Exploring Behavior of People with Suicidal Ideation in a Chinese Online Suicidal Community

Breaking the silence: leveraging social interaction data to identify high-risk suicide users online using network analysis and machine learning

Suicidal thought and behavior (STB) is highly stigmatized and taboo. Prone to censorship, yet pervasive online, STB risk detection may be improved through development of uniquely insightful digital markers. Focusing on Sanctioned Suicide, an online pro-choice suicide forum, this work derived 17 egocentric network features to capture dynamics of social interaction and engagement within this uniquely uncensored community. Using network data generated from over 3.2 million unique interactions of N = 192 individuals, n = 48 of which were determined to be highest risk users (HRUs), a machine learning classification model was trained, validated, and tested to predict HRU status. Model prediction dynamics were analyzed using introspection techniques to uncover patterns in feature influence and highlight social phenomena. The model achieved a test AUC = 0.73 ([0.61, 0.85], 95% CI), suggesting that network-based socio-behavioral patterns of online interaction can signal for heightened suicide risk. Transitivity, density, and in-degree centrality were among the most important features driving this performance. Moreover, predicted HRUs tended to be targets of social exchanges with lesser frequency and possessed egocentric networks with "small world" network properties. Through the implementation of an underutilized method on an unlikely data source, findings support future incorporation of network-based social interaction features in descriptive, predictive, and preventative STB research.

Does suicide contagion (Werther effect) take place in response to social media? A systematic review

INTRODUCTION

The Werther, Copycat or contagion effect of suicidal behaviour is a complex phenomenon that can arise due to exposure to media stories in which identifiable people take their lives. On the contrary, the Papageno effect prevents people from suicide by promoting positives examples of suicidal crisis management. Impact of both effects has been widely studied in different types of situations, but its existence in social media is a source of much debate.

METHODS

A systematic search following the PRISMA guidelines of PubMed, Scopus, Embase, PsycInfo, Web of Science and the references of prior reviews yielded 25 eligible studies.

RESULTS

Most of the studies found were observational, with very different methodologies and generally with low risk of bias. In these, the results suggest the existence of the Werther effect in response to social media stories about suicide. This is mediated by multiple factors, including the characteristic of the users, the type of interaction and the content of the publications. At the same time, the Papageno effect is also described. Evidence found by type of social media and future implications are discussed.

CONCLUSION

Suicidal content on social media can be both contagious and protective. It is confirmed that the Werther and Papageno effects may occur in response to social media, so they could be an interesting target for preventive interventions.

Problematic Smartphone Use Mediates the Pathway from Suicidal Ideation to Positive Psychotic Experiences: a Large Cross-Sectional, Population-Based Study

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.

Misinformation in Italian Online Mental Health Communities During the COVID-19 Pandemic: Protocol for a Content Analysis Study

Background

Social media platforms are widely used by people suffering from mental illnesses to cope with their conditions. One modality of coping with these conditions is navigating online communities where people can receive emotional support and informational advice. Benefits have been documented in terms of impact on health outcomes. However, the pitfalls are still unknown, as not all content is necessarily helpful or correct. Furthermore, the advent of the COVID-19 pandemic and related problems, such as worsening mental health symptoms, the dissemination of conspiracy narratives, and medical distrust, may have impacted these online communities. The situation in Italy is of particular interest, being the first Western country to experience a nationwide lockdown. Particularly during this challenging time, the beneficial role of community moderators with professional mental health expertise needs to be investigated in terms of uncovering misleading information and regulating communities.

Objective

The aim of the proposed study is to investigate the potentially harmful content found in online communities for mental health symptoms in the Italian language. Besides descriptive information about the content that posts and comments address, this study aims to analyze the content from two viewpoints. The first one compares expert-led and peer-led communities, focusing on differences in misinformation. The second one unravels the impact of the COVID-19 pandemic, not by merely investigating differences in topics but also by investigating the needs expressed by community members.

Methods

A codebook for the content analysis of Facebook communities has been developed, and a content analysis will be conducted on bundles of posts. Among 14 Facebook groups that were interested in participating in this study, two groups were selected for analysis: one was being moderated by a health professional (n=12,058 members) and one was led by peers (n=5598 members). Utterances from 3 consecutive calendar years will be studied by comparing the months from before the pandemic, the months during the height of the pandemic, and the months during the postpandemic phase (2019-2021). This method permits the identification of different types of misinformation and the context in which they emerge. Ethical approval was obtained by the Università della Svizzera italiana ethics committee.

Results

The usability of the codebook was demonstrated with a pretest. Subsequently, 144 threads (1534 utterances) were coded by the two coders. Intercoder reliability was calculated on 293 units (19.10% of the total sample; Krippendorff α=.94, range .72-1). Aside from a few analyses comparing bundles, individual utterances will constitute the unit of analysis in most cases.

Conclusions

This content analysis will identify deleterious content found in online mental health support groups, the potential role of moderators in uncovering misleading information, and the impact of COVID-19 on the content.

International Registered Report Identifier (IRRID)

PRR1-10.2196/35347

Understanding information behavior of South Korean Twitter users who express suicidality on Twitter

Objective

Although there were few studies on how suicidal users behave on Twitter, they only investigated partial aspects such as tweeting frequency and tweet length. Therefore, we aim to understand the various information behavior of suicidal users in South Korea.

Methods

To achieve this goal, we annotated 20,000 tweets and identified 1097 tweets with the expression of suicidality (i.e. suicidal tweets) and 229 suicidal users (i.e. experimental group). Using the data, a user profile analysis, comparative analysis with control group, and tweets/hashtags analysis were performed.

Results

Our results show that many suicidal users used suicide-related keywords in their user IDs, usernames, descriptions, and pinned tweets. We also found that, compared to the control group, the experimental group show different patterns of information behavior. The experimental group did not frequently use Twitter and, on average, wrote longer texts than the control group. A clear seasonal pattern was also identified in the experimental group's tweeting behavior. Frequently used keywords/hashtags were extracted from tweets written by the experimental group for the purpose of understanding their concerns and detecting more suicidal tweets.

Conclusions

We believe that our study will help in the understanding of suicidal users' information behavior on social media and lay the basis for more accurate actions for suicide prevention and early intervention on social media.

Characteristics of High Suicide Risk Messages From Users of a Social Network-Sina Weibo "Tree Hole"

BACKGROUND

People with suicidal ideation post suicide-related information on social media, and some may choose collective suicide. Sina Weibo is one of the most popular social media platforms in China, and "Zoufan" is one of the largest depression "Tree Holes." To collect suicide warning information and prevent suicide behaviors, researchers conducted real-time network monitoring of messages in the "Zoufan" tree hole via artificial intelligence robots.

OBJECTIVE

To explore characteristics of time, content and suicidal behaviors by analyzing high suicide risk comments in the "Zoufan" tree hole.

METHODS

Knowledge graph technology was used to screen high suicide risk comments in the "Zoufan" tree hole. Users' level of activity was analyzed by calculating the number of messages per hour. Words in messages were segmented by a Jieba tool. Keywords and a keywords co-occurrence matrix were extracted using a TF-IDF algorithm. Gephi software was used to conduct keywords co-occurrence network analysis.

RESULTS

Among 5,766 high suicide risk comments, 73.27% were level 7 (suicide method was determined but not the suicide date). Females and users from economically developed cities are more likely to express suicide ideation on social media. High suicide risk users were more active during nighttime, and they expressed strong negative emotions and willingness to end their life. Jumping off buildings, wrist slashing, burning charcoal, hanging and sleeping pills were the most frequently mentioned suicide methods. About 17.55% of comments included suicide invitations. Negative cognition and emotions are the most common suicide reason.

CONCLUSION

Users sending high risk suicide messages on social media expressed strong suicidal ideation. Females and users from economically developed cities were more likely to leave high suicide risk comments on social media. Nighttime was the most active period for users. Characteristics of high suicide risk messages help to improve the automatic suicide monitoring system. More advanced technologies are needed to perform critical analysis to obtain accurate characteristics of the users and messages on social media. It is necessary to improve the 24-h crisis warning and intervention system for social media and create a good online social environment.

Emotional Contagion in the Online Depression Community

Negative emotions are prevalent in the online depression community (ODC), which potentially puts members at risk, according to the theory of emotional contagion. However, emotional contagion in the ODC has not been confirmed. The generalized estimating equation (GEE) was used to verify the extent of emotional contagion using data from 1548 sample users in China's popular ODC. During interaction, the emotional themes were analyzed according to language use. The diurnal patterns of the interaction behaviors were also analyzed. We identified the susceptible groups and analyzed their characteristics. The results confirmed the occurrence of emotional contagion in ODC, that is, the extent to which the user's emotion was affected by the received emotion. Our study also found that when positive emotional contagion occurred, the replies contained more hopefulness, and when negative emotional contagion occurred, the replies contained more hopelessness and fear. Second, positive emotions were easier to spread, and people with higher activity in ODC were more susceptible. In addition, nighttime was an active period for user interaction. The results can help community managers and support groups take measures to promote the spread of positive emotions and reduce the spread of negative emotions.

Understanding Psychosocial Wellbeing in the Context of Complex and Multidimensional Problems

This Special Issue deals with the topic of how people and social groups face problems in an increasingly complex and globalized society. The topics included in the call for papers were the interaction of psychosocial well-being and mental health with economic, gender, racial and ethnic inequalities, migration and demographic change and conflict and war, as well as the effects of stigma on people discriminated against because of their differential characteristics, whether they are of a sexual, disability or other minority. We made this proposal because we believed that, despite the introduction of the biopsychosocial model in the late 1970s as a paradigm of the integration of different disciplinary views, research in mental health and psychosocial well-being is still highly fragmented. For decades, we have tried to advance by emphasizing a part of the equation, with results that are at least modest. Therefore, in this Special Issue, we prioritized works aiming at disciplinary and methodological integration. The Special Issue was open to any subject area related to the impacts of social issues on mental health and psychosocial well-being. We were interested in empirical and theoretical enquiries at all ecological levels, from the psychosocial impact of social dynamics on individuals, to the analysis of how sociocultural and geopolitical factors influence health and collective psychosocial well-being.

Relationship between Internet addiction, susceptible personality traits, and suicidal and self-harm ideation in Chinese adolescent students

BACKGROUND AND AIMS

Internet addiction (IA) is common among young students. This study aimed to examine the influence and mechanisms of IA and susceptible personality traits on the impact of suicidal ideation in adolescent students in China.

METHODS

This cross-sectional study (09/2012-09/2015) used stratified cluster sampling with "school type" for stratification; 136,266 students from 63 schools completed the questionnaire. Logistic regression analysis was performed to estimate the effect of IA (Young's Internet Addiction Test) and susceptible personality (Barratt impulsiveness scale, Buss & Perry Aggression Questionnaire; and Eysenck Personality Questionnaire-R Short Scale) on suicidal ideation (Scale of Suicidal Ideation).

RESULTS

Suicidal ideation was observed in 20,218 (14.77%) of the students, and IA was detected in 28,836 (21.16%) subjects. Compared with those without IA, students with IA had a higher prevalence of suicidal ideation (P < 0.0001). No planning impulsiveness had a predictive effect on suicidal ideation in the impulsive personality trait, while in the aggressive personality trait, hostility and self-aggression had a predictive effect on suicidal ideation (all P < 0.0001). High psychoticism and neuroticism were impact factors for suicidal ideation, but extroversion was a protective factor (all P < 0.0001).

DISCUSSION

These results highlight the importance of assessing personality traits and reducing IA as a possible means of lessening suicidal ideation. Susceptible personality (such as high psychoticism, high neuroticism, and low extroversion) play a prominent role in influencing the probability of having suicidal behavior among those recently exposed to IA.

CONCLUSIONS

IA and susceptible personality traits were significantly correlated with suicidal and self-harm ideation among adolescent students.

A Comparative Study of Online Depression Communities in China

Online communities have become a tool for researchers to understand and help individuals with depression. According to their operation mode in terms of management, communities can be divided into management depression communities (MDCs) and lacking-management depression communities (LDCs). This study aimed to investigate the characteristics and impact of LDCs in comparison with MDCs. All postings from the previous year were collected from the LDC and MDC. Keywords were extracted and coded to identify the themes, and a text classifier was built to identify the type of emotions and social support expressed in the postings. Community members were then clustered to explore their different participation patterns. We found that in the LDC, the expression of negative emotions was the most popular theme, there was a lack of information about the treatment of depression and a lack of social support providers, the level of engagement of providers was low, and support seekers did not receive attention. These results reveal the need for community management and can be used to develop more effective measures to support members of online depression communities.

Mediation Effect of Suicide-Related Social Media Use Behaviors on the Association Between Suicidal Ideation and Suicide Attempt: Cross-Sectional Questionnaire Study

Background

A limited number of studies have examined the differences in suicide-related social media use behaviors between suicide ideators and suicide attempters or have sought to elucidate how these social media usage behaviors contributed to the transition from suicidal ideation to suicide attempt.

Objective

Suicide attempts can be acquired through suicide-related social media use behaviors. This study aimed to propose 3 suicide-related social media use behaviors (ie, attending to suicide information, commenting on or reposting suicide information, or talking about suicide) based on social cognitive theory, which proposes that successive processes governing behavior transition include attentional, retention, production, and motivational processes.

Methods

We aimed to examine the mediating role of suicide-related social media use behaviors in Chinese social media users with suicidal risks. A sample of 569 Chinese social media users with suicidal ideation completed measures on suicidal ideation, suicide attempt, and suicide-related social media use behaviors.

Results

The results demonstrated that suicide attempters showed a significantly higher level of suicidal ideation (t_563.64=5.04; P<.001; two-tailed) and more suicide-related social media use behaviors, which included attending to suicide information (t₅₆₇=1.94; P=.05; two-tailed), commenting on or reposting suicide information (t₅₆₇=2.12; P=.03; two-tailed), or talking about suicide (t_542.22=5.12; P<.001; two-tailed). Suicidal ideation also affected suicide attempts through the mediational chains.

Conclusions

Our findings thus support the social cognitive theory, and there are implications for population-based suicide prevention that can be achieved by identifying behavioral signals.