Self-Injury and the Internet




Deliberate nonsuicidal self-injury is the intentional harming of one’s own body, and may include cutting, burning, scratching, minor overdosing, banging, or hitting. New research finds that images and live-action videos depicting self-injury permeate the internet. The images are accessible to youth at risk for this dangerous behavior, and reinforce, glamorize, and provoke self-destructive behavior.

The research, published a recent issue of Pediatrics, evaluated the presence and viewing patterns of self-injury videos on YouTube. The authors searched the video-sharing website using the key words “self-injury” and “self-harm” and analyzed the content and viewership of  the top 50 most-viewed videos showing a live person (character videos) and the top 50 videos without a live person (noncharacter videos). In total, 28% of the character videos had in-action footage of self-injury and 90% of the noncharacter videos had photographs of the same.

On average, the individuals who uploaded the videos to YouTube were 25 years old, though many admitted lying about their age on previous occasions, so the reliability of the data is questionable. Also, 95% of the video uploaders were female.  Overall, the top 100 videos analyzed were viewed more than 2 million times. More than three-quarters of the videos were accessible to a general audience with no viewer restrictions; 58% of the videos did not warn viewers of the content. The videos were positively ranked by viewers, with an average score of 4.6 out of 5.0; the self-injury videos were rated as viewer “favorites” more than 12,000 times.

The accessibility and graphic content of self-injury videos are worrisome. The rate of self-injury among adolescents and young adults ranges from 14% to 24%, and individuals who self-injure are more likely to have other mental health disorders, including depressive disorders and attention-related issues, and a higher risk of suicide. Exposure to photographs and videos of others who self-injure fosters a feeling of normalcy, and may actually educate or provoke self-injury and teach new methods of self-injury or concealing the self-injury. The same phenomenon is seen with pro-eating disorder websites among young girls at risk for anorexia nervosa and bulimia. Reportedly, individuals who self-injure do so to alleviate negative emotions, express self-directed anger, or resist suicidal thoughts.

More than half of the videos analyzed in the Pediatrics research presented an educational tone, providing statistics and facts about self-injury. A few actively discouraged self-injury. Most videos had a melancholic tone, depicting sadness, hopelessness, or crying. Noncharacter videos were more popular in this analysis, and these videos were much richer in artistic expression, using music, art, and text to discuss self-injury. This glamorization and artistic representation makes a destructive behavior that much more attractive to individuals who engage in self-injury. The individuals who make or appear in the videos also gain a sense of identity and garner a large following of “fans” based on their self-injury behavior.

YouTube is the largest video-sharing website available today, and it receives the third most traffic of any website on the internet. Adolescents and young adults, the same population at risk for self-injury, use the internet and video-sharing applications more than any other age group. The internet, and other modern media, has caused society to become desensitized to harmful and unsafe behavior. Dangerous activities are now sensationalized, and individuals can become internet celebrities for performing injurious acts. Clinicians who treat individuals who self-injure must be aware of the prevalence of these harmful videos on the internet and the role they play in encouraging self-injury.

References

Borzekowski DL, Schenk S, Wilson JL, & Peebles R (2010). e-Ana and e-Mia: A content analysis of pro-eating disorder Web sites. American journal of public health, 100 (8), 1526-34 PMID: 20558807

Jett S, LaPorte DJ, & Wanchisn J (2010). Impact of exposure to pro-eating disorder websites on eating behaviour in college women. European eating disorders review : the journal of the Eating Disorders Association, 18 (5), 410-6 PMID: 20572210

Klonsky ED, & Muehlenkamp JJ (2007). Self-injury: a research review for the practitioner. Journal of clinical psychology, 63 (11), 1045-56 PMID: 17932985

Lewis SP, Heath NL, St Denis JM, & Noble R (2011). The scope of nonsuicidal self-injury on YouTube. Pediatrics, 127 (3) PMID: 21339269

Nixon MK, Cloutier P, & Jansson SM (2008). Nonsuicidal self-harm in youth: a population-based survey. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne, 178 (3), 306-12 PMID: 18227450

Tuisku V, Pelkonen M, Kiviruusu O, Karlsson L, Ruuttu T, & Marttunen M (2009). Factors associated with deliberate self-harm behaviour among depressed adolescent outpatients. Journal of adolescence, 32 (5), 1125-36 PMID: 19307015

Jennifer Gibson, PharmD

Jennifer Gibson, PharmD, is a practicing clinical pharmacist and medical writer/editor with experience in researching and preparing scientific publications, developing public relations materials, creating educational resources and presentations, and editing technical manuscripts. She is the owner of Excalibur Scientific, LLC.
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