualitative case series.

RECENT FINDINGS

Machine learning classifiers are progressively stabilizing with moderate to high performances in detecting affective-related diagnosis, symptoms, and risks from social media linguistic markers. Qualitatively, such markers appear to translate ambivalent and socially constrained motivations such as self-disclosure, passive support seeking, and connectedness reinforcement. Binding data science and psychosocial research appears as the unique condition to ground a translational web-clinic for treating and preventing affective-related issues on social media.

Demographic Evaluation of Oro-Dental Self-Injury for Insurance Deception; Evaluation of the Cases Referred to Shiraz Forensic Medicine Center

STATEMENT OF THE PROBLEM

Nonsuicidal self-inflicted injuries are socially unacceptable and may cause mild to severe damages.

PURPOSE

This study aimed to evaluate the demographic features of the subjects with orodental self-injuries referred to a forensic medicine center in Shiraz, Iran.

MATERIALS AND METHOD

This cross-sectional study evaluated 51 participants (49 men and 2 women) with orodental injuries referred to forensic medicine administration. Orodental self-injury was detected in the subjects, based on the last forensic criterion of self-injuries, considering their history, clinical examinations, and panoramic radiographs.

RESULTS

The findings of this study revealed that dental self-injuries were more prevalent among married men from urban areas with secondary education levels. Most of the cases were due to the monetary compensation received. In the majority of cases, a hard object was used for this self-injury. Moreover, no statistical association was observed between the economic status and orodental self-injury.

CONCLUSION

This study concluded that dental self-injury could be regarded as an unplanned incident because no significant correlation was observed between the participants, their economic status, and the type of dental trauma. Furthermore, detailed investigations on the latent variables are required.

Young People's Reasons for Feeling Suicidal

Background: While considerable attention has been given to explanations for youth suicide, less is known about the reasons that young people themselves give for suicidality. Research on online communications gives an opportunity to investigate the real-time reasons young people give for feeling suicidal. Aims: This study aimed to identify the reasons that young people provide for feeling suicidal in posts published on a suicide prevention forum, hosted on the social media platform Tumblr. Method: We filtered 2 months' worth of posts to identify those that related specifically to suicide. In total, 210 posts were thematically analyzed to identify the reasons given for suicidality and the meanings associated with these. Results: Six main reasons for suicidality were identified in the analysis: feeling lonely and socially disconnected, experiencing identity stigma, failing to meet expectations, being helpless, feeling worthless, and experiences of mental ill-health. Limitations: There are advantages as well as limitations associated with relying on Internet-based data. Limitations include the inability to establish participant demographics and the lack of context for posts. Conclusion: Suicide prevention efforts should target the reasons that young people give for feeling suicidal in the moment of crisis in order to engage this population more effectively.

Suicidal thoughts and behaviors and social isolation: A narrative review of the literature

BACKGROUND

Social isolation is one of the main risk factors associated with suicidal outcomes. The aim of this narrative review was to provide an overview on the link between social isolation and suicidal thoughts and behaviors.

METHODS

We used the PubMed database to identify relevant articles published until April 13, 2018. We focused on: (a) systematic reviews, meta-analyses, and narrative reviews; (b) original observational studies with large samples (N ≥ 500); and (c) qualitative studies. We included all relevant suicidal outcomes: suicidal ideation (SI), suicidal planning, non-suicidal self-injury, deliberate self-harm, suicide attempt (SA), and suicide.

RESULTS

The main social constructs associated with suicidal outcomes were marital status (being single, separated, divorced, or widowed) and living alone, social isolation, loneliness, alienation, and belongingness. We included 40 original observational studies, the majority of them performed on adolescents and/or young adults (k = 23, 57.5%). Both the objective condition (e.g., living alone) and the subjective feeling of being alone (i.e., loneliness) were strongly associated with suicidal outcomes, in particular with SA and SI. However, loneliness, which was investigated in most studies (k = 24, 60%), had a major impact on both SI and SA. These associations were transculturally consistent.

LIMITATIONS

Confounding factors can limit the weight of the results obtained in observational studies.

CONCLUSIONS

Data from the observational studies suggest that both objective social isolation and the subjective feeling of loneliness should be incorporated in the risk assessment of suicide. Interventional studies targeting social isolation for suicide prevention are needed.

Self-disgust as a potential mechanism explaining the association between loneliness and depression

BACKGROUND

Loneliness and self-disgust have been considered as independent predictors of depressive symptoms. In the present study, we hypothesized that self-disgust can explain the association between loneliness and depression, and that emotion regulation strategies interact with self-disgust in predicting depressive symptoms.

METHODS

Three hundred and seventeen participants (M = 29.29 years, SD = 14.11; 76.9% females) completed structured anonymous self-reported measures of loneliness, self-disgust, emotion regulation strategies, and depressive symptoms.

RESULTS

One-way MANOVA showed that participants in the high-loneliness group reported significantly higher behavioural and physical self-disgust, compared to those in the middle and low-loneliness groups. Bootstrapped hierarchical linear regression analysis showed that self-disgust significantly improved predicted variance in depressive symptoms, after controlling for the effects of loneliness. Regression-based mediation modelling showed that both physical and behavioural self-disgust significantly mediated the association between loneliness and depression. Finally, moderated regression analysis showed that expressive suppression interacted with self-disgust in predicting depressive symptoms.

LIMITATIONS

A cross-sectional design was used, and our study focused on expressive suppression and cognitive reappraisal but not on other aspects of emotion regulation or the modulation of emotional arousal and responses.

CONCLUSIONS

We demonstrated, for the first time, that self-disgust plays an important role in the association between loneliness and depressive symptoms. Furthermore, variations in emotion regulation strategies can explain the association between self-disgust and depressive symptoms.

The Impact of Social Media Platforms on Self-Injurious Behavior in Adolescents

The paper provides a review of studies on non-suicidal self-injury (NSSI) in online social networking. Content characteristics of online self-injury narrative are examined by focusing on such categories as hashtags, images, and comments. Negative and positive aspects of social networks’ impact on the risk of self-injury in adolescent are summarized. The presence of NSSI content online and the ability to communicate on issues relating to self-injury can either improve psychological well-being of the users by increasing their mood and self-acceptance, giving means to receive support from others and get information on mental health resources, or increase the person’s susceptibility to self-injuries by initiating their interest in this subject and reinforcing, and encouraging repeated self-harm. Therefore, mental health professionals are facing a global challenge: to create supportive and helpful online content, which implies the development of a new methodology, including language and terminology, that could integrate existing online discourse on self-injury and transform it from within.

Monitoring Online Discussions About Suicide Among Twitter Users With Schizophrenia: Exploratory Study

BACKGROUND

People with schizophrenia experience elevated risk of suicide. Mental health symptoms, including depression and anxiety, contribute to increased risk of suicide. Digital technology could support efforts to detect suicide risk and inform suicide prevention efforts.

OBJECTIVE

This exploratory study examined the feasibility of monitoring online discussions about suicide among Twitter users who self-identify as having schizophrenia.

METHODS

Posts containing the terms suicide or suicidal were collected from a sample of Twitter users who self-identify as having schizophrenia (N=203) and a random sample of control users (N=173) over a 200-day period. Frequency and timing of posts about suicide were compared between groups. The associations between posting about suicide and common mental health symptoms were examined.

RESULTS

Twitter users who self-identify as having schizophrenia posted more tweets about suicide (mean 7.10, SD 15.98) compared to control users (mean 1.89, SD 4.79; t₃₇₄=-4.13, P<.001). Twitter users who self-identify as having schizophrenia showed greater odds of tweeting about suicide compared to control users (odds ratio 2.15, 95% CI 1.42-3.28). Among all users, tweets about suicide were associated with tweets about depression (r=0.62, P<.001) and anxiety (r=0.45, P<.001).

CONCLUSIONS

Twitter users who self-identify as having schizophrenia appear to commonly discuss suicide on social media, which is associated with greater discussion about other mental health symptoms. These findings should be interpreted cautiously, as it is not possible to determine whether online discussions about suicide correlate with suicide risk. However, these patterns of online discussion may be indicative of elevated risk of suicide observed in this patient group. There may be opportunities to leverage social media for supporting suicide prevention among individuals with schizophrenia.

Social Media and Suicide: A Review of Technology-Based Epidemiology and Risk Assessment

Introduction: Suicide is a significant public health problem among teenagers and young adults in the United States, placing significant stress on emergency departments (EDs) to effectively screen and assess for the presence of suicidality in a rapid yet efficient manner. Methods: A literature search was performed using PubMed and MEDLINE with the following terms: "Social media," "Suicide," "Facebook^®," "Twitter^®," "MySpace^®," "Snapchat^®," "Ethics," "Digital Media," and "Forums and Blog." Data were extracted from each article, specifically the sample size, study setting, and design. Only English-language studies were included. We reviewed the reference lists of included articles for additional studies, as well. Abstracts, unpublished data, and duplicate articles were excluded. Results: A total of 363 articles met our initial criteria. Studies older than 10 years and/or in a language other than English were removed. After review, a total of 31 peer-reviewed articles were included in the study. Teenagers and young adults often fail to disclose risk factors to physicians, despite sharing them with the public on social media platforms such as Facebook and Twitter. Therefore, physician access to a patient's social media can assist in identifying suicidal ideation and/or acts. Conclusions: Viewing a patient's social media accounts can help ED physicians gain perspective into his or her mental health status and identify those at risk for suicide; however, ethical and privacy concerns associated with this method of data gathering make implementation of such a practice controversial. To justify its use, formal prospective studies analyzing if and how physician access to a patient's social media influences care should be performed.

The role of online social networking on deliberate self-harm and suicidality in adolescents: A systematized review of literature

Social media use by minors has significantly increased and has been linked to depression and suicidality. Simultaneously, age-adjusted suicide rates have steadily increased over the past decade in the United States with suicide being the second most common cause of death in youth. Hence, the increase in suicide rate parallels the simultaneous increase in social media use. In addition, the rate of nonsuicidal self-injury ranges between 14% and 21% among young people. Evidence suggests that self-harming youth is more active on online social networks than youth who do not engage in self-harm behavior. The role of online social networking on deliberates self-harm and suicidality in adolescents with a focus on negative influence was assessed by conducting a systematized literature review. A literature search on "PubMed" and "Ovid Medline" using a combination of MeSH terms yielded nine articles for data extraction satisfying predefined inclusion/exclusion criteria. It was found that social networking websites are utilized by suicidal and self-harming youth as a medium to communicate with and to seek social support from other users. Online social networking also leads to increased exposure to and engagement in self-harm behavior due to users receiving negative messages promoting self-harm, emulating self-injurious behavior of others, and adopting self-harm practices from shared videos. Greater time spent on social networking websites led to higher psychological distress, an unmet need for mental health support, poor self-rated mental health, and increased suicidal ideation. In conclusion, greater time spent on online social networking promotes self-harm behavior and suicidal ideation in vulnerable adolescents.

A content analysis of thinspiration images and text posts on Tumblr

Thinspiration is content advocating extreme weight loss by means of images and/or text posts. While past content analyses have examined thinspiration content on social media and other websites, no research to date has examined thinspiration content on Tumblr. Over the course of a week, 222 images and text posts were collected after entering the keyword 'thinspiration' into the Tumblr search bar. These images were then rated on a variety of characteristics. The majority of thinspiration images included a thin woman adhering to culturally based beauty, often posing in a manner that accentuated her thinness or sexuality. The most common themes for thinspiration text posts included dieting/restraint, weight loss, food guilt, and body guilt. The thinspiration content on Tumblr appears to be consistent with that on other mediums. Future research should utilize experimental methods to examine the potential effects of consuming thinspiration content on Tumblr.

Social Media Use and Access to Digital Technology in US Young Adults in 2016

BACKGROUND

In 2015, 90% of US young adults with Internet access used social media. Digital and social media are highly prevalent modalities through which young adults explore identity formation, and by extension, learn and transmit norms about health and risk behaviors during this developmental life stage.

OBJECTIVE

The purpose of this study was to provide updated estimates of social media use from 2014 to 2016 and correlates of social media use and access to digital technology in data collected from a national sample of US young adults in 2016.

METHODS

Young adult participants aged 18-24 years in Wave 7 (October 2014, N=1259) and Wave 9 (February 2016, N=989) of the Truth Initiative Young Adult Cohort Study were asked about use frequency for 11 social media sites and access to digital devices, in addition to sociodemographic characteristics. Regular use was defined as using a given social media site at least weekly. Weighted analyses estimated the prevalence of use of each social media site, overlap between regular use of specific sites, and correlates of using a greater number of social media sites regularly. Bivariate analyses identified sociodemographic correlates of access to specific digital devices.

RESULTS

In 2014, 89.42% (weighted n, 1126/1298) of young adults reported regular use of at least one social media site. This increased to 97.5% (weighted n, 965/989) of young adults in 2016. Among regular users of social media sites in 2016, the top five sites were Tumblr (85.5%), Vine (84.7%), Snapchat (81.7%), Instagram (80.7%), and LinkedIn (78.9%). Respondents reported regularly using an average of 7.6 social media sites, with 85% using 6 or more sites regularly. Overall, 87% of young adults reported access or use of a smartphone with Internet access, 74% a desktop or laptop computer with Internet access, 41% a tablet with Internet access, 29% a smart TV or video game console with Internet access, 11% a cell phone without Internet access, and 3% none of these. Access to all digital devices with Internet was lower in those reporting a lower subjective financial situation; there were also significant differences in access to specific digital devices with Internet by race, ethnicity, and education.

CONCLUSIONS

The high mean number of social media sites used regularly and the substantial overlap in use of multiple social media sites reflect the rapidly changing social media environment. Mobile devices are a primary channel for social media, and our study highlights disparities in access to digital technologies with Internet access among US young adults by race/ethnicity, education, and subjective financial status. Findings from this study may guide the development and implementation of future health interventions for young adults delivered via the Internet or social media sites.