Researchers from Oxford University in England say while social media can help vulnerable teenagers seeking support, internet
use can do more harm than good for young people at risk of self-harm or
Senior study author Paul Montgomery, a professor of psycho-social intervention at Oxford's Centre for Evidence-Based Intervention said: "I think it's surprising that so little is known about the internet and suicidal behaviour given its importance.
The study found conflicting evidence on whether online activity poses a positive or negative influence for vulnerable teens, but observed a strong link between the use of internet forums or "chat rooms" and an increased risk of suicide.
Internet use increased globally by more than 566% between December 2000 and June 2012, according to the study authors. Although this new study links more extensive internet use with higher rates of self-harm, it doesn't prove that computer use caused the self-injurious behaviour.
Greater risks of suicide
For the report, published in the journal PLoS ONE, Montgomery's team reviewed 14 studies from Western countries and Asia about internet use and self-harm or suicide among young people.
The investigators found that some studies suggested internet forums support socially isolated people, helping them to cope. But others concluded that young people who went online to find out more about self-harm and suicide were exposed to violent imagery and acted out what they had seen online.
Moderate or severe addiction to the internet is also connected to higher
risks of self-harm and increased levels of depression or thoughts of suicide,
the study authors said.
The use of chat rooms was strongly linked to greater risks of suicide - a connection not observed in relation to other social networking sites.
One specialist thinks he knows why.
"In chat rooms, self-harm can be normalised," said Dr Matthew Lorber, acting director of child and adolescent psychiatry at Lenox Hill Hospital in New York City.
"I've observed this in my own practice. A teen told me she went to a chat room on cutting, where basically a lot of teens were acting as if it were cool and no big deal.
"The internet also provides access to suicidal content, like how to cut or kill yourself, and certainly that information is readily available," added Lorber.
Positives and negatives
About 4 600 people between the ages of 10 and 24 take their own lives in the United States every year and many more survive suicide attempts, said the US Centres for Disease Control and Prevention.
About 157 000 young people receive emergency room treatment for self-inflicted injuries.
In one study Montgomery's team reviewed, 59% of young people said they had researched suicide online and 80% of those who had carried out particularly violent acts of self-harm said they had researched self-harm online beforehand.
Another study showed that out of nearly 300 posts, 9% were about methods of
self-harm, and users swapped tips in chat rooms on how to conceal the behaviour.
While some adolescents used the forums to congratulate one another for not cutting and provided emotional support for one another, no evidence suggested the support translated into reduced levels of self-harm.
Cyber-bullying was found to make victims more likely to self-harm and one study suggested online bullying put both victims and perpetrators at higher risk of attempted suicide.
How to help these at-risk adolescents remains a concern.
Lorber said group therapy was often helpful "because they have the opportunity to make social connections in a protected place and then they feel they're not the only ones who feel that way."
He also encourages parents to open the lines of communication between themselves and their teens by engaging in joint activities, even playing video games together.
"I definitely agree with the mixed message of the study," Lorber said.
"What it really means to me is, there are significant positives and significant negatives that come with the internet. We just need to see how to maximise the positives and minimise the negatives."
The Pew Research Centre offers more facts about teen internet use.