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Purpose: Despite increased media and scholarly attention to digital forms of aggression directed toward adolescents by their peers (e.g., cyberbullying), very little research has explored digital aggression directed toward oneself. "Digital self-harm" is the anonymous online posting, sending, or otherwise sharing of hurtful content about oneself. The current study examined the extent of digital self-harm among adolescents. Methods: Survey data were obtained in 2016 from a nationally representative sample of 5,593 American middle and high school students (12-17 years old). Logistic regression analysis was used to identify correlates of participation in digital self-harm. Qualitative responses were also reviewed to better understand motivations for digital self-harm. Results: About 6% of students have anonymously posted something online about themselves that was mean. Males were significantly more likely to report participation (7.1% compared to 5.3%). Several statistically significant correlates of involvement in digital self-harm were identified, including sexual orientation, experience with school bullying and cyberbullying, drug use, participation in various forms of adolescent deviance, and depressive symptoms. Conclusions: Digital self-harm is a new problem that demands additional scholarly attention. A deeper inquiry as to the motivations behind this behavior, and how it correlates to offline self-harm and suicidal ideation, can help direct mental health professionals toward informed prevention approaches.
Original article
Digital Self-Harm Among Adolescents
Justin W. Patchin, Ph.D.
, and Sameer Hinduja, Ph.D.
University of Wisconsin-Eau Claire, Eau Claire, Wisconsin
Florida Atlantic University, Jupiter, Florida
Article history: Received February 24, 2017; Accepted June 15, 2017
Keywords: Cyberbullying; Self-cyberbullying; Digital self-harm; Self-harm; Suicide; Depressive symptoms
Purpose: Despite increased media and scholarly attention to digital forms of aggression directed
toward adolescents by their peers (e.g., cyberbullying), very little research has explored digital
aggression directed toward oneself. Digital self-harmis the anonymous online posting, sending,
or otherwise sharing of hurtful content about oneself. The current study examined the extent of
digital self-harm among adolescents.
Methods: Survey data were obtained in 2016 from a nationally representative sample of 5,593
American middle and high school students (12e17 years old). Logistic regression analysis was used
to identify correlates of participation in digital self-harm. Qualitative responses were also reviewed
to better understand motivations for digital self-harm.
Results: About 6% of students have anonymously posted something online about themselves that
was mean. Males were signicantly more likely to report participation (7.1% compared to 5.3%).
Several statistically signicant correlates of involvement in digital self-harm were identied,
including sexual orientation, experience with school bullying and cyberbullying, drug use,
participation in various forms of adolescent deviance, and depressive symptoms.
Conclusions: Digital self-harm is a new problem that demands additional scholarly attention. A
deeper inquiry as to the motivations behind this behavior, and how it correlates to ofine self-
harm and suicidal ideation, can help direct mental health professionals toward informed pre-
vention approaches.
Ó2017 Society for Adolescent Health and Medicine. All rights reserved.
This study empirically ex-
plores digital self-harm be-
haviors among middle and
high school aged youth with
a large nationally represen-
tative sample. Several sig-
nicant covariates were
identied, including expe-
rience with bullying,
depression, and adolescent
problem behaviors.
Over the last decade, teens have embraced and exploited
social media and the online world to engage in self-expression
and self-construction, explore the boundaries of their identity,
and come into their own [1e3]. During this transformative sea-
son of life, many youth are using communications technology in
predominantly positive and productive ways to meet certain
psychological, emotional, social, and relational needs [4].
Others, however, are meeting those needs in maladaptive ways
that trouble the professionals and families who care for them.
One newly identied online behavior of concernedigital
self-harm occurs when an individual creates an online account
and uses it to anonymously send hurtful messages or threats
to oneself. These behaviors rst entered the public spotlight in
2013 when it was learned that 14-year-old Hannah Smith, from
Leicestershire, England, had anonymously sent hurtful messages
to herself on the social media platform in the weeks
leading up to her suicide [5].
Author Biographies: Justin W. Patchin is a Professor of Criminal Justice at the
University of Wisconsin-Eau Claire. He received his Ph.D. in Criminal Justice from
Michigan State University. Since 2002, he has been exploring the intersection of
teens and technology, with particular focus on cyberbullying, social networking,
and sexting. Sameer Hinduja is a Professor of Criminology and Criminal Justice at
Florida Atlantic University. He received his Ph.D. in Criminal Justice from
Michigan State University. His research seeks to understand the causes and
consequences of various forms of online victimization and to identify best
practices in prevention and response.
*Address correspondence to: Justin W. Patchin, Ph.D., University of
Wisconsin-Eau Claire, 105 Gareld Avenue, Eau Claire, WI 54702-4004.
E-mail address: (J.W. Patchin).
1054-139X/Ó2017 Society for Adolescent Health and Medicine. All rights reserved.
Journal of Adolescent Health xxx (2017) 1e6
Much attention in clinical, school, and community settings
has been given to traditional forms of self-injury among teens
(e.g., cutting and burning) [6], not only because of the damage
that is physically done and the internal turmoil it betrays, but
also because self-harm has been linked to suicide [7e11 ]. The
online variant of self-harmdalso known as self-cyberbullying,
cyber self-harm, or self-trollingdhas only recently been identi-
ed and has therefore not yet been adequately examined despite
preliminary evidence that a nontrivial amount of youth have
engaged in the behavior [12,13]. We use the term digital
self-harm,which we dene as the anonymous online posting,
sending, or otherwise sharing of hurtful content about oneself.
This conceptualization encompasses self-harm as it occurs
through SMS, email, social media, gaming consoles, web forums,
virtual environments, and any other online platform yet to be
In the text that follows, we briey summarize the extant
literature on adolescent self-harm with particular focus on
prevalence rates and motivations. This serves as the backdrop for
the current work, which utilizes a nationally representative
sample of U.S. youth to determine the extent to which those aged
12e17 years are engaging in digital self-harm. Apart from parsing
out how certain demographic variables differentiate participant
behaviors, we examine the relationship to several salient cova-
riates such as bullying and cyberbullying victimization, drug use,
participation in traditional forms of deviance, and depressive
symptoms. After discussing the ndings, we provide suggestions
for future work to help society better understand and address
this emerging behavior.
The nature and extent of adolescent self-harm
Research among general samples of adolescents across the
world suggests that approximately 13%e18% engage in self-
injurious behaviors during their lifetime and that this behavior
has been on the rise over the last two decades [14,15]. To be sure,
prevalence rates have varied based on what behaviors are
considered. Typical conceptualizations include cutting, scratch-
ing, biting, or hitting (oneself); abusing pills; eating disorders;
and/or reckless or bone breaking behaviors [16].
An adolescents decision to self-harm may not be as much a
call for help as a demonstration of felt pain and distress. Indeed,
an analysis of studies examining self-reported reasons for
physical self-harmdincluding those featuring adolescent
samplesdfound a widespread theme of affect regulation. Spe-
cically, top reasons endorsed were the desire to stop bad feel-
ings (such as emptiness, abandonment, guilt, or desperation), to
release tension and stress, or because the respondent was un-
happy or depressed [17]. Other explanations include self-hatred
and self-punishment and to a lesser extent antidisassociation
(the desire to feel something other than numbness),
interpersonal-inuence (to get others to act differently or to care
more), sensation seeking (to feel excitement or stimulation), to
prevent suicidal behavior or attempts, or to exert control and
ownership over ones body [18].
Social media researcher boyd [13] rst wrote about digital
self-harm in a blog post in 2010 and speculated that it may reect
a cry for help, a desire to look cool, or an effort to trigger com-
pliments as others defend against the harassment. A year later,
Englander [12] explored the phenomena among a sample of 617
college students and found that 9% had done so in high school
(13% of boys and 8% of girls). This study also found that while
depression did not differentiate between those who engaged in
digital self-harm, drug and alcohol use did [12]. Englander [12]
found that both males and females engaged in digital self-harm
mostly to gain the attention of peers. Interestingly, girls did it
to prove they could handle it, encourage others to worry, or get
attention from adults, while boys did it because they were mad at
someone and wanted to start a ght [12].
It has also been suggested that digital self-harm might relate
to empathy seeking, serve as a way to demonstrate a measure of
toughness and strength, help clarify whether certain negative
perceptions of them are universally shared by others, and make
their pain more visible and, consequently, more real [19]. That is,
pain may be not only something they feel, but something they
perform in order to elicit a desired response from others [19]. The
ubiquity of social media and the way in which youth present and
represent themselves in order to obtain attention, validation, and
feedback from an audience may enhance the likelihood they
choose online spaces as the preferred venue through which they
can affect and reach others.
The current study seeks to expand upon these early obser-
vations by systematically examining digital self-harm among
adolescents. We inquire both about participation in digital
self-harm and motivations for such behavior. In addition, we
examine if certain correlates identied in ofine self-harm
research also apply to digital forms of self-harm. We discuss
their relevance before detailing how research on digital self-
harm might further develop to better inform our understand-
ing and response.
Data for the current work came from a survey administered to
a nationally representative sample of English-speaking 12- to
17-year-old middle and high school students residing in the U.S.
A survey was distributed digitally between August and October
2016 that examined perceptions of, and experiences with,
bullying, cyberbullying, and related teen behaviors. Parental
consent and child assent were obtained for all participants, and
the survey took 23 minutes to complete on average. Three
separate research rms were contracted with to distribute the
instrument through four different sample sources via email.
Although this data collection practice is not well entrenched in
the history of survey research, such a cost-effective and
comparatively efcient approach has been utilized in recent
years by other researchers [20]. Furthermore, it seems especially
appropriate for exploratory inquiries into relatively new phe-
nomena among youthful populations.
With regard to the sampling design, nested age, sex, and re-
gion quotas were used to ensure a diverse sample of respondents
that was representative of students across U.S. After the data
were cleaned, the nal sample size totaled to 5,593 adolescents.
The nal response rate for this survey was approximately 15%.
Admittedly, this is lower than other methods of data collection
and not ideal [21,22] but still satisfactory for a preliminary in-
quiry to an understudied problem. It is worth mentioning that
ndings from the current study on other measures (e.g., cyber-
bullying) were comparable to previous research we have con-
ducted using different methodologies [23]. We are therefore
more condent in the results obtained. Nevertheless, the rela-
tively low response rate, and limitations to the methodology
J.W. Patchin and S. Hinduja / Journal of Adolescent Health xxx (2017) 1e62
overall (e.g., email recruitment to participate), should be kept in
mind when interpreting the results [24,25]. The project meth-
odology was approved by the Institutional Review Board of
University of Wisconsin-Eau Claire (PATCHINJ51502016).
Digital Self-Harm. Two items were used to assess youth
involvement in digital self-harm: (1) In my lifetime, I have
anonymously posted something online about myself that was
meanand (2) In my lifetime, I have anonymously cyberbullied
myself online.The response set for these questions was never,
once,”“a few times,and many times,where never¼0 and
many times¼4. Responses were dichotomized with no
involvement coded as 0, while any involvement was coded as 1.
Respondents were also asked to describe why they engaged in
the behavior(s) via a single open-ended question.
Covariates. As an exploratory study, we rst examined de-
mographic variables such as age, sex, and race. Age was included
as a continuous variable representing the respondents age in
years (range 12e17; mean ¼14.5). Generally, previous research
has found that self-harm is inversely related to age and occurs
(along with suicidal ideation) disproportionately among youth
and young adult populations [26].Sex was a dichotomous item
where 1 ¼male and 0 ¼female. The sample was evenly divided
across sex (49.9% female and 49.7% male). Recent research in-
dicates that traditional self-harm becomes more prevalent
among boys during the later teen years, while girls participate
more frequently than boys earlier in adolescence [27]. To note,
Englander [12] found that boys were more likely to engage in
digital self-harm. Race was a categorical variable where
respondents indicated if they were white/Caucasian, black/
African-American, Hispanic, Asian, American Indian/Native
American, multiracial, or another race. These groups were
collapsed into the following four categories: 1 ¼white,
2¼African-American, 3 ¼Hispanic, and 4 ¼other. Sixty-six
percent of the sample identied as white, 12% African-
American, 11.9% Hispanic, and 10% identied as multiracial or
some other race. Research on race and ethnicity largely shows
that self-harming occurs among people from all backgrounds,
although there may be regional variations to consider [28].
Next, we explored a series of other variables that could be
related to digital self-harm. Sexual orientation is a dichotomous
variable where students who identied as heterosexual were
coded as 0 and those who identied as lesbian, gay, bisexual,
questioning, or other were coded as 1. Previous research has
found that sexual minority youth are more likely to engage in
traditional self-harm [29].
Victim of school bullying and victim of cyberbullying were
collected as categorical variables with a response set of never (0),
once (1), a few times (2), and many times (3). Both were
dichotomized into single-item variables where students who
reported that they had been bullied at school (or online) at some
point in the 30 days preceding the survey (1 or higher) were
coded as 1, while those who were not were coded as 0. School
bullying victimization has been moderately to strongly linked
with self-harming behaviors in both cross-sectional and longi-
tudinal studies involving adolescents, and the limited research
on cyberbullying victimization indicates a similar trend [30e32].
Depressive symptoms was a dichotomous single-item variable
where students who responded yes to the following question
were coded as 1: In the past year, did you feel so sad or hopeless
almost every day for two weeks or more in a row that you
stopped doing some of your usual activities?Those who
responded no were coded as 0. Various indicators and manifes-
tations of depression have been consistently associated with
self-harm, particularly among youthful populations [33].Ofine
self-harm was a dichotomous single-item variable where stu-
dents who responded yes to the following question were coded
as 1: In the past year, have you ever hurt yourself on purpose in
any way (for example, by taking an overdose of pills or by cutting
yourself).Those who responded no were coded as 0. No
previous research has explored the link between traditional
self-harm and digital self-harm, but we hypothesize that they are
related [7e11] .
Used drugs was a dichotomous variable where students who
said they had used (1) marijuana or (2) other illegal drugs in the
previous 30 days were coded as 1, while those who had not were
coded as 0 (Cronbachs
¼.54). Some research has found that
alcohol and drug use are associated with self-harm among girls
[34], while other studies have found it a correlate among both
sexes [33].Deviance was a dichotomous variable where students
who said they had (1) stolen money or things worth $100 or less,
(2) stolen money or things worth more than $100, or (3) attacked
someone with the idea of seriously hurting them (all in the past
30 days) were coded as 1, while those who had not participated
in any of these activities were coded as 0 (Cronbachs
Delinquency and aggression have been linked to self-harm
among populations of Korean [35] and Finnish youth [36]
based on parent evaluations of their childs behavioral problems.
We rst present the prevalence rates of digital self-harm,
using both operationalizations of the behavior (I have anony-
mously posted something online about myself that was mean
and I have anonymously cyberbullied myself). We utilized
t-tests to determine if there were any statistically signicant
differences across sex, race, and age with respect to respondent
involvement in digital self-harm. We then computed a series of
binary logistic regression models, testing the unique inuence of
each of the covariates of interest while controlling for age, sex,
and race. Quantitative statistical analyses were performed using
SPSS 18, and p<.05 was considered statistically signicant (two-
tailed). Finally, responses to the open-ended questions were
reviewed by both authors to identify recurring themes or general
patterns of motivations for participation in digital self-harm. We
did not develop categories ahead of time but instead relied on
the data to construct themes during our review [37].
As shown in Table 1, 6.2% of students in our sample reported
that they had anonymously posted something online about
myself that was mean.Among those who had, about half (51.3%)
said they did it just once, about one-third (35.5%) said they did it
a few times, while 13.2% said they had done it many times.
Similarly, 5.3% said they had anonymously cyberbullied myself.
Again focusing on those who had, 44.4% had done it once, 37.2%
had done it a few times, and 18.4% had done it many times. When
looking at demographic factors related to digital self-harm, boys
were signicantly more likely to report participating in the
behavior (in line with the ndings by Englander [12] involving
J.W. Patchin and S. Hinduja / Journal of Adolescent Health xxx (2017) 1e63
college students), while neither race nor age was signicantly
related to digital self-harm.
Table 2 presents results of the binary logistic regression an-
alyses. Even though the table lists all of the measures together,
each covariate of interest was entered separately in the models,
while controlling for age, race, and sex. Just over 7% of our sample
identied as nonheterosexual and those who did were three
times more likely to post something online that was mean about
themselves than heterosexual students and 2.75 times more
likely to say they cyberbullied themselves. Nearly 40% of students
had been bullied at school, and 16.5% had been bullied online.
Both groups were signicantly more likely to have participated in
digital self-harm than those who were not bullied. Specically,
victims of cyberbullying were nearly 12 times as likely to have
cyberbullied themselves compared to those who were not vic-
tims. Similarly, those who reported using drugs or participating
in deviance, had depressive symptoms, or had previously
engaged in self-harm behaviors ofine were all signicantly
more likely to have engaged in digital self-harm.
To better understand the nature and motivations for this
behavior, we included an open-ended question where we simply
asked respondents to tell us why they had engaged in digital self-
harm. Among the 347 students who reported that they had
posted something mean about themselves anonymously online,
160 provided comments about why they did it (see Table 3). Most
comments centered around certain themes: self-hate (32), That
time was a time full of hate for myself;attention seeking (13),
So people could see that people bully me too and that I could
be mean to other people because peoplewere mean to
me;depressive symptoms (15), I did it mainly out of depression
and a time that I was feeling suicidal; and, to be funny (24), Ido
not like hurting others, but its easy to make fun of myself. I was
bored and did it to maybe make others laugh as a joke.Others
were simply doing to see if anyone would react (20), A couple
times to see how people I know would react so I would know if
they were talking about me behind my back.
Digital self-harm rst gained public attention with the suicide
of 14-year-old Hannah Smith in 2013. In November 2016, a
15-year-old girl from Texas took her own life after apparently
posting anonymous comments toward herself saying she was
uglyand should kill herself.[38]. Despite these heartbreaking
examples, very little academic attention has been directed
toward this problem. The current work is the rst comprehensive
empirical investigation of this behavior among middle and
high school students. According to our data, about one in twenty
12- to 17-year-olds have participated in the behavior. In addition,
students who reported being depressed or participating in off-
line self-harm were signicantly more likely to be involved in
digital self-harm. Research has shown that self-harm and
depression are linked to increased risk for suicide and so, like
physical self-harm and depression, it is possible that digital self-
harm behaviors might precede suicide attempts [7e9]. More
research is necessary to better understand the temporal ordering
of these behaviors and experiences. For example, does depres-
sion lead to self-harm (online or ofine) which then leads to
suicidal thoughts or attempts? Alternatively, do suicidal
thoughts manifest themselves as various forms of self-harm that
can surface ofine and/or online?
The ndings also illustrate a connection between digital self-
harm and experience with bullying. Those who were bullied
(either at school or online) were signicantly more likely to
report that they had engaged in digital self-harm. This was
evidenced in the open-ended responses as well. A 16-year-old
white female wrote: After this happened at school, and online,
I became very depressed. I didnt like myself very much. I felt like
I deserved to be treated that way, so I thought I would get in on
the fun.Research has shown that some who have self-harmed
have experienced interpersonal conict or relationship break-
down [6,16]. As such, it is logical that relational conict, drama,
Table 1
Experience with digital self-harm
size (%)
I have anonymously
posted something
online about myself
that was mean (%)
I have anonymously
myself (%)
Total 5,593 6.2 5.3
Male 2,777 (49.7) 7.1
Female 2,792 (49.9) 5.3 4.2
3,691 (66.0) 6.4 5.4
African-American 637 (12.0) 5.8 4.8
Hispanic 667 (11.9) 4.8 4.1
Other 561 (10.0) 7.3 6.0
12 850 (15.2) 6.1 4.4
13 1,011 (18.1) 6.9 5.9
917 (16.4) 5.7 5.0
15 1,018 (18.2) 7.4 7.2
16 946 (16.9) 5.6 4.2
17 851 (15.2) 5.5 4.6
p<.01, t-test.
represents reference group.
Table 2
Logistic regression examining predictors of digital self-harm
% I have anonymously posted something online about myself that was mean I have anonymously cyberbullied myself
B (S.E.) Exp(B) 95% CI B (S.E.) Exp(B) 95% CI
Nonheterosexual 7.2 1.09 (.16) 3.00
2.19e4.04 1.01 (.21) 2.75
Victim of school bullying 38.6 1.34 (.13) 3.82
2.99e4.89 1.71 (.16) 5.53
Victim of cyberbullying 16.5 2.02 (.12) 7.51
5.99e9.41 2.48 (.15) 11.88
Deviance 6.3 2.21 (.19) 9.14
6.35e13.16 2.57 (.20) 13.07
Used drugs 9.0 1.60 (.19) 4.95
3.43e7.16 1.84 (.21) 6.28
Depressive symptoms 15.4 1.58 (.16) 4.86
3.57e6.62 1.64 (.18) 5.17
Ofine self-harm 7.2 .87 (.08) 2.38
2.03e2.79 .98 (.09) 2.67
All analyses include individual indicator while controlling for age, sex, and race.
CI ¼condence interval; SE ¼standard error of the mean.
J.W. Patchin and S. Hinduja / Journal of Adolescent Health xxx (2017) 1e64
and strifedmanifested in school based or online bullyingd
might trigger self-harming behaviors because of the dysphoria it
It was also evident from the qualitative data that many who
had participated in digital self-harm were looking for a response.
Of the 160 responses to the question of why the youth engaged in
digital self-harm, nearly half (73) included some reference to
others. For example, a 14-year-old white male from Wisconsin
said that he wanted other peoples pityand wanted to be
validated that someone did actually care about me.Some
thought it would be a way to get help, like a 14-year-old male
from Virginia: Everyone is going to have moments in their lives
hating themselves, sometimes it helps posting about it online.
People try to help you out and make you feel better. The internet
might be a terrible place, but there [are] tons of people around
the world who [are] willing to help you.As such, these incidents
are often outwardly visible and therefore subject to our obser-
vation and intervention. Parents, youth-serving professionals,
and teens themselves should be trained to identifydand
empowered to intervenedin all instances of online abuse, irre-
spective of who is responsible. A rst step would be to
acknowledge the hurtful content and offer support to the target.
Later, an investigation can be performed to determine whether
the cyberbullying was self-inicted (and, if so, the motivations
for such behavior).
Even though the current study was able to shed some addi-
tional light on the understudied problem of digital self-harm, it is
not without limitations. We sought to obtain a nationally
representative sample of middle and high school students across
the U.S. but can never be certain of the generalizability of the
sample of youth who ultimately completed surveys. Even though
the demographic characteristics of the sample closely match to
those of the U.S. as a whole, there could be uncontrolled for
differences between those who ultimately agreed to complete
our survey and those who did not. Moreover, the low response
rate (about 15%) suggests that the ndings should be interpreted
with caution. Another limitation is that the data were collected at
one point in time. As a result, we are unable to ensure proper
temporal ordering of key variables and therefore do not know
whether experience with bullying at school caused students to
engage in digital self-harm or if these behaviors occurred
concurrently. In fact, it is possible that many of the experiences
examined in this study co-occurdthat is, that digital self-harm is
another manifestation of depression [39]. Finally, some have
argued that data stemming from individualsrecollection about
the past are inherently unreliable because of the tendency
for them to misrepresent or distort facts from a previous time
period [40].
Considerations for future research
One notable concern that bears mention has to do with the
perceived prevalence and acceptability of digital self-harm
among youth. Research on traditional self-harm has identied
a clustering and contagion effect among young people and that
knowledge of self-harming among ones immediate peer group is
a noteworthy risk factor for similar engagement [41,42]. More-
over, messages on social media sites like Facebook, YouTube,
Tumblr, Instagram, and Twitter which condone or even
encourage this behavior might contribute todor exacerbated
the problem [43,44], even though the Terms of Service of most
sites specically ban representations of self-harm. If a critical
mass of adolescents comes to believe that self-cyberbullying is a
normative and justiable behavior, or if disclosure or help
seeking is discouraged in certain online channels of communi-
cation, it stands to reason that others may be more inclined to
It is also unclear whether those who self-harmed online did
so because they were genuinely but maladaptively coping with
serious pain or stressors in their lives or if they intentionally lied
to provide themselves some sort of misguided pleasure in
deceiving others. Over the last 20 years, the latter explanation
has been explored by journalists [45,46] and researchers [47,48]
who have examined how some individuals have virtual facti-
tious disorderand gravitate online to fake pain and suffering in
various Internet-based support groups (now termed Munchau-
sen by Internet or MBI). Future inquiries should esh out dif-
ferences in participantsmotivations and rationalizations in
order to determine whether medicine, cognitive behavior ther-
apy, or other psychiatric approaches are best suited to help these
self-harmers. It has also been suggested that MBI be formally
acknowledged as a disorder in a revised version of the Diagnostic
and Statistical Manual (DSM-5) to help identify and minimize its
growth [47]. Perhaps, subsequent research will strengthen the
case for such a call.
Given that human beings are highly responsive to cultural
and social norms, and this aspect of the prevention of suicide and
self-harm has been neglected[6], educators, coaches, mentors,
celebrities, athletes, and other adults who have a platform and
voice into the lives of youth should continue to speak out against
any form of self-injurious behavior. This has been done with the
help of new technology and social media by various organiza-
tions (such as To Write Love On Her Arms [], which
caters to millennials and the It Gets Better project [itgetsbetter.
com], which focuses on LGBT youth). We believe these efforts
should be redoubled by other far-reaching entities, especially
given the powerful and unparalleled inuence that digital con-
tent and communications have on this population.
Table 3
Motivations for digital self-harm
Motivation Number Example
Self-hate 32 Self-hate is a strong thing.”“Because I
already felt bad and just wanted myself
to feel worse.
To be funny 24 I dont like hurting others, but its easy to
make fun of myself. I was bored and did
it to maybe make others laugh as a
Looking for reaction 20 I did it to see what others were saying
and to see how others saw me.”“I
wanted to see if someone was really
my friend.
Depressive symptoms 15 Because I was very sad and upset and
nobody would listen or talk to me so I
posted how I really felt about myself
Attention seeking 13 Because I feel sad and needed attention
from others.
Other 61 At the time, I had very low self-esteem
and didnt rely on myself for happiness,
I expected others to make me happy.
This resulted in my own belief that
everyone hated me, which was of
course completely false.
J.W. Patchin and S. Hinduja / Journal of Adolescent Health xxx (2017) 1e65
To be sure, much more work needs to be done to understand
digital self-harm. As boyd aptly points out, irrespective of who
the perpetrator is, targets of cyberbullying need help. Teens who
are the victims of bullyingdwhether by a stranger, a peer, or
themselvesdare often in need of support, love, validation, and,
most of all, healthy attention[13]. Researchers should continue
to shed light on the epidemiological precursors and enduring
associated outcomes of digital self-harm. Their efforts can then
inform the work of youth professionals, who must consider the
gravity of this phenomenon and collectively work to develop
therapies and programming to provide struggling teens with the
help they need well before they decide to hurt themselves.
Funding Sources
The data utilized in this study were collected through a grant
from the Digital Trust Foundation (#31-3).
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J.W. Patchin and S. Hinduja / Journal of Adolescent Health xxx (2017) 1e66
... To date, very few studies have investigated the causal mechanisms as well as the distal and proximal correlates of digital self-harm. Recent research, however, demonstrates positive associations between digital self-harm and physical self-harm (Patchin & Hinduja, 2017) as well as common etiological pathways between these two constructs; further, negative emotions have been found to partially mediate the association between bullying victimization and engagement in digital self-harm . Similarly, digital self-harm shares overlapping correlates with bullying victimization and physical self-harm behaviors, such as sleep deficiencies and depressive symptoms (Semenza et al., 2021). ...
... Depressive symptoms are common in youth with greater cumulative exposure to ACEs (Blum et al., 2019) and are salient predictors of delinquency in adolescents (Kofler et al., 2011). According to prior research, adolescents with depressive symptoms are also more likely to engage in digital self-harm (Patchin & Hinduja, 2017). Given the strong, positive associations between bullying victimization and digital self-harm Patchin & Hinduja, 2017) and the positive associations between bullying victimization and increased levels of depressive symptoms in adolescents (Glassner, 2020), depressive symptoms may represent a key pathway to digital self-harm. ...
... According to prior research, adolescents with depressive symptoms are also more likely to engage in digital self-harm (Patchin & Hinduja, 2017). Given the strong, positive associations between bullying victimization and digital self-harm Patchin & Hinduja, 2017) and the positive associations between bullying victimization and increased levels of depressive symptoms in adolescents (Glassner, 2020), depressive symptoms may represent a key pathway to digital self-harm. Adolescents high in internalizing symptoms are also more likely than adolescents with co-occurring internalizing and externalizing symptoms to demonstrate asocial tendencies with peers in adolescence (Fanti & Henrich, 2010). ...
Full-text available
Drawing on Agnew's general strain theory, this study investigates the extent to which adverse childhood experiences (ACEs) are associated with engagement in digital self-harm-the anonymous posting of mean or hurtful information about oneself on the internet and social media platforms. It also assesses the extent to which depressive symptoms mediate this association. To address these two issues, we use data collected from 7,799 middle-school and high-school students who participated in the 2019 Florida Youth Substance Abuse Survey. The results indicate a strong, positive association between cumulative ACEs and recent engagement in digital self-harm, with nearly 50% of this association operating through depressive symptoms. The findings of this study add to the growing body of research linking ACEs to maladaptive behavior, and they identify a new potential causal pathway for understanding youth engagement in digital self-harm.
... At the same time, if the metabolome (as a biochemical trace of a disorder) has yet to be assessed in terms of specificity in relation to behavioral deviations, then the search for traces in social networks already gives certain results. For example, the digital footprint of young people who committed self-harm differed on social network profile pages from the control group in the ется несколько аспектов этой проблемы -как использовать явные и неявные признаки суицидальности, проявляющиеся в информационном пространстве в сочетании с генетической информацией для предикции и превенции суицидов [108], и какие из этих сигналов можно расценивать как своеобразную цифровую аутоагрессию -изображение себя в негативном ключе [109]. Таким образом, самые современные и технологичные подходы к анализу данной проблемы также свидетельствуют о взаимосвязи агрессии и аутоагрессии. ...
... Как любой биологически укоренённый инстинкт, зави-presence of aggressive content and the abundance of images with aggressive content [107]. The literature simultaneously discusses several aspects of this problemhow to use explicit and implicit signs of suicidality, manifested in the information space in combination with genetic information for the prediction and prevention of suicides [108], and which of these signals can be regarded as a kind of digital autoaggression -the image of oneself in in a negative way [109]. Thus, the most modern and technological approaches to the analysis of this problem also indicate the relationship between aggression and auto-aggression. ...
... Digital self-harm is the anonymous online posting, sending, or sharing of hurtful content about oneself. The motivations behind this behaviour still need to be properly investigated (Patchin & Hinduja, 2017). Another aspect related to the internet and NSSI is internet addiction. ...
Full-text available
In this study, the researcher investigated the effectiveness of Gestalt Psychotherapy with adolescents engaging in Non-Suicidal Self-Injury (NSSI). Adolescents are sometimes overwhelmed by anger, sadness, anxiety, and self- loathing. Some resort to self-injury as a means of refocusing emotional pain into a physical behaviour they can control. Using a small-sample quasi-experimental design, the researcher offered Gestalt therapy to seven adolescents between 12 and 14 years of age and assessed their NSSI at entry point using ISAS. They were also assessed using ABUSI, GAD -7 and KADS -11 at three different stages. The therapeutic journey of each adolescent was then recorded using a Narrative style of Inquiry. The results indicated that Gestalt Therapy is very effective with this population. All seven of the adolescents stopped self-harming. In the majority of cases, the depression, anxiety, and urge to self-harm disappeared. As an outcome of this research, the author developed the NSSI Gestalt Cycle of Experience which can be used by other therapists to understand NSSI in adolescents.
... Num contexto de uso generalizado das tecnologias digitais pelos adolescentes, têm-se registado uma nova forma de agressão dirigida ao próprio, designada de digitalself-harm, münchausen digital (FELDMAN, 2000;ENGLANDER, 2012;PATCHIN, HINDUJA, 2017) ou autocyberbullying, por serem perpetradas recorrendo aos media digitais.Trata-se de um comportamento praticado de forma deliberada e anónima por um indivíduo, que consiste em provocar dano psicológico a si próprio recorrendo à simulação Educação, Psicologia e Interfaces, Volume 2, Número 2, p. 57-76, Maio/Agosto, 2018. ISSN: 2594-5343. ...
O autocyberbullying traduz uma forma de autoagressão premeditada e anónima, concretizada predominantemente nas redes sociais, nos jogos online e SMS. As vítimas autoagressivas procuram, sobretudo, aliviar estados de angústia, raiva e frustração, alertar para situações de vitimização por qualquer forma de bullying ou conquistarem atenção. A prevalência desta forma de autoagressão digital entre os adolescentes portugueses permanece desconhecida. Este estudo exploratório, transversal, descritivo e quantitativo teve como objetivo conhecer a prevalência do autocyberbullying, a sua relação com algumas variáveis sociodemográficas e com a reprovação escolar. Participaram 914 adolescentes do 3º ciclo, sendo 50,3% rapazes. Foi usado o Questionário Perceção dos Alunos sobre Autocyberbullying, aplicado online. Realizaram-se análises estatísticas, descritivas e inferenciais. Como principais resultados destacam-se a prevalência de 7,4%, sendo 68,7% rapazes e a correlação significativa entre a reprovação e autocyberbullying. Verificou-se que, no grupo de autocyberbullies, os alunos que já tinham reprovado apresentavam uma média de frequência do comportamento autocyberbullying, superior à dos que nunca tinham reprovado. Evidencia-se que o mal-estar que este comportamento proporciona requer a atenção dos profissionais da saúde, da educação e dos pais, a definição de políticas conjuntas de educação e saúde e uma intervenção que previna este comportamento nos adolescentes. Sugere-se que combater o insucesso pode constituir uma estratégia de intervenção secundária que vise prevenir o autocyberbullying. É importante retomar o tema em estudos futuros de caráter mais amplo.
... Over the past decade, young people have increasingly been using social networking sites as locations for identity exploration (Patchin & Hinduja, 2017). Research concerning social networking sites and identity development has thus far been dominated by the notion that such platforms provide convenient and powerful venues for self-disclosure and self-presentation. ...
Full-text available
Callous-unemotional (CU) traits are a temperament dimension associated with more severe antisocial behaviour. Children with CU traits are low academic achievers, but unlike antisocial children without CU traits, they do not possess poor intelligence. This suggests heterogeneous risk pathways for poor academic performance in antisocial children with, versus without CU traits. However, most research has been conducted on parenting, with the school context largely neglected. This article aims to provide an overview of the theory explaining the relationship between CU traits and poor academic outcomes and how it can be expanded to inform school-based interventions for children with CU traits.
... According to some study findings, these victims are more prone to display more behavioral problems than the adolescents with no such experiences (Sandhu & Kaur, 2016) and have significant health care problems (Ouytsel et al., 2015;Przybylski & Bowes, 2017) including psychological health problems (Chu et al., 2018;Fahy et al., 2016;Landoll et al., 2015;Uçar et al., 2020;Yuchang et al., 2017;Wright, 2015). As the cases of cyberbullying behavior (Eroglu et al., 2015;Patchin & Hinduja, 2017;Safaria et al., 2016) and the number of victims increases, it becomes more and more important to raise awareness of cyberbullying behaviors among people, especially parents and school staff. Despite the high number of cyber-victimization/bullying cases (Eroglu et al., 2015;Ahern et al., 2016) reported that only 20% of parents check their children's Internet use. ...
Full-text available
Cyberbullying awareness of parents is significant to reduce exposure to cyberbullying. However, it is noteworthy that there are limited studies on the factors affecting parents’ knowledge and competencies about cyberbullying and the change of these factors according to the education level of the child. This study aims to determine the relationships among cyberbullying knowledge and competence levels of parents with children studying in K-12 and mediation in children’s Internet use, family harmony and technology usage experience and examine how it differs according to the child’s education level. This study was done with a representative sample consisting of 662. It was found that the competencies of the parents in preventing cyberbullying were related to positive harmonious relationships within the family, technology use experience and parental mediation. The results indicate that positive parental involvement can be predicted from higher scores in parental knowledge in cyberbullying, perception of parental competence, risk adjustment, and attribution of parental responsibility. In addition, instead of parents’ restrictive mediation styles in their children’s use of technology, the co-use, active mediation, and supervision styles can help reduce the likelihood of children being exposed to risks such as cyberbullying and victimization. In the multi-group analyzes made, it is seen that the research model works at the primary school level with the highest explanation rate. Moreover, it was concluded that different mediation types were effective for primary, secondary, and high school levels.
Using a quasi‐experimental, cross‐sectional design, we examined coping differences among American adolescents who reported a history of nonsuicidal self‐injury (NSSI; n = 90, 25.7%) and those without a history of NSSI (n = 260, 74.3%). Findings from a profile analysis indicated that a measurable difference in coping profiles may exist between those with a history of NSSI and those without a history of NSSI. Specifically, adolescents who have a history of NSSI appear to rely upon, at higher rates, maladaptive methods of coping, including acting out and rumination, in comparison to adolescents who have never engaged in NSSI, who appear to rely upon adaptive methods of coping, including distraction and self‐care, at higher rates. No meaningful difference was apparent between groups on seeking social support as a method of coping. These findings confirm the importance of assessing and enhancing effective coping strategies among adolescent clients who self‐injure and potentially utilizing coping skill enhancement strategies as a form of NSSI prevention.
Recent estimates suggest between 5–10% of U.S. adolescents report engaging in digital self-harm. Despite these troubling figures, there remains a paucity of empirical work investigating factors contributing to this relatively new yet harmful behavior. Guided by the robust research base linking weak parental attachment to self-harm, this study uses Agnew’s general strain theory to investigate whether parental attachment influences adolescents’ propensity to engage in digital self-harm, and whether this relationship occurs indirectly through negative affective states. Using data from the 2019 Florida Youth Substance Abuse Survey, the results of this study indicate that even after adjusting for a range of potential confounding influences such as age, family drug problems, race, and self-control, weak parental attachment significantly increased one’s odds of engaging in digital self-harm, with most of this relationship occurring indirectly through adolescents’ negative emotions. The results of this study provide researchers and families with important information that may help them in reducing the prevalence of this destructive behavior.
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Studies on liquid identity have been done by many previous researchers. However, this article sees it differently where liquid identity is experienced by adolescents with disabilities who basically have many difficulties, obstacles in interacting with society in general. This study aimed to look at the process, intention, and purpose of the liquid identity experienced by adolescents with disabilities on social media. This study used a virtual ethnographic method with informants who are members of the Facebook community named “Indonesian Association of People with Disabilities.” The number of informants is 23 adolescents with disabilities who are users of social media. The findings of this study showed that adolescents with disabilities take various ways to get recognition and acceptance by a wide audience according to their type and characteristics. This is done by using social media called liquid identity. To get recognition and acceptance on social media, the practice of liquid identity of adolescents with disabilities was shown by hiding their real identity, having multiple accounts, and sharing positive things on social media. This study concluded that support from various parties is needed, either from the community, parents, friends, schools, and the environment. The role of these parties is important to provide motivation, enthusiasm, and encouragement so that adolescents with disabilities can show value on social media with their identity that is recognized by the public as a positive identity.
Technical Report
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This report describes research conducted in 2011 and 2012 on 617 subjects, 10% of whom reported self-cyberbullying. The report details the frequency of self-cyberbullying in boys versus girls (17% versus 8%) and the frequency of the incidents in questions. The data also reveals some of the characteristics of self-cyberbullies, their motivations for digital self-­‐harm and the relative success of the tactic.
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One question that arises when discussing the usefulness of web-based surveys is whether they gain the same response rates compared to other modes of collecting survey data. A common perception exists that, in general, web survey response rates are considerably lower. However, such unsystematic anecdotal evidence could be misleading and does not provide any useful quantitative estimate. Metaanalytic procedures synthesising controlled experimental mode comparisons could give accurate answers but, to the best of the authors' knowledge, such research syntheses have so far not been conducted. To overcome this gap, the authors have conducted a meta-analysis of 45 published and unpublished experimental comparisons between web and other survey modes. On average, web surveys yield an 11% lower response rate compared to other modes (the 95% confidence interval is confined by 15% and 6% to the disadvantage of the web mode). This response rate difference to the disadvantage of the web mode is systematically influenced by the sample recruitment base (a smaller difference for panel members as compared to one-time respondents), the solicitation mode chosen for web surveys (a greater difference for postal mail solicitation compared to email) and the number of contacts (the more contacts, the larger the difference in response rates between modes). No significant influence on response rate differences can be revealed for the type of mode web surveys are compared to, the type of target population, the type of sponsorship, whether or not incentives were offered, and the year the studies were conducted. Practical implications are discussed.
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Objectives To investigate the mental health, substance use, educational, and occupational outcomes of adolescents who self harm in a general population sample, and to examine whether these outcomes differ according to self reported suicidal intent. Design Population based birth cohort study. Setting Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of children born in 1991-92. Participants Data on lifetime history of self harm with and without suicidal intent were available for 4799 respondents who completed a detailed self harm questionnaire at age 16 years. Multiple imputation was used to account for missing data. Main outcome measures Mental health problems (depression and anxiety disorder), assessed using the clinical interview schedule-revised at age 18 years, self reported substance use (alcohol, cannabis, cigarette smoking, and illicit drugs) at age 18 years, educational attainment at age 16 and 19 years, occupational outcomes at age 19 years, and self harm at age 21 years. Results Participants who self harmed with and without suicidal intent at age 16 years were at increased risk of developing mental health problems, future self harm, and problem substance misuse, with stronger associations for suicidal self harm than for non-suicidal self harm. For example, in models adjusted for confounders the odds ratio for depression at age 18 years was 2.21 (95% confidence interval 1.55 to 3.15) in participants who had self harmed without suicidal intent at age 16 years and 3.94 (2.67 to 5.83) in those who had self harmed with suicidal intent. Suicidal self harm, but not self harm without suicidal intent, was also associated with poorer educational and employment outcomes. Conclusions Adolescents who self harm seem to be vulnerable to a range of adverse outcomes in early adulthood. Risks were generally stronger in those who had self harmed with suicidal intent, but outcomes were also poor among those who had self harmed without suicidal intent. These findings emphasise the need for early identification and treatment of adolescents who self harm.
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Published prevalence estimates of nonsuicidal self-injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. Accordingly, the objectives of this study were to investigate the influence of methodological factors on heterogeneity in NSSI prevalence estimates, explore changes over time, and estimate overall international NSSI prevalence. Results showed that methodological factors contributed over half (51.6%) of the heterogeneity in prevalence estimates, and, after adjusting for these factors, NSSI prevalence did not increase over time. Overall, pooled NSSI prevalence was 17.2% among adolescents, 13.4% among young adults, and 5.5% among adults. Clearly, development of standardized methodology in NSSI research is crucial if accurate estimates are desired.
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This inquiry shows how youths negotiate sexualities and gender when commenting on profile pictures on a social networking site. Attention is given to (1) how discourses are constituted within heteronormativity, and (2) how the mediated nature of the SNS contributes to resistance. Using insights from cultural media studies, social theory and queer criticism, self-representations in SNSs are viewed as sites of struggle. A textual analysis is used to show how commenting on a picture is a gendered practice, continuously cohering between the biological sex, performative gender and demanded desire. Although significant resignifications are found, they are often accompanied by a recuperation of heteronormativity. Therefore, this inquiry argues for continued attention to current contradictions in self-representations.
As platforms for self-expression, social media sites require users to consciously, visibly, and deliberately perform their identity. While a dominant developmental discourse encourages young people to test and explore different identities, a self-conscious and highly visible performance of identity via social media brings into question the form and value of this activity. This article reviews a range of popular arguments about how young people use media, and demonstrates how this use comes into conflict with a broader developmental discourse. It proposes that this conflict contributes to the perception that young people's media use is dangerous for healthy development, and that a different kind of approach to youth is needed. Engaging Judith Butler's notion of performativity, the article argues that social media and the structures of performative display are a way to reconceptualise youth and the relationship between social media and young people's self-development.
Purpose: Nonsuicidal self-injury (NSSI) content is present on social media and may influence adolescents. Instagram is a popular site among adolescents in which NSSI-related terms are user-generated as hashtags (words preceded by a #). These hashtags may be ambiguous and thus challenging for those outside the NSSI community to understand. The purpose of this study was to evaluate the meaning, popularity, and content advisory warnings related to ambiguous NSSI hashtags on Instagram. Methods: This study used the search term "#selfharmmm" to identify public Instagram posts. Hashtag terms co-listed with #selfharmmm on each post were evaluated for inclusion criteria; selected hashtags were then assessed using a structured evaluation for meaning and consistency. We also investigated the total number of Instagram search hits for each hashtag at two time points and determined whether the hashtag prompted a Content Advisory warning. Results: Our sample of 201 Instagram posts led to identification of 10 ambiguous NSSI hashtags. NSSI terms included #blithe, #cat, and #selfinjuryy. We discovered a popular image that described the broader community of NSSI and mental illness, called "#MySecretFamily." The term #MySecretFamily had approximately 900,000 search results at Time 1 and >1.5 million at Time 2. Only one-third of the relevant hashtags generated Content Advisory warnings. Conclusions: NSSI content is popular on Instagram and often veiled by ambiguous hashtags. Content Advisory warnings were not reliable; thus, parents and providers remain the cornerstone of prompting discussions about NSSI content on social media and providing resources for teens.
Objective: Despite consistently greater rates of non-suicidal self-injury (NSSI) and suicidal thoughts and behaviors (STBs; i.e., suicidal ideation, method/plan, and attempts) in lesbian, gay, and bisexual (LGB) individuals, prevalence, characteristics, and relations between these dangerous thoughts and behaviors are equivocal. The present study sought to examine and compare the rates of NSSI and STBs in a large sample of sexual minority and majority young adults. In addition, this study is the first to our knowledge to examine how different NSSI characteristics (i.e., frequency, number of forms, and number of functions) relate to STBs of varying severity by sexual attraction (SA). Methods: Participants were 12,422 college students (ages 18-29; 57.3% female) who self-reported demographic characteristics, NSSI frequency, the number of NSSI forms used, the number of NSSI functions, as well as STB history (i.e., ideation, method/plan, and attempts). Each participant’s degree of SA was assessed via a 7-point scale (i.e., K0-K6) from Alfred Kinsey’s research of sexual attraction and sexual experiences. This scale was collapsed to create five categories of SA: exclusively other SA (K0), mostly other SA (K1/2), equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6). Respondents who chose two or more groups were categorized as having equally other and same SA (K3). Results: Consistent with previous research, we found that being a sexual minority young adult was associated with significantly higher odds of STBs compared to being a heterosexual young adult. In addition, compared to the exclusively other SA group (K0), being in the mostly other SA group (K1/2), equally other and same SA group (K3), or mostly same SA group (K4/5) was associated with significantly higher odds of NSSI engagement. Among those with NSSI, we found that the number of NSSI forms was significantly associated with suicide attempts, but was not associated with either suicidal ideation or suicide method/plan in the mostly other SA group (K1/2) or in the equally other and same SA group (K3). We also found a significant curvilinear relation between NSSI frequency and STBs in the mostly other SA group (K1/2) and between NSSI frequency and suicide method/plan and attempt in the exclusively other SA group (K0). In addition, we revealed specificity with regard to the relation between the number of lifetime NSSI episodes and risk for STBs among the equally other and same SA (K3), mostly same SA (K4/5), and exclusively same SA (K6) groups. Conclusion: Our findings suggest that among sexual minority young adults, equally other and same SA individuals may be at higher risk of NSSI and STBs than their sexual minority counterparts. In addition, our findings extend previous research by suggesting that the relation between NSSI frequency, number of forms, and number of functions and STBs might vary according to SA. A multi-theory based explanation is provided to explain the key findings and the study implications are discussed.
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