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Chen Z, Liao X, Yang J, Tian Y, Peng K, Liu X, Li Y. Association of screen-based activities and risk of self-harm and suicidal behaviors among young people: A systematic review and meta-analysis of longitudinal studies. Psychiatry Res 2024; 338:115991. [PMID: 38833936 DOI: 10.1016/j.psychres.2024.115991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
Emerging evidence suggests that screen-based activities are associated with self-harm and suicidal behaviors. This study aimed to examine these associations among young people through a meta-analysis. We systematically searched EBSCO pshyARTICLES, MEDLINE (via PubMed), EMBASE, and Web of Science from their inception to April 1, 2022, and updated on May 1, 2024. Longitudinal studies reporting the association between various screen-based activities and subsequent self-harm and suicidal behaviors in young people aged 10 to 24 were included. Nineteen longitudinal studies were included in the qualitative synthesis, and 13 studies comprising 43,489 young people were included in the meta-analysis, revealing that total screen use is significantly associated with the risks of self-harm and suicidal behaviors. Cyberbullying victimization was also related to these adverse outcomes. Subgroup analyses indicated that social media use and problematic screen use are significant risk factors for self-harm and suicidal behaviors. Study quality was appraised using the Newcastle-Ottawa Scale, and potential publication bias was deemed unlikely to affect the results significantly. These findings suggest that screen-based activities should be considered in the management and intervention strategies for self-harm and suicidal behaviors in young people.
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Affiliation(s)
- Zengyu Chen
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Xiaoli Liao
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; School of Computer Science and Engineering, Central South University, Changsha, Hunan, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China; Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Kexin Peng
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaopei Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
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Fekih-Romdhane F, Malaeb D, Loch AA, Farah N, Stambouli M, Cheour M, Obeid S, Hallit S. Problematic Smartphone Use Mediates the Pathway from Suicidal Ideation to Positive Psychotic Experiences: a Large Cross-Sectional, Population-Based Study. Int J Ment Health Addict 2023:1-18. [PMID: 36820017 PMCID: PMC9930705 DOI: 10.1007/s11469-023-01028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2023] [Indexed: 02/17/2023] Open
Abstract
The present study followed the newly hypothesized "suicidal drive for psychosis" suggesting that psychosis may be consequential to suicidal ideation (SI) and behavior and attempted to explain parts of the pathway between these variables. To this end, we aimed to test whether problematic smartphone use (PSU) has an indirect mediating effect in the cross-sectional relationship between SI and positive psychotic experiences (PEs). Lebanese community young adults (N=4158; 64.4% females; mean age 21.91±3.79) have been invited to participate to a cross-sectional, web-based study in the period from June to September 2022. After adjusting for potential confounders (i.e., the living situation, marital status, household crowding index, economic pressure, cannabis use, other drugs use, and past history of mental illness other than psychosis), we found that higher levels of suicidal ideation was significantly associated with greater PSU, which was also positively and significantly associated with more positive PEs. Finally, greater suicidal ideation was significantly and directly associated with more positive PEs. Our findings suggest that SPU may be regarded as a potential target for prevention and intervention in psychosis. Clinicians, educators, and school administrators ought to give greater attention to PSU among vulnerable young people who present with SI.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
- Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Nour Farah
- Faculty of Science, Lebanese University, Fanar, Lebanon
| | - Manel Stambouli
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Majda Cheour
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry “Ibn Omrane”, Razi Hospital, 2010 Manouba, Tunisia
- Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478 Saudi Arabia
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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Moss C, Wibberley C, Witham G. Assessing the impact of Instagram use and deliberate self-harm in adolescents: A scoping review. Int J Ment Health Nurs 2023; 32:14-29. [PMID: 35996859 DOI: 10.1111/inm.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 01/14/2023]
Abstract
The use of Instagram by adolescents to access deliberate self-harm content is a growing concern among scholars, mental health professionals and families, with many adolescents (10-19-year-olds) imitating offline what they have seen online. This scoping review aims to investigate the extent to which Instagram use impacts the mental health of its adolescent users, identifying whether there is a relationship between time spent on Instagram and engagement in deliberate self-harm. The databases, PubMed, Web of Science, Google scholar, APA PsycInfo, CINAHL and child development and adolescent studies were explored, and after applying the inclusion/exclusion criteria, 15 papers were included in this review. Thematic analysis indicated that there was a relationship between time spent on Instagram and deliberate self-harm; desensitization of deliberate self-harm resulting in normalization; social contagion and that Instagram provided a sense of belonging to its users who engaged in deliberate self-harm. Implications of this research is that it is quickly outdated as new social media platforms are developed and that the reliance on self-reports does not have high validity or reliability.
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Affiliation(s)
- Carla Moss
- Tameside and Glossop Integrated Care NHS Foundation Trust, Greater Manchester, UK
| | | | - Gary Witham
- Department of Nursing, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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Mavragani A, Whitlock J, Chapman J, Bhandari A, Bazarova N. Young Adults' Perceptions of 2 Publicly Available Digital Resources for Self-injury: Qualitative Study of a Peer Support App and Web-Based Factsheets. JMIR Form Res 2023; 7:e41546. [PMID: 36633896 PMCID: PMC9880808 DOI: 10.2196/41546] [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: 07/29/2022] [Revised: 12/05/2022] [Accepted: 12/12/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Digital resources have the potential to bridge the gaps in mental health services for young people who self-injure. Most research on digital resources for this population has involved observational studies of content in web-based communities or formative studies focused on the design and early evaluation of new interventions. Far less research has sought to understand young people's experiences with publicly available digital resources or to identify specific components of these resources that are perceived to be of value in their recovery. OBJECTIVE This study aimed to understand young people's experiences with 2 publicly available digital resources for self-injury-a peer support app and web-based factsheets-and to disentangle potential explanatory mechanisms associated with perceived benefits and harms. METHODS Participants were 96 individuals (aged 16-25 years) with nonsuicidal self-injury behavior in the past month, who recently completed a pilot randomized controlled trial designed to assess the efficacy of a peer support app as compared with web-based factsheets to reduce self-injury behavior. The trial showed that participants using the peer support app reported less self-injury behavior relative to those receiving the web-based factsheets over 8 weeks. In this study, we used a conventional approach to content analysis of responses to 2 open-ended questions delivered at the end of the trial with the aims of exploring participants' overall experiences with these resources and identifying the qualities of these resources that were perceived to be beneficial to or harmful for participants' recovery. RESULTS Overall, participants were more likely to report benefits than harms. Participants who used the peer support app reported more harms than those who received the web-based factsheets. In the open coding phase, clear benefits were also derived from repeated weekly surveys about self-injury. Key benefits across digital resources included enhanced self-knowledge, reduction in self-injury activity, increased outreach or informal conversations, improved attitudes toward therapy, improved mood, and feeling supported and less alone. Key challenges included worsened or unchanged self-injury activity, diminished mood, and increased barriers to outreach. The most prominent benefit derived from the web-based factsheets and weekly surveys was improved self-understanding. However, the way this manifested differed, with factsheets providing insight on why participants engage in self-injury and the function it serves them and surveys making the frequency and severity of participants' behaviors more apparent. The benefits perceived from using the peer support app were general improvements in mood and feeling less alone. CONCLUSIONS Findings contribute a nuanced understanding of young people's experiences with these digital resources and have implications for the optimization of existing platforms and the design of novel resources to support individuals who self-injure.
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Affiliation(s)
| | - Janis Whitlock
- Department of Communication, Cornell University, Ithaca, NY, United States
| | - Julia Chapman
- Department of Communication, Cornell University, Ithaca, NY, United States
| | - Aparajita Bhandari
- Department of Communication, Cornell University, Ithaca, NY, United States
| | - Natalya Bazarova
- Department of Communication, Cornell University, Ithaca, NY, United States
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Gonçalves AF, Avanci JQ, Njaine K. ["Razors always speak louder": the topic of self-harm in online communities]. CAD SAUDE PUBLICA 2023; 39:e00197122. [PMID: 37132721 DOI: 10.1590/0102-311xpt197122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/02/2023] [Indexed: 05/04/2023] Open
Abstract
This study aims to understand how Brazilian online communities portray the topic of self-harm, discussing its particularities, the narratives produced, the interactions established, and the purpose of the digital space. It was based on qualitative research in the digital environment from the silent observation of Facebook online communities, which were selected considering the number of participants and their interaction. The observation followed a previous script and posts were recorded by screenshots. Publications were organized in the following categories: characterization and functioning of the community; self-directed violence (self-harm and suicide); motivations for the act; strategies to prevent the act; and loving experience. Results showed that the communities were positively guided and defended self-harm without any regulation, which guaranteed the free expression of their participants and detailed reports describing the methods and objects used, the level of efficiency, and how to hide the wounds. Although participants shared the fear of being discovered, they published images of their own scars and wounds, materializing discourses of suffering on the Internet and glamorizing the cuts, the feeling of pleasure, and the sense of belonging, since they are also identity marks. Our findings show that young people who harm themselves share their suffering experiences with other young people without the mediation of a professional, therefore, considering its possible effects on mental health is necessary.
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Affiliation(s)
| | - Joviana Quintes Avanci
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Kathie Njaine
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
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Green-Labelled Rice versus Conventional Rice: Perception and Emotion of Chinese Consumers Based on Review Mining. Foods 2022; 12:foods12010087. [PMID: 36613303 PMCID: PMC9818160 DOI: 10.3390/foods12010087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/15/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
The COVID-19 pandemic increased public health awareness, changing consumers' sensitivity and beliefs about food health. Food anxiety and health scares turn consumers toward safe and healthy foods to strengthen their immunity, which makes green food more popular. However, it remains unclear how to understand the gap between consumer intention to purchase green food and their actual purchasing behaviour. Taking rice as an object of study, comparing differences in consumer perceptions and emotions towards green-labelled rice and conventional rice is beneficial for understanding the components and psychological characteristics of consumer perceptions of green food. Therefore, we used topic modelling and sentiment analysis to explore consumers' focus of attention, attitudinal preferences, and sentiment tendencies based on the review (n = 77,429) from JD.com. The findings revealed that (1) consumers' concerns about green-labelled rice are increasing rapidly, and most have a positive attitude; (2) consumers of green-labelled rice are more concerned about origin, aroma, and taste than conventional rice; (3) consumers of conventional rice are more concerned about the cost-performance ratio, while consumers of green-labelled rice are also price-sensitive; (4) green label mistrust and packaging breakage during logistics are the leading causes of negative emotions among consumers of green-labelled rice. This study provides a comparative analysis of consumer perceptions and emotions between the two types of rice, thus revealing the main influencing factors of the intention-behaviour gap and providing valuable consumer insights for the promotion of green consumption and the sustainable development of the green food industry.
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Xin M, Zhang L, Yang C, Yang X, Xiang M. Risky or protective? Online social support's impact on NSSI amongst Chinese youth experiencing stressful life events. BMC Psychiatry 2022; 22:782. [PMID: 36510160 PMCID: PMC9743110 DOI: 10.1186/s12888-022-04399-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This study was designed to investigate potential gender differences in the interrelations between different types of stressful life events and non-suicidal self injury (NSSI) among Chinese youth, as well as to test the direct and moderating impacts of online social support on Chinese students' NSSI engagement under the pressure of different types of stressful life events. METHODS Based on the data of 2200 students from middle - highschools and universities in Northwestern China, gender difference (male/female binary) in stressful life events, online social support, NSSI and their correlations were analyzed in the study. RESULTS Among different types of stressful life events, male students were reported to experience a significantly higher impact of punishment and interpersonal relationship than females. Female students only experienced significantly higher learning pressure than males; Gender difference was not indentified in NSSI among youth; Stressful life events related to punishment could significantly predict NSSI engagement among males. Stressful life events related to learning pressures, interpersonal relationships, and adaption were significantly correlated to NSSI engagement among females; Online social support didn't had a significant direct effect on youth's NSSI, although it did significantly moderate the relationship between specific types of stressful life events (i.e., loss, interpersonal relationships, adaption among males and all types among females) and their NSSI. CONCLUSION The present study has provided evidence of specified types of stressful life events being risk factors in affecting youth's NSSI: For male students, the higher impacts of stressful life events related to punishment they experienced, the more likely they were about to engage in NSSI. For female students, stressful life events related to learning pressure, interpersonal relationships and adaption were all proved as significant predictors and risky factors of female youth's NSSI; Online social support did not impact on individual's NSSI engagement directly, but moderated it significantly as a protective factor.
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Affiliation(s)
- Moye Xin
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China. .,Shaanxi Key Research Center for Children Mental and Behavioral Health, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China. .,Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Normal University, Xi'an, Shaanxi, China.
| | - Lijin Zhang
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Research Center for Children Mental and Behavioral Health, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Normal University, Xi'an, Shaanxi, China
| | - Chengxi Yang
- College of Liberal Arts, Yulin University, No. 51, Chongwen Road, Yulin, 719000, China
| | - Xueyan Yang
- The Institute for Population and Develoment Studies, Xi'an Jiaotong University, Xi'an, No. 28 Xianning West Road, Xi'an, 710049, China
| | - Meiqiu Xiang
- School of Psychology, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Research Center for Children Mental and Behavioral Health, Shaanxi Normal University, No. 199, South Chang'an Road, Xi'an, 710062, Shaanxi, China.,Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, Shaanxi Normal University, Xi'an, Shaanxi, China
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Hirvonen N. Nameless strangers, similar others: the affordances of a young people's anonymous online forum for health information practices. JOURNAL OF DOCUMENTATION 2022. [DOI: 10.1108/jd-09-2021-0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
PurposeThe study examines how the technical features and associated social practices of an anonymous, text-based online forum intended for young people make it a unique platform for acquiring and sharing health information among peers.Design/methodology/approachThe features and content of a young people's section of a popular Finnish discussion forum were examined with a focus on health-related threads. Observational notes and thread content were analysed with a focus on the forum's affordances for health information practices.FindingsThe findings indicate that the forum's affordances including anonymity, persistence, searchability, cohesion and tolerance enabled the pooling of peer experiences, opinions and experience-based advice on health, rather than sharing factual information or embracing reciprocal discussion. As such, instead of competing for a cognitive authority position with medical authorities or offering emotional support like tight online support communities, the anonymous forum served as a platform for young people to gain information on others' experiences and opinions on sensitive, mundane and disnormative health issues and for reflecting their own lived experiences to those of others.Originality/valueThe study is original in its approach to examining the affordances of an online platform for health information practices. It helps in understanding young people's ways of using different resources to meet their diverse health information needs and the value of gaining access to experiential health information.
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Simone AC, Yu S, Hamza CA. Understanding experiences of disclosing and receiving disclosures of nonsuicidal self-injury amongst peers in university: A qualitative investigation. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2144807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Ariana C. Simone
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor Street West, Toronto, ON, Canada, M5S 1V6
| | - Shutong Yu
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor Street West, Toronto, ON, Canada, M5S 1V6
| | - Chloe A. Hamza
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor Street West, Toronto, ON, Canada, M5S 1V6
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Xin M, Petrovic J, Zhang L, Yang X. Relationships between negative life events and suicidal ideation among youth in China: The direct and moderating effects of offline and online social support from gender perspective. Front Psychol 2022; 13:998535. [PMID: 36275303 PMCID: PMC9583011 DOI: 10.3389/fpsyg.2022.998535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022] Open
Abstract
Background Suicidal ideation was proved to be a critical precondition leading to the occurrence of subsequent suicidal behavior. Studies have confirmed that negative life events and forms of social support that youth are experiencing in the current socio-cultural context might have unique impacts on their suicidal ideation. However, the specific mechanism is relatively underexplored. Objective We sought to investigate the impacts of offline and online social supports on Chinese students’ suicidal ideation under the pressure of various negative life events, as well as potential gender differences in these relationships. Methods Participants were 2,018 middle – high school and university students from Northwestern China, who completed a demographics questionnaire and self-report measures of negative life events, social support, and suicidal ideation. Results Offline social support had a significant direct effect on suicidal ideation across genders. Among male youth, offline social support only had a moderating effect on the relationship between punitive negative life events and suicidal ideation. Among female youth, offline social support had a significant moderating effect on suicidal ideation under the pressure of all types of negative life events; Online social support only had a significant direct effect on female youth’s suicidal ideation, although it did significantly moderate the relationship between all types of negative life events and suicidal ideation, across genders. Conclusion Our findings revealed direct and moderating effects of offline and online social support on suicidal ideation among youth under the pressure of different types of negative life events, as well as gender-specific patterns in these relationships.
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Affiliation(s)
- Moye Xin
- School of Psychology, Shaanxi Normal University, Xi'an, China
- Shaanxi Provincial Key Laboratory for Behavioral and Cognitive Psychology, Shaanxi Normal University, Xi'an, China
- Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, Shaanxi, China
- *Correspondence: Moye Xin,
| | - Julia Petrovic
- Human Development, McGill University, Montreal, QC, Canada
| | - Lijin Zhang
- School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Xueyan Yang
- Institude for Population and Development Studies, School of Public Policy and Administration, Xi’an Jiaotong University, Xi'an, China
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Mindel C, Mainstone-Cotton L, de Ossorno Garcia S, Sefi A, Sugarman G, Salhi L, Brick H, Jackson K, Hanley T. The design and development of an experience measure for a peer community moderated forum in a digital mental health service. Front Digit Health 2022; 4:872404. [PMID: 36698648 PMCID: PMC9869953 DOI: 10.3389/fdgth.2022.872404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 08/31/2022] [Indexed: 01/28/2023] Open
Abstract
Online digital mental health communities can contribute to users' mental health positively and negatively. Yet the measurement of experience, outcomes and impact mechanisms relating to digital mental health communities is difficult to capture. In this paper we demonstrate the development of an online experience measure for a specific children and young people's community forum inside a digital mental health service. The development of the Peer Online Community Experience Measure (POCEM) is informed by a multi-phased design: (i) item reduction through Estimate-Talk-Estimate modified Delphi methods, (ii) user testing with think-aloud protocols and (iii) a pilot study within the digital service community to explore observational data within the platform. Experts in the field were consulted to help reduce the items in the pool and to check their theoretical coherence. User testing workshops helped to inform the usability appearance, wording, and purpose of the measure. Finally, the pilot results highlight completion rates, differences in scores for age and roles and "relate to others", as the most frequent domain mechanism of support for this community. Outcomes frequently selected show the importance of certain aspects of the community, such as safety, connection, and non-judgment previously highlighted in the literature. Experience measures like this one could be used as indicators of active therapeutic engagement within the forum community and its content but further research is required to ascertain its acceptability and validity. Multi-phased approaches involving stakeholders and user-centred design activities enhances the development of digitally enabled measurement tools.
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Affiliation(s)
| | - Lily Mainstone-Cotton
- Kooth Plc, London, United Kingdom,Correspondence: Lily Mainstone-Cotton Santiago de Ossorno Garcia
| | | | - Aaron Sefi
- Kooth Plc, London, United Kingdom,Department of Psychology, University of Exeter, Devon, United Kingdom
| | | | - Louisa Salhi
- Kooth Plc, London, United Kingdom,School of Psychology, University of Kent, Canterbury, United Kingdom
| | | | | | - Terry Hanley
- School of Environment, Education and Development, The University of Manchester, Manchester, United Kingdom
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King R, Carter P. Exploring Young Millennials’ Motivations for Grieving Death Through Social Media. JOURNAL OF TECHNOLOGY IN BEHAVIORAL SCIENCE 2022; 7:567-577. [PMID: 36043161 PMCID: PMC9411041 DOI: 10.1007/s41347-022-00275-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/21/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022]
Abstract
Past research has explored social media grief; however, the motivations for using a range of social media sites, specifically by young millennials, to grieve death fail to be explored expansively in existing thanatology research. Fourteen young millennials participated in individual semi-structured interviews, specifically questioning their motivations for using social media sites to grieve. The interviews were analysed using the thematic analysis framework identified by Braun and Clarke (2013). Four themes were generated: online influence, to announce the death, personal benefit and the hypocrisy of online mourning. The online influence theme suggests that individuals are motivated to grieve due to online influence and pressure. The personal benefit theme suggested social media present many benefits for the bereaved, including continuing bonds, which motivated them to use these platforms. The analysis also indicated that within the motivations there was hypocrisy regarding how young millennials perceive their grief posting activity when compared to others.
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Schuler KR, Baer MM, McDermott RC, Smith PN. A Psychometric Pilot Study Examining the Functions of Suicidal Communications Using IRT and Factor Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10081. [PMID: 36011712 PMCID: PMC9408711 DOI: 10.3390/ijerph191610081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/08/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Suicide prevention, an important public health issue, relies on suicidal communications to identify and intervene with those at risk. Scant research tests explicit theories of suicidal communication impeding applications to prevention science. The current study pilots a new measure assessing the functions of suicidal communications using factor analysis and item response theory. METHODS MTurk workers (n = 898) completed an anonymous survey. The original scale included 35 items refined using exploratory and confirmatory factor analysis, bifactor modeling, and item response theory. RESULTS The initial EFA identified a two-correlated-factor solution. The two-correlated-factor and unidimensional models yielded a poor fit. A bifactor model yielded a borderline to acceptable fit. The final four items were identified using a bifactor model and item response theory graded response models capturing ambivalence resolution defined as behaviors aimed to aid in suicide decision making. The final model yielded an excellent fit: 𝝌2(2) = 1.81, CFI (1.00), TLI (1.00), RMSEA (0.00), and SRMR (0.01). CONCLUSIONS There may be one function of suicidal communications. Disclosure may elicit connection and reasons for living that serve as barriers to suicide and resolve ambivalence. Key limitations include convenience sampling and limited validity measures. Future research should partner with participants to improve scale and theory development efforts.
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Affiliation(s)
- Kaitlyn R. Schuler
- Department of Psychology, University of South Alabama, Mobile, AL 36608, USA
| | - Margaret M. Baer
- Department of Psychology, University of Toledo, Toledo, OH 43606, USA
| | - Ryon C. McDermott
- Department of Psychology, University of South Alabama, Mobile, AL 36608, USA
| | - Phillip N. Smith
- Department of Psychology, University of South Alabama, Mobile, AL 36608, USA
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Pearce H, Smoliak O, Lewis SP. Individuals’ accounts and explanations of continued engagement in non-suicidal self-injury: a qualitative study. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2108762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Heather Pearce
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Olga Smoliak
- Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Stephen P. Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
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15
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Perowne R, Gutman LM. Barriers and enablers to the moderation of self-harm content for a young person's online forum. J Ment Health 2022:1-9. [PMID: 35574666 DOI: 10.1080/09638237.2022.2069721] [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: 11/04/2021] [Revised: 03/04/2022] [Accepted: 03/21/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Self-harm amongst young people in the United Kingdom is higher than in other European countries. Young people who self-harm are often reluctant to seek professional help, turning increasingly to the internet for support, including online forums. There are concerns about misinformation or harmful content being shared, potentially leading to self-harm contagion. Moderation of online forums can reduce risks, improving forum safety. Moderation of self-harm content, however, is an under-researched area. AIMS Using the Behaviour Change Wheel (BCW), this study examines the barriers and enablers to moderation of self-harm content and suggests behaviour change techniques (BCTs) to address barriers. METHOD Qualitative interviews with 8 moderators (of a total of 16) from the UK's leading young people's support service for under 25s, The Mix, were conducted. RESULTS Thematic analysis identified eleven enablers, four barriers and one both an enabler and a barrier. Barriers included emotional exhaustion, working with partial information, access to timely support, vagueness within the guidelines and influence of community users. BCTs selected included increasing social support through a moderation buddy. CONCLUSIONS Optimisation strategies focus on increasing the support and level of information available to moderators and could be considered by other organisations providing similar services.
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Affiliation(s)
- Rachel Perowne
- Department of Clinical, Educational and Health Psychology, University College London, London, England
| | - Leslie Morrison Gutman
- Department of Clinical, Educational and Health Psychology, University College London, London, England
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Himelein-Wachowiak M, Giorgi S, Kwarteng A, Schriefer D, Smitterberg C, Yadeta K, Bragard E, Devoto A, Ungar L, Curtis B. Getting "clean" from nonsuicidal self-injury: Experiences of addiction on the subreddit r/selfharm. J Behav Addict 2022; 11:128-139. [PMID: 35312631 PMCID: PMC9109623 DOI: 10.1556/2006.2022.00005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/21/2022] [Accepted: 02/27/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND & AIMS Previous studies have shown that nonsuicidal self-injury (NSSI) has addictive features, and an addiction model of NSSI has been considered. Addictive features have been associated with severity of NSSI and adverse psychological experiences. Yet, there is debate over the extent to which NSSI and substance use disorders (SUDs) are similar experientially. METHODS To evaluate the extent that people who self-injure experience NSSI like an addiction, we coded the posts of users of the subreddit r/selfharm (n = 500) for each of 11 DSM-5 SUD criteria adapted to NSSI. RESULTS A majority (76.8%) of users endorsed at least two adapted SUD criteria in their posts, indicative of mild, moderate, or severe addiction. The most frequently endorsed criteria were urges or cravings (67.6%), escalating severity or tolerance (46.7%), and NSSI that is particularly hazardous. User-level addictive features positively predicted number of methods used for NSSI, number of psychiatric disorders, and particularly hazardous NSSI, but not suicidality. We also observed frequent use of language and concepts common in SUD recovery circles like Alcoholics Anonymous. DISCUSSION & CONCLUSION Our findings support previous work describing the addiction potential of NSSI and associating addictive features with clinical severity. These results suggest that NSSI and SUD may share experiential similarities, which has implications for the treatment of NSSI. We also contribute to a growing body of work that uses social media as a window into the subjective experiences of stigmatized populations.
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Affiliation(s)
| | - Salvatore Giorgi
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA,Department of Computer and Information Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Kwarteng
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Destiny Schriefer
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Chase Smitterberg
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Kenna Yadeta
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Elise Bragard
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA,Department of Psychology, Fordham University, Bronx, NY, USA
| | - Amanda Devoto
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Lyle Ungar
- Department of Computer and Information Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Brenda Curtis
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA,Corresponding author. Biomedical Research Center, 251 Bayview Blvd. Suite 200, Baltimore, MD 21224, USA. Tel.:+ 443-740-2126. E-mail:
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17
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Extraversion moderates the relationship between social media use and depression. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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18
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Lee SE, Yim M, Hur JW. Beneath the surface: Clinical and psychosocial correlates of posting nonsuicidal self-injury content online among female young adults. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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Abou Seif N, John-Baptiste Bastien R, Wang B, Davies J, Isaken M, Ball E, Pitman A, Rowe S. Effectiveness, acceptability and potential harms of peer support for self-harm in non-clinical settings: systematic review. BJPsych Open 2022; 8:e28. [PMID: 35034666 PMCID: PMC8811789 DOI: 10.1192/bjo.2021.1081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many people who have self-harmed prefer informal sources of support or support from those with lived experience. However, little is known about whether peer support improves outcomes for people who have self-harmed or about the risks of peer support interventions in non-clinical settings. AIMS The aims of this review were to examine the effectiveness, acceptability and potential risks of peer support for self-harm, and how these risks might be mitigated. METHOD We searched bibliographic databases and grey literature for papers published since 2000. We included peer support for self-harm that occurred in voluntary-sector organisations providing one-to-one or group support, or via moderated online peer support forums. RESULTS Eight of the ten papers included focused on peer support that was delivered through online media. No study compared peer support with other treatments or a control group, so limited conclusions could be made about its effectiveness. Peer support for self-harm was found to be acceptable and was viewed as having a range of benefits including a sense of community, empowerment, and access to information and support. The most commonly perceived risk associated with peer support was the potential for triggering self-harm. CONCLUSIONS Our findings highlighted a range of benefits of being part of a group with very specific shared experiences. Mitigations for potential risks include organisations using professional facilitators for groups, trigger warnings for online forums, and providing regular supervision and training so that peers are prepared and feel confident to support vulnerable people while maintaining their own emotional health.
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Affiliation(s)
| | | | - Belinda Wang
- Division of Psychiatry, University College London, UK
| | | | | | | | - Alexandra Pitman
- Division of Psychiatry, University College London, and Camden and Islington NHS Foundation Trust, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, UK
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Kruzan KP, Whitlock J, Bazarova NN, Bhandari A, Chapman J. Use of a Mobile Peer Support App Among Young People With Nonsuicidal Self-injury: Small-scale Randomized Controlled Trial. JMIR Form Res 2022; 6:e26526. [PMID: 35006076 PMCID: PMC8787664 DOI: 10.2196/26526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/10/2021] [Accepted: 11/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a widespread behavior among adolescents and young adults. Although many individuals who self-injure do not seek treatment, there is evidence for web-based help-seeking through web-based communities and mobile peer support networks. However, few studies have rigorously tested the efficacy of such platforms on outcomes relevant for NSSI recovery. OBJECTIVE The aim of this small-scale preregistered randomized controlled trial is to provide preliminary insight into the shorter- and longer-term efficacy of the use of a peer support app, TalkLife, in reducing NSSI frequency and urges and increasing readiness to change. In addition, we explore contact with informal support, interest in therapy, and attitudes toward professional help-seeking. METHODS Individuals aged 16-25 years with current (within 3 months) and chronic (>6 episodes in the past year) NSSI history were eligible to participate in this study. After baseline assessments, the intervention group was instructed to use the app actively (eg, post or comment at least three times per week) and the control group received weekly psychoeducational materials through email, for 8 weeks. Follow-up was assessed at 1 month and 2 months. Linear mixed modeling was used to evaluate condition and time point effects for the primary outcomes of NSSI frequency and urges, readiness to change, contact with informal support, interest in therapy, and attitudes toward professional help-seeking. RESULTS A total of 131 participants were included in the analysis. We evidenced a significant effect of condition on NSSI frequency such that the participants using the peer support app self-injured less over the course of the study (mean 1.30, SE 0.18) than those in the control condition (mean 1.62, SE 0.18; P=.02; η2=0.02). We also evidenced a significant condition effect of readiness to change such that the treatment participants reported greater confidence in their ability to change their NSSI behavior (mean 6.28, SE 0.41) than the control participants (mean 5.67, SE 0.41; P=.04; η2=0.02). No significant differences were observed for contact with informal support, interest in therapy, or attitudes toward professional help-seeking. CONCLUSIONS Use of the peer support app was related to reduced NSSI frequency and greater confidence in one's ability to change NSSI behavior over the course of the study period, but no effects on NSSI urges, contact with informal support, interest in therapy, or attitudes toward professional help-seeking were observed. The findings provide preliminary support for considering the use of mobile peer support apps as a supplement to NSSI intervention and point to the need for larger-scale trials. TRIAL REGISTRATION Open Science Foundation; https://osf.io/3uay9.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Janis Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States
| | - Natalya N Bazarova
- Department of Communication, Cornell University, Ithaca, NY, United States
| | - Aparajita Bhandari
- Department of Communication, Cornell University, Ithaca, NY, United States
| | - Julia Chapman
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States
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21
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Hamdan S, Apter A, Levi-Belz Y. Non-suicidal Self-Injury Among Adolescents From Diverse Ethnocultural Groups in Israel: The Association With Sleep Problems and Internet Addiction. Front Psychiatry 2022; 13:899956. [PMID: 35633814 PMCID: PMC9136052 DOI: 10.3389/fpsyt.2022.899956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Although Non-suicidal Self-Injury (NSSI) has received more attention in recent years, most of these studies focused on samples from North American and European countries; consequently, little is known about its patterns and frequency in other cultures as well as its relation to sleep problems and internet addiction. As one of the few studies that aim to fill this gap, the current study examined the prevalence, characteristics, and types of NSSI behaviors among adolescents from diverse ethnocultural groups. METHODS A sample of 642 adolescents, aged 12-18 years, were randomly recruited from different middle and high schools in Israel, employing a snowball sampling technique. The sample included the following: 50% Jews and 34.7% Muslims born in Israel, 9.7% immigrants from the former Soviet Union (FSU), and 4.4% immigrants from Ethiopia. The participants completed self-report questionnaires that assessed their NSSI, sleep problems, internet addictions, and depressive symptoms. RESULTS Almost one-third of the sample had engaged in NSSI, while 6% frequently injured themselves. More than half of the FSU immigrants and one-third of the Muslim participants indicated that they engaged in NSSI. These two population groups also exhibited severe depressive symptoms, sleep problems, and internet addictions. The most parsimonious correlations with NSSI included being male, an immigrant/Muslim minority who exhibited severe depressive symptoms and internet addictions. CONCLUSIONS These results emphasize the need for routine NSSI assessments to prevent long-term sequelae, including any forms of suicidal thoughts and behaviors and adult borderline personality disorder (BPD). Primary preventive programs that include adaptive coping skills may eliminate the social contagion effect of NSSI.
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Affiliation(s)
- Sami Hamdan
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo (MTA), Tel Aviv, Israel
| | - Alan Apter
- Fienberg Child Study Center, Schneider Children' Medical Center of Israel, Tel Aviv University, Tel Aviv, Israel
| | - Yossi Levi-Belz
- The Lior Tsfaty Center for Suicide and Mental Pain Studies, Ruppin Academic Center, Hadera, Israel
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22
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Kruzan KP, Meyerhoff J, Biernesser C, Goldstein T, Reddy M, Mohr DC. Centering Lived Experience in Developing Digital Interventions for Suicide and Self-injurious Behaviors: User-Centered Design Approach. JMIR Ment Health 2021; 8:e31367. [PMID: 34951602 PMCID: PMC8742214 DOI: 10.2196/31367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/13/2021] [Accepted: 10/07/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The prevalence of self-injurious thoughts and behaviors (SITB) signals a growing public health crisis. Despite a recognized need for improved and scalable interventions, the field of SITB intervention faces several challenges: existing interventions are often time and resource intensive, most individuals with SITB do not seek formal mental health care, and efficacious treatments are characterized by small effects. Combined, these challenges indicate a need for improved SITB interventions for individuals in formal treatment and those who are not treatment engaged but are at high risk of worsening mental health and future suicide attempts. OBJECTIVE We present a methodological approach and set of techniques that may address these challenges by centering the lived experience of individuals with SITB in the process of developing needed services: user-centered design (UCD). METHODS We highlight the value of UCD in the context of digital interventions for SITB by describing the UCD approach and explicating how it can be leveraged to include lived experience throughout the development and evaluation process. We provide a detailed case example highlighting 3 phases of the early development process that can be used to design an intervention that is engaging and meets end-user needs. In addition, we point to novel applications of UCD to complement new directions in SITB research. RESULTS In this paper, we offer a 2-pronged approach to meet these challenges. First, in terms of addressing access to effective interventions, digital interventions hold promise to extend the reach of evidence-based treatments outside of brick-and-mortar health care settings. Second, to address challenges related to treatment targets and engagement, we propose involving individuals with lived experience in the design and research process. CONCLUSIONS UCD offers a well-developed and systematic process to center the unique needs, preferences, and perceived barriers of individuals with lived SITB experience in the development and evaluation of digital interventions.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Jonah Meyerhoff
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Candice Biernesser
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Tina Goldstein
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Madhu Reddy
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine, Irvine, CA, United States
| | - David C Mohr
- Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Carter P, Gee M, McIlhone H, Lally H, Lawson R. Comparing manual and computational approaches to theme identification in online forums: A case study of a sex work special interest community. METHODS IN PSYCHOLOGY 2021. [DOI: 10.1016/j.metip.2021.100065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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24
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Liu S, Lin MP, Lee YT, Wu JYW, Hu WH, You J. Internet addiction and nonsuicidal self-injury in adolescence: Associations with offline and online social support. J Clin Psychol 2021; 78:971-982. [PMID: 34655439 DOI: 10.1002/jclp.23264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 09/13/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVES Both nonsuicidal self-injury (NSSI) and Internet addiction (IA) are important health issues for adolescents, and social support has been extensively examined as a protective factor for both. This study aims to compare the effect of offline and online social support on IA, and that on NSSI as well. METHOD A total of 1911 Chinese adolescents (53.27% females, Mage = 16.83 ± 0.37) completed self-report questionnaires assessing offline social support, online social support, IA, and NSSI. RESULTS The structural equation modeling analysis showed that offline social support was negatively associated with IA and NSSI, while online social support was positively associated with IA and NSSI; IA was positively associated with NSSI. Furthermore, implications for preventions and interventions of IA and NSSI were discussed. The indirect model explained a relatively small variance of NSSI, indicating the possibility of additional factors in the development of NSSI that should be further investigated. CONCLUSION This study indicated the differences between offline and online social support, and their different associations with IA and NSSI.
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Affiliation(s)
- Sihan Liu
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, PR China.,Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, PR China
| | - Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Yueh-Ting Lee
- Department of Counseling and Guidance, National University of Tainan, Tainan, Taiwan
| | | | - Wei-Hsuan Hu
- Department of Counseling and Guidance, National University of Tainan, Tainan, Taiwan
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, PR China
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Pritchard TR, Fedchenko CA, Lewis SP. Self-Injury Is My Drug: The Functions of Describing Nonsuicidal Self-Injury as an Addiction. J Nerv Ment Dis 2021; 209:628-635. [PMID: 33958550 DOI: 10.1097/nmd.0000000000001359] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Adolescents and emerging adults who engage in nonsuicidal self-injury (NSSI) often participate in online activity regarding their self-injury. Of particular importance are the potential benefits and risks associated with online NSSI activity, including how individuals describe their NSSI experiences. One way that individuals describe these experiences is by discussing NSSI as an addiction. Accordingly, we used thematic analysis to explore why individuals may use addiction references to describe their NSSI experiences. To do this, we examined 71 posts from a popular NSSI social network. Four themes emerged: difficulty inherent in stopping, authentication, warn others, and communicate the plight of the behavior. Findings highlight a number of avenues for research as well as implications for clinicians working with clients who self-injure perceive NSSI as an addiction. Mental health professionals can leverage their understanding of clients' perceptions of NSSI to better serve this population.
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Bowersox NW, Jagusch J, Garlick J, Chen JI, Pfeiffer PN. Peer-based interventions targeting suicide prevention: A scoping review. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 68:232-248. [PMID: 33720444 PMCID: PMC9165581 DOI: 10.1002/ajcp.12510] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Peers of individuals at risk for suicide may be able to play important roles in suicide prevention. The aim of the current study is to conduct a scoping review to characterize the breadth of peer-delivered suicide prevention services and their outcomes to inform future service delivery and research. Articles were selected based on search terms related to peers, suicide, or crisis. After reviews of identified abstracts (N = 2681), selected full-text articles (N = 286), and additional references (N = 62), a total of 84 articles were retained for the final review sample. Types of suicide prevention services delivered by peers included being a gatekeeper, on-demand crisis support, crisis support in acute care settings, and crisis or relapse prevention. Peer relationships employed in suicide prevention services included fellow laypersons; members of the same sociodemographic subgroup (e.g., racial minority), workplace, or institution (e.g., university, correctional facility); and the shared experience of having a mental condition. The majority of published studies were program descriptions or uncontrolled trials, with only three of 84 articles qualifying as randomized controlled trials. Despite a lack of methodological rigor in identified studies, peer support interventions for suicide prevention have been implemented utilizing a diverse range of peer provider types and functions. New and existing peer-delivered suicide prevention services should incorporate more rigorous evaluation methods regarding acceptability and effectiveness.
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Affiliation(s)
- Nicholas W. Bowersox
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Jennifer Jagusch
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | - James Garlick
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | - Jason I. Chen
- VA Center to Improve Veteran Involvement in Care, Portland, OR, USA
| | - Paul N. Pfeiffer
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
- VA Center for Clinical Management Research, Ann Arbor, MI, USA
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Self-Injurious Behavior in Community Youth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041955. [PMID: 33671424 PMCID: PMC7921995 DOI: 10.3390/ijerph18041955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/10/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
The rapid increase of self-injurious behavior among Korean adolescents, and its reckless spread on social media, has driven the necessity to study this behavior. The present study investigates the characteristics of self-injurious behavior among adolescents in local communities, and the psychological factors affecting such behavior. Questionnaires were administered to 516 sixth graders in elementary school and first to third graders in middle school of both genders, nationwide. They measured the prevalence and characteristics of self-injurious behavior and the relevant psychological factors, such as levels of depression, anxiety, and self-esteem. Furthermore, group differences were assessed for self-injury experience and the characteristics relevant to self-injurious behavior. In addition, this study performs logistic regression to explore the risk factors predicting self-injurious behavior. In all, 166 participants (32.2%) reported self-injury, with a higher rate of self-injury in female students than in male students. Although the study finds high rates of mild forms of self-injury, such as "biting", "pulling hair," and "hitting self", it also finds relatively high reports of more risky methods, such as "cutting or carving". The logistic regression shows a significant effect of the negative self-image sub-factor of depression (CDI) and oversensitivity and physical and sleep problems sub-factors of anxiety (RCMAS) on self-injurious behavior. The rates of self-injury were higher in female participants than in male ones, and adolescents in local communities reported higher rates of mild forms of self-injury than the moderate/severe forms. The results of this study suggest that early screenings and interventions should be conducted through evaluation of self-image and emotional stability of early adolescents to hinder the risk of self-harm.
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Mitchell KJ, Jones LM, Turner HA. Past Year Technology-Involved Peer Harassment Victimization and Recent Depressive Symptoms and Suicide Ideation Among a National Sample of Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP1165-1179NP. [PMID: 29284332 DOI: 10.1177/0886260517748413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article aims to better understand the complex role of technology in peer victimization events with recent depressive symptomatology and suicide ideation (SI). Telephone interviews were conducted with a national sample of 791 youth in the United States, aged 10 to 20 years, collected from December 2013 to March 2014. Rates of any peer harassment victimization varied by past month depressive symptomatology and SI -28% of youth with no/low depressive symptomatology reported past year peer harassment as did 43% of youth with high depressive symptomatology without SI, and 66% of youth with SI. When examining the role of technology in peer harassment, youth experiencing any mixed harassment (i.e., those incidents that occurred both in-person and through technology) were almost 4 times more likely to report past month depressive symptoms without SI (RRadj = 3.9, 95% confidence interval [CI] = [1.5, 10.0], p ≤ .01) and 7.5 times (95% CI = [1.9, 28.9], p ≤ .01) more likely to report past month SI compared with youth who had no past year peer harassment. Given the multilayered relationships among these variables, schools, medical, and mental health professionals might screen youth who are involved in higher risk peer victimization situations, for depressive symptoms and SI to improve their access to appropriate mental health services.
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Kruzan KP, Whitlock J, Bazarova NN. Examining the Relationship Between the Use of a Mobile Peer-Support App and Self-Injury Outcomes: Longitudinal Mixed Methods Study. JMIR Ment Health 2021; 8:e21854. [PMID: 33507154 PMCID: PMC7878111 DOI: 10.2196/21854] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/16/2020] [Accepted: 12/15/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Many individuals who self-injure seek support and information through online communities and mobile peer-support apps. Although researchers have identified risks and benefits of participation, empirical work linking participation in these web-based spaces to self-injury behaviors and thoughts is limited. OBJECTIVE This study aims to investigate the relationship between behavioral and linguistic traces on a mobile peer support app and self-injury outcomes. METHODS Natural use data and web-based surveys (N=697) assessing self-injury outcomes were collected from 268 users (aged 13-38 years; median 19; 149/268, 55.6% female) of a mobile peer-support app for 4 months. Participants were identified as having posted self-injury content using an internal classifier. Natural log data was used to predict self-injury outcomes in a series of multilevel logistic and linear regressions. RESULTS Greater engagement on a mobile peer-support app was associated with a decreased likelihood of self-injury thoughts (odds ratio [OR] 0.25, 95% CI 0.09-0.73) and fewer intentions to self-injure (b=-0.37, SE 0.09), whereas posting triggering content was associated with an increased likelihood of engaging in behaviors (OR 5.37, 95% CI 1.25-23.05) and having self-injury thoughts (OR 17.87, 95% CI 1.64-194.15). Moreover, viewing triggering content was related to both a greater ability to resist (b=1.39, SE 0.66) and a greater intention to self-injure (b=1.50, SE 0.06). CONCLUSIONS To our knowledge, this is the first study to connect naturally occurring log data to survey data assessing self-injury outcomes over time. This work provides empirical support for the relationship between participation in online forums and self-injury outcomes, and it articulates mechanisms contributing to this relationship.
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Affiliation(s)
- Kaylee Payne Kruzan
- Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States
| | - Janis Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States
| | - Natalya N Bazarova
- Department of Communication, Cornell University, Ithaca, NY, United States
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Bryant LD, O'Shea R, Farley K, Brennan C, Crosby HF, Guthrie E, House A. Understanding the functions of repeated self-harm: A Q methodology approach. Soc Sci Med 2020; 268:113527. [PMID: 33293170 DOI: 10.1016/j.socscimed.2020.113527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Multiple repetition of self-harm is common and is associated with poor quality of life and with an increased risk of suicide. Treatment outside specialist clinics rarely takes account of what is known about the varied and conflicting reasons for multiple repetition. We aimed to identify ways in which individuals who self-harm make sense of their motivations for repetition. METHODS In 2018/2019 we recruited 59 participants from NHS services, support organizations in England and via social media into a Q-methodology study. Participants sorted, ranked and commented on 46 separate functions of self-harm according to whether they agreed or disagreed with them as reasons for their own self-harm. The functions were identified from a range of academic sources and first-person accounts. RESULTS Principal Component Analysis was used to identify four distinct accounts for repeated self-harm: 1) Managing my mental state, 2) Communicating Distress, 3) Distract from suicidal thoughts or feelings and 4) Producing positive feelings. There were no clear links between account and gender or other respondent characteristic, although those who self-harmed most regularly and frequently ('so many times I've lost count') were mostly in Accounts 1 and 4. CONCLUSIONS This is the first study to use Q methodology to explore reasons for repeated self-harm. The accounts identified can help in personalizing therapy by going beyond models that focus on a single function such as affect regulation or experiential avoidance, while reducing the field to a manageable number of points of view that can be explored in therapy.
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Affiliation(s)
- Louise D Bryant
- Leeds Institute of Health Sciences, University of Leeds, UK.
| | | | - Kate Farley
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Cathy Brennan
- Leeds Institute of Health Sciences, University of Leeds, UK
| | - Helen F Crosby
- Leeds Institute of Health Sciences, University of Leeds, UK
| | | | - Allan House
- Leeds Institute of Health Sciences, University of Leeds, UK
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Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
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Yang X, Xin M, Liu K, Böke BN. The impact of internet use frequency on non-suicidal self injurious behavior and suicidal ideation among Chinese adolescents: an empirical study based on gender perspective. BMC Public Health 2020; 20:1727. [PMID: 33198703 PMCID: PMC7670714 DOI: 10.1186/s12889-020-09866-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/09/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND We attempted to find if there were gender differences in Non-suicidal self injurious (NSSI) behaviors and Suicidal ideation among Chinese adolescents, then analyze the impact of Internet use frequency on these variables among adolescents of different genders. METHODS Based on the data from 6 high-schools and 4 universities in 4 cities in China, the gender difference in NSSI behaviors and Suicidal ideation and their related factors were analyzed in the study. RESULTS Gender differences were found during different purposes of Internet use; There was no significant gender difference in NSSI behaviors among Chinese adolescents, yet females reported significantly higher intensity of suicidal ideation compared to males; Internet use frequency could explain the prevalence of NSSI behaviors and Suicidal ideation by gender, to some categories. CONCLUSIONS There were gender differences in Internet use frequency among adolescents; Gender difference of NSSI engagement among Chinese adolescents was not statistically significant; Females had higher suicidal ideation than males; the overuse of social softwares was found to be a risk factor to both NSSI engagements and suicidal ideations for both genders; males would engage less NSSI behaviors when they spent more time on knowledge sharing softwares while might have more suicidal ideation when they spent too much time on gaming.
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Affiliation(s)
- Xueyan Yang
- Institute for Population and Development Studies, Xi'an Jiaotong University, No.28, Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Moye Xin
- Institute for Population and Development Studies, Xi'an Jiaotong University, No.28, Xianning West Road, Xi'an, 710049, Shaanxi, China.
| | - Kun Liu
- Institute for Population and Development Studies, Xi'an Jiaotong University, No.28, Xianning West Road, Xi'an, 710049, Shaanxi, China
| | - Bilun Naz Böke
- Human Development, McGill University, 3700 McTavish Street, Montreal, QC, H3A1Y2, Canada
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Black EB, Mildred H. Characteristics of non‐suicidal self‐injury in women accessing internet help sites. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12094] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Emma B. Black
- School of Psychology, Deakin University, Burwood, Victoria, Australia,
- School of Medicine, University of Queensland, Rural Clinical School, Darling Heights, Queensland, Australia,
| | - Helen Mildred
- School of Psychology, Deakin University, Burwood, Victoria, Australia,
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Lavis A, Winter R. #Online harms or benefits? An ethnographic analysis of the positives and negatives of peer-support around self-harm on social media. J Child Psychol Psychiatry 2020; 61:842-854. [PMID: 32459004 DOI: 10.1111/jcpp.13245] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/26/2020] [Indexed: 01/30/2023]
Abstract
BACKGROUND There is emerging evidence of the potentially detrimental impact of social media on young people's mental health. Against this background, online self-harm content has been a recent focus of concern across academia, policy and the media. It has been argued to encourage or even cause acts such as self-cutting through mechanisms of contagion. However, little is known about why a young person might engage with such content or about its impact on behaviour or well-being. METHODS Online ethnographic observation of interactions around self-harm on Twitter, Reddit and Instagram: collection and analysis of 10,169 original posts and 36,934 comments, both written and pictorial, at two time-points in 2018 and 2019. Ten in-depth semi-structured interviews exploring engagements with self-harm content on social media. RESULTS Our data show that peer support is the central component of online interactions around self-harm. Young people accessing such content are likely to already be self-harming; they may turn to social media to understand, and seek help for, their actions and feelings in a context of offline stigma and service support gaps. This paper engages with the mechanisms, complexities and impact of this peer-support, reflecting on the benefits and dangers to caring for oneself and others through social media. CONCLUSIONS Self-harm content is a fraught issue at the centre of current debates around risks and opportunities for child and adolescent mental health in the digital age. Whilst the importance of supporting young people's online safety is clear, moves to eradicate self-harm content must be undertaken with caution so as not to cause unintentional harm. Our research highlights a need to think beyond a model of contagion, instead attending to other mechanisms of harm and benefit. In so doing, it challenges prevailing attitudes towards online communication about self-harm and accepted approaches to managing this.
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Affiliation(s)
- Anna Lavis
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rachel Winter
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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The Role of Trust When Adolescents Search for and Appraise Online Health Information. J Pediatr 2020; 221:215-223.e5. [PMID: 32446485 DOI: 10.1016/j.jpeds.2020.02.074] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/21/2020] [Accepted: 02/26/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To assess the role of trust when adolescents search for and appraise online health information. STUDY DESIGN A systematic search of online databases (MEDLINE, EMBASE, PsycINFO, and ERIC) was performed. Google Scholar and reference lists for included studies were manually searched for additional articles. Studies were included if they examined the role of trust when adolescents (in the 13- to 18-year-old age range) searched for and/or appraised online health information. Findings were synthesized using thematic analysis. RESULTS There were 22 studies that met the inclusion criteria. Four key themes were identified: adolescents generally distrust the Internet but use it anyway (subthemes were why adolescents distrust online health information; why adolescents still use online health information), adolescents use heuristics to appraise the trustworthiness of online health information (subthemes were different heuristics used by different adolescents, range of heuristics used by adolescents), adolescents trust websites more than social media or social networking sites, and adolescents' level of trust in online health information guides their actions and responses. CONCLUSIONS Adolescents often distrust health information from the Internet, but continue to use it. Adolescents are aware of the need to evaluate the trustworthiness of online health information; however, their approaches vary in sophistication. As the reach and content of the Internet expands, it is important to equip adolescents with effective eHealth literacy to assess the trustworthiness of online health information.
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Fulcher JA, Dunbar S, Orlando E, Woodruff SJ, Santarossa S. #selfharn on Instagram: understanding online communities surrounding non-suicidal self-injury through conversations and common properties among authors. Digit Health 2020; 6:2055207620922389. [PMID: 32426154 PMCID: PMC7218342 DOI: 10.1177/2055207620922389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 04/06/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives #selfharm has been blocked by Instagram, but manoeuvring hashtags (e.g. #selfharn) are beginning to appear in order for secret non-suicidal self-injury (NSSI) communities to communicate. The purpose of this study was to (a) determine the nature of the #selfharn conversation on Instagram, (b) analyze common properties of the visual content (i.e. images and videos; n = 93) tagged with #selfharn, and (c) discover what kind of environment the authors (n = 50) of #selfharn were creating. Methods A multi-method approach was utilized for this study. Netlytic was used to generate a text and content analysis to examine the authors’ captions and comments (n = 8772) associated with #selfharn (collected over a seven-day period). Results After removing #selfharn from the dataset, the text analysis revealed that #depression (n = 3081) and #suicide (n = 2270) were the most commonly used terms associated with #selfharn. Overall, 52% (n = 4386) of the popular words/phrases related with #selfharn posts were categorized as ‘bad feelings’. Through manual coding, it was determined that the majority of #selfharn visual content (n = 92; 99%) did not generate an advisory warning but did contain a wound (n = 70; 75%). The #selfharn author analysis suggests that most were women (n = 18; 36%) with a dark-coloured profile aesthetic (n = 37; 74%) determined by an overwhelming amount of grey, black, blue, red, or purple colours. Conclusion According to the text and content analyses, #selfharn on Instagram may be contributing negatively to an online community of mental-health issues. More resources should be provided by Instagram to those who are involved in the NSSI Instagram community.
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Affiliation(s)
- Jory A Fulcher
- Faculty of Human Kinetics, University of Windsor, Canada
| | - Sarah Dunbar
- Faculty of Human Kinetics, University of Windsor, Canada
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Shahwan S, Lau JH, Abdin E, Zhang Y, Sambasivam R, Teh WL, Gupta B, Ong SH, Chong SA, Subramaniam M. A typology of nonsuicidal self-injury in a clinical sample: A latent class analysis. Clin Psychol Psychother 2020; 27:791-803. [PMID: 32314453 PMCID: PMC7754372 DOI: 10.1002/cpp.2463] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/18/2020] [Accepted: 04/20/2020] [Indexed: 11/28/2022]
Abstract
Nonsuicidal self‐injury(NSSI) is a behavioural concern and can present in diverse ways, varying by method, frequency, severity, function and so forth. The possible combinations of these features of NSSI produce an array of profiles that makes evaluation and management of this behaviour challenging. The aim of this study was to build upon previous work that reduces the heterogeneity of NSSI patterns by using latent class analysis (LCA) to identify a typology of NSSI. Participants consisted of 235 outpatients aged 14–35 years attending a tertiary psychiatric hospital in Singapore who had reported at least one NSSI behaviour within the last year. Eight indicators captured using the Functional Assessment of Self‐Mutilation were used in the LCA: frequency of NSSI, length of contemplation before engaging in NSSI, usage of more than three NSSI methods, suicidal ideation and four psychological functions of NSSI, that is, social‐positive, social‐negative, automatic‐positive and automatic‐negative. The LCA revealed three distinct groups: Class 1—Experimental/Mild NSSI, Class 2—Multiple functions NSSI/Low Suicide Ideation and Class 3—Multiplefunctions NSSI/Possible Suicide Ideation. Multinomial logistic regression analyses were conducted to examine the associations between class membership and sociodemographic variables as well as measures of emotion dysregulation, childhood trauma, depression and quality of life. Females were overrepresented in Class 3. In general, Class 3 had the poorest scores followed by Class 2. Our analyses suggest that different NSSI subtypes require different treatment indications. Profiling patterns of NSSI may be a potentially useful step in guiding treatment plans and strategies.
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Affiliation(s)
| | - Jue Hua Lau
- Research Division, Institute of Mental Health, Singapore
| | | | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore
| | | | - Wen Lin Teh
- Research Division, Institute of Mental Health, Singapore
| | - Bhanu Gupta
- Department of Mood and Anxiety, Institute of Mental Health, Singapore
| | - Say How Ong
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Sarno I, Madeddu F, Gratz K. Self-injury, psychiatric symptoms, and defense mechanisms: Findings in an Italian nonclinical sample. Eur Psychiatry 2020; 25:136-45. [DOI: 10.1016/j.eurpsy.2009.05.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 05/26/2009] [Accepted: 05/27/2009] [Indexed: 11/25/2022] Open
Abstract
AbstractIntroductionThis study provides data on the rates, characteristics, and correlates of self-injury (SI) in an Italian nonclinical sample, a population previously unexamined within the SI literature. This study examined the associations between SI and defense mechanisms, as well as the differences between self-injurers (episodic and recurrent) and non self-injurers with regard to the severity and variety of their psychiatric symptoms and psychological distress.Materials and methodsFive hundred and seventy-eight university students (82.5% female; mean age = 22.3; S.D. = 3.4) were administered a battery of self-report questionnaires, including the “Deliberate Self Harm Inventory” for SI, the Response Evaluation Measure-71 for defense mechanisms, and the “Symptom Checklist-90-Revised” for psychological distress and psychiatric symptoms.ResultsOne hundred and nineteen participants (20.6%) reported having engaged in SI at least once during their lifetime. Individuals with recurrent SI (SI ≥ 5) reported significantly higher levels of all psychiatric symptoms and many maladaptive defense mechanisms than individuals without SI. Results also provided evidence for differences between individuals with recurrent and episodic SI.ConclusionResults suggest that recurrent self-injurers are distinguished from both episodic self-injurers and non self-injurers by their greater use of maladaptive defense mechanisms, rather than their lesser use of adaptive defenses. Further, results suggest that recurrent self-injurers differ from episodic self-injurers not in terms of the severity of their psychiatric symptoms, but the variety and number of these symptoms.
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Franz PJ, Nook EC, Mair P, Nock MK. Using Topic Modeling to Detect and Describe Self-Injurious and Related Content on a Large-Scale Digital Platform. Suicide Life Threat Behav 2020; 50:5-18. [PMID: 31264733 DOI: 10.1111/sltb.12569] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 03/04/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Self-injurious thoughts and behaviors (SITBs) are a complex and enduring public health concern. Increasingly, teenagers use digital platforms to communicate about a range of mental health topics. These discussions may provide valuable information that can lead to insights about complex issues like SITBs. However, the field of clinical psychology currently lacks an easy-to-implement toolkit that can quickly gather information about SITBs from online sources. In the present study, we applied topic modeling, a natural language processing technique, to identify SITBs and related themes online, and we validated this approach using human coders. METHOD We separately used topic modeling software and human coders to identify themes present in text from a popular online Internet support forum for teenagers. We then determined the degree to which results from the software's topic model aligned with themes identified by human coders. RESULTS We found that topic modeling detected SITBs and related themes in online discussions in a way that accurately distinguishes between relevant and irrelevant human-coded themes. CONCLUSIONS This approach has the potential to drastically increase our understanding of SITBs and related issues discussed on digital platforms, as well as our ability to identify those at risk for such outcomes.
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Affiliation(s)
- Peter J Franz
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Erik C Nook
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Patrick Mair
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Papadima M. Rethinking self-harm: a psychoanalytic consideration of hysteria and social contagion*. JOURNAL OF CHILD PSYCHOTHERAPY 2020. [DOI: 10.1080/0075417x.2019.1700297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Maria Papadima
- Service for Adolescents and Families in Enfield (SAFE), Bay Tree House, Christchurch Close, Enfield EN2 6NZ
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Schwartz-Mette RA, Lawrence HR. Peer Socialization of Non-Suicidal Self-Injury in Adolescents' Close Friendships. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 47:1851-1862. [PMID: 31209626 PMCID: PMC6812616 DOI: 10.1007/s10802-019-00569-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Non-suicidal self-injury (NSSI), or self-harming behavior without intent to die (Nock Current Directions in Psychological Science, 18, 78-83, 2009), is associated with distress and impairment across domains, including increased risk for suicidality (Kiekens et al. Journal of Affective Disorders, 239, 171-179, 2018). In adolescence, prevalence of NSSI is high (Swannell et al. Suicide and Life-threatening Behavior, 44, 273-303, 2014), and peer influence regarding NSSI is thought to be strong (Brechwald and Prinstein Journal of Research on Adolescence, 21, 166-79, 2011). Although concern regarding "clusters" of NSSI has long been documented, peer socialization of NSSI in adolescence is understudied. This paper tests peer influence on NSSI frequency within adolescent friendship dyads. Emotion regulation difficulties and friendship quality were evaluated as factors that may influence susceptibility to peer influence effects. Adolescents (N = 196, M age = 15.68, 69.9% female, 87.6% White) nested within 93 friendship dyads reported on their own NSSI frequency, difficulties in emotion regulation, and friendship quality at three time points spaced 3 months apart. Cross-lagged Actor-Partner Interdependence Models examined peer influence effects over time. Friends' Time 1 frequency of NSSI uniquely predicted adolescents' own NSSI frequency over 3 and 6 months, controlling for initial similarity among friends as well as individual risk factors for NSSI. Peer influence effects were strongest in adolescents with higher levels of emotion regulation difficulty but did not vary as a function of friendship quality. Friends' NSSI frequency is a significant and unique predictor of increases in adolescents' own NSSI frequency over time. Implications for interventions that leverage the important developmental context of peer relationships are discussed.
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Affiliation(s)
| | - Hannah R Lawrence
- Department of Psychology, University of Maine, 301 Little Hall, Orono, ME, 04469, USA
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Gardner W, Pajer K, Cloutier P, Zemek R, Currie L, Hatcher S, Colman I, Bell D, Gray C, Cappelli M, Duque DR, Lima I. Changing Rates of Self-Harm and Mental Disorders by Sex in Youths Presenting to Ontario Emergency Departments: Repeated Cross-Sectional Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:789-797. [PMID: 31184929 PMCID: PMC6882075 DOI: 10.1177/0706743719854070] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To document the rates of intentional self-harm and mental disorders among youths aged 13 to 17 years visiting Ontario emergency departments (EDs) from 2003-2017. METHODS This was a repeated cross-sectional observational design. Outcomes were rates of adolescents with (1) at least 1 self-harm ED visit and (2) a visit with a mental disorder code. RESULTS Rates of youths with self-harm visits fell 32% from 2.6/1000 in 2003 to 1.8 in 2009 but rose 135% to 4.2 by 2017. The slope of the trend in self-harm visits changed from -0.18 youths/1000/year (confidence interval [CI], -0.24 to -0.13) during 2003 to 2009 to 0.31 youths/1000/year (CI, 0.27 to 0.35) during 2009 to 2017 (P < 0.001). Rates of youths with mental health visits rose from 11.7/1000 in 2003 to 13.5 in 2009 (15%) and to 24.1 (78%) by 2017. The slope of mental health visits changed from 0.22 youths/1000/year (CI, 0.02 to 0.42) during 2003 to 2009 to 1.84 youths/1000/year (CI, 1.38 to 2.30) in 2009 to 2017 (P < 0.001). Females were more likely to have self-harm (P < 0.001) and mental health visits (P < 0.001). Rates of increase after 2009 were greater for females for both self-harm (P < 0.001) and mental health (P < 0.001). CONCLUSIONS Rates of adolescents with self-harm and mental health ED visits have increased since 2009, with greater increases among females. Research is required on the determinants of adolescents' self-harm and mental health ED visits and how they can be addressed in that setting. Sufficient treatment resources must be supplied to address increased demands for services.
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Affiliation(s)
- William Gardner
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Kathleen Pajer
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Paula Cloutier
- Research Institute, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Roger Zemek
- Department of Pediatrics & Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Lisa Currie
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Simon Hatcher
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Dayna Bell
- Department of Pediatrics & Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Clare Gray
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Daniel Rodriguez Duque
- Department of Epidemiology, Biostatistics, and Public Health, McGill University, Montreal, Quebec, Canada
| | - Isac Lima
- ICES Ottawa, Ottawa, Ontario, Canada
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Hanley T, Prescott J, Gomez KU. A systematic review exploring how young people use online forums for support around mental health issues. J Ment Health 2019; 28:566-576. [PMID: 31267813 DOI: 10.1080/09638237.2019.1630725] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Young people increasingly look towards the Internet for support. Online forums have been developed to provide mental health support, but they have received little attention in the research to date. Aims: To summarise the existing literature examining how individuals use online forums to obtain support for mental health difficulties. Methods: A systematic review of electronic databases was conducted to identify empirical literature in this area. The papers that met the inclusion criteria and satisfied quality assessment review were analysed for key themes. Results: Twenty-one papers were found. Three common themes in the papers were associated with opportunities of the technology: (1) Providing stand alone or complementary informal support, (2) Providing informational, emotional and infomotional support, and (3) Making use of the specific practical opportunities afforded by forum technology. A further three themes were associated with challenges: (1) Managing the expectations of forum users, (2) Ensuring service user safety, and (3) Navigating the technical challenges associated with forums. Conclusions: The paper highlights the potential for individuals to access dynamic and responsive support within online forums. Additionally, it reflects upon the major areas that mental health professionals need to be aware of when entering into this arena.
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Affiliation(s)
- Terry Hanley
- Senior Lecturer in Counselling Psychology, University of Manchester , Manchester , UK
| | - Julie Prescott
- School of Education and Psychology, University of Bolton , Bolton , UK
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Butler C, Joiner R, Bradley R, Bowles M, Bowes A, Russell C, Roberts V. Self-harm prevalence and ideation in a community sample of cis, trans and other youth. INT J TRANSGENDERISM 2019; 20:447-458. [PMID: 32999629 PMCID: PMC6913646 DOI: 10.1080/15532739.2019.1614130] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background: Trans youth have been reported to have high rates of self-harm, depression and bullying, and find it difficult to seek support. However, much of this research comes from gender identity clinics; non-clinical samples and those who reject gender binaries remain under-researched. Aims: This study investigated the experiences of a community school-based sample of Trans, identifying youth, Other, and cis-gendered adolescents in relation to their experiences of low mood, bullying, associated support, self-harm ideation and peer-related self-harm. Methods: An online survey was completed by 8440 13-17 year olds (3625 male, 4361 female, 227 Other, and 55 Trans). Results: Trans and Other students had significantly higher rates of self-harm ideation and peer self-harm, in comparison to cis-gendered students. These Trans and Other students reported significantly higher rates of bullying and self-reported depression and significantly less support from teachers and staff at school, in fact these students did not know where to go to access help. Discussion: This community sample confirms findings of high rates of self-harm ideation, self-reported depression and bullying for Trans youth as previously reported in clinic-based samples. However, by accessing a community sample, the salience of the category "Other" was established for young people today. While Other and Trans identified students both struggled to find support, those who identified as Trans were more likely to have been bullied, and have experienced self-reported depression and thoughts of self-harm. Thus, those who identify as transgender represent a high-risk group that needs targeted support within schools and by statutory and nonstatutory community services. Unpacking the category of Other would be beneficial for future research, as well as exploring resilience within this group and intersecting identities such as sexuality, Autism, or experiences such as earlier abuse.
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Affiliation(s)
| | | | | | | | | | - Claire Russell
- Department of Psychology, University of Bath, Bath, UK
- Addaction, London, UK
- The Training Effect, Ashford, Kent, UK
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Moseley RL, Gregory NJ, Smith P, Allison C, Baron-Cohen S. A 'choice', an 'addiction', a way 'out of the lost': exploring self-injury in autistic people without intellectual disability. Mol Autism 2019; 10:18. [PMID: 31007885 PMCID: PMC6458651 DOI: 10.1186/s13229-019-0267-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 03/17/2019] [Indexed: 12/19/2022] Open
Abstract
Background Non-suicidal self-injury (NSSI) describes a phenomenon where individuals inflict deliberate pain and tissue damage to their bodies. Self-injurious behaviour is especially prevalent across the autism spectrum, but little is understood about the features and functions of self-injury for autistic individuals without intellectual disability, or about the risk factors that might be valuable for clinical usage in this group. Methods One hundred and three autistic adults who responded to an online advertisement were classified as current, historic or non-self-harmers in accordance with responses to the Non-Suicidal Self-Injury Assessment Tool (NSSI-AT). Multinomial regression aimed to predict categorisation of participants in accordance with scores on tests of autistic traits, alexithymia, depression, anxiety, mentalising and sensory sensitivity. Linear regression examined relationships between these predictors and the range, frequency, lifetime occurrence and functional purposes of NSSI. Qualitative analysis explored the therapeutic interventions that participants had found helpful, and what they wished people understood about self-injury. Results Current, historic and non-self-harming participants did not differ in age, age at diagnosis, male-to-female ratio, level of employment or education (the majority qualified to at least degree level). The most common function of NSSI was the regulation of low-energy affective states (depression, dissociation), followed by the regulation of high-energy states such as anger and anxiety. Alexithymia significantly predicted the categorisation of participants as current, historic or non-self-harmers, and predicted use of NSSI for regulating high-energy states and communicating distress to others. Depression, anxiety and sensory-sensitivity also differentiated participant groups, and sensory differences also predicted the range of bodily areas targeted, lifetime incidence and frequency of NSSI. Sensory differences, difficulty expressing and identifying emotions also emerged as problematic in the qualitative analysis, where participants expressed the need for compassion, patience, non-judgement and the need to recognise diversity between self-harmers, with some participants perceiving NSSI as a practical, non-problematic coping strategy. Conclusions Alexithymia, depression, anxiety and sensory differences may place some autistic individuals at especial risk of self-injury. Investigating the involvement of these variables and their utility for identification and treatment is of high importance, and the voices of participants offer guidance to practitioners confronted with NSSI in their autistic clients.
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Affiliation(s)
- R. L. Moseley
- Social, Cognitive, Clinical and Affective Neuroscience group, Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset UK
| | - N. J. Gregory
- Social, Cognitive, Clinical and Affective Neuroscience group, Department of Psychology, Bournemouth University, Talbot Campus, Fern Barrow, Poole, Dorset UK
| | - P. Smith
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - C. Allison
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - S. Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
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Duarte E, Gouveia-Pereira M, Gomes HS, Sampaio D. Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adolescents. J Pers Assess 2019; 102:405-414. [DOI: 10.1080/00223891.2018.1557667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Eva Duarte
- CIE-ISPA, ISPA–Instituto Universitário, Lisbon, Portugal
| | | | - Hugo Santos Gomes
- CIPsi-Psychology Research Center, Victims, Offenders and Justice System Research Unit, School of Psychology, University of Minho, Braga, Portugal
| | - Daniel Sampaio
- Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Polskaya N, Yakubovskaya D. The Impact of Social Media Platforms on Self-Injurious Behavior in Adolescents. КОНСУЛЬТАТИВНАЯ ПСИХОЛОГИЯ И ПСИХОТЕРАПИЯ 2019. [DOI: 10.17759/cpp.2019270310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
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.
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Social Representations About the Functions of Deliberate Self-Harm: Construction and Validation of a Questionnaire for Portuguese Adults. BEHAVIOUR CHANGE 2018. [DOI: 10.1017/bec.2018.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AbstractThe present article focuses on the validation of the Questionnaire of Social Representations about the Functions of Deliberate Self-Harm for adults. The understanding of the social representations about deliberate self-harm can be relevant for clinical intervention and prevention. However, there is still a lack of instruments to assess these representations. The basis for this instrument was the translation of the Inventory of Statements About Self-Injury. To complement this instrument, we conducted semi-directive interviews with adults without deliberate self-harm and analysed the Portuguese written press. Results from these studies complemented the questionnaire with new items and functions. Study 1 consisted of an exploratory factor analysis with a sample of 462 adults. Results revealed a two-factor structure of interpersonal and intrapersonal dimensions. After item reduction, the factorial analysis of the independent functions was also acceptable. This structure was then corroborated in Study 2 by a confirmatory factor analysis with a new sample of 474 adults, revealing an acceptable model fit. This questionnaire presents a relatively solid structure and is based on acceptable psychometric properties, which allows its use in future research.
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Memon AM, Sharma SG, Mohite SS, Jain S. The role of online social networking on deliberate self-harm and suicidality in adolescents: A systematized review of literature. Indian J Psychiatry 2018; 60:384-392. [PMID: 30581202 PMCID: PMC6278213 DOI: 10.4103/psychiatry.indianjpsychiatry_414_17] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
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.
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Affiliation(s)
- Aksha M Memon
- Department of Physiology and Pharmacology, School of Medicine, West Virginia University, Morgantown, West Virginia, USA
| | - Shiva G Sharma
- Department of Preventive Medicine, School of Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Satyajit S Mohite
- Department of Psychiatry and Behavioral Sciences, UTHealth McGovern School of Medicine, Houston, Texas, USA
| | - Shailesh Jain
- Department of Psychiatry, Texas Tech University Health Sciences Center at Permian Basin, Odessa, Texas, USA
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