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      Exposure to, and searching for, information about suicide and self-harm on the Internet: Prevalence and predictors in a population based cohort of young adults

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          Abstract

          Background

          There is concern over the potential impact of the Internet on self-harm and suicidal behaviour, particularly in young people. However, little is known about the prevalence and patterns of suicide/self-harm related Internet use in the general population.

          Methods

          Cross sectional study of 3946 of the 8525 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) who were sent a self-report questionnaire including questions on suicide/self-harm related Internet use and self-harm history at age 21 years.

          Results

          Suicide/self-harm related Internet use was reported by 22.5% (886/3946) of participants; 11.9% (470/3946) had come across sites/chatrooms discussing self-harm or suicide, 8.2% (323/3946) had searched for information about self-harm, 7.5% (296/3946) had searched for information about suicide and 9.1% (357/3946) had used the Internet to discuss self-harm or suicidal feelings. Suicide/self-harm related Internet use was particularly prevalent amongst those who had harmed with suicidal intent (70%, 174/248), and was strongly associated with the presence of suicidal thoughts, suicidal plans, and history of self-harm. Sites offering help, advice, or support were accessed by a larger proportion of the sample (8.2%, 323/3946) than sites offering information on how to hurt or kill yourself (3.1%, 123/3946). Most individuals (81%) who had accessed these potentially harmful sites had also accessed help sites.

          Limitations

          (i) There were differences between questionnaire responders and non-responders which could lead to selection bias and (ii) the data were cross-sectional, and we cannot conclude that associations are causal.

          Conclusions

          Suicide/self-harm related Internet use is common amongst young adults, particularly amongst those with suicidal thoughts and behaviour. Both harmful and helpful sites were accessed, highlighting that the Internet presents potential risks but also offers opportunities for suicide prevention.

          Highlights

          • We examined suicide/self-harm related Internet use in a sample of young adults.

          • 22.5% of participants reported suicide/self-harm related Internet use.

          • It was strongly associated with self-harm, suicidal thoughts, and suicidal plans.

          • A greater proportion had accessed helpful sites than potentially harmful sites.

          • The Internet presents potential risks but also offers opportunities for prevention.

          Related collections

          Most cited references38

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          Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

          Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Over 30,000 mainly 15- and 16-year-olds completed anonymous questionnaires at school in Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway. Study criteria were developed to identify episodes of self-harm; the prevalence of self-harm acts and thoughts, methods used, repetition, reasons given, premeditation, setting for the act, associations with alcohol and drugs, hospitalisation, and whether other people knew, were examined. Self-harm was more than twice as common among females as males and, in four of the seven countries, at least one in ten females had harmed herself in the previous year. Additional young people had thought of harming themselves without doing so. More males and females in all countries except Hungary cut themselves than used any other method, most acts took place at home, and alcohol and illegal drugs were not usually involved. The most common reasons given were 'to get relief from a terrible state of mind' followed by 'to die', although there were differences between those cutting themselves and those taking overdoses. About half the young people decided to harm themselves in the hour before doing so, and many did not attend hospital or tell anyone else. Just over half those who had harmed themselves during the previous year reported more than one episode over their lifetime. Deliberate self-harm is a widespread yet often hidden problem in adolescents, especially females, which shows both similarities and differences internationally.
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            Deliberate self harm in adolescents: self report survey in schools in England.

            To determine the prevalence of deliberate self harm in adolescents and the factors associated with it. Cross sectional survey using anonymous self report questionnaire. 41 schools in England. 6020 pupils aged 15 and 16 years. Deliberate self harm. 398 (6.9%) participants reported an act of deliberate self harm in the previous year that met study criteria. Only 12.6% of episodes had resulted in presentation to hospital. Deliberate self harm was more common in females than it was in males (11.2% v 3.2%; odds ratio 3.9, 95% confidence interval 3.1 to 4.9). In females the factors included in a multivariate logistic regression for deliberate self harm were recent self harm by friends, self harm by family members, drug misuse, depression, anxiety, impulsivity, and low self esteem. In males the factors were suicidal behaviour in friends and family members, drug use, and low self esteem. Deliberate self harm is common in adolescents, especially females. School based mental health initiatives are needed. These could include approaches aimed at educating school pupils about mental health problems and screening for those at risk.
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              The virtual cutting edge: the internet and adolescent self-injury.

              The 2 studies reported here use observational data from message boards to investigate how adolescents solicit and share information related to self-injurious behavior. Study 1 examines the prevalence and nature of these message boards, their users, and most commonly discussed topics. Study 2 was intended to explore the correlations between content areas raised for discussion. Both studies were intended to shed light on the role of message boards in spreading information about self-injurious practices and influencing help-seeking behavior. More than 400 self-injury message boards were identified. Most are populated by females who describe themselves as between 12 and 20 years of age. Findings show that online interactions clearly provide essential social support for otherwise isolated adolescents, but they may also normalize and encourage self-injurious behavior and add potentially lethal behaviors to the repertoire of established adolescent self-injurers and those exploring identity options. ((c) 2006 APA, all rights reserved).
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                Author and article information

                Contributors
                Journal
                J Affect Disord
                J Affect Disord
                Journal of Affective Disorders
                Elsevier/North-Holland Biomedical Press
                0165-0327
                1573-2517
                01 October 2015
                01 October 2015
                : 185
                : 239-245
                Affiliations
                [a ]School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom
                [b ]Samaritans, United Kingdom
                [c ]PAPYRUS Prevention of Young Suicide, United Kingdom
                Author notes
                [* ]Corresponding author. Tel.: +44 117 3310144. becky.mars@ 123456bristol.ac.uk
                Article
                S0165-0327(15)00372-9
                10.1016/j.jad.2015.06.001
                4550475
                26150198
                ad49a908-9c4f-406a-ae19-d7ad0684ed57
                © 2015 The Authors

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 18 March 2015
                : 1 June 2015
                : 2 June 2015
                Categories
                Research Report

                Clinical Psychology & Psychiatry
                alspac,internet,self-harm,suicide attempt,suicide
                Clinical Psychology & Psychiatry
                alspac, internet, self-harm, suicide attempt, suicide

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