Research review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms

<p><strong>Background:</strong>&nbsp;Viewing self-harm and suicide-related images online can precede these behaviours. We reviewed studies of potential impacts and mechanisms associated with viewing self-harm-related images on the internet and social media.</p> <p>&...

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Main Authors: Susi, K, Glover-Ford, F, Stewart, A, Knowles Bevis, R, Hawton, K
Format: Journal article
Language:English
Published: Wiley 2023
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author Susi, K
Glover-Ford, F
Stewart, A
Knowles Bevis, R
Hawton, K
author_facet Susi, K
Glover-Ford, F
Stewart, A
Knowles Bevis, R
Hawton, K
author_sort Susi, K
collection OXFORD
description <p><strong>Background:</strong>&nbsp;Viewing self-harm and suicide-related images online can precede these behaviours. We reviewed studies of potential impacts and mechanisms associated with viewing self-harm-related images on the internet and social media.</p> <p><strong>Method:</strong>&nbsp;CINAHL, Cochrane Library, EMBASE, HMIC, MEDLINE, PsycArticles, PsycINFO, PubMed, Scopus, Sociological Abstracts and Web of Science Core Collection databases were searched for relevant studies from inception to 22 January 2022. Inclusion criteria were English language, peer-reviewed, empirical studies with data related to impacts of viewing self-harm images or videos on the internet or social media. Quality and risk of bias were assessed using Critical Appraisal Skills Programme tools. A narrative synthesis approach was used.</p> <p><strong>Results:</strong>&nbsp;Of the 15 identified studies, all found harmful effects of viewing self-harm-related images online. These included escalation of self-harm, reinforcement of engagement behaviours (e.g. commenting and sharing images), encouragement of social comparison (comparing own self-harm with others), development of a self-harm identity, social connection perpetuating or escalating self-harm, and emotional, cognitive, and physiological impacts triggering self-harm urges and acts. Nine studies found protective effects, including self-harm mitigation or reduction, promotion of self-harm recovery, encouraging social connection and help-giving, and emotional, cognitive and physiological impacts mitigating or reducing self-harm urges and acts. Causality of impact was not determined in any study. Most of the studies did not explicitly evaluate or discuss potential mechanisms.</p> <p><strong>Conclusions:</strong>&nbsp;Viewing self-harm images online may have both harmful and protective effects, but harmful effects predominated in the studies. Clinically, it is important to assess individual's access to images relating to self-harm and suicide, and the associated impacts, alongside pre-existing vulnerabilities and contextual factors. Higher quality longitudinal research with less reliance on retrospective self-report is needed, as well as studies that test potential mechanisms. We have developed a conceptual model of the impact of viewing self-harm images online to inform future research.</p>
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spelling oxford-uuid:7d394151-e4cd-4152-a9b0-c248216a83352023-10-04T07:34:03ZResearch review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanismsJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7d394151-e4cd-4152-a9b0-c248216a8335EnglishSymplectic ElementsWiley2023Susi, KGlover-Ford, FStewart, AKnowles Bevis, RHawton, K<p><strong>Background:</strong>&nbsp;Viewing self-harm and suicide-related images online can precede these behaviours. We reviewed studies of potential impacts and mechanisms associated with viewing self-harm-related images on the internet and social media.</p> <p><strong>Method:</strong>&nbsp;CINAHL, Cochrane Library, EMBASE, HMIC, MEDLINE, PsycArticles, PsycINFO, PubMed, Scopus, Sociological Abstracts and Web of Science Core Collection databases were searched for relevant studies from inception to 22 January 2022. Inclusion criteria were English language, peer-reviewed, empirical studies with data related to impacts of viewing self-harm images or videos on the internet or social media. Quality and risk of bias were assessed using Critical Appraisal Skills Programme tools. A narrative synthesis approach was used.</p> <p><strong>Results:</strong>&nbsp;Of the 15 identified studies, all found harmful effects of viewing self-harm-related images online. These included escalation of self-harm, reinforcement of engagement behaviours (e.g. commenting and sharing images), encouragement of social comparison (comparing own self-harm with others), development of a self-harm identity, social connection perpetuating or escalating self-harm, and emotional, cognitive, and physiological impacts triggering self-harm urges and acts. Nine studies found protective effects, including self-harm mitigation or reduction, promotion of self-harm recovery, encouraging social connection and help-giving, and emotional, cognitive and physiological impacts mitigating or reducing self-harm urges and acts. Causality of impact was not determined in any study. Most of the studies did not explicitly evaluate or discuss potential mechanisms.</p> <p><strong>Conclusions:</strong>&nbsp;Viewing self-harm images online may have both harmful and protective effects, but harmful effects predominated in the studies. Clinically, it is important to assess individual's access to images relating to self-harm and suicide, and the associated impacts, alongside pre-existing vulnerabilities and contextual factors. Higher quality longitudinal research with less reliance on retrospective self-report is needed, as well as studies that test potential mechanisms. We have developed a conceptual model of the impact of viewing self-harm images online to inform future research.</p>
spellingShingle Susi, K
Glover-Ford, F
Stewart, A
Knowles Bevis, R
Hawton, K
Research review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms
title Research review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms
title_full Research review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms
title_fullStr Research review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms
title_full_unstemmed Research review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms
title_short Research review: Viewing self-harm images on the internet and social media platforms: systematic review of the impact and associated psychological mechanisms
title_sort research review viewing self harm images on the internet and social media platforms systematic review of the impact and associated psychological mechanisms
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