This entry describes the evolution and current state of research related to Non-suicidal self-injury on the Internet across a variety of mediums, including social networking websites, video-sharing websites, and informational websites. Although the full influence of such online behaviours on off-line behaviours and functioning remains relatively unknown, it appears that such activities pose both risks and benefits to mental health and wellbeing. Online activities may provide individuals with a history of or interest in self-injury with guidance and education, informal support, a sense of community, as well as allow for personal expression. However, such activities can also serve to trigger, reinforce, and normalize self-injury and may substitute for off-line relationships. The pervasiveness of self-injury online suggests that regular assessment of on-line activity is an important aspect of self-injury treatment. The chapter concludes with suggestions for utilizing the Internet as a novel approach to self-injury prevention and intervention efforts.
TopIntroduction
Non-suicidal self-injury is defined as the deliberate, self-inflicted destruction of body tissue without suicidal intent, and for purposes not socially sanctioned (ISSS, 2010). Nomenclature varies within the field and includes terms such as self-injury, self-injurious behavior, self-mutilation, bodily harm, deliberate self-harm, and self-cutting. Certain terms, such as “deliberate self-harm,” often refer to behaviors with and without suicidal intent and thus can include behaviors such as hanging, self-poisoning and deliberate substance abuse. Due to the well-documented differences between suicidal and self-injurious behavior with regards to intent, lethality, methodology, functions and treatment, it is essential to emphasize and understand the distinction between the two terms (See Walsh, 2006 for a review). While the contents of this chapter may include studies dedicated to examining deliberate self-harm, the focus of the chapter is restricted to self-injurious behavior undertaken without suicidal intent and most commonly referred to as Non-suicidal self-injury.
Online behaviours include social networking, information seeking, picture sharing, and video posting. The current chapter presents a comprehensive summary of existing literature regarding NSSI behaviours across a variety of mediums, while concomitantly examining the beneficial and detrimental influences of such online activities on virtual and real life functioning. The chapter will conclude with a discussion of the implications of on-line behaviors in self-injury prevention and intervention efforts and suggestions for future research. As NSSI and Internet use are both more common among adolescents than any other age group, and all NSSI-Internet studies to date find a predominately adolescent presence, what follows is essentially a review of the on-line NSSI-related behaviors of adolescents. The following self-injury message board posts provide an example of self-injury behaviours in cyber space:
“I’m writing to ask you, as an ex-cutter and a person still dealing with the effects of self-injury in my life, to please take down the pictures you have on your website. They help no cutter or cutter’s friend to understand what happens. Instead, they inspire sick, twisty feelings of inadequacy and self-pity, which, in turn, may lead to deeper, worse cuts, and a desire not to stop. You’re making the problem worse, not better… Sort things out... I appreciate what you’re trying to do, but I feel you’re making it harder for self-injurers to stop and get help”.
“…For some people the pictures may be ‘harmful’, I personally have never met anyone else who was affected negatively by them…I also am a recovering self-injurer, I however was infinitely helped by these living testaments to the fact that we are not alone. There is no way that I could have gone this long without cutting without this site, especially the pictures page”.
TopInterest in and study of NSSI has grown exponentially within the last decade. Self-injury was initially identified as a behavior most often seen among atypically functioning populations and most commonly found in clinical settings, including individuals diagnosed with psychosis and borderline personality disorder (Walsh, 2006). However, during the 1990’s and early part of the new millennium, growing awareness of NSSI among community populations of youth prompted inquiry into the scope and nature of the “new” and “puzzling” disorder (Welch, 2004). Since then, NSSI has garnered a high degree of attention in mainstream media such as movies, music, and news reports as evidenced by an increase from almost non-existent to hundreds of references per year over the span of half a decade (Walsh, 2006; Whitlock, Purington, & Gershkovich, 2009). Whether this awareness reflected an actual increase in cases or simply an awakening to a more longstanding issue will remain indefinitely obscure since empirical baseline data on NSSI prevalence in community populations of youth is non-existent in the US prior to this time. It does suggest, however, that NSSI is a behavior unlikely to recede into the annals of social and clinical history any time soon.