This study examines the digital representation of Non-Suicidal Self-Injury (NSSI)
on TikTok, with particular attention to the emergence of online communities
and the communicative strategies users employ to share content while evading
platform moderation. As TikTok becomes increasingly influential among
adolescents and young adults, understanding how sensitive mental health
topics like NSSI circulate on the platform is critical for developing effective
digital health interventions. We conducted a qualitative content analysis of 400
posts referencing NSSI, collected using a mixed-method approach: 25.5%
using TikTok’s official API and 74.5% via the “For You” feed of a simulated
account designed to mirror organic user experience. Posts were selected
based on visual indicators (e.g., scars, tools), textual cues (e.g., hashtags,
metaphors), and thematic references to emotional distress, recovery, or
relapse. The analysis focused on user profile characteristics, linguistic strategies,
and audiovisual aesthetics. Findings reveal a loosely structured yet emotionally
resonant digital community characterized by subcultural codes, such as
euphemisms, ambiguous hashtags, and stylized imagery. Despite content
moderation policies, most accounts remained active and visible, with minimal
enforcement of warnings or restrictions. While some posts portray NSSI as a
coping strategy or seek to normalize the behavior, others subtly encourage
recovery or offer indirect support. However, explicit messaging that
discourages self-harm is notably rare. These dynamics suggest that TikTok
unintentionally enables both the concealment and dissemination of self-harmrelated content, functioning as a space for affective connection but also as a
vector for potential normalization of harmful behaviors. The study underscores
the need for targeted, ethically grounded prevention strategies that address not
only the psychological functions of these communities but also the
algorithmic infrastructures that sustain their visibility. These findings contribute
to ongoing debates about digital mental health, platform responsibility, and the
design of safer online environments.
