Exploring the Use and Effects of Deliberate Self-Harm Websites: An Internet-Based Study

Abstract

BackgroundIn the United Kingdom, rates of deliberate self-harm (DSH) are rising. Alongside this, there has been an increase in the number of websites available with DSH content, and the Internet is known as a valuable resource for those who feel isolated by their condition(s). However, there is little and contradictory evidence available on the effects of using such websites. Further research is therefore required to examine the use and effects of DSH websites.ObjectiveOur objectives were to explore (1) the reasons people engage in the use of self-harm forums/websites, (2) the beliefs of users of self-harm forums regarding the role of such websites, (3) how the use of self-harm forums/websites modulates self-harm behaviors, and (4) other ways that self-harm forums affect the lives of individuals who use them.MethodsData were collected by a questionnaire hosted on 20 websites with self-harm content. Participants were self-selected from users of these sites. Results were analyzed using descriptive statistics and simple thematic analysis.ResultsIn total, 329 responses were received with 91.8% (302/329) from female site users. The majority of participants (65.6%, 187/285) visited these sites at least twice per week, and most participants used the sites to find information (78.2%, 223/285) or participate in the forums (68.4%, 195/285). Positive effects of website use such as gaining help and support, isolation reduction, and a reduction in self-harm behaviors were reported by a large number of participants. However, smaller but important numbers reported negative effects including worsened self-harm, being triggered to self-harm, and additional negative physical and psychological effects.ConclusionsThis is the first multisite study to explore DSH website use in depth. There are clear and important benefits to engaging in website use for many individuals; however, these are not experienced by all website users. Negative effects were experienced by moderate numbers following website use, and clinicians should consider the impact of a patient’s website use when consulting.

A Double-Edged Sword: A Review of Benefits and Risks of Online Nonsuicidal Self-Injury Activities

“…Competition among and between online peers to be an “authentic” self‐injurer has also been identified as potential risk. Supporting this view were results from a survey in which about one third of participants (out of 329) mentioned increased frequency and severity of NSSI through comparison of wounds and scars with other members (Harris & Roberts, ). Injury comparison has also been reported; for example, sharing NSSI photographs online may foster competitiveness among online community members by giving them an impression that their injuries were not “big enough” or “deep enough” compared with what was depicted in the photographs (Baker & Lewis, , p. 231).…”

“…Findings from surveys administered to members of NSSI e‐communities similarly indicate that support from like‐minded peers may mitigate their sense of isolation (Murray & Fox, ). Although the long‐term benefits of online social support are not well studied, survey data from users of NSSI web forums suggest that the reduction of social isolation through online interactions could improve self‐esteem and coping skills (Harris & Roberts, ).…”

“…Oftentimes this venting occurs with little expectation of response. For instance, respondents to a survey by Harris and Roberts () described the NSSI web forums as a safe space where they could ventilate their feelings without feeling judged or stigmatized. The need for emotional disclosure seems closely intertwined with a desire to express normally concealed parts of the self.…”

“…In some cases, individuals with NSSI actively search for graphic content with a hope to be triggered (Lewis & Michal, ). For instance, 10% of 329 participants in one study reported that they had intentionally looked for textual material or images that led them to NSSI (Harris & Roberts, ); in another study, 16% of 102 respondents actively sought out online NSSI content with a desire to be triggered (Murray & Fox, ).…”

Self‐harm in nurses: prevalence and correlates

“…, Klonsky , Kidger et al . , Harris & Roberts ) – the most common form; skin carving, puncturing, scratching and burning; striking oneself (Muehlenkamp ); banging body parts, tearing one's hair out and ingesting harmful substances (Hawton et al . , Hawton & James ) and other self‐mutilatory acts (Kapur & Gask , Nock ).…”