The Journey of Engaging With Web-Based Self-Harm and Suicide Content: Longitudinal Qualitative Study.

BACKGROUND: Self-harm and suicide are major public health concerns worldwide, with attention focused on the web environment as a helpful or harmful influence. Longitudinal research on self-harm and suicide-related internet use is limited, highlighting a paucity of evidence on long-term patterns and effects of engaging with such content. OBJECTIVE: This study explores the experiences of people engaging with self-harm or suicide content over a 6-month period. METHODS: This study used qualitative and digital ethnographic methods longitudinally, including one-to-one interviews at 3 time points to explore individual narratives. A trajectory analysis approach involving 4 steps was used to interpret the data. RESULTS: The findings from 14 participants established the web-based journey of people who engage with self-harm or suicide content. In total, 5 themes were identified: initial interactions with self-harm or suicide content, changes in what self-harm or suicide content people engage with and where, changes in experiences of self-harm or suicide behaviors associated with web-based self-harm or suicide content engagement, the disengagement-reengagement cycle, and future perspectives on web-based self-harm or suicide content engagement. Initial engagements were driven by participants seeking help, often when offline support had been unavailable. Some participants' exposure to self-harm and suicide content led to their own self-harm and suicide behaviors, with varying patterns of change over time. Notably, disengagement from web-based self-harm and suicide spaces served as a protective measure for all participants, but the pull of familiar content resulted in only brief periods of disconnection. Participants also expressed future intentions to continue returning to these self-harm and suicide web-based spaces, acknowledging the nonlinear nature of their own recovery journey and aiming to support others in the community. Within the themes identified in this study, narratives revealed that participants' behavior was shaped by cognitive flexibility and rigidity, metacognitive abilities, and digital expertise. Opportunities for behavior change arose during periods of cognitive flexibility prompted by life events, stressors, and shifts in mental health. Participants sought diverse and potentially harmful content during challenging times but moved toward recovery-oriented engagements in positive circumstances. Metacognitive and digital efficacy skills also played a pivotal role in participants' control of web-based interactions, enabling more effective management of content or platforms or sites that posed potential harms. CONCLUSIONS: This study demonstrated the complexity of web-based interactions, with beneficial and harmful content intertwined. Participants who demonstrated metacognition and digital efficacy had better control over web-based engagements. Some attributed these skills to study processes, including taking part in reflective diaries, showing the potential of upskilling users. This study also highlighted how participants remained vulnerable by engaging with familiar web-based spaces, emphasizing the responsibility of web-based industry leaders to develop tools that empower users to enhance their web-based safety.

Investigating How People Who Self-harm Evaluate Web-Based Lived Experience Stories: Focus Group Study.

BACKGROUND: The positive and negative effects of interacting with web-based content on mental health, and especially self-harm, are well documented. Lived experience stories are one such type of static web-based content, frequently published on health care or third-sector organization websites, as well as social media and blogs, as a form of support for those seeking help via the web. OBJECTIVE: This study aimed to increase understanding about how people who self-harm engage with and evaluate web-based lived experience stories. METHODS: Overall, 4 web-based focus groups were conducted with 13 people with recent self-harm experience (aged 16-40 years). In total, 3 example lived experience stories were read aloud to participants, who were then asked to share their reactions to the stories. Participants were also encouraged to reflect on stories previously encountered on the web. Data were analyzed thematically. RESULTS: Overall, 5 themes were generated: stories of recovery from self-harm and their emotional impact, impact on self-help and help-seeking behaviors, identifying with the narrator, authenticity, and language and stereotyping. CONCLUSIONS: Lived experience stories published on the web can provide a valuable form of support for those experiencing self-harm. They can be motivating and empowering for the reader, and they have the potential to distract readers from urges to self-harm. However, these effects may be moderated by age, and narratives of recovery may demoralize older readers. Our findings have implications for organizations publishing lived experience content and for community guidelines and moderators of web-based forums in which users share their stories. These include the need to consider the narrator's age and the relatability and authenticity of their journey and the need to avoid using stigmatizing language.

The effect of dysphoria on the relationship between autobiographical memories and the self.

Two experiments investigated the bi-directional relationship between episodic autobiographical memories (ABMs) and semantic self-images in dysphoric and nondysphoric individuals. Participants in Experiment 1 generated positive and negative "I am" statements, which were then used to cue specific ABMs. Nondysphoric participants generated similar numbers of ABMs to positive and negative cues, suggesting both positive and negative self-images are supported by clusters of specific ABMs. The same was observed in dysphoric participants, but phenomenological ratings showed that they rated positive ABMs as less vivid, and negative ABMs more central to their life story, than the nondysphoric group. Participants in Experiment 2 retrieved positive or negative ABMs and then generated "I am" self-statements. Retrieving positive ABMs increased the positivity of self-statements in the nondysphoric but not the dysphoric group. These findings suggest the interaction between ABMs and self-images functions to promote a positive view of the self, but this is disrupted in dysphoria.

Serum exosomal miRNA as biomarkers for Retinoblastoma.

Retinoblastoma (RB) is a childhood eye tumor, caused by RB1 mutation. Though diagnosing RB is easier, prognosticating RB is limited to examining the patient under anesthesia and imaging technique. The aim of the study is to find exosomal miRNA biomarkers to prognosticate RB. Exosomes were isolated from one control - MIO-M1 and two RB cell lines - WERI-Rb-1 and NCC-RbC-51. Small RNA sequencing was performed on exosomal miRNA isolated from the three cell lines. miRNAs specific to each cell line were shortlisted. A total of 243, 606 and 400 miRNAs were identified in MIO-M1, WERI-Rb-1 and NCC-RbC-51 cell lines respectively. Nine miRNAs were shortlisted based on adjusted p value and literature, MIO-M1 specific (n = 1), WERI-RB-1 specific (n = 2), NCC-RbC-51 specific (n = 2) and miRNAs common to both RB cell lines (n = 4) were chosen. Validation was done using specific Taqman miRNA assays.miRNA validation was carried out on cell lines, cell line derived exosomes, primary RB tissues and exosomes isolated from serum of the RB patients. Validation of the miRNAs in cell lines and exosomes derived from the cell lines, confirmed the sequencing data. However, only 2 miRNAs - hsa-miR-301b-3p and hsa-miR-216b-5p were upregulated in the primary RB tissues. None of the miRNAs had significant expression in the serum exosomes of RB patients. Therefore, serum exosomal miRNA may not be ideal for prognosticating RB.Further research on other body fluids like CSF and vitreous could serve as potential source for biomarkers for prognosticating RB.

Simulation, false memories, and the planning of future events.

Three experiments investigated the relationship between future thinking and false memories. In Experiment 1, participants remembered familiar events (e.g., a holiday) from their past, imagined planning the same events in the future, or took part in a control condition in which they visualized typical events. They then rated a series of schema-related and schema-unrelated nouns for how likely they were to be encountered within those events. In a surprise recognition test, participants in the future condition falsely recognized more schema-related items than participants in the past and control conditions. No reliable effects of rating condition were observed in correct recognition. Experiment 2 found the same pattern when participants imagined unfamiliar events (e.g., taking part in a bank robbery) from past or future perspectives. Participants in Experiment 3 remembered a past or imagined a future holiday and were then instructed to generate items that someone might take on a holiday. Participants in the future condition generated more nonstudied items and fewer studied items relative to participants in the past condition. The findings of Experiments 1 and 2 indicate that simulating future events enhances the activation of related items that gives rise to false memories. The findings of Experiment 3 suggest that these activation processes play an adaptive role in guiding the planning of future events. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Adaptive false memory: Imagining future scenarios increases false memories in the DRM paradigm.

Previous research has shown that rating words for their relevance to a future scenario enhances memory for those words. The current study investigated the effect of future thinking on false memory using the Deese/Roediger-McDermott (DRM) procedure. In Experiment 1, participants rated words from 6 DRM lists for relevance to a past or future event (with or without planning) or in terms of pleasantness. In a surprise recall test, levels of correct recall did not vary between the rating tasks, but the future rating conditions led to significantly higher levels of false recall than the past and pleasantness conditions did. Experiment 2 found that future rating led to higher levels of false recognition than did past and pleasantness ratings but did not affect correct recognition. The effect in false recognition was, however, eliminated when DRM items were presented in random order. Participants in Experiment 3 were presented with both DRM lists and lists of unrelated words. Future rating increased levels of false recognition for DRM lures but did not affect correct recognition for DRM or unrelated lists. The findings are discussed in terms of the view that false memories can be associated with adaptive memory functions.

A dysphoric's TALE: The relationship between the self-reported functions of autobiographical memory and symptoms of depression.

Autobiographical memory (AM) is believed to serve self, social and directive functions; however, little is known regarding how this triad of functions operates in depression. Using the Thinking About Life Experiences questionnaire [Bluck, S., & Alea, N. (2011). Crafting the TALE: Construction of a measure to assess the functions of autobiographical remembering. Memory, 19, 470-486.; Bluck, S., Alea, N., Habermas, T., & Rubin, D. C. (2005). A TALE of three functions: The self-reported uses of autobiographical memory. Social Cognition, 23, 91-117.], two studies explored the relationship between depressive symptomology and the self-reported frequency and usefulness of AMs for self, social and directive purposes. Study 1 revealed that thinking more frequently but talking less frequently about past life events was significantly associated with higher depression scores. Recalling past events more frequently to maintain self-continuity was also significantly associated with higher depressive symptomology. However, results from Study 2 indicated that higher levels of depression were also significantly associated with less-frequent useful recollections of past life events for self-continuity purposes. Taken together, the findings suggest atypical utilisations of AM to serve self-continuity functions in depression and can be interpreted within the wider context of ruminative thought processes.