Social media, Smartphone use and Self-harm in Young People (3S-YP study)

自残是指某人对自己的身体造成损害或伤害。通常，这是一种缓解痛苦想法和感受的方式。自我伤害通常包括减少或过量服用。然而，它也可以是任何导致伤害的行为，如烧伤、咬、抓或打自己。年轻人自残是一个重大的公共卫生问题。在世界范围内，这是后期自杀的最大风险因素。在英国，超过十分之一的年轻人被认为有过自残行为，但实际人数可能是这个数字的两倍多。这是因为在社区中发生的自残在很大程度上是隐藏的，不会引起临床服务的注意。自残背后的原因很复杂。自残报告的急剧增加，尤其是在英国的少女中，与社交媒体对心理健康的影响有关——尽管证据基础有限。年轻人似乎越来越多地使用社交媒体向同龄人传达痛苦。这是可能的，因为他们是拥有智能手机是常态的一代人。社交媒体在他们的生活中无处不在，随时随地，不分昼夜。智能手机是他们生活中不可或缺的一部分，也是一种强大的社交工具。但是，社交媒体和智能手机的哪些方面可能会增加自残的脆弱性呢？是过度使用，还是夜间使用影响睡眠？众所周知，年轻人深夜使用智能手机和醒来查看社交媒体更新会导致睡眠障碍。这与抑郁情绪、较差的自尊和应对能力有关，但这是否也会发生在自残之前呢？是否涉及成瘾的使用模式？是不断在网上发帖让年轻人容易收到更多负面评论，还是网络欺凌本身负有责任，还是多种因素共同作用？我们的目标是研究社交媒体和智能手机使用的机制，这些机制是年轻人自残的基础。我们最感兴趣的是社交媒体和智能手机的使用在导致自残事件发生的过程中可能发生的变化。我们还将在一年的随访期内调查自我伤害与智能手机成瘾、睡眠质量、抑郁、焦虑、孤独和欺凌之间的关系。我们将使用个人年轻人社交媒体足迹的类型和内容、他们的智能手机使用情况以及自我报告的自残事件之间的数据联系。我们将对以人群为基础的群体和有较高自残风险的精神健康患者群体都这样做。这将使我们能够研究一系列的自残行为。在这两个小组中，我们将能够研究社区自残和在医院治疗的自残，使用医院入院数据。对于精神健康患者群体，我们也将能够使用急诊科的出勤数据并识别临床医生在免费文本中指出的自我伤害。我们将开发与未来自残事件相关的行为概况，并开发未来事件的预测规则。这项研究的潜在好处是有助于为新的干预措施的发展提供信息，这些干预措施可能被用来确保弱势年轻人得到识别并得到他们所需的帮助。这可以通过利用社交媒体的积极保护作用来实现，例如在人们真正需要危机支持时获得支持，或者赋予年轻人做出改变、管理自身风险和建立复原力的能力。我们的研究问题的设计和关键伦理问题的考虑已经涉及到两个年轻人的专家咨询小组。通过我们正在研究的两个群体的年轻人和YoungMinds的代表的积极参与，合作制作将继续用于整个研究开发和研究成果的交流，YoungMinds是英国领先的年轻人福利和心理健康慈善机构。

Self-harm is when someone causes damage or injury to their body. Usually it is a way to relieve distressing thoughts and feelings. Often self-harm involves cutting or taking overdoses. However, it can also be any behaviour that causes injury such as burning, biting, scratching or hitting oneself.Self-harm in young people is a major public health problem. Worldwide, it is the strongest risk factor for later suicide. More than 1 in 10 young people in the UK are thought to have self-harmed, but it could be more than double this. This is because self-harm that occurs in the community is largely hidden and does not come to the attention of clinical services. The reasons behind self-harm are complex. The steep rise in reports of self-harm, especially amongst teenage girls in the UK has been linked to the impact of social media on mental wellbeing-although the evidence base is limited. Young people seem to be increasingly using social media to communicate distress to their peers. This is possible because they are the generation for whom smartphone ownership is the norm. Social media is ever-present in their lives, readily at hand at all times, day and night. Their smartphones are an integral part of life and a powerful social tool.But which aspects of social media and smartphone use might increase vulnerability to self-harm? Is it excessive use, or night-time use with its impact on sleep? Young people's late-night smartphone use and waking to check social media updates is known to cause sleep disturbance. This has been linked to depressed moods and poorer self-esteem and coping ability, but might it also happen just before someone self-harms? Is an addictive pattern of use involved? Could it be that constant posting online opens young people up to receiving more negative comments or that cyberbullying itself is responsible, or a combination of factors?We aim to study the mechanisms of social media and smartphone use that underpin self-harm in young people. We are most interested in the ways in which social media and smartphone use may change in the time leading up to a self-harm episode. We will also investigate how self-harm is related to smartphone addiction, sleep quality, depression, anxiety, loneliness and bullying over a 1 year follow-up period.We will use data linkage between the type and content of an individual young person's social media footprint, their smartphone usage, and self-reported episodes of self-harm. We will do this for both a population-based group and a mental health patient group, who are at higher risk of self-harm. This will enable us to study a whole range of self-harm behaviours. In both groups we will be able to study community self-harm and self-harm treated in hopsitals, using hospital admission data. For the mental health patient group we will also be able to use emergency department attendance data and identify self-harm noted in the free text by clinicians. We will develop profiles of behaviours that are linked to future self-harm episodes, and develop prediction rules for a future episode. The potential benefits of this research are to help inform the development of new interventions that might be used to ensure vulnerable young people are identified and get the help they need. This could be by harnessing the positive protective effects of social media, such as access to crisis support when someone really needs it, or empowering young people to make changes, manage their own risks and build resilience. The design of our research questions and consideration of key ethical issues has already involved two young people expert advisory groups. Co-production will continue to be used throughout study development and in communicating the outcomes of the research, by active involvement of young people from both the groups we are studying, and representatives from YoungMinds: the UK leading charity for the wellbeing and mental health of young people.