Elizabeth A Swedo1, Jennifer L Beauregard2, Sietske de Fijter3, Luke Werhan3, Kirkland Norris4, Martha P Montgomery5, Erica B Rose6, Corinne David-Ferdon7, Greta M Massetti7, Susan D Hillis8, Steven A Sumner7. 1. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: eswedo@cdc.gov. 2. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia. 3. Ohio Violence and Injury Prevention Program, Ohio Department of Health, Columbus, Ohio. 4. Stark County Health Department, North Canton, Ohio. 5. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Ohio Violence and Injury Prevention Program, Ohio Department of Health, Columbus, Ohio. 6. Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia. 7. Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia. 8. Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; Office of the Global AIDS Coordinator, Washington, District of Columbia.
Abstract
PURPOSE: Youth suicide clusters may be exacerbated by suicide contagion-the spread of suicidal behaviors. Factors promoting suicide contagion are poorly understood, particularly in the advent of social media. Using cross-sectional data from an ongoing youth suicide cluster in Ohio, this study examines associations between suicide cluster-related social media and suicidal behaviors. METHODS: We surveyed 7th- to 12th-grade students in northeastern Ohio during a 2017-2018 suicide cluster to assess the prevalence of suicidal ideation (SI), suicide attempts (SAs), and associations with potential contagion-promoting factors such as suicide cluster-related social media, vigils, memorials, news articles, and watching the Netflix series 13 Reasons Why before or during the cluster. Generalized estimating equations examined associations between potential contagion-promoting factors and SI/SA, adjusting for nonmodifiable risk factors. Subgroup analyses examined whether associations between cluster-related factors and SI/SA during the cluster varied by previous history of SI/SA. RESULTS: Among participating students, 9.0% (876/9,733) reported SI and 4.9% attempted suicide (481/9,733) during the suicide cluster. Among students who posted suicide cluster-related content to social media, 22.9% (267/1,167) reported SI and 15.0% (175/1,167) attempted suicide during the suicide cluster. Posting suicide cluster-related content was associated with both SI (adjusted odds ratio 1.7, 95% confidence interval 1.4-2.0) and SA during the cluster (adjusted odds ratio 1.7, 95% confidence interval 1.2-2.5). In subgroup analyses, seeing suicide cluster-related posts was uniquely associated with increased odds of SI and SA during the cluster among students with no previous history of SI/SA. CONCLUSIONS: Exposure to suicide cluster-related social media is associated with both SI and SA during a suicide cluster. Suicide interventions could benefit from efforts to mitigate potential negative effects of social media and promote prevention messages. Published by Elsevier Inc.
PURPOSE: Youth suicide clusters may be exacerbated by suicide contagion-the spread of suicidal behaviors. Factors promoting suicide contagion are poorly understood, particularly in the advent of social media. Using cross-sectional data from an ongoing youth suicide cluster in Ohio, this study examines associations between suicide cluster-related social media and suicidal behaviors. METHODS: We surveyed 7th- to 12th-grade students in northeastern Ohio during a 2017-2018 suicide cluster to assess the prevalence of suicidal ideation (SI), suicide attempts (SAs), and associations with potential contagion-promoting factors such as suicide cluster-related social media, vigils, memorials, news articles, and watching the Netflix series 13 Reasons Why before or during the cluster. Generalized estimating equations examined associations between potential contagion-promoting factors and SI/SA, adjusting for nonmodifiable risk factors. Subgroup analyses examined whether associations between cluster-related factors and SI/SA during the cluster varied by previous history of SI/SA. RESULTS: Among participating students, 9.0% (876/9,733) reported SI and 4.9% attempted suicide (481/9,733) during the suicide cluster. Among students who posted suicide cluster-related content to social media, 22.9% (267/1,167) reported SI and 15.0% (175/1,167) attempted suicide during the suicide cluster. Posting suicide cluster-related content was associated with both SI (adjusted odds ratio 1.7, 95% confidence interval 1.4-2.0) and SA during the cluster (adjusted odds ratio 1.7, 95% confidence interval 1.2-2.5). In subgroup analyses, seeing suicide cluster-related posts was uniquely associated with increased odds of SI and SA during the cluster among students with no previous history of SI/SA. CONCLUSIONS: Exposure to suicide cluster-related social media is associated with both SI and SA during a suicide cluster. Suicide interventions could benefit from efforts to mitigate potential negative effects of social media and promote prevention messages. Published by Elsevier Inc.
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