Michael Townsend Cooper1, David Bard2, Rebecca Wallace2, Stephen Gillaspy2, Stephanie Deleon2. 1. University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, Oklahoma City. Electronic address: michael-t-cooper@ouhsc.edu. 2. University of Oklahoma Health Sciences Center, Department of Pediatrics, Oklahoma City, Oklahoma City.
Abstract
PURPOSE: Release of the Netflix series 13 Reasons Why in March 2017 raised concern over associated suicide attempts. This study aimed to identify trends in self-harm admissions to a tertiary children's hospital with special attention paid to the time after series release. METHODS: Records for admitted patients ages 4-18 years from January 2012 to October 2017 were identified based on ICD codes indicating self-harm. Admissions were grouped by month, and the ARMA (Auto Regression and Moving Average) model was used in analysis. Log transformation was used to obtain a constant variance, and seasonal terms were added for adjustment. A "postintervention" level shift, temporary shift, and linear growth term were incorporated as predictors in ARMA models to test for differences using the series premier as the intervention. Terms from the best fitting model (without intervention effects) were fit to preintervention data and forecast predictions were compared to the observed data from the postintervention period. RESULTS: Seven hundred seventy-five records were included in analysis. There was an increase of .024 in the log of suicide admission counts per month (p < .001). The model that best explained the data was an ARMA (2,2) model with cubic growth curve terms, a post-intervention level shift, and a postintervention linear growth term, indicating an increase in observed over expected admissions following the premiere. CONCLUSIONS: Suicide admission counts increased over the time series. Actual suicide admissions following March 2017 were higher than predicted using the optimal model, suggesting an effect that temporally coincides with the release of 13 Reasons Why.
PURPOSE: Release of the Netflix series 13 Reasons Why in March 2017 raised concern over associated suicide attempts. This study aimed to identify trends in self-harm admissions to a tertiary children's hospital with special attention paid to the time after series release. METHODS: Records for admitted patients ages 4-18 years from January 2012 to October 2017 were identified based on ICD codes indicating self-harm. Admissions were grouped by month, and the ARMA (Auto Regression and Moving Average) model was used in analysis. Log transformation was used to obtain a constant variance, and seasonal terms were added for adjustment. A "postintervention" level shift, temporary shift, and linear growth term were incorporated as predictors in ARMA models to test for differences using the series premier as the intervention. Terms from the best fitting model (without intervention effects) were fit to preintervention data and forecast predictions were compared to the observed data from the postintervention period. RESULTS: Seven hundred seventy-five records were included in analysis. There was an increase of .024 in the log of suicide admission counts per month (p < .001). The model that best explained the data was an ARMA (2,2) model with cubic growth curve terms, a post-intervention level shift, and a postintervention linear growth term, indicating an increase in observed over expected admissions following the premiere. CONCLUSIONS: Suicide admission counts increased over the time series. Actual suicide admissions following March 2017 were higher than predicted using the optimal model, suggesting an effect that temporally coincides with the release of 13 Reasons Why.
Authors: Thomas Niederkrotenthaler; Steven Stack; Benedikt Till; Mark Sinyor; Jane Pirkis; David Garcia; Ian R H Rockett; Ulrich S Tran Journal: JAMA Psychiatry Date: 2019-09-01 Impact factor: 21.596
Authors: Jeffrey A Bridge; Joel B Greenhouse; Donna Ruch; Jack Stevens; John Ackerman; Arielle H Sheftall; Lisa M Horowitz; Kelly J Kelleher; John V Campo Journal: J Am Acad Child Adolesc Psychiatry Date: 2019-04-28 Impact factor: 8.829
Authors: Elizabeth A Swedo; Jennifer L Beauregard; Sietske de Fijter; Luke Werhan; Kirkland Norris; Martha P Montgomery; Erica B Rose; Corinne David-Ferdon; Greta M Massetti; Susan D Hillis; Steven A Sumner Journal: J Adolesc Health Date: 2020-07-07 Impact factor: 5.012
Authors: Laura M Hart; Kathy S Bond; Amy J Morgan; Alyssia Rossetto; Fairlie A Cottrill; Claire M Kelly; Anthony F Jorm Journal: Int J Ment Health Syst Date: 2019-11-16