1 - (SYM 72) Self-harm Content on Social Media and Proximal Risk for Self-injurious Thoughts and Behaviors Among Adolescents

Background: While social media has received attention in adolescent suicide risk, it remains unclear how and in what ways social media can confer risk. Exposure to self-harm content may be one important experience on social media that confers risk for self-injurious thoughts and behaviors (SITBs). Moving beyond cross-sectional designs, the current study uses an intensive monitoring design to examine the relationship between weekly exposure to self-harm content on social media and adolescent SITBs, including suicidal ideation and non-suicidal self-injurious (NSSI) thoughts and behaviors.

Method: Adolescents (N = 62; ages 14-17 years) recruited nationwide from social media (49% girls, 62% LGBTQ+, 41% White, 20% Black, 17% Latine, 12% Biracial, 10% Asian) completed a baseline survey and clinical interview, followed by 8 weeks of daily and weekly surveys. Daily surveys included questions about adolescents’ active suicidal ideation and NSSI urges and behaviors. Weekly surveys included exposure to self-harm content on social media (yes/no) and average social media hours. Logistic multilevel modeling was conducted to evaluate whether exposure to self-harm content on social media was associated with weekly SITBs, controlling for social media duration.

Results: Overall, 50% (N=31) of adolescents reported seeing self-harm related content on social media over the study period. In contrast to hypotheses, there was no association between weekly social media self-harm exposure and suicidal ideation that week (B=-.61, p =.23). However, there were significant associations between weeks of self-harm social media exposure and both weekly NSSI urges (B=.65, p=.02) and behaviors (B=1.92, p =.02), such that adolescents were almost 7x more likely to have NSSI the weeks of self-harm SM exposure.

Conclusion: Findings indicate that exposure to self-harm content on social media may be a proximal risk factor for NSSI urges and behaviors among adolescents. While weekly self-harm SM exposure was not related to active suicidal ideation, its effects on NSSI may heighten risk for future suicidal ideation and behaviors. Findings shed light on one modifiable way in which social media may heighten risk for suicide among adolescents, lending empirical support for current guidelines to limit self-harm content on social media. Further research is needed to investigate the nature and impact of self-harm content on social media in youth self-injury.