Washington: Internet forums are both good and bad for people, oxford researchers have concluded.
The researchers found that Internet provides a support network for socially isolated young people, but it is also linked to an increased risk of suicide and self-harm among vulnerable adolescents.
Following what is thought to be the biggest review of existing studies into internet use and young people, the researchers suggest that in future, clinical assessments of such young people should include questions about the online content they have viewed.
The global review, published in the journal PLOS ONE, shows that young people at risk of self-harm or suicide were often online for longer periods than other teenagers.
The Oxford team analysed a total of 14 studies and found contradictory findings on whether the internet exerted a positive or negative influence.
Some studies found that internet forums supported and connect socially isolated people, helping them to cope.
But other studies concluded that young people who went online to find out more about self-harm and suicide were exposed to violent imagery and acted out what they had seen online.
The review finds that internet use is linked with more violent methods of self-harm.
Moderate or severe addiction to the internet is also connected to an increased risk for self-harm, and increased levels of depression or thoughts about suicide, the Oxford review said.
The review also says there is a strong link between young people using internet forums and an increased risk of suicide- a connection not found in relation to other social network sites.
In one of the studies reviewed, well over half (59%) of young people interviewed said they had researched suicide online.
Meanwhile, of 15 teenagers who had carried out particularly violent acts of self-harm, 80% said they had gone online to research self-harm beforehand. Of 34 who self-harmed by cutting, 73% said they had researched it online.
One of the studies reviewed suggested that young people using the forums appeared to normalise self-harm.
Most users went to the forums for empathy or to discuss safety issues rather than talk about how they could reduce their self-harming behaviour.
Another study showed that out of nearly 300 posts, 9% were about methods of self-harm and users went to the forums to swap tips on how to hide the problem.
Internet forums did not make the users feel any better, and in some cases they showed signs of increasing distress after using the sites, said one study.
However, another study contradicts this, saying that an analysis of the posts created by forum users reveals that by the third month they were less distressed than they had been in the first couple of months.
Young people who went to the forums said positive behaviour was encouraged: they congratulated each other for not cutting or urged one another to seek help from GPs.
Despite this, the review said that overall although forums may have provided emotional support, there is no evidence to suggest that this translated into young people actually reducing levels of self-harm.
The review also highlights the risk of cyber-bullying to vulnerable young people. Online bullying was found to make victims more likely to self-harm.
One study suggested that it slightly increased rates of attempted suicide by the victim as well as the perpetrator.
Email was used in 18% of cases of cyber-bullying, followed by instant messaging (16%), MySpace (14%) and chat rooms (10%), says the review.