Self-injuries like 'cutting' are highly common among adolescents. The purpose is not so much to feel the pain rather than the relief from negative emotions. Scientists at Ulm University have investigated how pictures of such self-inflicted injuries are spread and commented on in social media like Instagram. They analysed 32,000 images and all comments that were posted during April 2016 via the most common German hashtags of this free online service for sharing photos and videos.
'Social media play an essential role in the daily lives and self-image of adolescents. It is therefore important to know how mental health conditions are communicated in these highly emotional media,' says Professor Paul Plener, Deputy Head Physician (Leitender Oberarzt) of the Clinic for Child and Adolescent Psychiatry and Psychotherapy. Together with his colleague Dr. Rebecca Brown, Plener analysed extensively what photos of self-injuries are posted on Instagram during a defined period of time and what comments they generated. They recently published the results of their comprehensive study open access in the journal 'Psychological Medicine'.
An elaborate multilevel coding procedure allowed the scientists to not only register type and severity of the displayed injuries but also to evaluate indicators of gender and age of users who spread pictures of self-harm on Instagram via German hashtags like #ritzen (cutting), #klinge (razor blade) or #selbstverletzung (self-harm). They also looked into comments that referred to these posts. The codes distinguished between the types of responses, for example, if they contained expressions of empathy, support or protection or if they were abusive or bashing.
'Most pictures show light to semi-severe wounds that were caused by "cutting". The majority of comments were compassionate or supportive and only rarely insulting or abusive,' Dr. Rebecca Brown sums up the results. The scientists - who had help from Scottish scientist Robert Young, programmer David Goldwich and data journalist Martin Fischer - also noticed after the statistical evaluation that more severe injuries generated significantly more comments. The images were usually uploaded in the evening hours, many also on Sundays.
The researchers from Ulm furthermore looked for indications of social contagion. Imitation effects are known to play a huge role in the personal interaction between youth who demonstrate self-harming behaviour. The study at hand was not able to directly prove such effects. However, the scientists see clear indications of social amplification effects in social media when it comes to the severity of injuries and user reaction.
'Youth psychiatrists and psychotherapists have, of course, great interest in the question if social media can amplify such behaviour or if they might also have preventative potential,' Plener and Brown emphasise. In the first instance, however, their study is predominantly explorative in nature. Thanks to their work it is now established for the first time how prevalent pictures of non-suicidal self-injury (NSSI) really are on channels like Instagram in German-speaking regions. The providers of such online image services increasingly recognise their responsibility to counteract such problematic contents. Upon entering the hashtag #ritzen on Instagram you now receive in a pop-up window information on professional help offers. The study was funded by the Volkswagen Foundation.
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Information on the internet on the prevention project "Schulen stark machen gegen Suizidalität und selbstverletzendes Verhalten (4S)" (strengthening schools against suicidal and self-harming behaviour): www.projekt-4s.de
Brown RC, Fischer T, Goldwich AD, Keller F, Young R, Plener PL: "#cutting: Nonsuicidal Self-injury (NSSI) on Instagram", in: 'Psychological Medicine'.
Text: Andrea Weber-Tuckermann
Translation: Dani Wittmeier