Background: Many individuals who self-injure seek support and information through online communities and mobile peer-support apps. Although researchers have identified risks and benefits of participation, empirical work linking participation in these web-based spaces to self-injury behaviors and thoughts is limited. Objective: This study aims to investigate the relationship between behavioral and linguistic traces on a mobile peer support app and self-injury outcomes. Methods: Natural use data and web-based surveys (N=697) assessing self-injury outcomes were collected from 268 users (aged 13-38 years; median 19; 149/268, 55.6% female) of a mobile peer-support app for 4 months. Participants were identified as having posted self-injury content using an internal classifier. Natural log data was used to predict self-injury outcomes in a series of multilevel logistic and linear regressions. Results: Greater engagement on a mobile peer-support app was associated with a decreased likelihood of self-injury thoughts (odds ratio [OR] 0.25, 95% CI 0.09-0.73) and fewer intentions to self-injure (b=−0.37, SE 0.09), whereas posting triggering content was associated with an increased likelihood of engaging in behaviors (OR 5.37, 95% CI 1.25-23.05) and having self-injury thoughts (OR 17.87, 95% CI 1.64-194.15). Moreover, viewing triggering content was related to both a greater ability to resist (b=1.39, SE 0.66) and a greater intention to self-injure (b=1.50, SE 0.06). Conclusions: To our knowledge, this is the first study to connect naturally occurring log data to survey data assessing self-injury outcomes over time. This work provides empirical support for the relationship between participation in online forums and self-injury outcomes, and it articulates mechanisms contributing to this relationship. Trial Registration:

中文翻译：

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检查移动同伴支持应用程序的使用与自伤结果之间的关系：纵向混合方法研究


背景：许多自残者通过在线社区和移动同伴支持应用程序寻求支持和信息。尽管研究人员已经确定了参与的风险和好处，但将这些网络空间的参与与自残行为和思想联系起来的实证工作仍然有限。目的：本研究旨在调查移动同伴支持应用程序上的行为和语言痕迹与自伤结果之间的关系。方法：从移动同伴支持应用程序的 268 名用户（年龄 13-38 岁；中位数 19；149/268，55.6% 女性）收集自然使用数据和评估自伤结果的网络调查 (N=697) 4个月。参与者被识别为使用内部分类器发布了自残内容。自然对数数据用于通过一系列多级逻辑回归和线性回归来预测自伤结果。结果：更多地参与移动同伴支持应用程序与自残想法的可能性降低（比值比 [OR] 0.25，95% CI 0.09-0.73）和自残意图较少相关（ b =−0.37， SE 0.09），而发布触发内容与参与行为（OR 5.37，95% CI 1.25-23.05）和产生自残想法（OR 17.87，95% CI 1.64-194.15）的可能性增加相关。此外，观看触发内容与更强的抵抗能力（ b = 1.39，SE 0.66）和更强的自残意图（ b = 1.50，SE 0.06）有关。结论：据我们所知，这是第一项将自然发生的日志数据与评估自伤结果随时间变化的调查数据联系起来的研究。 这项工作为参与在线论坛与自伤结果之间的关系提供了实证支持，并阐明了促进这种关系的机制。试用注册：