We all know that teenagers are easily swayed by the behavior of their peers, but does that sort of influence apply to acts of self-harm and other negative coping skills for mental illness? A 2020 study in Acta Psychiatrica Scandinavica considered the notion of self-harm in adolescents and “social contagion.” There have been reports that an adolescent’s knowledge of suicide by a peer actually increased their own thoughts and planning around suicide. “Groupthink plays a stronger role in adolescence than in adult years. The reason for this difference is the power of peers, i.e. ‘peer pressure’ during the pre-teen and teen years.” says Nekeshia Hammond, PsyD, psychologist and author of The Practical Guide to Raising Emotionally Healthy Children. While those who partake in nonsuicidal self-injury, or NSSI, do not always have a desire to die, the percentage of adolescents who are suicidal are higher within the group that engages in NSSI than those who do not.
Assessing the Influence of Self-Harm
Researchers found that awareness of a friend’s self-injury was associated with an adolescent’s own involvement with NSSI, suicidal ideation, and suicide attempts. Data showed that there was no increase in odds of engagement with NSSI for youth who were diagnosed with or met criteria for mental health disorders. Data from 1,483 youth in Ontario, Canada between the ages of 14 and 17 engaged in a digital self-report survey surrounding mental health and self-injury, with their parents providing demographic information. Questions required yes or no responses, and included the following inquiries:
“In the past 12 months, did any of your friends deliberately harm themselves but not mean to take their life?“Sometimes people deliberately harm themselves but they do not mean to take their life. In the past 12 months, did you ever deliberately harm yourself but not mean to take your life?“In the past 12 months, did you ever seriously consider taking your own life or killing yourself?”
In addition to these survey questions, researchers included other factors within the assessment. Demographic information was collected, including details such as income level, neighborhood location, and how many biological parents were in the household. Previous mental health disorders, assessed via the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) were also included in the study results.
What is Self-Harm?
Non‐suicidal self‐injury (NSSI) is intentional, self‐directed, non‐culturally sanctioned damage of the body without the conscious intent of suicide, frequently including skin‐cutting and scratching. There are many reasons why an adolescent would turn to self-harm during a stressful situation. “Self-harm behaviors are complex and there is no single reason to explain why,” says Yunyu Xiao, PhD, a faculty affiliate at the NYU McSilver Institute and an assistant professor at the School of Social Work at Indiana University Bloomington. “Usually, risk factors include negative life events, previous self-harm, contact with others engaging in self-harm, access to methods for self-harm or suicide, and lack of social support. There are many possible explanations (not causes) of suicide or NSSI contagion—factors could include experiences of family history of suicide death/attempts, lack of family support, low self-esteem, [and] social media exposure,” she says.
The Importance of Conversation
There is a hypothesized effect in relation to suicide called “suicide acceptability,” wherein the adolescent deems suicide a reasonable response due to normalization. This hypothesis leads researchers to question if the same was possible for NSSI, and the collection of data to determine if there were any connections between knowledge of a peer’s NSSI, an individual’s own NSSI, and any suicidal ideation. It is vital for parents and educators to spend time engaging in open dialogue about negative mental health coping skills like self-harm or suicide. This is how we can support teenagers and validate their challenging emotions. “It is critical to have these discussions,” says Hammond. “Pretending like suicidal thoughts and/or self-harm thoughts do not exist for adolescents is not helpful to their mental health. Instead, with more education about what to do if the thoughts are experienced, how to help a friend, and resources to utilize, the community can better respond to the mental health needs of youth,” she says. Xiao says, “Research indicates greater suicide disclosure for open discussion on suicidal ideation and self-harm, which could potentially increase connection to help-seeking and other resources.” Media is also another important aspect in regard to the normalization of self-harm and suicidality. Having open and candid conversations about mental health is important, but proper resources are necessary for those conversations to be fruitful and productive.
