title: A Systematic Review of Social Media Use to Discuss and View Deliberate Self-Harm Acts.
abstract: To conduct a systematic review of studies of social media platforms used by young people to discuss and view deliberate self-harm.
  
  
  
  11 electronic databases were searched from January 2000 to January 2012 for primary research; in June 2014 an updated search of Medline was conducted. Grey literature sources were also searched. Search results were screened by two reviewers. Data were extracted by one reviewer and verified by another. Methodological quality was assessed using the Mixed Methods Appraisal Tool.
  
  
  
  Due to heterogeneity in study objectives and outcomes, results were not pooled; a narrative analysis is presented. 26 studies were included. Most were conducted in Canada or the UK (30.8% each), used qualitative designs (42.3%), and evaluated discussion forums (73.1%). Participants were most often aged 19-21 years (69.2%), female (mean 68.6%), and 19.2% had a documented history of depression. The social media platforms evaluated were commonly supportive and provided a sense of community among users. Support included suggestions for formal treatment, advice on stopping self-harming behavior, and encouragement. Harms included normalizing and accepting self-harming behavior; discussion of motivation or triggers, concealment, suicidal ideation or plans; and live depictions of self-harm acts.
  
  
  
  Although this evidence is limited by its descriptive nature, studies identify beneficial and detrimental effects for young people using social media to discuss and view deliberate self-harm. The connections users make online may be valuable to explore for therapeutic benefit. Prospective, longitudinal investigations are needed to identify short- and long-term potential harms associated with use.
authors.affiliation: Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Michele P
authors.initials: MP
authors.lastname: Dyson
authors.affiliation: Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hartling
authors.affiliation: Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Shulhan
authors.affiliation: Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Annabritt
authors.initials: A
authors.lastname: Chisholm
authors.affiliation: Alberta Research Centre for Health Evidence, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Andrea
authors.initials: A
authors.lastname: Milne
authors.affiliation: Ontario Centre of Excellence for Child and Youth Mental Health, Ottawa, Ontario, Canada.
authors.forename: Purnima
authors.initials: P
authors.lastname: Sundar
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Scott
authors.affiliation: Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Amanda S
authors.initials: AS
authors.lastname: Newton
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009042:Motivation; D016728:Self-Injurious Behavior / Q000453:epidemiology / Q000523:psychology*; D012919:Social Behavior; D061108:Social Media; D055815:Young Adult