title: The scope of nonsuicidal self-injury on YouTube.
abstract: OBJECTIVE
  Nonsuicidal self-injury, the deliberate destruction of one's body tissue (eg, self-cutting, burning) without suicidal intent, has consistent rates ranging from 14% to 24% among youth and young adults. With more youth using video-sharing Web sites (eg, YouTube), this study examined the accessibility and scope of nonsuicidal self-injury videos online.
  
  
  METHODS
  Using YouTube's search engine (and the following key words: "self-injury" and "self-harm"), the 50 most viewed character (ie, with a live individual) and noncharacter videos (100 total) were selected and examined across key quantitative and qualitative variables.
  
  
  RESULTS
  The top 100 videos analyzed were viewed over 2 million times, and most (80%) were accessible to a general audience. Viewers rated the videos positively (M = 4.61; SD: 0.61 out of 5.0) and selected videos as a favorite over 12 000 times. The videos' tones were largely factual or educational (53%) or melancholic (51%). Explicit imagery of self-injury was common. Specifically, 90% of noncharacter videos had nonsuicidal self-injury photographs, whereas 28% of character videos had in-action nonsuicidal self-injury. For both, cutting was the most common method. Many videos (58%) do not warn about this content.
  
  
  CONCLUSIONS
  The nature of nonsuicidal self-injury videos on YouTube may foster normalization of nonsuicidal self-injury and may reinforce the behavior through regular viewing of nonsuicidal self-injury-themed videos. Graphic videos showing nonsuicidal self-injury are frequently accessed and received positively by viewers. These videos largely provide nonsuicidal self-injury information and/or express a hopeless or melancholic message. Professionals working with youth and young adults who enact nonsuicidal self-injury need to be aware of the scope and nature of nonsuicidal self-injury on YouTube.
authors.affiliation: Department of Psychology, University of Guelph, Guelph, ON N1G 2W1, Canada. slewis@psy.uoguelph.ca
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Lewis
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Heath
authors.forename: Jill M
authors.initials: JM
authors.lastname: St Denis
authors.forename: Rick
authors.initials: R
authors.lastname: Noble
mesh_terms: D000293:Adolescent; D000328:Adult; D000329:Advertising; D002170:Canada / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D020407:Internet; D008297:Male; D012189:Retrospective Studies; D012652:Self Mutilation / Q000453:epidemiology / Q000209:etiology*; D016728:Self-Injurious Behavior / Q000150:complications* / Q000453:epidemiology; D013406:Suicide, Attempted; D014743:Videotape Recording; D055815:Young Adult