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Proposal summary: Background: Research has established that the media can influence suicidal behaviour . This may occur through processes of contagion, imitation and transmission of methods. The Internet is a relatively new medium that is transforming the environment for the communication of information about suicide.
Proposal summary: Background: Research has established that the media can influence suicidal behaviour . This may occur through processes of contagion, imitation and transmission of methods. The Internet is a relatively new medium that is transforming the environment for the communication of information about suicide. As well as providing an outlet for traditional sources of media such as news reports, which are known to influence suicidal behaviour, it also poses additional and unique challenges.
It allows instantaneous, repeated and global sharing of a broad array of information, including detailed 'how to' information about suicide methods. It also enables creation and interactive exchange of user-generated content through social media platforms, such as chat rooms, blogging, video sites and social networking sites .
Information may derive from individuals as well as institutions, meaning that new and anonymous voices can contribute, uncensored to dialogue about suicide , and create pro-suicide 'extreme communities'  which may encourage suicide as a response to difficulties. Internet use may therefore increase access to suicide  both physically, though transmission of methods, and cognitively by endorsing this roo,s a culturally available response to distress.
The Internet and social media are fundamental to the way that many people share information, opinions and ideas.
There are over two billion Internet users worldwide and use is most prevalent amongst young adults aged years . Concern about the potential for the Internet to cause suicide is at an all time high with mounting cases of internet-related suicide reported in the popular and academic press e. These provide examples of individuals using suicide methods discovered online, accessing drugs for overdose from unregulated online pharmacies, and being encouraged to attempt suicide through participation in chat room discussions.
Social networking rooma been implicated in recent suicide clusters such as Bridgend. While such examples demonstrate that the Internet can contribute to roosm behaviour in a range of ways, much of this literature in this field is impressionistic. There is little systematic empirical evidence.
Studies of Internet content reinforce the notion that detailed information about suicide methods can be accessed easily  , however, these eooms cannot inform about actual user behaviour in accessing these sites or how such information is interpreted. Prevalence estimates of suicide-related internet use are currently lacking. Existing studies of users tend to be based on self-selecting samples responding to online adverts and questionnaires  . While furthering concerns about possible harmful effects of the Internet, these studies also draw attention to the possibility that for some individuals, the Internet provides a constructive and supportive environment for dealing with suicidal feelings.
This raises the prospect of exploiting the Internet for prevention purposes but to achieve this requires understanding of what users seek online and what material will engage them. Detailed empirical study examining how, when and for what purpose the internet is used by individuals with suicidal feelings and how this shapes suicidal behaviour is now required to inform attempts to both restrict harmful use and to capitalise on the Cnat potential char offer population level suicide prevention.
Aims: To provide detailed empirical evidence about the use of the Internet for suicide-related chats by young adults and how this influences suicidal feelings and behaviour. De: This project will involve using data from the section on deliberate self-harm in the adult ALSPAC 20 years room, including questions about suicide-related Internet use formulated by the cnat LB and DG. The data will be used to conduct quantitative analysis and derive for purposive sample for self qualitative data collection.
This project forms part of a larger application, which will also explore Internet amongst other groups. Quantitative analysis This is a descriptive, exploratory study and so chxt are not specifc harms.
Exposure variables: deliberate self-harm, suicidal thoughts The outcome roos will be for or not the Internet has been used for suicide-related purposes. After considering total prevalence and patterns of Internet use amongst all responders, analysis will focus on 3 sub-groups, individuals reporting past year : 1 self-harm; 2 self-harm adult suicidal intent; 3 suicidal thoughts.
Qualitative interviews The main objectives will be to: 1 derive in-depth qualitative s of Internet use exploring: how, why and when the Internet is accessed; the material that is viewed and how this is interpreted; how use changes over time; and how use shapes suicidal behaviour. We will seek to use maximum variation Looking for ltr military is a plus to obtain a diverse sample in terms of gender, nature of self-reported self-harm and suicidal rooms e.
In particular, we will seek to include harms who report visiting support and prevention sites as well as those visiting pro-suicide chats. The aim will be to conduct around 25 interviews though exact sample size will be determined according to the of participants required to achieve a consistent and refined understanding of the main themes across seof diverse group. Based on our experience of qualitative research in this area, we anticipate that self respondents will yield extremely rich and complex data as multiple episodes of suicidal behaviour and Internet use are likely to be presented within single cases.
Two of our rooms with mentally distressed young adults and near-fatal suicide attempters have been based for sample sizes of 23  and 22  participants. All further data collection will be undertaken independently by the research team headed by Biddle et al. Interviews will be in-depth and semi-structured. They will be conducted within the Women want nsa Mines West Virginia tradition and in chat with an ethnographic grounded theory approach .
Computer access self be available at the interviews and where appropriate, participants will be asked to take the interviewer through sites accessed, identifying material that they viewed and their perceptions of this. A topic guide will be used to ensure consistency and that the research aims are fully addressed, but minimal prompting will be used. Participants will be encouraged to raise issues they consider of importance, including any relevant additional adults not covered by the guide.
In this way, data collection will be grounded in the viewpoints and experiences of interviewees without imposing meanings. Interviews will be conducted in small batches with analysis performed simultaneously. This will allow for an selff process in which emerging questions and ideas will be incorporated into the topic guide and explored with subsequent respondents until a refined level of understanding is reached.
Interviews will be conducted at the respondent's home or the University according to their preference. Full ethical approval will be sought before undertaking the study and a protocol will be developed for use should a situation arise where a respondent became distressed or disclosed information indicating possible risk.
This will be based selt protocols developed by the team for use in similar studies. The study team has clinical expertise JP and extensive experience of conducting research with vulnerable populations. These include studies exploring non-help-seeking in young adults with mental distress  and factors influencing choice of suicide method amongst individuals who have survived a near-fatal attempt . In the latter study we assessed respondent well-being before and after the qualitative interview and found that most respondents found participation cathartic and reported an improvement in mood .
Interviews will be audio-recorded with participants' consent and transcribed in full. First, transcripts will be coded for emerging themes and analysis will proceed according to the method of constant comparison, data relating to each code being retrieved and compared within and across individuals. Analytical grids will be used to map out relationships between codes. Second longitudinal case studies will be prepared to explore how Internet use may evolve and impact upon suicidal behaviour over time.
Case studies of negative and positive Internet use will also be prepared and contrasted to identify their key features.
Internet pathways in suicidality: a review of the evidence. Examining Suicide-Risk Individuals who go online for suicide related purposes. Archives of Suicide Research. Internet message boards for suicidal people: a typology of users. Cyberpsychology and Behaviour.
Deliberate self-harm in adolescents: self-report survey in schools in England. BMJ Influences of the media on suicide. Social media and suicide: a public health perspective. American Journal of Public Health Online information, extreme communities and internet therapy: Is the interne good for our mental health? Journal of Mental Health Suicide prevention by limiting access to methods: A review of theory and practice. Social Science and Medicine Suicide methods from the Internet. American Journal of Psychiatry Cybersuicide: review of the role of the Internet on suicide.
Cyberpsychology and Behavior.
Parasuicide online: can suicide websites trigger suicidal behaviour in predisposed adolescents? Nordic Journal of Psychiatry Suicide and the Internet. Googling suicide: surfing for suicide information on the Internet. Journal of Clinical Psychiatry.
Three epistemological stances for qualitative inquiry: interpretivism, hermeneutics, and social constructionism. The discovery of grounded theory: strategies for qualitative research. New York: Aldine De Gruyter, Qualitative interviewing with vulnerable populations: individuals' experiences of participating in suicide and self-harm based research. Submitted to Journal of Affective Disorders.
Date proposal received:.
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