Online Risk Factors and Youth Suicide

A recent study found an association between online risk factors and suicidal behavior among youth. According to the authors, this was the first longitudinal study to examine risk markers for youth suicide-related behavior beyond screen time, with the study design allowing for temporal associations between risk factors and outcomes.

The matched case-control study included students from 2,600 schools participating in an online safety monitoring program via the Bark online safety tool from July 27, 2019 to May 26, 2020. Researchers identified 227 youth (cases) who made statements online indicating an imminent or recent suicide attempt and/or self-harm, which sent a “severe suicide/self-harm alert” to school administrators. These cases were matched to 1,135 youth (controls) who did not have a “severe suicide/self-harm alert,” were enrolled in the same school, and had a similar volume of observable online activity.

The researchers then evaluated the association between eight potential suicide risk factors with having a “severe suicide/self-harm alert”: cyberbullying, drug-related content, sexual content, violence, hate speech, profanity, depression, and viewing content related to suicide or self-harm (which sent a “low-severity suicide/self-harm alert” to school administrators).

Of the eight potential risk factors examined, the researchers found all except hate speech demonstrated significant differences between case and control youth, with cyberbullying being the most prevalent. They also found an intensifying risk of experiencing a “severe suicide/self-harm alert” based on the number of risk factors that a student displayed.

These findings were limited by a lack of data on hospitalizations or suicides among the youth studied, making it impossible to establish a causal link between online behavior and actual suicide attempts or self-harm. Data were also limited to online behaviors happening inside the school systems. Although cases and controls were diverse and randomly drawn, the analysis did not stratify results by demographic factors. Finally, the study took place during the COVID-19 pandemic, which could have influenced the results, as many students were spending more time online.

Sumner, S. A., Ferguson, B., Bason, B., Dink, J., Yard, E., Hertz, M., Hilkert, B., Holland, K., Mercado-Crespo, M., Tang, S., & Jones, C. M. (2021). Association of online risk factors with subsequent youth suicide-related behaviors in the U.S. Jama Network Open, 4(9): e2125860.