By Felecia Singh-Sumner, D.O.

Young people who have a history of harming themselves or attempting suicide might be particularly vulnerable to negative messages posted online, new research shows.

The new review, published Wednesday in the journal PLOS ONE, found that kids and young adults who have thoughts of self-harm or suicide actually spend more time on the Internet and are more often victims of cyberbullying than their peers who do not have such thoughts.

The findings paint a disturbing picture - one that suggests that vulnerable young people looking to Internet-based social groups for support may end up stumbling into places that offer exactly the opposite.

Lead study author Paul Montgomery, a professor at the University of Oxford in the U.K., said the new research is important in light of rising rates of Internet use - at a time when suicide is a growing issue of concern as well.

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Montgomery and his team examined 14 studies that looked at young people's use of Internet "forums" - in other words, virtual meeting places - as well as risk of self-harm, suicide, cyberbullying and depression. What they found was that instead of finding resources to help them avoid self-destructive behaviors, youth at risk of hurting themselves often found "suicidal partners" who would share suggestions on methods to practice self-harm. In some cases, these confidantes would discourage them from talking to loved ones or medical professionals about their thoughts. Other young people reported being exposed to taunting and negative messages in these online meeting areas.

"[These are] all things that we would like to encourage in an opposite direction," Montgomery said.

Conversely, Montgomery and his colleagues found that Internet forums can also sometimes provide a safe haven and support network for these young people - and he said more needed to be done to promote such outlets.

"There are sites such as online support groups that we would like to encourage further use," he said, adding that for kids who are less likely to communicate face-to-face, the internet may provide a means of social interaction that they may not otherwise get.

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But given the minefield of potentially negative messages in these forums, should children and young adults be looking to the Internet for help in the first place? Dr. Carol Bernstein, associate professor of psychiatry at the NYU School of Medicine, said she worries that while the increase in Internet use may help those who are socially withdrawn, it may also prohibit children from "developing the same social cues" that previous generations have developed prior.

"We can only guess what the impact is going to be now that our kids are learning to communicate this way," said Bernstein, who is also past president of the American Psychiatric Association. "It is second nature to them." As for the long-term positive or negative effects of the Internet on these vulnerable young people: "We just don't know," she said. "It's just not clear."

Doctor's Take:

In the midst of these unanswered questions, parents of kids who are vulnerable to self-harm may wonder what to do. Montgomery said that recognizing how dangerous the Internet can be is a good first step - especially if it leads to discussing those issues with kids and modifying their Internet use.

Bernstein said that for parents, the usual warning signs of depression or self-harming behavior still apply. "Find out what's going on with them," she said. "There's no substitute for getting to know your kids."

Parents can also take several other steps to ensure that their kids are not dangerously influenced by negative messages on the Internet:

• It's never too early to talk with your kids about computers. Encourage them to tell you or a professional if they feel threatened or uncomfortable by someone or something online.
• Set clear rules for Internet use, including the duration. The American Academy of Pediatrics suggests that computer/TV/phone use should be limited to no more than two hours per day for entertainment purposes.
• Use Internet safety tools to limit access to content and websites that are inappropriate for their age group.
• Keep computers in an open-area where their access can be easily monitored.
• If you begin to question your child's behavior, then that's an important cue. Pay attention to what you think and pay attention to your children.