Research Article

Exploring self-harm on Twitter (X): Content moderation and its psychological effects on adolescents

David Atauri-Mezquida 1 , Celia Nogales-González 2 , Esther Martínez-Pastor 3 *
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1 University Rey Juan Carlos, Móstoles, SPAIN2 University Rey Juan Carlos, Alcorcón, SPAIN3 University Rey Juan Carlos, Fuenlabrada, SPAIN* Corresponding Author
Online Journal of Communication and Media Technologies, 15(1), January 2025, e202503, https://doi.org/10.30935/ojcmt/15867
Published: 20 January 2025
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ABSTRACT

The number of non-suicidal self-injuries (NSSI) has grown exponentially in the last two decades, especially in the young population. Likewise, the number of textual tweets and images in photography and video has increased, to share the experience of self-harm. A quantitative and qualitative analysis of the posts on self-harm on Twitter is presented. The objective is to make visible the importance of this growing phenomenon among young people and to discuss its psychological and behavioral impact on the individual, as well as to analyze whether Twitter has adequate content controls in accordance with its conduct policies. 32,231 tweets were collected between 24 November 2022, and 29 January 2023, containing four keywords: “selfharm”, “shtwt”, “goretwt”, and “ouchietwt”. An average of 725 daily tweets were found. These tweets were posted by a total of 11,749 different users. Of those published, only 3,859 tweets (8.3%) were blocked by Twitter’s content moderation procedures, and they did so only after having produced a high number of impressions and reactions in the community. No coherence was found between the tweets blocked due to their sensitive or non-sensitive load, or between Twitter’s criteria for blocking tweets and those that are finally deleted. By number of posts, the violence of the messages, photographs, videos, and the interactions produced because of these, the importance of the procedures of moderation and supervision of content by Twitter are discussed, in terms of the danger and the psychological impact on the users.
Keywords: self-harm (NSSI), X, Twitter, content moderation, psychological impact, shtwt

CITATION (APA)

Atauri-Mezquida, D., Nogales-González, C., & Martínez-Pastor, E. (2025). Exploring self-harm on Twitter (X): Content moderation and its psychological effects on adolescents. Online Journal of Communication and Media Technologies, 15(1), e202503. https://doi.org/10.30935/ojcmt/15867

REFERENCES

  1. Abi-Jaoude, E., Naylor, K. T., & Pignatiello, A. (2020). Smartphones, social media use and youth mental health. Canadian Medical Association Journal, 192(6), E136–E141. https://doi.org/10.1503/cmaj.190434
  2. Alhassan, M. A., Inuwa-Dutse, I., Bello, B. S., & Pennington, D. (2021). Self-harm: Detection and support on Twitter. In Proceedings of the 8th European Conference on Social Media. Academic Conferences International. https://doi.org/10.48550/arXiv.2104.00174
  3. Ali, S., Saeed, M. H., Aldreabi, E., Blackburn, J., de Cristofaro, E., Zannettou, S., & Stringhini,G. (2021). Understanding the effect of deplatforming on social networks. In Proceedings of the 13th ACM Web Science Conference (pp. 187–195). ACM. https://doi.org/10.1145/3447535.3462637
  4. American Psychiatric Association. (2014). Diagnostic and statistical manual of mental disorders. American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425596
  5. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders. American Psychiatric Association Publishing. https://doi.org/10.1176/appi.books.9780890425787
  6. Angelakis, I., & Gooding, P. (2021). Experiential avoidance in non-suicidal self-injury and suicide experiences: A systematic review and meta-analysis. Suicide and Life-Threatening Behavior, 51(5), 978–992. https://doi.org/10.1111/sltb.12784
  7. Baer, M. M., Tull, M. T., Forbes, C. N., Richmond, J. R., & Gratz, K. L. (2020). Methods matter: Nonsuicidal self-injury in the form of cutting is uniquely associated with suicide attempt severity in patients with substance use disorders. Suicide and Life-Threatening Behavior, 50(2), 397–407. https://doi.org/10.1111/Sltb.12596
  8. Barrocas, A. L., Hankin, B. L., Young, J. F., & Abela, J. R. (2012). Rates of nonsuicidal self-injury in youth: Age, sex, and behavioral methods in a community sample. Pediatrics, 130(1), 39–45. https://doi.org/10.1542/peds.2011-2094
  9. Brown, R. C., Fischer, T., Goldwich, A. D., Keller, F., Young, R., & Plener, P. L. (2018). # cutting: Non-suicidal self-injury (NSSI) on Instagram. Psychological Medicine, 48(2), 337–346. https://doi.org/10.1017/S0033291717001751
  10. Buelens, T., Luyckx, K., Verschueren, M., Schoevaerts, K., Dierckx, E., Depestele, L., & Claes, L. (2020). Temperament and character traits of female eating disorder patients with (out) non-suicidal self-injury. Journal of Clinical Medicine, 9(4), Article 1207. https://doi.org/10.3390/jcm9041207
  11. Calvete Zumalde, E., Orue Sola, I., Aizpuru, L., & Brotherton, H. (2015). Prevalence and functions of non-suicidal self-injury in Spanish adolescents. Psicothema, 27(3), 223–228. https://doi.org/10.7334/psicothema2014.262
  12. Chappell, Z. (2022). The enacted ethics of self-injury. Topoi, 41, 383–394. https://doi.org/10.1007/s11245-022-09796-z
  13. Cipriano, A., Cella, S., & Cotrufo, P. (2017). Nonsuicidal self-injury: A systematic review. Frontiers in Psychology, 8, Article 1946. https://doi.org/10.3389/fpsyg.2017.01946
  14. Dyson, M. P., Hartling, L., Shulhan, J., Chisholm, A., Milne, A., Sundar, P., Scott, S. D., & Newton, A. S. (2016). A systematic review of social media use to discuss and view deliberate self-harm acts. PLoS ONE, 11(5), Article e0155813. https://doi.org/10.1371/journal.pone.0155813
  15. Emma Hilton, C. (2017). Unveiling self-harm behaviour: What can social media site Twitter tell us about self-harm? A qualitative exploration. Journal of Clinical Nursing, 26(11–12), 1690–1704. https://doi.org/10.1111/jocn.13575
  16. Faura-García, J., Calvete Zumalde, E., & Orue Sola, I. (2021). Autolesión no suicida: Conceptualización y evaluación clínica en población hispanoparlante [Non-suicidal self-harm: Conceptualization and clinical evaluation in the Spanish-speaking population]. Papeles del Psicólogo, 42(3), 207–214. https://doi.org/10.23923/pap.psicol.2964
  17. Favazza, A. R., & Favazza, B. (1987). Bodies under siege: Self-mutilation in culture and psychiatry. Johns Hopkins University Press.
  18. Funkhouser, C. J., Correa, K. A., Carrillo, v. L., Klemballa, D. M., & Shankman, S. A. (2019). The time course of responding to aversiveness in females with a history of non-suicidal self-injury. International Journal of Psychophysiology, 141, 1–8. https://doi.org/10.1016/j.ijpsycho.2019.04.008
  19. Goldenberg, A., Farmer, J., Jussim, L., Sutton, L., Finkelstein, D., Ramos, C., Paresky, P., & Finkelstein, J. (2022). Online communities of adolescents and young adults celebrating, glorifying, and encouraging self-harm and suicide are growing rapidly on Twitter. https://networkcontagion.us/
  20. Hjelmeland, H., & Grøholt, B. (2005). A comparative study of young and adult deliberate self-harm patients. Crisis, 26(2), 64–72. https://doi.org/10.1027/0227-5910.26.2.64
  21. Holland, G., & Tiggemann, M. (2017). “Strong beats skinny every time”: Disordered eating and compulsive exercise in women who post fitspiration on Instagram. International Journal of Eating Disorders, 50(1), 76–79. https://doi.org/10.1002/eat.22559
  22. Houghton, D. J., & Joinson, A. N. (2012). Linguistic markers of secrets and sensitive self-disclosure in Twitter. In Proceedings of the 45th Hawaii International Conference on System Sciences (pp. 3480–3489). IEEE. https://doi.org/10.1109/HICSS.2012.415
  23. Jhaver, S., Birman, I., Gilbert, E., & Bruckman, A. (2019). Human-machine collaboration for content regulation: The case of reddit automoderator. ACM Transactions on Computer-Human Interaction, 26(5), Article 31. https://doi.org/10.1145/3338243
  24. Jhaver, S., Boylston, C., Yang, D., & Bruckman, A. (2021). Evaluating the effectiveness of deplatforming as a moderation strategy on Twitter. Proceedings of the ACM on Human-Computer Interaction, 5(CSCW2), Article 381. https://doi.org/10.1145/3479525
  25. Khasawneh, A., Madathil, K. C., Dixon, E., WiśNiewski, P., Zinzow, H., & Roth, R. (2020). Examining the self-harm and suicide contagion effects of the Blue Whale Challenge on YouTube and Twitter: Qualitative study. JMIR Mental Health, 7(6), Article e15973. https://doi.org/10.2196/15973
  26. Khasawneh, A., Madathil, K. C., Zinzow, H., Wisniewski, P., Ponathil, A., Rogers, H., Agnisarman, S., Roth, R., & Narasimhan, M. (2021). An investigation of the portrayal of social media challenges on YouTube and Twitter. ACM Transactions on Social Computing, 4(1), Article 2. https://doi.org/10.1145/3444961
  27. Klonsky, E. D. (2011). Non-suicidal self-injury in United States adults: Prevalence, sociodemographics, topography and functions. Psychological Medicine, 41(9), 1981–1986. https://doi.org/10.1017/S0033291710002497
  28. Klonsky, E. D., & Olino, T. M. (2008). Identifying clinically distinct subgroups of self-injurers among young adults: A latent class analysis. Journal of Consulting and Clinical Psychology, 76(1), Article 22. https://doi.org/10.1037/0022-006X.76.1.22
  29. Kumar, D., Kelley, P. G., Consolvo, S., Mason, J., Bursztein, E., Durumeric, Z., Thomas, K., & Bailey, M. (2021). Designing toxic content classification for a diversity of perspectives. In Proceedings of the 17th Symposium on Usable Privacy and Security (pp. 299–318). USENIX. https://doi.org/10.48550/arXiv.2106.04511
  30. Lerman, K., Karnati, A., Zhou, S., Chen, S., Kumar, S., He, Z., Yau, J., & Horn, A. (2023). Radicalized by thinness: Using a model of radicalization to understand pro-anorexia communities on Twitter. arXiv. https://doi.org/10.48550/arXiv.2305.11316
  31. Lewis, S. P., & Seko, Y. (2016). A double-edged sword: A review of benefits and risks of online nonsuicidal self-injury activities. Journal of Clinical Psychology, 72(3), 249–262. https://doi.org/10.1002/jclp.22242
  32. Lookingbill, V. (2022). Examining nonsuicidal self-injury content creation on TikTok through qualitative content analysis. Library & Information Science Research, 44(4), Article 101199. https://doi.org/10.1016/j.lisr.2022.101199
  33. Martínez-Pastor, E., Atauri-Mezquida, D., Nicolás-Ojeda, M. Á., & Blanco-Ruiz, M. (2023). Visualización e interpretación de las interacciones en los mensajes de autolesiones no suicidas (NSSI) en Twitter [Visualizing and interpreting interactions on non-suicidal self-injury (NSSI) messages on Twitter]. Revista Hispana Para el Análisis de Redes Sociales, 34(2), 238–253. https://doi.org/10.5565/rev/redes.996
  34. Memon, A. M., Sharma, S. G., Mohite, S. S., & Jain, S. (2018). The role of online social networking on deliberate self-harm and suicidality in adolescents: A systematized review of literature. Indian Journal of Psychiatry, 60(4), Article 384. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_414_17
  35. Moreno, M. A., Ton, A., Selkie, E., & Evnssi, Y. (2016). Secret society 123: Understanding the language of self-harm on Instagram. Journal of Adolescent Health, 58(1), 78–84. https://doi.org/10.1016/j.jadohealth.2015.09.015
  36. Muehlenkamp, J. J., Xhunga, N., & Brausch, A. M. (2018). Self-injury age of onset: A risk factor for NSSI severity and suicidal behavior. Archives of Suicide Research, 23(4), 551–563. https://doi.org/10.1080/13811118.2018.1486252
  37. Naslund, J. A., Bondre, A., Torous, J., & Aschbrenner, K. A. (2020). Social media and mental health: Benefits, risks, and opportunities for research and practice. Journal of Technology in Behavioral Science, 5, 245–257. https://doi.org/10.1007/s41347-020-00134-x
  38. Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6, 339–363. https://doi.org/10.1146/annurev.clinpsy.121208.131258
  39. Nock, M. K., & Favazza, A. R. (2009). Nonsuicidal self-injury: Definition and classification. In M. K. Nock (Ed.), Understanding nonsuicidal self-injury: Origins, assessment, and treatment (pp. 9–18). American Psychological Association. https://doi.org/10.1037/11875-001
  40. Pattison, E. M., & Kahan, J. (1983). The deliberate self-harm syndrome. The American Journal of Psychiatry, 140(7), 867–872. https://doi.org/10.1176/ajp.140.7.867
  41. Pérez-Elizondo, A. D. (2020). ¿Qué es el síndrome FOMO? [What is FOMO syndrome?] Psicología. com. https://psiquiatria.com/trabajos/usr_7775066768657.pdf
  42. Pérez-Elizondo, A. D. (2021). Enfermedad por autolesión. ¡Primero me corto, luego existo [Enfermedad por autolesión. ¡Primero me corto, luego existo]! Archivos de Investigación Materno Infantil, 11(2), 77–81. https://doi.org/10.35366/101554
  43. Rowe, S. L., French, R. S., Henderson, C., Ougrin, D., Slade, M., & Moran, P. (2014). Help-seeking behaviour and adolescent self-harm: A systematic review. Australian & New Zealand Journal of Psychiatry, 48(12), 1083–1095. https://doi.org/10.1177/0004867414555718
  44. Seering, J. (2020). Reconsidering self-moderation: The role of research in supporting community-based models for online content moderation. Proceedings of the ACM on Human-Computer Interaction, 4(CSCW2), Article 107. https://doi.org/10.1145/3415178
  45. Stacy, S. E., Bandel, S. L., Lear, M. K., & Pepper, C. M. (2018). Before, during, and after self injury: The practice patterns of nonsuicidal self-injury. The Journal of Nervous and Mental Disease, 206(7), 522–527. https://doi.org/10.1097/NMD.0000000000000846
  46. Staniland, L., Hasking, P., Boyes, M., & Lewis, S. (2021). Stigma and nonsuicidal self-injury: Application of a conceptual framework. Stigma and Health, 6(3), Article 312. https://doi.org/10.1037/sah0000257
  47. Statista. (2023). Redes sociales con mayor número de usuarios activos a nivel mundial en enero de 2022 (en millones) [Social networks with the highest number of active users worldwide in January 2022 (in millions)]. https://es.statista.com/estadisticas/600712/ranking-mundial-de-redes-sociales-pornumero-de-usuarios
  48. Sutton, J. (2007). Healing the hurt within: Understand self-injury and self-harm, and heal the emotional wounds. How To Books.
  49. Swannell, S. V., Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior, 44(3), 273–303. https://doi.org/10.1111/sltb.12070
  50. Twitter. (2023a). Policy regarding sensitive multimedia content. Retrieved June 2023, from https://help.twitter.com/es/rules-and-policies/media-policy
  51. Twitter. (2023b). Suicide and self-harm policy. Retrieved June 2023, from https://help.twitter.com/en/rules-and-policies/glorifying-self-harm
  52. UNICEF. (2020). Annual report 2020. https://www.unicef.org/reports/unicef-annual-report-2020
  53. UNICEF. (2021a). Por lo menos 1 de cada 7 niños y jóvenes ha vivido confinado en el hogar durante gran parte del año, lo que supone un riesgo para su salud mental y su bienestar [At least 1 in 7 children and young people have been confined to their homes for much of the year, posing a risk to their mental health and well-being]. https://www.unicef.org/es/comunicados-prensa/1-cada-7-ninos-jovenes-ha-vivido-confinado-hogar-durante-gran-parte-ano
  54. UNICEF. (2021b). Estado mundial de la infancia 2021 [State of the world’s children 2021]. https://www.unicef.org/es/informes/estado-mundial-de-la-infancia-2021
  55. Wang, Y., Tang, J., Li, J., Li, B., Wan, Y., Mellina, C., O’Hare, N., & Chang, Y. (2017). Understanding and discovering deliberate self-harm content in social media. In Proceedings of the 26th International Conference on World Wide Web (pp. 93–102). ACM. https://doi.org/10.1145/3038912.3052555