Self-injury support online: Exploring use of the mobile peer support application TalkLife

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There is growing interest in how technologies can be leveraged to support mental health. Accessible through the Internet and mobile applications (apps), online communities are ubiquitous and have promise in providing individuals with peer support, information, and additional resources. However, empirical evidence for the effects of participation in online communities on mental health outcomes is limited. In this dissertation I address this gap by exploring how individuals use a mobile peer support application, TalkLife, to discuss and exchange support on self-injury. Self-injury was chosen as a case study because it is a common and concerning behavior that affects many young people. While stigma associated with the behavior can prevent people from getting help, the pervasiveness of online communities and online activity around self-injury has been noted. Informal online help-seeking is a recognized, and potentially a critical, resource for these individuals. In chapter 1, I provide an overview of relevant literature on online communities, peer support, and self-injury and discuss areas in need of further study. In chapter 2, I contribute an in-depth description of self-injury related activity on TalkLife including user characteristics, natural use patterns, and common language in posts and comments. In chapter 3, I investigate the dynamics of peer support on TalkLife. I characterize the types of support solicitations and responses on the platform and investigate the relationship between them. Then, I investigate peer responsiveness by identifying individual, message, and platform factors which predict the amount of support posts received and the amount of time it takes for community members to respond to certain types of posts. In chapter 4, I combine log data and survey data in a longitudinal examination of the relationship between TalkLife use and several self-injury outcomes including self-injury behaviors, thoughts, urges, and intentions to injure. Finally, I summarize key findings, describe implications for three key stakeholder groups (designers, clinicians, researchers), and discuss future directions in the concluding chapter. Together the findings from this dissertation make several novel contributions. First, while the methods employed here have proven to be valuable in understanding other mental health conditions, few studies have applied them to self-injury communities, or to TalkLife. Second, I contribute a detailed empirical account of the dynamics of peer support and identify factors which predict the amount of support posts generate. Lastly, this work provides initial evidence for relationship between TalkLife use and self-injury outcomes over time.

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Behavior Change; Online Communities; mobile application; peer support; self-injury; Communication
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Whitlock, Janis L.
Bazarova, Natalya N.
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Whitlock, Janis L.
Washburn, Jason Jared
Won, Andrea Stevenson
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Ph.D., Communication
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Doctor of Philosophy
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dissertation or thesis
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