In 2011, our research teams studied the nature of non-suicidal self-injury (NSSI) videos on YouTube. Findings for this study were summarized in a Pediatrics for Parents article in July of 2012.

NSSI includes self-cutting, burning, or hitting until bruised and is defined as the intentional destruction of one’s own body tissue. (NSSI excludes tattooing and piercing and is distinct from suicide attempts on the basis of its underlying reason being without suicide intent.) Among adolescents and emerging adults, the prevalence of having self-injured at least once ranges from 14 to 24%. Many of these individuals will report self-injuring multiple times.

Over the last few years, there has been an increase in the amount of research examining how young people communicate about NSSI on the Internet. Findings from this research suggest that for many youth who self-injure, the Internet represents an important, and in some cases, a preferred, way to communicate and obtain needed support and acceptance.

At the same time, certain forms of online communication about NSSI may be potentially harmful. For example, some research has shown that youth are often exposed to hopeless messages about NSSI and as a result may come to believe that NSSI is a useful method to cope with stress and that recovery is not possible.

One of the most popular websites used to communicate about NSSI for today’s youth is YouTube. Our previous research that examined the 100 most-viewed NSSI videos on YouTube found that many of the videos posted contained graphic images of NSSI; some had live, in-action NSSI. Most videos had hopeless themes, which tended to emphasize emotional pain. Although this provided some insight into what is posted, the response of the viewers was only recently studied.

In the current study, we investigated common responses made by viewers to the NSSI videos mentioned above in order to better understand the effect of viewing NSSI videos on those who access them. Specifically, we scrutinized 869 total comments that were randomly selected from all of the comments made in response to the originally studied 100 most-viewed videos.

In a manner consistent with other YouTube research methods, we coded these comments for their content. The most frequent comment type involved people sharing their own NSSI experiences (38.39%). The second most common comment involved people giving feedback to the individual who posted the video (21.95%). This feedback included providing admiration of the video quality or the message presented in the video. Finally, 11.15% of the comments provided encouragement to the video uploader. An example of a personally encouraging message is “you’re so brave.”

Next, in order to further understand the comments in which individuals shared their personal NSSI experiences, we coded for whether individuals discussed NSSI recovery.

Our analysis for these messages revealed that 51.19 % made no mention of recovery. In addition to this, 40.58% explicitly included an indication that the individual commenter had not recovered and was still self-injuring. Only 8.49% made mention that they had recovered from NSSI and only 4.51% indicated they wanted to recover.

The results from this study demonstrate that individuals who go on YouTube to view NSSI videos and who comment on them are doing so to share their own experiences. This suggests that the Internet in general, and YouTube in particular, represent important ways for individuals who self-injure to share their own experience and to receive needed validation and support.

Of greatest concern is that in this online environment, the discussion almost never focuses on recovery. Instead, most shared NSSI experiences focus on people’s continued struggle with NSSI. If this is the typical comment people read when viewing videos that have hopeless messages about recovery, then it may potentially reinforce the view that NSSI recovery is either difficult or not possible.

Taken together, these results are consistent with our previous research in that although the Internet can bring isolated young people who self-injure together and provide needed support, there are potential problems for youth who self-injure and who go online to communicate about it.

These particular results are the first to highlight that young people are strongly motivated to share their NSSI stories with an understanding audience. These findings also suggest that many young people who self-injure are either not understood elsewhere or do not believe they will be.

Parents are encouraged to gain an understanding about NSSI in order to better understand why youth self-injure and how they can effectively respond to youth and initiative conversations about it. It is also important that youth have access to more recovery-focused messages about NSSI on the Internet.

Young people should have opportunities to share their NSSI experiences in a supportive way, and that those who care about them respond in a supportive, understanding, and recovery-oriented manner. Recently, in order to facilitate this, and to offer a place where recovery-focused and hopeful messages are emphasized, we developed Self-injury Outreach & Support (SiOS, www.sioutreach.org), an online outreach initiative for NSSI that provides resources and guides for youth who self-injure, their parents, and others (including friends, romantic partners, school professionals, medical professionals, and mental health professionals) that can play an important and supportive role in the recovery process.

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From issue: 28/07-08