Association between adolescents' problematic online behaviors and self-harm risk

Introduction: Problematic online behaviors, including sexting, cyberbullying, and Internet gaming disorder (IGD), were associated with a higher risk of self-harm among adolescents. However, the independent effect on self-harm brought by each problematic online behavior remains unknown. Methods: This cross-sectional nationwide survey investigated a representative sample of 8446 Taiwanese adolescents (49.7 % female, mean age = 15.4 +/- 1.8, ranging from 10 to 18) in the summer of 2021. We used self-reported questionnaires to assess adolescents' problematic online behaviors. 18-item Risk-Taking and Self-Harm Inventory was applied to evaluate their self-harm risks. Adolescents with score >= 7 were considered self-harm identified. Multivariate regression analyses were performed to investigate the association between problematic online behaviors and self-harm risks. Results: The prevalence of sexting, cyberbullying victimization, cyberbullying perpetration, and IGD was 1.3 %, 1.1 %, 0.9 %, and 0.7 %, respectively. Adolescents with sexting were associated with higher self-harm scores (beta = 4.30, 95 % CI [3.35, 5.25]), so did adolescents with IGD (beta = 3.33, 95 % CI [1.96, 4.71]), cyberbullying perpetration (beta = 2.61, 95 % CI [1.03, 4.20]), and cyberbullying victimization (beta = 1.40, 95 % CI [0.04, 2.76]). Also, sexting (OR = 5.16, 95 % CI [3.26, 8.07]) and IGD (OR = 3.11, 95 % CI [1.50, 6.15]) were associated with increased odds of identified self-harm behaviors. Conclusions: Sexting, cyberbullying victimization, cyberbullying perpetration, and IGD were all independently associated with an increased self-harm risk among adolescents. Among them, sexting was shown to be the most robust risk factor of identified self-harm behaviors. To prevent self-harm among adolescents, it is important to identify youth involved in problematic online behaviors, especially sexting.

Automated summary

Problematic online behaviors, such as sexting, cyberbullying, and Internet gaming disorder (IGD), were found to be associated with an increased risk of self-harm among adolescents. Among these behaviors, sexting was identified as the most robust risk factor for self-harm. To prevent self-harm among adolescents, it is crucial to identify youth involved in problematic online behaviors, particularly sexting.