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Online forums a 'mixed bag' for depressed youth

By Genevra Pittman

NEW YORK (Reuters Health) - Troubled kids can find helpful support on the Internet. They can also find encouragement to hurt themselves and avoid professional help, suggests a new look at past studies.

Researchers said Internet forums and other online resources may be both good and bad influences when it comes to self-harm and suicidal thoughts among depressed young people.

"Certainly there were ways in which the Internet gave anonymous support for people, for this population, and that could be helpful," said Paul Montgomery. He worked on the review at the University of Oxford in the UK.

But, he added, "Many of the better-quality studies seem to indicate that there were also many sites … which also taught people not to disclose, not to be open about the difficulties they were having, not to seek help."

Some websites might encourage young people to seek out suicidal partners, he told Reuters Health.

Montgomery and his colleagues analyzed 14 studies that looked at Internet use and self-harm among people under age 25, typically teenagers and preteens. Self-harm includes intentional cutting and burning but is usually not intended as a suicide attempt.

The quality of those studies and how they were conducted varied widely, the researchers noted.

Their results were published Wednesday in the online journal PLOS ONE.

Half of the studies reported Internet forums could have positive effects on young people. Forums reinforced positive behaviors, such as not using self-harm, and helped users connect with other people and seek out empathy and support.

But five studies found self-harm was sometimes discussed in a way that made it seem normal, or that forums were used by people looking for suicidal partners.

Studies also tied Internet addiction and large amounts of Internet use and gaming to a greater risk of self-harm. Two suggested online bullying could affect self-harm and suicidal thoughts.

"It's a mixed bag," Janis Whitlock, from Cornell University in Ithaca, New York, said.

"There are some real assets, there are some real benefits to being able to access information and other people that may be supportive on the web. And also there are some real risks," she told Reuters Health.

Even if young people get a sense of belonging and support from an online community, Whitlock said it's not the same as being led through the healing process by a therapist.

And it may be harder for children and teens who hurt themselves to stop if getting better means they're cut off from that community.

Montgomery said parents should talk to their children about what websites they're using. For children who are depressed, both parents and doctors can ask if they visit any sites related to self-harm.

"The best thing to do is have a conversation with young people who one knows are self-injuring and maybe ask if they're getting information online, ask if they're accessing online communities … and find out what their experience is with that," Whitlock said. She has studied Internet use and self-harm but wasn't involved in the review.

"If I was a parent, I would certainly want to know if they've ever had a bad experience or if they ever leave some of the forums they visit feeling not very good for other reasons or feeling triggered," she added.

But even when young people are very depressed, parents shouldn't keep them off the Internet altogether, Montgomery said.

"There may well be positive attributes for many kids," he said.

SOURCE: http://bit.ly/cxPBJV PLOS ONE, online October 30, 2013.

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