Infectious Disease

Eight online factors related to suicidal behavior in adolescents

September 28, 2021

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Sumner does not report any relevant financial information. Please refer to the study for all relevant financial information from the other authors.

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Cyberbullying and content related to drugs, depression and violence were major risk factors for subsequent suicidal behavior in adolescents, according to the results of a consistent case-control study published in the JAMA Network Open.

“Most previous studies of youth suicide and online activity have only focused on screen time.” Steven A. Sumner, MD, MSc, from the CDC’s National Center for Injury Prevention and Control, said Healio Psychiatry. “In our study, we took a closer look at the specific online activities that preceded the suicidal behavior of adolescents.”

Previous studies examining possible links between online activity and teenage suicide have been limited by their reliance on survey data and focus on risks related to total screen time. In the current study, Sumner and colleagues wanted to investigate the correlation between various online risk factors and the behavior of adolescents in connection with suicide using real online activity data between July 27, 2019 and May 26, 2020. The sample included more than 2,600 US schools that participated in an online security monitoring program through the online security tool Bark.

The researchers compared 227 adolescents who had a severe suicide / self-harm warning that required notification of the school administration at a ratio of 1: 5 to 1,135 controls (all participants, mean age 13.3 years; 51.3% boys) on site, number follower up time and general online activity volume. The online risk factors assessed included eight related to cyberbullying, violence, drugs, hate speech, profanity, sexual content, depression, and minor self-harm, as assessed using text, image, and video data.

The results showed differences between case and control populations as well as significant associations with subsequent severe suicide / self-harm warnings when assessing the total direct and indirect pathways for all eight online risk factors. The researchers reported that adjusted ORs for the associations ranged from 1.17 (95% CI, 1.09-1.26) for drug-related content to 1.82 (95% CI, 1.73-2.03) for depression-related content were enough. They found an exponentially increased risk of major suicide / self-harm warnings when you factor in the total number of different types of online risk factors among the eight measured. The risk of later suffering a severe suicide / self-harm alert increased 70 times in those who had at least five of the eight risk factors in their online activity (aOR = 78.64; 95% CI, 34, 39-179.84).

“Many parents are concerned about teenage suicide and want to do more to help their children, but don’t know how to address the new online risks children face today,” said Sumner. “It’s important to emphasize that suicide is preventable, and our study shows that paying close attention to what children are exposed to and posting online can potentially help parents and caregivers help them sooner.”

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