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<dc:title>Digital mental health and hidden support: a qualitative analysis of non-suicidal self-injury communities on TikTok</dc:title>
<dc:creator>Martínez-Pastor, Esther</dc:creator>
<dc:creator>Blanco-Ruiz, Marian</dc:creator>
<dc:creator>Sanmartín Feijóo, Sandra</dc:creator>
<dc:subject>Non-Suicidal Self-Injury (NSSI</dc:subject>
<dc:subject>Self-harm</dc:subject>
<dc:subject>Digital mental health</dc:subject>
<dc:subject>Online peer support</dc:subject>
<dc:subject>Social media platforms</dc:subject>
<dc:subject>TikTok</dc:subject>
<dc:subject>Adolescents and young adults</dc:subject>
<dc:subject>Social media influence</dc:subject>
<dc:description>This study examines the digital representation of Non-Suicidal Self-Injury (NSSI)&#xd;
on TikTok, with particular attention to the emergence of online communities&#xd;
and the communicative strategies users employ to share content while evading&#xd;
platform moderation. As TikTok becomes increasingly influential among&#xd;
adolescents and young adults, understanding how sensitive mental health&#xd;
topics like NSSI circulate on the platform is critical for developing effective&#xd;
digital health interventions. We conducted a qualitative content analysis of 400&#xd;
posts referencing NSSI, collected using a mixed-method approach: 25.5%&#xd;
using TikTok’s official API and 74.5% via the “For You” feed of a simulated&#xd;
account designed to mirror organic user experience. Posts were selected&#xd;
based on visual indicators (e.g., scars, tools), textual cues (e.g., hashtags,&#xd;
metaphors), and thematic references to emotional distress, recovery, or&#xd;
relapse. The analysis focused on user profile characteristics, linguistic strategies,&#xd;
and audiovisual aesthetics. Findings reveal a loosely structured yet emotionally&#xd;
resonant digital community characterized by subcultural codes, such as&#xd;
euphemisms, ambiguous hashtags, and stylized imagery. Despite content&#xd;
moderation policies, most accounts remained active and visible, with minimal&#xd;
enforcement of warnings or restrictions. While some posts portray NSSI as a&#xd;
coping strategy or seek to normalize the behavior, others subtly encourage&#xd;
recovery or offer indirect support. However, explicit messaging that&#xd;
discourages self-harm is notably rare. These dynamics suggest that TikTok&#xd;
unintentionally enables both the concealment and dissemination of self-harmrelated content, functioning as a space for affective connection but also as a&#xd;
vector for potential normalization of harmful behaviors. The study underscores&#xd;
the need for targeted, ethically grounded prevention strategies that address not&#xd;
only the psychological functions of these communities but also the&#xd;
algorithmic infrastructures that sustain their visibility. These findings contribute&#xd;
to ongoing debates about digital mental health, platform responsibility, and the&#xd;
design of safer online environments.</dc:description>
<dc:date>2025-10-23T09:11:01Z</dc:date>
<dc:date>2025-10-23T09:11:01Z</dc:date>
<dc:date>2025-10</dc:date>
<dc:type>info:eu-repo/semantics/article</dc:type>
<dc:identifier>https://hdl.handle.net/10259/10989</dc:identifier>
<dc:identifier>10.3389/fdgth.2025.1645276</dc:identifier>
<dc:identifier>2673-253X</dc:identifier>
<dc:language>eng</dc:language>
<dc:relation>Frontiers in Digital Health. 2025, V. 7, 1645276</dc:relation>
<dc:relation>https://doi.org/10.3389/fdgth.2025.1645276</dc:relation>
<dc:rights>http://creativecommons.org/licenses/by/4.0/</dc:rights>
<dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
<dc:rights>Atribución 4.0 Internacional</dc:rights>
<dc:publisher>Frontiers</dc:publisher>
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