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Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review

Amanda Marchant Orcid Logo, Keith Hawton Orcid Logo, Lauren Burns, Anne Stewart Orcid Logo, Ann John Orcid Logo

Journal of Medical Internet Research, Volume: 23, Issue: 3, Start page: e18048

Swansea University Authors: Amanda Marchant Orcid Logo, Lauren Burns, Ann John Orcid Logo

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DOI (Published version): 10.2196/18048

Abstract

Background:Given recent moves to remove or blur self-harm imagery or content on the web, it is important to understand the impact of posting, viewing, and reposting self-harm images on young people.Objective:The aim of this study is to systematically review research related to the emotional and beha...

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Published in: Journal of Medical Internet Research
ISSN: 1438-8871
Published: JMIR Publications Inc. 2021
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URI: https://cronfa.swan.ac.uk/Record/cronfa56263
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last_indexed 2024-11-14T12:09:43Z
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Search terms were categorized into internet use, images nonspecific and specific to the internet, and self-harm and suicide. Stepwise screening against specified criteria and data extraction were completed by two independent reviewers. Eligible articles were quality assessed, and a narrative synthesis was conducted.Results:A total of 19 independent studies (20 articles) were included. Of these, 4 studies focused on images, 10 (11 articles) on videos, and 5 on both. There were 4 quantitative, 9 qualitative, and 7 mixed methods articles. In total, 11 articles were rated as high quality. There has been an increase in graphic self-harm imagery over time. Potentially harmful content congregated on platforms with little moderation, anonymity, and easy search functions for images. A range of reactions and intentions were reported in relation to posting or viewing images of self-harm: from empathy, a sense of solidarity, and the use of images to give or receive help to potentially harmful ones suggesting new methods, normalization, and exacerbation of self-harm. Viewing images as an alternative to self-harm or a creative outlet were regarded in 2 studies as positive impacts. Reactions of anger, hostility, and ambivalence have been reported. There was some evidence of the role of imitation and reinforcement, driven partly by the number of comments and wound severity, but this was not supported by time series analyses.Conclusions:Although the results of this review support concern related to safety and exacerbation of self-harm through viewing images of self-harm, there may be potential for positive impacts in some of those exposed. Future research should evaluate the effectiveness and potential harms of current posting restrictions, incorporate user perspectives, and develop recovery-oriented content. 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spelling 2024-10-11T10:45:55.7251505 v2 56263 2021-02-16 Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review 0776f450dd575004ba7c69930c579cae 0000-0001-7013-6980 Amanda Marchant Amanda Marchant true false 1f3dbae84455bb30f236511503a09c09 Lauren Burns Lauren Burns true false ed8a9c37bd7b7235b762d941ef18ee55 0000-0002-5657-6995 Ann John Ann John true false 2021-02-16 MEDS Background:Given recent moves to remove or blur self-harm imagery or content on the web, it is important to understand the impact of posting, viewing, and reposting self-harm images on young people.Objective:The aim of this study is to systematically review research related to the emotional and behavioral impact on children and young people who view or share web-based self-harm–related videos or images.Methods:We searched databases (including Embase, PsychINFO, and MEDLINE) from January 1991 to February 2019. Search terms were categorized into internet use, images nonspecific and specific to the internet, and self-harm and suicide. Stepwise screening against specified criteria and data extraction were completed by two independent reviewers. Eligible articles were quality assessed, and a narrative synthesis was conducted.Results:A total of 19 independent studies (20 articles) were included. Of these, 4 studies focused on images, 10 (11 articles) on videos, and 5 on both. There were 4 quantitative, 9 qualitative, and 7 mixed methods articles. In total, 11 articles were rated as high quality. There has been an increase in graphic self-harm imagery over time. Potentially harmful content congregated on platforms with little moderation, anonymity, and easy search functions for images. A range of reactions and intentions were reported in relation to posting or viewing images of self-harm: from empathy, a sense of solidarity, and the use of images to give or receive help to potentially harmful ones suggesting new methods, normalization, and exacerbation of self-harm. Viewing images as an alternative to self-harm or a creative outlet were regarded in 2 studies as positive impacts. Reactions of anger, hostility, and ambivalence have been reported. There was some evidence of the role of imitation and reinforcement, driven partly by the number of comments and wound severity, but this was not supported by time series analyses.Conclusions:Although the results of this review support concern related to safety and exacerbation of self-harm through viewing images of self-harm, there may be potential for positive impacts in some of those exposed. Future research should evaluate the effectiveness and potential harms of current posting restrictions, incorporate user perspectives, and develop recovery-oriented content. Clinicians assessing distressed young people should ask about internet use, including access to self-harm images, as part of their assessment. Journal Article Journal of Medical Internet Research 23 3 e18048 JMIR Publications Inc. 1438-8871 self-harm; suicide; social media; internet; systematic review 19 3 2021 2021-03-19 10.2196/18048 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University 2024-10-11T10:45:55.7251505 2021-02-16T11:57:45.9298315 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Amanda Marchant 0000-0001-7013-6980 1 Keith Hawton 0000-0003-4985-5715 2 Lauren Burns 3 Anne Stewart 0000-0001-6560-2553 4 Ann John 0000-0002-5657-6995 5 56263__20029__70c25aa3af784d20a54e2eb7dbfd573f.pdf 56263.pdf 2021-05-28T19:08:29.3384390 Output 402555 application/pdf Version of Record true ©Amanda Marchant, Keith Hawton, Lauren Burns, Anne Stewart, Ann John. This is an open-access article distributed under the terms of the Creative Commons Attribution License true eng https://creativecommons.org/licenses/by/4.0/
title Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review
spellingShingle Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review
Amanda Marchant
Lauren Burns
Ann John
title_short Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review
title_full Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review
title_fullStr Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review
title_full_unstemmed Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review
title_sort Impact of Web-Based Sharing and Viewing of Self-Harm–Related Videos and Photographs on Young People: Systematic Review
author_id_str_mv 0776f450dd575004ba7c69930c579cae
1f3dbae84455bb30f236511503a09c09
ed8a9c37bd7b7235b762d941ef18ee55
author_id_fullname_str_mv 0776f450dd575004ba7c69930c579cae_***_Amanda Marchant
1f3dbae84455bb30f236511503a09c09_***_Lauren Burns
ed8a9c37bd7b7235b762d941ef18ee55_***_Ann John
author Amanda Marchant
Lauren Burns
Ann John
author2 Amanda Marchant
Keith Hawton
Lauren Burns
Anne Stewart
Ann John
format Journal article
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container_volume 23
container_issue 3
container_start_page e18048
publishDate 2021
institution Swansea University
issn 1438-8871
doi_str_mv 10.2196/18048
publisher JMIR Publications Inc.
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
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description Background:Given recent moves to remove or blur self-harm imagery or content on the web, it is important to understand the impact of posting, viewing, and reposting self-harm images on young people.Objective:The aim of this study is to systematically review research related to the emotional and behavioral impact on children and young people who view or share web-based self-harm–related videos or images.Methods:We searched databases (including Embase, PsychINFO, and MEDLINE) from January 1991 to February 2019. Search terms were categorized into internet use, images nonspecific and specific to the internet, and self-harm and suicide. Stepwise screening against specified criteria and data extraction were completed by two independent reviewers. Eligible articles were quality assessed, and a narrative synthesis was conducted.Results:A total of 19 independent studies (20 articles) were included. Of these, 4 studies focused on images, 10 (11 articles) on videos, and 5 on both. There were 4 quantitative, 9 qualitative, and 7 mixed methods articles. In total, 11 articles were rated as high quality. There has been an increase in graphic self-harm imagery over time. Potentially harmful content congregated on platforms with little moderation, anonymity, and easy search functions for images. A range of reactions and intentions were reported in relation to posting or viewing images of self-harm: from empathy, a sense of solidarity, and the use of images to give or receive help to potentially harmful ones suggesting new methods, normalization, and exacerbation of self-harm. Viewing images as an alternative to self-harm or a creative outlet were regarded in 2 studies as positive impacts. Reactions of anger, hostility, and ambivalence have been reported. There was some evidence of the role of imitation and reinforcement, driven partly by the number of comments and wound severity, but this was not supported by time series analyses.Conclusions:Although the results of this review support concern related to safety and exacerbation of self-harm through viewing images of self-harm, there may be potential for positive impacts in some of those exposed. Future research should evaluate the effectiveness and potential harms of current posting restrictions, incorporate user perspectives, and develop recovery-oriented content. Clinicians assessing distressed young people should ask about internet use, including access to self-harm images, as part of their assessment.
published_date 2021-03-19T14:03:31Z
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