title: Exposure to, and searching for, information about suicide and self-harm on the Internet: Prevalence and predictors in a population based cohort of young adults.
abstract: BACKGROUND
  There is concern over the potential impact of the Internet on self-harm and suicidal behaviour, particularly in young people. However, little is known about the prevalence and patterns of suicide/self-harm related Internet use in the general population.
  
  
  METHODS
  Cross sectional study of 3946 of the 8525 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) who were sent a self-report questionnaire including questions on suicide/self-harm related Internet use and self-harm history at age 21 years.
  
  
  RESULTS
  Suicide/self-harm related Internet use was reported by 22.5% (886/3946) of participants; 11.9% (470/3946) had come across sites/chatrooms discussing self-harm or suicide, 8.2% (323/3946) had searched for information about self-harm, 7.5% (296/3946) had searched for information about suicide and 9.1% (357/3946) had used the Internet to discuss self-harm or suicidal feelings. Suicide/self-harm related Internet use was particularly prevalent amongst those who had harmed with suicidal intent (70%, 174/248), and was strongly associated with the presence of suicidal thoughts, suicidal plans, and history of self-harm. Sites offering help, advice, or support were accessed by a larger proportion of the sample (8.2%, 323/3946) than sites offering information on how to hurt or kill yourself (3.1%, 123/3946). Most individuals (81%) who had accessed these potentially harmful sites had also accessed help sites.
  
  
  CONCLUSIONS
  (i) There were differences between questionnaire responders and non-responders which could lead to selection bias and (ii) the data were cross-sectional, and we cannot conclude that associations are causal.
  
  
  CONCLUSIONS
  Suicide/self-harm related Internet use is common amongst young adults, particularly amongst those with suicidal thoughts and behaviour. Both harmful and helpful sites were accessed, highlighting that the Internet presents potential risks but also offers opportunities for suicide prevention.
authors.affiliation: School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom. Electronic address: becky.mars@bristol.ac.uk.
authors.forename: Becky
authors.initials: B
authors.lastname: Mars
authors.affiliation: School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom.
authors.forename: Jon
authors.initials: J
authors.lastname: Heron
authors.affiliation: School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom.
authors.forename: Lucy
authors.initials: L
authors.lastname: Biddle
authors.affiliation: School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom.
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
authors.affiliation: Samaritans, United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Holley
authors.affiliation: PAPYRUS Prevention of Young Suicide, United Kingdom.
authors.forename: Martyn
authors.initials: M
authors.lastname: Piper
authors.affiliation: School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Potokar
authors.affiliation: Samaritans, United Kingdom.
authors.forename: Clare
authors.initials: C
authors.lastname: Wyllie
authors.affiliation: School of Social and Community Medicine, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Gunnell
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D020407:Internet; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D015995:Prevalence; D012306:Risk; D057566:Self Report; D016728:Self-Injurious Behavior / Q000453:epidemiology*; D059020:Suicidal Ideation; D013405:Suicide / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000517:prevention & control; D011795:Surveys and Questionnaires; D055815:Young Adult; D000092864:Suicide Prevention
keywords: ALSPAC; Internet; Self-harm; Suicide; Suicide attempt