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<field name="value">Martínez-Pastor, Esther</field>
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<field name="value">Blanco-Ruiz, Marian</field>
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<field name="value">Sanmartín Feijóo, Sandra</field>
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<field name="value">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.</field>
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<field name="value">The author(s) declare that financial support was received for&#xd;
the research and/or publication of this article. This article has&#xd;
been funded by the project: Media Representation of Self-Harm&#xd;
in Minors in the Media and Social Networks (PID2021-&#xd;
124550OB-I00) of the Ministry of Science and Innovation (Spain).</field>
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<field name="value">Frontiers</field>
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<field name="value">Frontiers in Digital Health. 2025, V. 7, 1645276</field>
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<field name="value">Non-Suicidal Self-Injury (NSSI</field>
<field name="value">Self-harm</field>
<field name="value">Digital mental health</field>
<field name="value">Online peer support</field>
<field name="value">Social media platforms</field>
<field name="value">TikTok</field>
<field name="value">Adolescents and young adults</field>
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<field name="value">Digital mental health and hidden support: a qualitative analysis of non-suicidal self-injury communities on TikTok</field>
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