Non-suicidal self-injury is something that occurs amongst teens and young adults in alarming rates. Current research indicates that almost 1 in 4 teens engages in some sort of deliberate self-harm as a means of regulating emotion. This is an area of great interest to me and one that I specialize in within my private practice. I was very excited to be part of this segment, as I do think that it is an under-examined, and under-reported phenomenon happening amongst our youth, despite the high numbers of teens reporting engaging in the behavior.
Below are some important questions and answers regarding NSSI and the study conducted looking at YouTube and how certain videos may trigger increases in the behavior amongst our young people.
WHAT DOES NSSI MEAN?
Nonsuicidal self-injury (NSSI) refers to the deliberate destruction ofone’s body tissue in the absence of conscious suicidal intent. A fewcommon forms of NSSI include cutting, burning, and hitting oneself.Overall, cutting was the most commonly depicted NSSI method, followed byself-embedding, burning, and then, less frequently, acts includinghitting, biting, skin picking, and wound interference.
Teens engage in these behaviors as a means to regulate their emotions. Many people have healthier outlets for managing their feelings. When angry, maybe you go to the gym; when sad, maybe you watch weepy soap operas. For people who engage in NSSI, those types of things do not provide relief and often they look to other means. When feeling emotions intensely, NSSI may be the only thing that provides a sense of calm. Since it works to relieve the emotional pain, its use gets reinforced, thus leading the teen to do it again and again.
WHY DID THIS STUDY FOCUS ON YOUTUBE?
Since its inception in 2005, YouTube has not only been recognized as thelargest and fastest-growing video-sharing website, but it currentlyreceives the third most traffic of all websites on the Internet. Youngadults use the Internet — and Youtube — more than other age groups andrepresent those at highest risk for NSSI.
THIS HAS NEVER BEEN ADDRESSED/STUDIED BEFORE?
Previous works have examined NSSI on the Internet, but no studies haveexamined NSSI imagery. This is the first study to formally examine thisnew phenomenon, which has implications for risk, prevention, andmanagement. We can compare this situation to the sites in the late 1990s and early 2000s that promoted anorexia and bulimia.
WHAT IS SO DANGEROUS ABOUT ONLINE COMMUNICATION ABOUT NSSI?
Online communication about NSSI by youth can exacerbate the risk forNSSI repetition via a “social contagion” effect… In other words it canreinforce the behavior through normalization. The possible impact of this material on viewers is certainly worrisome. Research indicates that some youth who self-injure find this material upsetting and triggering — especially for those who have enacted NSSI repetitively and for youth who have just started to self-injure.
HOW PREVALENT AMONG TEENS IS THIS?
Uploaders of NSSI videos, within this study, reported a mean age of 25-39 years and weremostly female (95%). (However, the actual mean age is likely lowerbecause several individuals indicated on their profile page that theywere younger (eg, age 14 years) yet adopted an older identity to accessmore YouTube content.) Given its high rates (14-24%) and co-occurrencewith psychiatric difficulties, non-suicidal self-injury among youth isworrisome.
IS IT EASY TO FIND THIS STUFF ONLINE?
80% of videos are accessible to a general audience. NSSI videos receivefrequent viewership and often are discussed and rated favorably. NSSI videos on YouTube sometimes have a trigger warning, which indicates to viewers that the video content might be upsetting and may evoke NSSI thoughts and behavior. In our study, over half of the videos did not provide the audience with a trigger warning. And few actively discourageNSSI.
AS A PARENT, IF YOU ARE CONCERNED, WHERE SHOULD YOU BE LOOKING ON YOUR CHILD FOR SELF-INJURY MARKS?
Generally, NSSI occurs on the arms, upper thighs, or abdomen. If you are concerned that this may be occurring with your teen, look for a few distinctive things:
- Is your teen wearing long sleeves/long pants all the time, even if the weather promotes shorts and short sleeves? Will he/she not let you see his/her body at all?
- After an argument or a period of being upset, does your teen remove herself from the situation briefly, only to return in a significantly more positive mood?
- Does your teen have unexplained cuts on his body that he “excuses” away?
- Are you finding drops of blood around? Bandaids being used more?
If you notice these things happening, don’t be afraid to talk with your child. Be careful not to immediately attack, as it will shut down any conversation that you are hoping to have. Validate your child’s feelings, as they are intense and often difficult to manage (if they were easier, your child wouldn’t be engaging in NSSI). Offer support and find help for your child. It’s possible that he/she needs to speak with a professional to learn alternative ways of managing emotions.
NSSI is happening. We can’t avoid paying attention to it. Be aware of the warning signs. Be aware of how your kids are learning about it. And don’t be afraid to talk about it.
Here’s the link to the clip from The Early Show.