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<title>Digital mental health and hidden support: a qualitative analysis of non-suicidal self-injury communities on TikTok</title>
<creator>Martínez-Pastor, Esther</creator>
<creator>Blanco-Ruiz, Marian</creator>
<creator>Sanmartín Feijóo, Sandra</creator>
<subject>Non-Suicidal Self-Injury (NSSI</subject>
<subject>Self-harm</subject>
<subject>Digital mental health</subject>
<subject>Online peer support</subject>
<subject>Social media platforms</subject>
<subject>TikTok</subject>
<subject>Adolescents and young adults</subject>
<subject>Social media influence</subject>
<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.</description>
<date>2025-10-23</date>
<date>2025-10-23</date>
<date>2025-10</date>
<type>info:eu-repo/semantics/article</type>
<identifier>https://hdl.handle.net/10259/10989</identifier>
<identifier>10.3389/fdgth.2025.1645276</identifier>
<identifier>2673-253X</identifier>
<language>eng</language>
<relation>Frontiers in Digital Health. 2025, V. 7, 1645276</relation>
<relation>https://doi.org/10.3389/fdgth.2025.1645276</relation>
<rights>http://creativecommons.org/licenses/by/4.0/</rights>
<rights>info:eu-repo/semantics/openAccess</rights>
<rights>Atribución 4.0 Internacional</rights>
<publisher>Frontiers</publisher>
</thesis></metadata></record></GetRecord></OAI-PMH>