参与基于网络的自残和自杀内容的历程:纵向定性研究。

IF 3.5 Q1 HEALTH CARE SCIENCES & SERVICES
JMIR infodemiology Pub Date : 2024-03-28 DOI:10.2196/47699
Zoë Haime, Laura Kennedy, Lydia Grace, Rachel Cohen, Jane Derges, Lucy Biddle
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引用次数: 0

摘要

背景:自残和自杀是全球关注的主要公共卫生问题,而网络环境对自残和自杀的影响则是关注的焦点。对自残和自杀相关网络使用的纵向研究十分有限,这凸显了有关接触此类内容的长期模式和影响的证据十分匮乏:本研究探讨了人们在 6 个月内接触自残或自杀内容的经历:本研究采用纵向定性和数字人种学方法,包括在 3 个时间点进行一对一访谈,以探究个人叙述。结果:14 名参与者的研究结果确立了网络自残的概念:14名参与者的研究结果确定了参与自残或自杀内容的人的网络历程。总共确定了 5 个主题:与自残或自杀内容的最初互动、人们接触自残或自杀内容的内容和地点的变化、与网络自残或自杀内容接触相关的自残或自杀行为体验的变化、脱离-再接触循环以及对网络自残或自杀内容接触的未来展望。最初参与的原因是参与者寻求帮助,通常是在无法获得线下支持的情况下。一些参与者接触到自残和自杀内容后,开始了自己的自残和自杀行为,并随着时间的推移发生了不同的变化。值得注意的是,脱离网络自残和自杀空间对所有参与者来说都是一种保护措施,但熟悉内容的牵引只会导致短暂的脱离。参与者还表达了未来继续回到这些自残和自杀网络空间的意愿,他们承认自己的康复历程是非线性的,并希望为社区中的其他人提供支持。在本研究确定的主题中,叙述显示,参与者的行为是由认知的灵活性和刚性、元认知能力和数字专业知识决定的。在由生活事件、压力和心理健康变化引起的认知灵活性时期,出现了改变行为的机会。在具有挑战性的时期,参与者会寻求各种可能有害的内容,但在积极的情况下,他们会转向以康复为导向的参与。元认知和数字效能技能在参与者控制网络互动方面也发挥了关键作用,使他们能够更有效地管理可能造成伤害的内容或平台或网站:本研究显示了网络互动的复杂性,有益和有害的内容交织在一起。表现出元认知和数字效能的参与者能够更好地控制网络互动。一些人将这些技能归功于学习过程,包括参与反思日记,这显示了提高用户技能的潜力。本研究还强调了参与者如何在熟悉的网络空间中保持脆弱,强调网络行业领导者有责任开发工具,增强用户的网络安全能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Journey of Engaging With Web-Based Self-Harm and Suicide Content: Longitudinal Qualitative Study.

Background: Self-harm and suicide are major public health concerns worldwide, with attention focused on the web environment as a helpful or harmful influence. Longitudinal research on self-harm and suicide-related internet use is limited, highlighting a paucity of evidence on long-term patterns and effects of engaging with such content.

Objective: This study explores the experiences of people engaging with self-harm or suicide content over a 6-month period.

Methods: This study used qualitative and digital ethnographic methods longitudinally, including one-to-one interviews at 3 time points to explore individual narratives. A trajectory analysis approach involving 4 steps was used to interpret the data.

Results: The findings from 14 participants established the web-based journey of people who engage with self-harm or suicide content. In total, 5 themes were identified: initial interactions with self-harm or suicide content, changes in what self-harm or suicide content people engage with and where, changes in experiences of self-harm or suicide behaviors associated with web-based self-harm or suicide content engagement, the disengagement-reengagement cycle, and future perspectives on web-based self-harm or suicide content engagement. Initial engagements were driven by participants seeking help, often when offline support had been unavailable. Some participants' exposure to self-harm and suicide content led to their own self-harm and suicide behaviors, with varying patterns of change over time. Notably, disengagement from web-based self-harm and suicide spaces served as a protective measure for all participants, but the pull of familiar content resulted in only brief periods of disconnection. Participants also expressed future intentions to continue returning to these self-harm and suicide web-based spaces, acknowledging the nonlinear nature of their own recovery journey and aiming to support others in the community. Within the themes identified in this study, narratives revealed that participants' behavior was shaped by cognitive flexibility and rigidity, metacognitive abilities, and digital expertise. Opportunities for behavior change arose during periods of cognitive flexibility prompted by life events, stressors, and shifts in mental health. Participants sought diverse and potentially harmful content during challenging times but moved toward recovery-oriented engagements in positive circumstances. Metacognitive and digital efficacy skills also played a pivotal role in participants' control of web-based interactions, enabling more effective management of content or platforms or sites that posed potential harms.

Conclusions: This study demonstrated the complexity of web-based interactions, with beneficial and harmful content intertwined. Participants who demonstrated metacognition and digital efficacy had better control over web-based engagements. Some attributed these skills to study processes, including taking part in reflective diaries, showing the potential of upskilling users. This study also highlighted how participants remained vulnerable by engaging with familiar web-based spaces, emphasizing the responsibility of web-based industry leaders to develop tools that empower users to enhance their web-based safety.

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