Nonsuicidal self‑injury on Instagram: Examining hashtag trends

We sought to investigate how individuals who upload nonsuicidal self-injury (NSSI) content on Instagram conceptualize self-injury by examining associated hashtags. Additionally, we explored NSSI hashtag usage trends over time. Using a web-based crawler and data analysis system, we downloaded 1,217,208 Instagram posts containing one of five popular NSSI hashtags (#cutting, #selfharm, #selfharmmm, #hatemyself, and #selfharmawareness) and categorized them based on psychological constructs (suicide, depression, anxiety/panic, eating disorders, addiction, general mental distress, other specific mental illnesses, and self-injury). Results show that NSSI hashtags were most associated with suicide, depression, general mental distress, anxiety/panic, and eating disorders, and, to a lesser extent, other specific mental illnesses, borderline personality disorder, and addiction. We determined that three of the five hashtags demonstrated an increase in usage over time, one remained relatively stable, and one decreased in usage. We discuss implications for mental health professionals regarding how to discuss social media use with clients who self-injure and consider clients’ technology use in treatment plans.