Strong link observed between online forums and suicide risk, study says
THURSDAY, Oct. 31, 2013 (HealthDay News) -- While social media can help vulnerable teenagers seeking support, Internet use can do more harm than good for young people at risk of self-harm or suicide, a new study suggests.
Researchers from Oxford University in England found conflicting evidence on whether online activity poses a positive or negative influence for vulnerable teens, but observed a strong link between the use of Internet forums or "chat rooms" and an increased risk of suicide.
"I think it's surprising that so little is known about the Internet and suicidal behavior given its importance," said senior study author Paul Montgomery, a professor of psycho-social intervention at Oxford's Center for Evidence-Based Intervention. "But I am unsurprised that what we found appears to be generally negative, as these vulnerable kids often feel isolated. We need to support such kids a great deal more [and] ask about their Internet usage."
Globally, Internet use increased by more than 566 percent between December 2000 and June 2012, according to the study authors. Although this new study links more extensive Internet use with higher rates of self-harm, it doesn't prove that computer use caused the self-injurious behavior.
For the report, published Oct. 30 in the journal PLoS ONE, Montgomery's team reviewed 14 studies from Western countries and Asia about Internet use and self-harm or suicide among young people. The investigators found that some studies suggested Internet forums support socially isolated people, helping them to cope. But others concluded that young people who went online to find out more about self-harm and suicide were exposed to violent imagery and acted out what they had seen online.
Moderate or severe addiction to the Internet is also connected to higher risks of self-harm and increased levels of depression or thoughts of suicide, the study authors said. Use of chat rooms was strongly linked to greater risks of suicide -- a connection not observed in relation to other social networking sites.
One specialist thinks he knows why.
"In chat rooms, self-harm can be normalized," said Dr. Matthew Lorber, acting director of child and adolescent psychiatry at Lenox Hill Hospital in New York City. "I've observed this in my own practice. A teen told me she went to a chat room on cutting, where basically a lot of teens were acting as if it were cool and no big deal.
"The Internet also provides access to suicidal content, like how to cut or kill yourself, and certainly that information is readily available," added Lorber, who wasn't involved in the research.
In the United States each year, about 4,600 people between 10 and 24 years old take their own lives, and many more survive suicide attempts, according to the U.S. Centers for Disease Control and Prevention. About 157,000 young people receive emergency room treatment for self-inflicted injuries.
In one study Montgomery's team reviewed, 59 percent of young people said they had researched suicide online, and 80 percent of those who had carried out particularly violent acts of self-harm said they had researched self-harm online beforehand.
Another study showed that out of nearly 300 posts, 9 percent were about methods of self-harm, and users swapped tips in chat rooms on how to conceal the behavior. While some adolescents used the forums to congratulate one another for not cutting and provided emotional support for one another, no evidence suggested the support translated into reduced levels of self-harm.
Cyber-bullying was found to make victims more likely to self-harm, and one study suggested online bullying put both victims and perpetrators at higher risk of attempted suicide.
How to help these at-risk adolescents remains a concern. Lorber said group therapy is often helpful "because they have the opportunity to make social connections in a protected place, and then they feel they're not the only ones who feel that way."
He also encourages parents to open the lines of communication between themselves and their teens by engaging in joint activities, even playing video games together.
"I definitely agree with the mixed message of the study," Lorber said. "What it really means to me is, there are significant positives and significant negatives that come with the Internet. We just need to see how to maximize the positives and minimize the negatives."
The Pew Research Center offers more facts about teen Internet use (http://www.pewresearch.org/millennials/teen-internet-use-graphic/ ).
SOURCES: Paul Montgomery, D.Phil., professor, psycho-social intervention, Center for Evidence-Based Intervention, University of Oxford, Oxford, England; Matthew Lorber, M.D., acting director, child and adolescent psychiatry, Lenox Hill Hospital, New York City; Oct. 30, 2013, PLoS ONE