A Systematic Review of Media Use and Non-Suicidal Self-Injury Behaviors

Theoretical Background and research questions/hypothesis:

Self-injury occurs when someone intentionally and repeatedly harm themselves in a way that is not intended to be suicidal. Research shows that non-suicidal self-injury is the second leading cause of death for people aged 15-19 years old (Lancet, 2017). In the US, 17%- 35% college students reported engaging in some form of self-injury, making it a significant public health concern (CDC, 2017). Research found that close to half (43.6%) of the adolescents and young adults reported that media exposure had an impact on their non-suicidal self-injury (NSSI) behaviors (Heath et al., 2009). The role of media, especially social media, on NSSI has garnered increasing attention from health practitioners and researchers. It remains unclear, however, what the association is between media use habit and self-injury among adolescents and young adults, as well as how such studies have been conducted. The current project aims to use a systematic review to examine the current state of research on 1) the linkage between self-injury and media use, and 2) the theoretical processes through which media influence NSSI.

Methods:

Two researchers conducted an extensive search for relevant articles published in English-language peer-reviewed journals from all the years to November 2018. Databases including PsychINFO, Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Complete, and Communication and Mass Media Complete using the terms self-injur* or self-harm and media or communication were searched. The initial search yielded 599 articles. After duplicates were removed, 482 articles were archived in an Endnote (ver. 7.8) database. One researcher reviewed the search results and selected papers that met the inclusion criteria for the study. Protocol was created and one researcher coded a subset of the articles. Abstracts that did not clearly meet the inclusion criteria were set aside to determine the study’s eligibility through a review of the methods section of the article. Full text copies of the remaining 43 potential eligible articles were examined more closely, and only 14 articles reported the relationship between media consumption and self-injury.

Results:

A total of 14 studies were selected for this systematic review. These studies mainly used qualitative research methods (e.g., interview, textual analysis) (n=15). Most studies looked at adolescents and young adult sample (n=17), and focused on social media (e.g., Instagram, Tumblr) (n=15). Few studies have discussed the association between media consumption and self-injury behaviors in the context of communication theories.

Conclusions:

The findings suggest that media consumption (e.g., social media) generally has a negative impact on participants’ perception of self-injury norms, and often serves as a platform to foster and encourage the maintenance of self-injury behaviors among adolescents and young adults. The lack of communication theory in this research area is concerning as theories help to understand the prevalence of such behaviors and have the potential to inform effective campaigns.

Implications for research and/or practice:

More quantitative and long-term investigation need to be conducted to identify the linkage between media consumption and self-injury behaviors. There is also dire need for the development of theory-grounded health communication campaigns.