Non-suicidal self-injury (NSSI),sometimes called self-injury or self-harm, is the deliberate destruction of one’s body tissue (e.g., self-cutting, burning, or hitting until bruised). This does not include tattooing and piercing. As the term implies, NSSI is a behaviour that is without suicidal intent, making it distinct from suicide attempts.

The prevalence and risk factors for NSSI have received increasing attention by researchers over the
last twenty years. Studies have consistently found that 14-24% of adolescents admit to having injured themselves on purpose at least once in their lifetime. Many of these adolescents report self-injuring
multiple times.

Studies that investigate the underlying function or reason for the behaviour suggest that there are two broad categories of reasons why youth may engage in this action. The first (and most common) is internal or intrapersonal, and the second is social or interpersonal. A typical example of an internal/intrapersonal reason for self-injuring is to cope with overwhelming negative emotions (e.g., stress, sadness, anger) and/or tension. Following an episode of self-injury, many youth report a sense of calm or relief.

Far fewer youth indicate that they self-injure for social/interpersonal reasons, however, for those who do, it is often about trying to communicate their pain or emotions to someone else and/or to reach out or connect with someone.

Clearly, youth who self-injure are in distress and require support. Furthermore, it is known that although
non-suicidal self-injury is not a suicide attempt, those who self-injure are at risk for repeated incidents,
other mental health issues such as depression, eating disorders and, in some cases, attempted suicide and death by suicide.

Recently, researchers noted that there was a significant amount of material about self-injury in online forums, including interactive websites. However, while interactive websites are quite popular, one of
the fastest growing online activities among youth is the use of video-sharing websites, such as YouTube.

Since its inception in 2005, YouTube has not only been recognized as the largest and fastest growing video-sharing website, but also it currently receives the third most traffic of all websites on the Internet. Furthermore, statistics indicate that youth access videosharing websites more than any other age group.
The appeal of video sharing, posting videos, viewing videos and commenting on them is substantial
for youth. These activities permit young people to share message with a potentially huge audience without any involvement or censorship.

Research shows that self-injury is a largely secretive behaviour in youth; they rarely reveal their self-injury to any adult. Therefore, YouTube may hold particular appeal for these individuals as it permits them to post/view and interact with others who also engage in this behavior. Thus, our research team sought to examine the scope and nature of the videos about non-suicidal self-injury shared on YouTube.

We searched YouTube using the keywords “self-injury” and “self-harm” and selected the 50 most viewed character (i.e., with a live individual) and non-character videos (100 total) for examination. Our results found that in July 2010 there were more than 5,000 videos on YouTube on this topic. As a group, the top 100 videos we selected had been viewed over two million times with most (80%) accessible to a general audience (i.e., in no way restricted).

Multiple indications were found that many of those posting and viewing videos were youth providing false
ages to access more material (i.e., material intended for more mature audiences). Additionally, viewers rated the videos very positively and often selected or saved them as a “favorite,” which allows viewers to
have quick access to the video for repeated viewing. The videos were almost exclusively created and posted by individuals who were struggling with self-injury. In the videos, they frequently “warned” viewers about starting or engaging in self-injury and/or emphasized the message of “you are not alone.” Thus, the content of the videos was found to be largely informational (providing facts and warnings about self-injury in a creative, appealing format) with a sad or hopeless tone.

However, of significant concern was the finding that explicit images of self-injury were common. Specifically, 90% of non-character videos while 28% of character videos had in-action self-injury, showing a live person engaging in self-injury.

Our study highlights that self-injury videos on YouTube are frequently being posted and viewed by youth. These videos have graphic content, some questionable messages, and appear to be appealing to youth (i.e., receiving “favorite” votes). It suggests that there is an online community available to youth who begin self-injuring or who have a history of self-injury. While this community may decrease feelings of isolation and has the potential to be supportive, parents need to be aware if their adolescent accesses these videos and participates in their forums to ensure the effects of their child’s interaction with the community are beneficial.

Parents should educate themselves on self-injury, learn how common it is amongst youth and develop an understanding of why young people might engage in self-cutting or burning. Youth are very aware of self-injury and likely have heard of it being used by their peers. Therefore, it is helpful to have an open discussion about the behavior, acknowledge the feelings that might prompt youth to engage in the behavior and explore healthier coping strategies.

Regarding video-sharing websites such as YouTube, parents that show an interest in what their adolescent enjoys about the videos and encourage him to think about both the benefits and possible dangers of video sharing demonstrate and support the goal of open communication. Although imposing strict limitations for online activities for adolescents appeals to many parents, this may give a false sense of security as too often the teen will find a way around the limitations, resulting in the online activities becoming secretive.

In summary, self-injury represents an important issue for parents and their teens. With more youth using the Internet, and with an increase in the amount of self-injury material online, it is essential for parents to know what’s out there. Whether or not parents are aware, videos about self-injury are common and frequently viewed on YouTube. Although there may be some benefits to these videos (e.g., bringing isolated teens together), the content of some of them is questionable (e.g., images of self-injury). It is important for parents to learn about self-injury and its presentation on the Internet and to have open discussions about this subject with their teenager.

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From issue: 27/07-08