Abstract
Purpose:
Eating-disorder psychopathology is associated with self-harm behaviors. With much time spent and many social interactions taking place online, self-cyberbullying has emerged as a new form of self-harm that is digital. The current study examined digital self-harm in adults and its associations with eating-disorder psychopathology and behaviors.
Methods:
Participants were adults (N=1794) who completed an online cross-sectional survey. Participants reported whether they had ever posted mean things about themselves online, whether they had ever anonymously bullied themselves online and completed measures of eating-disorder psychopathology and disordered eating behaviors.
Results:
Digital self-harm was reported by adults across demographic characteristics and across the lifespan, although there were some significant differences in demographic characteristics associated with reported digital self-harm. Participants who engaged in digital self-harm were younger than those denying digital self-harm. Eating-disorder psychopathology and disordered eating behaviors were significantly higher among individuals reporting digital self-harm compared with age-matched controls.
Conclusions:
This was the first study to examine digital self-harm among adults and the first study to examine associations of digital self-harm with eating-disorder psychopathology and disordered eating behaviors. Importantly, digital self-harm is reported by adults and therefore is not limited to youth. Our findings that digital self-harm is associated with disordered eating suggests that digital self-harm is a clinically-significant topic that needs further research to inform clinical practice and clinical research.
Level of evidence:
Level III, Evidence obtained from well-designed cohort or case-controlled analytic studies
Keywords: disordered eating, cyberbullying, self-harm, weight
Introduction
Self-harm has long been a concern to clinicians and has been receiving increasing research attention since the addition of non-suicidal self-injury to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) as a condition warranting further research (1). Self-injurious behaviors often begin during adolescence; approximately 6% of adults report self-injuring at some time during their lives (2). Self-injury has been associated with younger age but not with gender, race/ethnicity, or education (2). Self-injury and self-harm, terms that are often used interchangeably, yet differ in whether there is a physical injury or broader harm inflicted (3), both appear to be individuals’ attempts to improve or respond to negative affect (2, 3). In the limited literature, self-injurious behavior is associated with suicide attempts (4). Importantly, the number of methods individuals used to inflict harm, rather than number of times individuals have inflicted harm on themselves, has been associated with number of suicide attempts (4). This suggests that clinicians should ask about multiple forms of self-harm when they assess for suicide risk, which may require additional understanding of how individuals can harm themselves.
Some lines of research on self-harm have focused on self-harm among individuals with eating disorders (5) and disordered eating (i.e., subthreshold eating disorders) and these studies have reported an association of eating-disorder psychopathology with “traditional” forms of self-harm (5–11). It has been suggested that the co-occurrence of eating disorders and self-harm may be related to the shared focus on the body, in addition to shared distal and proximal risk factors, such as low body esteem, negative mood intolerance, adverse childhood and maltreatment experiences, and social pressures (12, 13). Given the documented associations between eating-disorder psychopathology and traditional self-harm, and the relationship between number of methods of self-harm with suicide attempts, it is imperative for clinicians to understand whether there may be additional methods of self-harm that are going unnoticed.
Widespread social interaction on the internet has led to the emergence of a new form of self-harm: digital self-harm. Mimicking cyberbullying (14), individuals can post, share, or otherwise communicate hurtful or threatening statements about themselves online when engaging in digital self-harm (15). Although there are known negative consequences for victims of cyberbullying (14, 16, 17), the consequences of bullying oneself online (i.e., digital self-harm) are largely unknown (15). To date, there have only been anecdotal reports of digital self-harm and three studies. Two studies examined the prevalence of digital self-harm among adolescents and their reported motivations (15, 18). A third study examined the association between bullying victimization, negative emotions, and digital self-harm (19). Approximately 6% of participants in a study comprising a nationally-representative sample of American youth aged 12–17 years reported that they had engaged in digital self-harm (15). This was replicated in a study of New Zealand youth, which also found that approximately 6% of participants reported digital self-harm (18). Digital self-harm was higher among boys than girls and higher among sexual minority youth than heterosexual youth, but was not associated significantly with race or age (15). Importantly, digital self-harm was higher among those who had previously engaged in traditional self-harm (15) and strongly associated with bullying victimization (19).
Motivations described for digital self-harm (15, 18) paralleled the interpersonal and intrapersonal motivations driving traditional self-harm (2, 9, 20). The majority of youth who reported digital self-harm described doing so for interpersonal reasons: to evoke a reaction (such as humor), test relationships, elicit sympathy, or gain attention (15, 18). Others reported digital self-harm was a way to express strong negative feelings or a way to express and exacerbate self-hatred (15). Digital self-harm was associated with depression, other bullying experiences, drug use, and behavioral problems (15, 19). There is, again, a parallel with traditional self-harm among individuals with eating disorders. Self-harm and eating disorders share similar motivations, including emotion regulation and expression, and eliciting social reactions (21). Despite these similarities, the association of digital self-harm with disordered eating behaviors has not been examined.
Aims of the Study
Digital self-harm is a new phenomenon that has only been studied in youth. Just as traditional self-harm has received more attention in youth but also occurs among adults, research is needed to understand whether adults engage in digital self-harm and whether digital self-harm has negative consequences for adults. In the current study, we extended work on digital self-harm in adolescents by examining whether it occurs among adults. Given strong associations in the literature of self-harm and eating-disorder psychopathology, we also evaluated whether, among adults, digital self-harm was associated with eating-disorder psychopathology.
Methods
Participants
Survey respondents (N=1794) were individuals from the US who responded to an advertisement to “share your opinions about eating, weight, and health” on Mechanical Turk. Mechanical Turk yields data with reliability and validity that is comparable to psychometrics from data collected through other recruitment sources such as psychology student subject pools (22). Mechanical Turk has been used in many studies, including those focusing on eating behaviors (23) and bullying (24). Following recommended practices, we used three formal validity checks throughout the survey with varied response formats and also inspected data for illogical or impossible response patterns. Participants with potentially invalid data were excluded. This study was approved by the university’s institutional review board (Yale University Human Investigations Committee). All participants provided informed consent prior to the online survey.
As data were collected as part of a larger survey battery, we were able to create two groups for the current study. First, individuals reporting digital self-harm (either or both self-cyberbullying items), as were individuals who denied both self-cyberbullying items. From among the individuals who denied digital self-harm, a subgroup was selected that matched the age of the group reporting digital self-harm.
Measures
Digital Self-Harm.
The two items used by the earlier studies on digital self-harm among adolescents (15, 18, 19) were used in the current study: “I have anonymously posted something online about myself that was mean” and “I have anonymously cyberbullied myself.” Frequencies were reported for each item: “never,” “once,” “a few times,” or “many times.” As with the original study on digital self-harm (15), items in the current study were recoded to reflect never or ever (i.e., once, a few times, or many times) engaging in each form of digital self-harm.
Eating-Disorder Psychopathology and Disordered Eating Behaviors.
The Eating Disorder Examination-Questionnaire (EDE-Q) measures eating-disorder psychopathology over the past 28 days (25). The current study used a brief version of the EDE-Q, which has three subscales (Dietary Restraint, Overvaluation, and Dissatisfaction). The EDE-Q subscale scores range from 0–6. Higher scores indicate greater severity. The brief version has demonstrated superior psychometric properties in nonclinical and clinical studies compared with the original measure (26, 27). Items had internal consistency in the current study, α=.89. Frequency of objective overeating episodes (eating an unusually large amount of food but not feeling a subjective sense of loss of control while eating), objective binge-eating episodes (eating an unusually large amount of food and feeling a subjective sense of loss of control while eating), subjective binge-eating episodes (eating an amount of food that is not unusually large yet experiencing a loss of control while eating), secretive eating episodes (eating in a furtive manner, often out of embarrassment or shame), and compensatory behaviors (vomiting, laxative misuse, and/or diuretic misuse) were also assessed by the EDE-Q and categorized as “recurrent” when episodes occurred at least 4 or more times within the past 4 weeks.
Statistical Analysis
Differences in participant characteristics by whether or not they reported each type of digital self-harm were examined using chi-square tests for categorical variables (gender, education level, sexual orientation, racial identity, ethnicity) and analyses of variance (ANOVAs) for continuous variables (age and BMI). Because of potential age-related differences in internet usage, associations between digital self-harm and eating-disorder psychopathology (linear regressions) and disordered eating behaviors (chi-square tests) were evaluated by comparing individuals reporting any digital self-harm with age-matched controls denying digital self-harm.
Results
Characteristics of Individuals Endorsing Digital Self-Harm
In the full sample (N=1794), 293 participants (16.3%) endorsed anonymously posting something mean about themselves online. Fewer participants, but still a substantial minority (n=144; 8.0%) endorsed anonymously cyberbullying themselves. Overall, 7.5% of participants reported both mean postings and self-cyberbullying; 8.8% reported only mean postings; 0.5% reported only self-cyberbullying; and 83.2% reported neither activity. See Table 1 for additional details on frequency.
Table 1.
Description of digital self-harm frequencies.
| n | % | |
|---|---|---|
|
| ||
| I have anonymously posted something online about myself that was mean† | ||
| Never | 1501 | 83.7% |
| Once | 121 | 6.7% |
| A few times | 150 | 8.4% |
| Many times | 22 | 1.2% |
| I have anonymously cyberbullied myself† | ||
| Never | 1650 | 92.0% |
| Once | 70 | 3.9% |
| A few times | 64 | 3.6% |
| Many times | 10 | 0.6% |
7.5% of participants reported both mean postings and self-cyberbullying; 8.8% reported only mean postings; 0.5% reported only self-cyberbullying; and 83.2% reported neither activity
When dichotomized into those who reported ever (n=293) or never (n=1501) posting something mean about themselves, significant demographic differences emerged and are described in Table 2. Those endorsing mean postings about themselves were significantly younger (t(5128.53)=9.74, p<.001) than those not reporting mean postings. Those reporting mean postings were 31.5 years old (SD=9.4) on average, with an age range from 18 to 68 years old. Those not reporting mean postings were 37.7 years old (SD=12.5) on average and ranged in age from 18 to 85 years old. A significantly greater proportion of men endorsed mean postings than women (χ2(1, N=1789)=7.39, p=.007). Race differed significantly (χ2(4, N=1794)=11.60, p=.021): a significantly greater proportion of Asian individuals endorsed mean postings than White individuals, but other pairwise comparisons were not significant. Ethnicity also differed significantly (χ2(1, N=1794)=14.03, p<.001): a significantly greater proportion of Latinx individuals endorsed mean postings than non-Hispanic individuals. Sexual orientation also differed significantly (χ2(3, N=1794)=10.44, p=.015): a significantly greater proportion of individuals identifying as bisexual than heterosexual reported mean postings, but other pairwise comparisons were not significant. Education did not differ significantly (χ2(3, N=1794)=4.78, p=.188).
Table 2.
Comparison of characteristics of individuals endorsing or denying digital self-harm.
| Overall sample | Mean posting about self | Self-cyberbullying | |||
|---|---|---|---|---|---|
| (N=1794) | Yes (n=293) | No (n=1501) | Yes (n=144) | No (n=1650) | |
|
| |||||
| Sex | |||||
| Male, n (%) | 571 (31.8%) | 113 (19.8%) A | 458 (80.2%) | 59 (10.3%) A | 512 (89.7%) |
| Female, n (%) | 1218 (67.9%) | 179 (14.7%) A | 1039 (85.3%) | 85 (7.0%) A | 1133 (93.0%) |
| Race/Ethnicity | |||||
| White, n (%) | 1447 (80.7%) | 219 (15.1%) B | 1228 (84.9%) | 97 (6.7%) B | 1350 (93.3%) |
| Black, n (%) | 125 (7.0%) | 27 (21.6%) | 98 (78.4%) | 14 (11.2%) | 111 (88.8%) |
| Asian, n (%) | 135 (7.5%) | 33 (24.4%) B | 102 (75.6%) | 24 (17.8%) B | 111 (82.2%) |
| Mutli-racial, n (%) | 42 (2.3%) | 5 (11.9%) | 37 (88.1%) | 3 (7.1%) | 39 (92.9%) |
| Other, n (%) | 45 (2.5%) | 9 (20.0%) | 36 (80.0%) | 6 (13.3%) | 39 (86.7%) |
| Latinx, n (%) | 156 (8.7%) | 42 (26.9%) C | 114 (73.1%) | 17 (10.9%) | 139 (89.1%) |
| Sexual Orientation | |||||
| Heterosexual, n (%) | 1607 (89.6%) | 250 (15.6%) D | 1357 (84.4%) | 126 (7.8%) | 1481 (92.2%) |
| Homosexual, n (%) | 47 (2.6%) | 7 (14.9%) | 40 (85.1%) | 3 (6.4%) | 44 (93.6%) |
| Bisexual, n (%) | 124 (6.9%) | 33 (26.6%) D | 91 (73.4%) | 14 (11.3%) | 110 (88.7%) |
| Other, n (%) | 16 (0.9%) | 3 (18.8%) | 13 (81.3%) | 1 (6.3%) | 15 (93.8%) |
| Education | |||||
| High School or Less, n (%) | 166 (9.3%) | 33 (19.9%) | 133 (80.1%) | 15 (9.0%) | 151 (91.0%) |
| Some College, n (%) | 634 (35.3%) | 112 (17.7%) | 522 (82.3%) | 51 (8.0%) | 583 (92.0%) |
| College Degree, n (%) | 614 (34.2%) | 86 (14.0%) | 528 (86.0%) | 48 (7.8%) | 566 (92.2%) |
| More than College, n (%) | 380 (21.2%) | 62 (16.3%) | 318 (83.7%) | 30 (7.9%) | 350 (92.1%) |
| Age, M (SD) | 36.7 (12.3) | 31.5 (9.4)* | 37.7 (12.5) | 30.4 (8.0)* | 37.2 (12.4) |
significantly different from those not endorsing activity.
men were significantly more likely to endorse than women
Asian individuals were significantly more likely to endorse than White individuals
Latinx individuals were significantly more likely to endorse than non-Hispanic individuals
Bisexual individuals were significantly more likely to endorse than heterosexual individuals.
Similar demographic differences emerged when self-cyberbullying was dichotomized into those who reported ever (n=144) or never (n=1650) anonymously cyberbullying themselves. These demographic characteristics are also described in Table 2. Individuals endorsing anonymous self-cyberbullying were significantly younger (t(208.42)=9.30, p<.001) than those not endorsing self-cyberbullying. Those reporting self-cyberbullying had an average age of 30.4 years (SD=8.0), with an age range from 18 to 54 years. Those not reporting mean postings were 37.2 years old (SD=12.4) on average, with an age range from 18 to 85 years. A significantly greater proportion of men endorsed anonymous self-cyberbullying than women (χ2(1, N=1789)=5.91, p=.015). Race significantly differed (χ2(4, N=1794)=24.29, p<.001): a significantly greater proportion of Asian individuals endorsed anonymous bullying than White individuals, but other pairwise comparisons were not significant. Ethnicity (χ2(1, N=1794)=1.91, p=.167), sexual orientation, (χ2(3, N=1794)=2.11, p=.55), and education all did not differ significantly between those who did or did not self-cyberbully (χ2(3, N=1794)=0.28, p=.965).
Eating-Disorder Psychopathology among Individuals Endorsing Digital Self-Harm
Because of possible generational differences related to internet usage, clinical characteristics were examined by comparing those who endorsed digital self-harm (i.e., mean postings and/or self-cyberbullying; n=302) with an age-matched study group (n=302) of those endorsing neither mean postings nor self-cyberbullying.
Table 3 summarizes eating-disorder psychopathology and BMI of individuals who reported or denied digital self-harm. Participants endorsing digital self-harm scored significantly higher on all eating-disorder variables than those who denied digital self-harm, including overvaluation, dissatisfaction, and dietary restraint (all ps < .001). Similarly, participants endorsing digital self-harm were significantly more likely to report recurrent (weekly or more frequent) disordered eating behaviors than those denying digital self-harm: overeating episodes, objective binge-eating episodes, subjective binge-eating episodes, secretive eating episodes, and purging (vomiting, laxative abuse and/or diuretic misuse) episodes (all ps < .001). Participants endorsing digital self-harm had higher BMIs than those denying digital self-harm (p=.048).
Table 3.
Analyses of variance comparing individuals reporting self-cyberbullying with age-matched controls.
| Digital Self-Harm | Age-matched Controls | ANOVA | Chi-square | |||||
|---|---|---|---|---|---|---|---|---|
| n=302 | n=302 | F | p | ηp2 | χ2 | p | φ | |
|
| ||||||||
| BMI, M (SD) | 28.02 (7.93) | 26.84 (6.43) | 3.94 | .048 | .007 | |||
| EDE-Q | ||||||||
| Restraint, M (SD) | 2.77 (1.76) | 2.14 (1.89) | 17.84 | <.001 | .029 | |||
| Overvaluation, M (SD) | 3.51 (1.90) | 2.62 (2.13) | 28.55 | <.001 | .046 | |||
| Dissatisfaction, M (SD) | 3.80 (1.83) | 3.08 (2.10) | 19.67 | <.001 | .032 | |||
| Episodes | ||||||||
| OBE, n (%) | 99 (32.8%) | 48 (16.1%) | 22.75 | <.001 | .195 | |||
| SBE, n (%) | 97 (32.1%) | 41 (13.7%) | 28.78 | <.001 | .219 | |||
| OOE, n (%) | 100(33.1%) | 39 (13.0%) | 34.04 | <.001 | .238 | |||
| Secret, n (%) | 181 (59.9%) | 93 (31.1%) | 50.34 | <.001 | .289 | |||
| Purging, n (%) | 72 (23.8%) | 21 (7.0%) | 32.49 | <.001 | .233 | |||
Note. BMI=Body Mass Index; OBE=Objective binge episode; SBE=Subjective binge episode; OOE=Objective overeating episode; EDE-Q=Eating Disorder Examination Questionnaire.
Discussion
This study is the first to examine digital self-harm among adults and the first to examine associations of digital self-harm with eating-disorder psychopathology. As this is an early study of digital self-harm, we offer suggestions for future research in Table 4. Although the current study used a convenience sample and is not nationally-representative, it is critical to highlight that digital self-harm occurs among adults across demographic characteristics and across the lifespan. In particular, the age range for digital self-harm, while younger for those reporting digital self-harm (depicted in Figure 1), captured 18 through 68 years old with an average age in the early thirties. Similarly, both men and women and all racial/ethnic groups, sexual orientations, and education levels had some individuals who reported digital self-harm.
Table 4.
Research needs and questions related to digital self-harm
| Category | Research Need or Question |
|---|---|
|
| |
| Methodology | • Exploration into other forms of digital self-harm, including non-anonymous postings. |
| • Inclusion of digital self-harm alongside assessment of traditional self-harm. | |
| • Qualitative analysis of digital self-harm material to determine whether harm is evident objectively. | |
| • Assessment of the role of anonymity in digital self-harm. | |
| Theory | • Examination of adults’ intent behind their engagement in digital self-harm. |
| • Test of potential predictors and models of digital self-harm. | |
| • Cross-cultural assessment of digital self-harm prevalence using nationally-representative samples. | |
| Correlates | • What mental health disorders are comorbid with digital self-harm? |
| • Do digital and traditional self-harm, including non-suicidal self-injury, serve the same functions? | |
| • Does the co-occurrence of digital and traditional self-harm increase risk for suicide attempts? | |
| • Is digital self-harm associated with impulsivity? | |
| Treatment | • Does addressing digital self-harm in treatments that address traditional self-harm (e.g., borderline personality disorder, eating disorders, depression) improve outcomes? |
| • Can adaptive or alternative coping strategies replace digital self-harm in the presence of strong negative affect? | |
| • Does interpersonal therapy lead to reductions in digital self-harm among individuals with interpersonal motivations for self-harm? | |
| • Does digital self-harm enhance individuals’ motivation to engage in extreme weight-control behaviors among those with eating disorders? | |
| Prevention | • Improved understanding of digital self-harm age of onset and developmental stages to target for prevention work. |
| • What is the cost to the individual and to public health associated with digital self-harm? | |
| • Do universal or targeted prevention programs for bullying also prevent self-cyberbullying? | |
| • Are associations of disordered eating and digital self-harm stronger among individuals with a history of experiencing bullying? | |
| • What influence on others does digital material have when it is intended as a form of self-harm? | |
Figure 1. Depiction of the age of individuals reporting digital self-harm.
Note. Visual depiction of the age of individuals reporting ever engaging in digital self-harm (i.e., mean postings and/or self-cyberbullying).
A greater proportion of men than women reported engaging in digital self-harm. This is an important finding in the context of the literature on self-injury, which has primarily focused on women, even though research shows that self-injury also occurs among men (2). Findings on gender and self-injury suggest that there may be a lower threshold for men to initiate self-injurious behavior (28). Men are more likely to perpetrate cyberbullying (i.e., directed at others rather than towards oneself) than women, whereas women are more likely to be victims of cyberbullying than men (17), which might make self-cyberbullying a viable outlet for digital self-harm among men. Other differences in demographic characteristics could reflect differences in who engages in self-harm behavior, who has been bullied or cyberbullied, or who uses the internet for social purposes; future research using nationally-representative samples should characterize the prevalence and demography of individuals who engage in digital self-harm to improve our understanding of the public health cost of digital self-harm.
Our study provides important new information that individuals who report digital self-harm have more eating-disorder psychopathology and are more likely to report recurrent disordered eating behaviors and purging behaviors than those who do not engage in digital self-harm. This pattern of associations is important in suggesting that digital self-harm is a clinically-significant topic or signal for clinicians and clinical researchers. Associations between eating-disorder psychopathology and self-cyberbullying extends earlier work on bullying, including both traditional and cyberbullying, that has shown associations of bullying with disordered eating (29–31). It is possible that individuals who have experienced bullying and who have eating-disorder psychopathology are also likely to select self-cyberbullying as a form of digital self-harm, although future research using longitudinal designs is essential to assess and establish the direction of associations.
The differences in eating-disorder psychopathology by digital self-harm also provide important new information to the emerging literature on self-harm and eating disorders. Specifically, inflicting harm to oneself in a digital setting is associated with eating-disorder psychopathology. It could be important for clinicians treating eating disorders and assessing for traditional self-harm to consider whether digital self-harm might also be occurring. For example, in the context of dialectical behavior therapy for eating disorders, clinicians attend to whether self-injury becomes more frequent as eating-disorder behaviors become less frequent (i.e., substituting maladaptive coping strategies). If behaviors are replaced by digital self-harm, but clinicians do not assess or track this behavior, it is possible that treatment progress could be impaired. Similarly, as the literature suggests that multiple methods of self-harm are associated with suicide attempts, it could be important for clinicians to assess carefully for suicide risk if digital and traditional self-harm are both reported.
Our study is an initial exploration and important first step in examining the association between digital self-harm and eating-disorder psychopathology. As such, strengths and limitations are described to provide a context to interpret our findings. The current study was cross-sectional and made use of a convenience sample, and therefore we cannot draw conclusions about possible directionality or causality. Participants were well-educated, primarily White, primarily heterosexual, and primarily women; generalizability of our findings to groups not well-represented in our sample is uncertain. Another limitation was the use of self-report questionnaires, although it is important to note that anonymous self-report might facilitate honest reporting when topics are sensitive or embarrassing. This study was also limited by the use of only two items, both of which assessed digital self-harm in terms of self-cyberbullying. Future research might consider other measures of digital self-harm, including qualitative content analyses of digital material paired with individuals’ report of intent to inflict harm on themselves. We also did not assess what participants meant when they endorsed these items or motivations for engaging in digital self-harm. Future studies should follow these important lines of research. An additional limitation is the use of a self-selected sample from Mechanical Turk, which tends to be younger than national samples (32). Despite this limitation, our study group spanned a wide age range (18 to 85 years old), which allowed us to capture digital self-harm reported by individuals across the lifespan. An important next step would be to learn when digital self-harm begins (i.e., average age of onset) and whether there are critical developmental stages when digital self-harm is more likely to occur, which could inform targeted prevention work.
This study found that adults engage in digital self-harm, which extends earlier work that has documented its occurrence among adolescents. Importantly, our data also showed a relation between digital self-harm and eating-disorder psychopathology, including disordered eating behaviors. Future research should examine whether digital self-harm has prognostic significance in efforts to prevent mental health problems or in mental health treatments. Within a cognitive-behavioral approach for the treatment of eating disorders, for example, digital self-harm could be addressed as a behavior that maintains eating-disorder psychopathology (e.g., enhancing motivation to engage in extreme weight-control behaviors) or as a coping strategy that could be replaced with a more adaptive and effective strategy to reduce negative emotions or thoughts. Further research is needed to improve understanding of these behaviors and how to address them in prevention and treatment settings.
What is already known?
Digital self-harm is communication of hurtful statements about oneself online. It is associated with mental health problems in youth. Eating disorders are associated with traditional self-harm.
What does this study add?
Digital self-harm occurs in adults across the lifespan and demographic characteristics. Digital self-harm is associated with eating-disorder psychopathology including behaviors.
Funding:
This research was supported, in part, by National Institutes of Health grants K23 DK092279 (Dr. Barnes) and K23 DK115893 and UL1 TR001863 (Dr. Lydecker). Funders played no role in the content of this paper.
Footnotes
Potential Conflicts of Interest: The authors have no conflicts of interest relevant to this article to disclose.
Data Availability:
Data are available from the corresponding author upon reasonable request.
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Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
Data are available from the corresponding author upon reasonable request.