A transitional object for relatedness and self‐development—A meta‐synthesis of youths&apos; experience of engagement in self‐harm content online

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Abstract

Studies report an increase in self‐harm, and engagement in risk content online has gained growing attention. This study aims to synthesize qualitative studies on youths' (12–25 years of age) engagement in self‐harm content online (SCO). We conducted a systematic database search of studies on first‐person experience and included 16 studies. The meta‐synthesis resulted in two meta‐themes: 1) “Belonging to a community – online engagement with peers who self‐harm” and 2) “Self‐development – online engagement to get to know myself”. Following Winnicott's (1953) thinking, digital activity is discussed as an extended peer arena with a “transitional” quality – neither completely internal, nor external, and potentially bridging an inner and outer world. Engagement in SCO is discussed as a transitional object or activity that enables relatedness and self‐definition – important developmental experiences for the exploration of social roles, borders between self and others and self‐identity during adolescence. However, engagement in SCO comes with a risk for deterioration of mental health. Clinicians should ask directly about digital activity and meet those engaged in digital risks with respect.

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Self-harm and suicide in adolescents.

Keith Hawton, Kate E A Saunders, Rory C O'Connor (2012)

Self-harm and suicide are major public health problems in adolescents, with rates of self-harm being high in the teenage years and suicide being the second most common cause of death in young people worldwide. Important contributors to self-harm and suicide include genetic vulnerability and psychiatric, psychological, familial, social, and cultural factors. The effects of media and contagion are also important, with the internet having an important contemporary role. Prevention of self-harm and suicide needs both universal measures aimed at young people in general and targeted initiatives focused on high-risk groups. There is little evidence of effectiveness of either psychosocial or pharmacological treatment, with particular controversy surrounding the usefulness of antidepressants. Restriction of access to means for suicide is important. Major challenges include the development of greater understanding of the factors that contribute to self-harm and suicide in young people, especially mechanisms underlying contagion and the effect of new media. The identification of successful prevention initiatives aimed at young people and those at especially high risk, and the establishment of effective treatments for those who self-harm, are paramount needs. Copyright © 2012 Elsevier Ltd. All rights reserved.