Instagram and self-harm: 1 in 3 youth who see cutting images try it themselves, study suggests

Young people who see images of cutting on Instagram are more likely to hurt themselves by imitating the act, and also are at higher risk for suicide, a new study suggests.

The research, led by the University of Pennsylvania’s Annenberg Public Policy Center, the University of Vienna, and the University of Leuven in Belgium, was published Monday in the journal New Media & Society. Here are the highlights:

It’s difficult to track how many youth harm themselves, but several studies suggest it’s more common than people think. Researchers say about 18 percent of teenagers intentionally harm themselves, and cutting is the most common form of self-injury.

Although those people are not necessarily suicidal in that moment, self-injury is one of the most powerful predictors of future suicidal thoughts. Suicide is the second leading cause of death for Americans ages 15 to 34.

The issue of cutting has gotten particular attention on Instagram, where images of mild to moderate cutting injuries can be seen frequently. Researchers have found some images also show bleeding flesh wounds, and those images get more comments.

Many people have raised concerns that such images will inspire copycats. Decades of research on suicide has shown that certain types of news coverage can lead to an increase in suicides. But little research has been done to see if the same effect exists for self-harm, especially on social media outlets.

As the conversation around social media’s effect on mental health continues, this is an area of increasing interest.

The study is based on 729 Americans, ages 18 to 29, who were recruited from internet gaming sites. Over 80 percent were women.

They were surveyed at two points a month apart, in May and June 2018. They answered a host of questions, including several about suicide and the Netflix show "13 Reasons Why,” which led to a separate study published earlier this year.

The questions used in this study had to do with how often users came across images of self-harm on Instagram, whether they sought them out or found them accidentally, and whether they engaged in self-harm themselves.

More than 40 percent of the survey participants had seen a post of self-harm on Instagram at least once, and more than half of those had seen more than one.

Eighty percent of individuals who saw such posts said they encountered them by accident. This can happen when certain hashtags overlap. For example, #cutting is sometimes used with images of self-harm, but it can also appear with #cat, to reference scratching or clawing. Instagram users who click on #cutting from a cat post might then be led to self-harm images.

Nearly a third of the participants who saw self-harm posts at the first interview said that they had performed the same or very similar self-harming behavior as a result. They were more likely than people who didn’t see any self-harm content to report their own cutting at the second interview.

The finding persisted after researchers took into account other sources of self-harm or suicidal content users might be exposed to, as well as their past histories of self-harm and suicidal thoughts.

While the study cannot establish causation — it doesn’t show that seeing self-harm images on Instagram makes people cut themselves — authors say these types of images can normalize the act of self-harm for young people.

“The findings suggest that whether the Instagram posts instigate self-harm on their own or not, they do reach vulnerable young people and may play a role in encouraging similar behavior in those who are exposed to them,” coauthor Dan Romer said in a statement. Romer is research director of Penn’s Annenberg Public Policy Center.

Although the study found a correlation between seeing self-harm images on Instagram and individuals cutting themselves, it does not indicate if one causes the other. It’s possible that people who are at higher risk of self-harm are more likely to run into this type of content.

It’s also hard to generalize the results, as the sample of participants was not representative of the general public. Although they were not highly vulnerable individuals with mental illness, the group might have over-represented people concerned with suicide since that was disclosed as one purpose of the survey.

The sample was also largely female, and only included adults 18 and older. Given the large number of teens of both genders that use Instagram, future studies may need to look at how that population is affected.

In February 2019 — after this survey was conducted — Instagram announced it would no longer allow graphic images of cutting, and will take steps to get more resources to people posting and searching for self-harm related content.

However, research has shown that self-harm images continue to appear on the platform. With over 500 million daily active users, Instagram is struggling to monitor all the content.

The platform still allows non-graphic images of self-harm, such as scars. The company says this allows people to share stories of recovery and build a community without stigmatizing them.

Researchers say the effect of non-graphic images need to be studied to determine if they are helpful or harmful.