Sharing is in fact about caring: Care concerns feature prominently in subreddits devoted to self-injurious thoughts and behaviors

Abstract

ObjectiveGiven poor treatment efficacy and utilization for self-injurious thoughts and behaviors (SITBs) and the pervasive SITB-stigma present in many treatment settings, research that identifies values and experiences that resonate with individuals engaged in SITBs is urgently needed to improve current treatment offerings. The present study uses Moral Foundations Theory, a leading framework for conceptualizing values and behavior, to identify responses to SITBs most likely to resonate with those who have lived SITB experience. MethodsNatural language processing methods (topic modeling, neural network-based classifier) were used to extract latent conversation topics and moral concerns from 1.68 M messages on the two largest SITB forums on Reddit. Once conversation topics and moral concerns were extracted, a linear regression model was fit to describe the relationship between likes on Reddit, moral concerns, and latent conversation topics. ResultsFindings revealed several types of messages most likely to resonate with individuals engaged in SITBs: 1) Specific situational narratives compared to general messages of sadness (p < .01); 2) messages that expressed care (p < .001); and 3) specific messages that expressed care, fairness, loyalty, and purity. ConclusionsSpecific, care-focused content (kind, nurturing content that discusses avoidance of emotional/physical harm to others) resonates most with individuals engaged in SITBs, providing insight to the real-time needs and experiences of those engaged in SITBs and suggesting the importance of framing SITB interventions in care language rather than success/failure language. Study findings may inform one-on-one clinical interactions, the development of SITB-specific interventions, and SITB training for clinicians.