Evidence map›Paper›PMID 41112207›Full record

ArticleFrontiers in digital health2025

Digital mental health and hidden support: a qualitative analysis of non-suicidal self-injury communities on TikTok.

Esther Martínez-Pastor, Marian Blanco-Ruiz, Sandra Feijóo

Abstract read
In one paragraph

Article in Frontiers in digital health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Esther Martínez-PastorFaculty of Communication Sciences, Rey Juan Carlos University, Fuenlabrada, Spain.
Marian Blanco-RuizFaculty of Communication Sciences, Rey Juan Carlos University, Fuenlabrada, Spain.
Sandra FeijóoDepartment Health Sciences, University of Burgos, Burgos, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study examines the digital representation of Non-Suicidal Self-Injury (NSSI) on TikTok, with particular attention to the emergence of online communities and the communicative strategies users employ to share content while evading platform moderation. As TikTok becomes increasingly influential among adolescents and young adults, understanding how sensitive mental health topics like NSSI circulate on the platform is critical for developing effective digital health interventions. We conducted a qualitative content analysis of 400 posts referencing NSSI, collected using a mixed-method approach: 25.5% using TikTok's official API and 74.5% via the "For You" feed of a simulated account designed to mirror organic user experience. Posts were selected based on visual indicators (e.g., scars, tools), textual cues (e.g., hashtags, metaphors), and thematic references to emotional distress, recovery, or relapse. The analysis focused on user profile characteristics, linguistic strategies, and audiovisual aesthetics. Findings reveal a loosely structured yet emotionally resonant digital community characterized by subcultural codes, such as euphemisms, ambiguous hashtags, and stylized imagery. Despite content moderation policies, most accounts remained active and visible, with minimal enforcement of warnings or restrictions. While some posts portray NSSI as a coping strategy or seek to normalize the behavior, others subtly encourage recovery or offer indirect support. However, explicit messaging that discourages self-harm is notably rare. These dynamics suggest that TikTok unintentionally enables both the concealment and dissemination of self-harm-related content, functioning as a space for affective connection but also as a vector for potential normalization of harmful behaviors. The study underscores the need for targeted, ethically grounded prevention strategies that address not only the psychological functions of these communities but also the algorithmic infrastructures that sustain their visibility. These findings contribute to ongoing debates about digital mental health, platform responsibility, and the design of safer online environments.

Indexed as

adolescents and young adultsdigital mental healthNon-Suicidal Self-Injury (NSSI)online peer supportself-harmsocial media influencesocial media platformsTikTok

Identifiers

PMID41112207
PMCPMC12533276

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.