Helpful or harmful? An examination of viewers' responses to nonsuicidal self-injury videos on YouTube.

PURPOSE To examine viewers' comment responses to nonsuicidal self-injury (NSSI) YouTube videos to determine the potential risks (e.g., NSSI continuation) and benefits (e.g., recovery-oriented social support) of the videos. METHODS Viewers' comments from the 100 most-viewed NSSI videos on YouTube were examined using two coding rubrics, one for the global nature of comments and one for recovery-oriented themes. Both rubrics were developed using an inductive (bottom-up) approach and had high coding inter-rater reliability (exceeding .80 in all cases). For the global nature of comments, 869 randomly selected comments were evaluated using the rubric, which included 8 coding categories and 22 subcategories. For the examination of recovery-oriented themes, self-disclosure comments (n = 377) were evaluated for nature of recovery statements. RESULTS Results revealed that the most frequent comments were self-disclosure comments in which individuals shared their own NSSI experiences (38.39%), followed by feedback for the video uploader, including admiration of the video quality (21.95%) or message (17.01%), and admiration for the uploader (15.40%) or encouragement to the video uploader (11.15%). Evaluation of the common self-disclosure comments for recovery-oriented content revealed that the majority did not mention recovery at all (42.89%) and indicated that they were still self-injuring (34.00%). Positive recovery statements were uncommon. CONCLUSIONS Results suggest that viewers' responses to videos may maintain the behavior (by sharing their own self-injury experiences) and rarely encourage or mention recovery. It is evident that sharing their own experience online is a strong motivator for viewers of NSSI YouTube videos.