Running head: POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI The influence of internet on non-suicidal self-injury in adolescents Fathimath Saaniya Saleem Maldives National University 1 POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI 2 The Influence Of Internet On Non-Suicidal Self-Injury In Adolescents Famous author J.K Rowling once stated that "Internet is both a boon and a curse for teenagers". With both benefits and risks, the internet provides a huge platform for young adults to express themselves in anonymity. As such, internet is one of the many factors that influence non-suicidal self-injury (NSSI) in adolescents (Whitlock, Powers & Eckenrode, 2006). Studies show that 13% to 20% of youths engage in non-suicidal self-injury behavior in their lifetime (Hawton, 2002). Non-suicidal self-injury is described as deliberately harming oneself in behaviors such as cutting; without the intention of suicide (Whitlock, Powers & Eckenrode, 2006). Even though this is a global phenomenon research found that the society of Maldives is not aware of NSSI as a mental issue but something illegal and haram (SunOnline). According to researcher's such as Whitlock, Powers, and Eckenrode (2006) and Niwa and Mandrusiak (2012), internet has both positive and negative impacts on NSSI in adolescents. The six works of literature reviewed for this paper observed almost the same patterns of benefits and risks throughout all the studies. The beneficial impact of the internet is that the NSSI youths who seek support on online platforms get encouragement for recovery. A platform for emotional self-disclosure in anonymity and a feeling of belonging which reduces loneliness in NSSI individuals (Harris & Roberts, 2013; Whitlock, Powers & Eckenrode, 2006). However, several other works indicate that due to the self-injury content on the internet, minors who participate in NSSI get triggering urges to self-harm (Lewis, Heath, St Denis & Noble, 2011). Reports also observe that in many online platforms NSSI is normalized and glamorized (Franzén & Gottzén, 2010). Another study found that young children who self-harm are harassed on social media such as Facebook or YouTube (Niwa & Mandrusiak, 2012; Lewis, Heath, St Denis & Noble, 2011). POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI 3 Positive influence The very first tip of the internet are search engines such as Google, Bing, etc. Likewise, on a research done by Swannell et al., (2010) they investigated the results of a google search on non-suicidal self-injury. The focus of this investigation was based on whether the results were either helpful or harmful to an individual searching about NSSI. The methodology used in this study was by searching seven self-harm related queries on www.gooogle.com. Individual links from the first webpage were opened to judge and identify the relevancy. 39 of the relevant links found were analyzed and categorized into 5 different groups such as websites, web pages, news results, book results and other. The results showed that 16 links to websites and web pages that provided support and information about self-harm., seven books found were also recovery-oriented books. From nine articles only two contained graphic images of self-harm and the other results were from the Wikipedia page about self-harm among other information based on self-harm that was mostly about recovery and support. This study indicates; that majority of the content found were of healing and caring nature, that it is a unique study done on a very basic aspect yet provides useful insight on NSSI. However, it only outlooks how an individual would first find information and does not extend to all the sources in the vast majority of the internet such as discussion boards or other social media. Advancing the google search of self-injury would lead to the discovering of many online communities and discussion forums. Two similar studies were done on the influence of the internet on NSSI adolescents by Whitlock, Powers, and Eckenrode (2006) and Harris and Roberts (2013). The investigation done by Whitlock, Powers, and Eckenrode (2006) involved two studies. One study measured the nature, prevalence, commonly discussed topics and the users of the message boards that post NSSI related content. Study two examined the POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI 4 correlation between the areas involved in the discussion of the previous study. Study one analyzed two units, one of the things were the message boards and the other one was individual posts on a selected number of message boards. Out of 400 message boards, 10 were selected for in-depth analysis for a period of two months along with of 3,219 individual posts. The content of the posts was analyzed by content analysis in which a series of binary codes drawn from previous research done on NSSI. Study two was conducted the same way but the content analysis was based on a set of six specific questions such as the attitude of the individuals towards disclosure use of formal support or disclosure to family and friends. The qualitative results showed that the majority, around 28.3% were supportive of other NSSI youths. This social support acts as a mitigation of social isolation in NSSI victims. The message boards also give a platform for the individual to "vent" and be themselves 2.9%. Although the results also show the negative influence such as triggering content 19.5% present on these posts. The outcome of the second study also had both negative and positive correlations. Offering support was positively correlated with disclosing the NSSI to someone suggestion seeking of formal treatment and solutions to stop NSSI. The negative effect was correlated to sharing of NSSI techniques or negative attitude towards the revelation of NSSI and seeking formal treatment. The study done by Harris and Roberts (2013) also showed similar trends to the research done by Whitlock, Powers and Eckenrode (2006). The observations of this research also show a positive impact to the youths who self-harm in online communities such as gaining support, platform to self-disclose and the removal of social isolation. Another trend found in these studies were that majority of the users were females aged ranging from 14 to 20. The method used to obtain results used by Harris and Roberts (2013) were collection of data by an anonymous questionnaire based on previous research that was posted on 20 websites with NSSI content for a period of six weeks. The qualitative data was analyzed same POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI 5 as the other study by thematic or concept analysis. The content analyzed in this research was less compared to the research done by Whitlock, Powers and Eckenrode (2006). Although such as the study done by Whitlock, Powers and Eckenrode (2006) this report also found negative consequences of the internet for instance triggering of NSSI urges. 329 individuals participated in this study by completing the questionnaire. Some of the predominant concepts that the participants agreed were the social support the websites provide and gives a platform to express themselves. Out of these 40% indicated that they self-harm less due to the internet. In spite of this 10% agreed that triggering content were present in the websites. Both the studies had limitations because the results found could not be generalized to all websites and message boards on the internet as only a few were selected for in-depth analysis. Another limitation of the research of Harris and Roberts (2013) is that the questionnaire was only limited to English speakers. However, both the studies provided useful data on understanding the influence of internet on NSSI adolescents. Negative influence Generally, social media such as Facebook and YouTube are easily accessible to on the internet to youths and adolescents. Facebook was found to be one of the most popular social media platforms among teens (Lenhart,2018). A research was done by Niwa & Mandrusiak (2012) to find out the communication within four Facebook groups dedicated to supporting people who non-suicidal self-injury. The information was obtained by a conceptual content analysis of posts on four of the most active self-harm groups on Facebook over 3 months. The concept analysis of these posts resulted in seven coded themes such as Trolling and Flaming, help-seeking and informal support offers. The results suggest that most high prevalent theme found was that of verbal abuse 16.8% of NSSI youth. Verbal abuse such as this would negatively impact already vulnerable adolescents who engage in NSSI. Although, POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI 6 the results imply that support and encouragement are also provided within these Facebook groups. It was speculated that of the individuals posting, 77% were female and 23% were male based on Facebook profiles. The study itself is ethical as information posted on public platforms is assumed as giving consent by the law of Canada where the research took place. The sample of this study was small and displayed only four groups hence it cannot be generalized to the entire population of NSSI or this cannot be a representation of how online support groups are. Nevertheless, this study was a helpful examination of the effects of social media on NSSI young adults and the response they get. Another popular website that young adults use is YouTube. Lewis, Heath, St Denis and Noble (2011) examined the nature of NSSI content posted on YouTube. They searched for NSSI related words such as self-injury or self-harm on YouTubes search engine. 100 most viewed videos were chosen. They were distributed into two parts, one with live individual and the other one with non-characters. All the videos were analyzed and coded based on the concept. Results showed that videos got around 2 million views and they were rated positively. Half of the themes of the videos were educational and the other half melancholic. The significant founding was that 90% of the non-character videos contained NSSI photographs and triggering content yet 58% had no trigger warnings. Since YouTube is easily accessible and has a huge demographic of youngsters this kind of triggering videos might have triggering like consequences to these children. Similar trends were observed in this research too such as majority is dominated by females and the limitation due to results not being applicable to the general population of NSSI individuals on the internet. Franzén and Gottzén (2010) study done on the impacts of the internet on self-harming young children found that online communities devoted to NSSI often, normalize or glamorize self-harming. A qualitative study was done to find empirical data on a Swedish-speaking POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI 7 online community that was found to be the most active for over two months. Data was taken further from eight selected individuals from this NSSI forum. The data were analyzed using previously used effective method of positioning theory. The qualitative data found concludes that internet has a negative effect on adolescents because of the glamorization and normalization of this behavior. The self-harmers believe that NSSI is a legitimate way of coping with mental problems and their whole identity is self-harming. This is very dangerous as this will further the individual away from seeking help (Franzén & Gottzén, 2010). Due to the sensitive ethical nature of this study consent was taken from all the participants of the study. Even though this research was effective in identifying the nature of influence on NSSI youths in the community, it cannot be generalized because the sample was not randomly selected and it was only one web community. Non-suicidal self-injury is still a widely increasing concerning phenomenon among adolescents (Hawton, 2002). The Internet is part of the daily life of youths. Likewise, it influences the behaviors of NSSI adolescents both negative and positive. The studies found that internet communities provide encouragement of recovery, a platform for emotional selfdisclosure and removal of social isolation to those children who self-injure (Whitlock, Powers & Eckenrode, 2006; Swannell et al., 2010; Harris & Roberts, 2013). However, various research also shows that internet impacts NSSI pubescents in a negative way such as providing triggering content, normalization of NSSI and verbal harassments of people who self-harm (Lewis, Heath, St Denis & Noble, 2011; Franzén & Gottzén, 2010; Niwa & Mandrusiak, 2012). All the studies showed some similar correlations such as most of the individuals are females between the age of 14-20. Limitations found were also of the same issue that is the sample being small hence cannot be generalized to all websites and social media that provides NSSI content. Another common limitation was the sampling is demographically focused on English speaking people. Almost no research about this issue POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI was done in regions such as Asia or Africa. Further research on this topic should be done to find out more about the male gender and people from other demographics too. Advanced research on this subject is very crucial as the epidemic of NSSI is increasing among youth and internet plays a huge role in the lives young adults. 8 POSTIVE VS NEGATIVE INFLUENCE OF INTERNET ON NSSI 9 Reference Franzén, A., & Gottzén, L. (2010). The beauty of blood? Self-injury and ambivalence in an Internet community. Journal Of Youth Studies, 14(3), 279-294. http://dx.doi.org/10.1080/13676261.2010.533755 Harris, I., & Roberts, L. (2013). Exploring the Use and Effects of Deliberate Self-Harm Websites: An Internet-Based Study. Journal Of Medical Internet Research, 15(12), e285. http://dx.doi.org/10.2196/jmir.2802 Hawton, K. 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