The influence of online images on self-harm: A qualitative study of young people aged 16–24

interaction via the medium of text, with limited consideration of the effect of images. This qualitative study explores how young people understand and use online images of selfharm. Semi-structured interviews were conducted with a community sample of 21 individuals aged 16e24 living in Wales, UK, with a previous history of self-harm. Interviewees reported the role of the Internet in normalising young people's self-harm. Images rather than textual interactions are the primary reason cited for using the Internet for self-harm purposes. Images invoke a physical reaction and inspire behavioural enactment, with Tumblr, which permits the sharing of images by anonymous individuals, being the preferred platform. Viewing online images serves a vital role in many young people's self-harm, as part of ritualistic practice. Online prevention and intervention need to attend to the importance of images.

"While some individuals reported discovery of self-harm through Internet searching for a tangential topic, which led to commencement of the behaviour, the majority engaged with online spaces to support and further develop a pre-existing set of self-harming practices. In alignment with existing research on the role of the Internet in behavioural enactment, engagement with online communities often led to an exacerbation of self-harm due to normalisation and increased exposure and access to new techniques... Despite the use of the Internet, it is apparent that not all platforms and micro-blogging sites are endorsed as equally conducive to sharing self-harm related materials or engagement in online interactions. Such a finding challenges the failure of researchers in this field to differentiate the corpus of online spaces, focusing only on the distinction between online and offline self-harm activity (Lewis & Michal, 2016). Although some individuals in the study lamented the lapsing of previously popular forums, the primacy of Tumblr in supporting young people's self-harming needs was clearly evident. Reasons for preferring this platform included the simplistic nature of its functionality and the anonymity and privacy afforded users. These notions do appear somewhat problematic, given that the premise of Tumblr is to be an open and visible platform...For many research participants, the predominant reason for use of Tumblr is its privileging of the image. Indeed, online communities seem to be increasingly assembled around the production and sharing of imagery in an attempt to document their self-harm journey. The purposeful searching of images may be bound up with the changing ways in which individuals use online media more broadly, where the publishing of photographs documenting everyday life is a common practice amongst young people." (Jacob et al, 2017: 144-5).