Hostname: page-component-8448b6f56d-sxzjt Total loading time: 0 Render date: 2024-04-24T21:47:16.165Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of psychological improvement on non-professional suicide message boards: content analysis

Published online by Cambridge University Press:  22 September 2016

T. Niederkrotenthaler ,
M. Gould ,
G. Sonneck ,
S. Stack  and
B. Till
T. Niederkrotenthaler*
Affiliation:
Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Kinderspitalgasse 15, A-1090 Vienna, Austria
M. Gould
Affiliation:
Columbia University/NYS Psychiatric Institute 1051 Riverside Drive, Unit 72, New York, NY 10032, USA
G. Sonneck
Affiliation:
Crisis Intervention Center Vienna, Lazarettgasse 14a, A-1090 Vienna, Austria
S. Stack
Affiliation:
Department of Criminal Justice, Wayne State University; 3293 Faculty/Administration Building, 656 W. Kirby, Detroit, MI 48202, USA
B. Till
Affiliation:
Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Kinderspitalgasse 15, A-1090 Vienna, Austria
*
*Address for correspondence: T. Niederkrotenthaler, Medical University of Vienna, Center for Public Health, Institute of Social Medicine, Suicide Research Unit, Kinderspitalgasse 15, A-1090 Vienna, Austria. (Email: thomas.niederkrotenthaler@meduniwien.ac.at)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Suicide message boards have been at the core of debates about negative influences of the Internet on suicidality. Nothing is currently known about communication styles that may help users to psychologically improve in these settings.

Method

In all, 1182 archival threads with 20 499 individual postings from seven non-professional suicide message boards supporting an ‘against-suicide’, ‘neutral’ or ‘pro-suicide’ attitude were randomly selected and subject to content analysis. Initial needs of primary posters (i.e. individual who open a thread), their psychological improvement by the end of the thread, their responses received and indicators of suicidality were coded. Differences between ‘pro-suicide’, ‘neutral’ and ‘against suicide’ boards, and correlations between primary posters and respondents in terms of suicidality were assessed. Logistic regression was used to test associations with psychological improvement.

Results

‘Pro-suicide’ boards (n = 4) differed from ‘neutral’ (n = 1) and ‘against-suicide’ (n = 2) boards in terms of communicated contents. Indicators of suicidality correlated moderately to strongly between primary posters and respondents on ‘pro-suicide’ message boards, but less on other boards. Several communicative strategies were associated with psychological improvement in primary posters, including the provision of constructive advice [adjusted odds ratio (aOR) 4.10, 95% confidence interval (CI) 2.40–7.03], active listening (aOR 1.60, 95% CI 1.12–2.27), sympathy towards the poster (aOR 2.22, 95% CI 1.68–2.95) and provision of alternatives to suicide (aOR 2.30, 95% CI 1.67–3.18).

Conclusions

Respondents resemble primary posters with regard to suicidality in ‘pro-suicide’ boards, which may hinder psychological improvement. Still, opportunities to intervene in these settings using simple communication techniques exist and need to be taken and evaluated.

Keywords

Communicationmessage boardspreventionsocial mediasuicide
Type
Original Articles
Information
Psychological Medicine , Volume 46 , Issue 16 , December 2016 , pp. 3429 - 3442
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alao, AO, Soderberg, M, Pohl, EL, Alao, AL (2006). Cybersuicide: review of the role of the Internet on suicide. CyberPsychology and Behavior 9, 489–493.CrossRefGoogle ScholarPubMed
Barak, A, Bloch, N (2006). Factors related to perceived helpfulness in supporting highly distressed individuals through an online support chat. CyberPsychology and Behavior 9, 60–68.CrossRefGoogle ScholarPubMed
Barak, A, Dolev-Cohen, M (2006). Does activity level in online support groups for distressed adolescents determine emotional relief? Counselling and Psychotherapy Research 6, 186–190.CrossRefGoogle Scholar
Baume, P, Cantor, CH, Rolfe, A (1997). Cybersuicide: the role of interactive suicide notes on the Internet. Crisis 18, 73–79.CrossRefGoogle ScholarPubMed
Becker, K, Mayer, M, Nagenborg, M, El-Faddagh, M, Schmidt, MH (2004). Parasuicide online: can suicide websites trigger suicidal behaviour in predisposed adolescents? Nordic Journal of Psychiatry 58, 111–114.CrossRefGoogle ScholarPubMed
Becker, K, Schmidt, MH (2004). Internet chat rooms and suicide. Journal of the American Academy of Child and Adolescent Psychiatry 43, 246–247.CrossRefGoogle ScholarPubMed
Collings, S, Niederkrotenthaler, T (2012). Suicide prevention and emergent media: surfing the opportunity. Crisis 33, 1–4.CrossRefGoogle ScholarPubMed
Cooney, GM, Morris, J (2009). Time to start taking an Internet history? British Journal of Psychiatry 194, 185.CrossRefGoogle ScholarPubMed
Dunlop, SM, More, E, Romer, D (2011). Where do youth learn about suicide on the Internet, and what influence does this have on suicidal ideation? Journal of Child Psychology and Psychiatry 52, 1073–1080.CrossRefGoogle ScholarPubMed
Eichenberg, C (2008). Internet message boards for suicidal people: a typology of users. Cyberpsychology and Behavior 11, 107–113.CrossRefGoogle ScholarPubMed
Etzersdorfer, E, Fielder, G, Witte, M (editors) (2003). Neue Medien und Suizidalität. Gefahren und Interventionsmöglichkeiten (New Media and Suicidality: Challenges and Opportunities for Intervention). Vandenhoeck & Ruprecht: Göttingen.Google Scholar
Faul, F, Erdfelder, E, Lang, A, Buchner, A (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods 39, 175–191.CrossRefGoogle ScholarPubMed
Gilat, I, Tobin, Y, Shahar, G (2011). Offering support to suicidal individuals in an online support group. Archives of Suicide Research 15, 195–206.CrossRefGoogle Scholar
Gilat, I, Tobin, Y, Shahar, G (2012). Responses to suicidal messages in an online support group: comparison between trained volunteers and lay individuals. Social Psychiatry and Psychiatric Epidemiology 47, 1929–1935.CrossRefGoogle Scholar
Gould, MS, Cross, W, Pisani, AR, Munfakh, JL, Kleinman, M (2013). Impact of applied suicide intervention skills training on the national suicide prevention lifeline. Suicide and Life Threatening Behavior 43, 676–691.CrossRefGoogle ScholarPubMed
Hales, SA, Blackwell, SE, Simplicio, M, Iyadurai, L, Young, K, Holmes, EA (2015). Chapter 4: Imagery-based cognitive–behavioral assessment. In Assessment in Cognitive Therapy (ed. Brown, GP and Clark, DA). Guilford Press: New York (http://www.ncbi.nlm.nih.gov/books/NBK311390/). Accessed August 2016.Google Scholar
Hales, SA, Deeprose, C, Goodwin, GM, Holmes, EA (2011). Cognitions in bipolar affective disorder and unipolar depression: imagining suicide. Bipolar Disorders 13, 651–661.CrossRefGoogle ScholarPubMed
Harris, KM, McLean, JP, Sheffield, J (2009). Examining suicide-risk individuals who go online for suicide-related purposes. Archives of Suicide Research 13, 264–276.CrossRefGoogle ScholarPubMed
Jones, R, Sharkey, S, Ford, T, Emmens, T, Hewis, E, Smithson, J, Sheaves, B, Owens, C (2011). Online discussion forums for young people who self-harm: user views. Psychiatrist 35, 364–368.CrossRefGoogle Scholar
Kemp, CG, Collings, SC (2011). Hyperlinked suicide: assessing the prominence and accessibility of suicide Web sites. Crisis 32, 143–151.CrossRefGoogle Scholar
Krippendorff, K (2004). Content Analysis: An Introduction to its Methodology. Sage: Thousand Oaks, CA.Google Scholar
Lehavot, K, Ben-Zeev, D, Neville, RE (2012). Ethical considerations and social media: a case of suicidal postings on facebook. Journal of Dual Diagnosis 8, 341–346.CrossRefGoogle Scholar
Miller, JK, Gergen, KJ (1998). Life on the line: the therapeutic potentials of computer-mediated conversation. Journal of Marital and Family Therapy 24, 189–202.CrossRefGoogle ScholarPubMed
Mishara, BL, Chagnon, F, Daigle, M, Balan, B, Raymond, S, Marcoux, I, Bardon, C, Campbell, JK, Berman, A (2007). Comparing models of helper behavior to actual practice in telephone crisis intervention: a silent monitoring study of calls to the U.S. 1-800-SUICIDE Network. Suicide and Life Threatening Behavior 37, 291–307.CrossRefGoogle Scholar
Mok, K, Jorm, AF, Pirkis, J (2016). Who goes online for suicide-related reasons? A comparison of suicidal people who use the Internet for suicide-related reasons and those who do not. Crisis 37, 112–120.CrossRefGoogle Scholar
Naito, A (2007). Internet suicide in Japan: implications for child and adolescent mental health. Clinical Child Psychology and Psychiatry 12, 583–597.CrossRefGoogle ScholarPubMed
Niederkrotenthaler, T, Haider, A, Till, B, Mok, K, Pirkis, J (in press). Comparison of suicidal people who use the Internet for suicide-related reasons and those who do not: survey study in Austria. Crisis. doi:10.1027/0227-5910/a000432.Google Scholar
Ozawa-de Silva, C (2010). Shared death: self, sociality and Internet group suicide in Japan. Transcultural Psychiatry 47, 392–418.CrossRefGoogle ScholarPubMed
Pirkis, J, Neal, L, Dare, A, Blood, RW, Studdert, D (2009). Legal bans on pro-suicide web sites: an early retrospective from Australia. Suicide and Life-Threatening Behavior 39, 190–193.CrossRefGoogle ScholarPubMed
Ringel, E (1976). The presuicidal syndrome. Suicide and Life Threatening Behavior 6, 131–149.CrossRefGoogle ScholarPubMed
Ringel, E (1997). Der Selbstmord. Abschluß einer krankhaften Entwicklung (Suicide. End of a Pathological Development). Klotz: Vienna/Düsseldorf.Google Scholar
Rodham, K, Gavin, J, Miles, M (2007). I hear, I listen, I care: a qualitative investigation into the function of a self-harm message board. Suicide and Life-threatening Behavior 37, 422–430.CrossRefGoogle Scholar
Shneidman, E (1995). Suicide as Psychache: A Clinical Approach to Self-Destructive Behavior. Aronson: Lanham, MD.Google Scholar
Sonneck, G, Kapusta, N, Tomandl, G, Voracek, M (2012). Krisenintervention und Suizidverhütung (Crisis Intervention and Suicide Prevention). Facultas: Vienna.Google Scholar
Sueki, H, Eichenberg, C (2012). Suicide bulletin board systems comparison between Japan and Germany. Death Studies 36, 565–580.CrossRefGoogle ScholarPubMed
Till, B, Niederkrotenthaler, T (2014). Surfing for suicide methods and help. Journal of Clinical Psychiatry 75, 886–892.CrossRefGoogle ScholarPubMed
Tseng, FY, Yang, HJ (2015). Internet use and web communication networks, sources of social support, and forms of suicidal and nonsuicidal self-injury among adolescents: different patterns between genders. Suicide and Life-Threatening Behavior 45, 178–191.CrossRefGoogle ScholarPubMed
Wasserman, D, Saraceno, B, Farberow, N (2001). Suicide: An Unnecessary Death. Martin Dunitz Ltd: London.Google Scholar
Westerlund, M, Hadlaczky, G, Wasserman, D (2015). Case study of posts before and after a suicide on a Swedish Internet forum. British Journal of Psychiatry 207, 476–482.CrossRefGoogle ScholarPubMed
Winkel, S, Groen, G, Petermann, F (2005). Soziale Unterstützung in Suizidforen (Social support in suicide forums, in German, English abstract). Praxis der Kinderpsychologie und Kinderpsychiatrie 54, 714–727.Google Scholar
World Health Organization (2008). Preventing Suicide. A Resource for Media Professionals. WHO: Geneva.Google Scholar
Supplementary material: File

Niederkrotenthaler supplementary material

Tables S1-S2

Download Niederkrotenthaler supplementary material(File)
File 155.6 KB