Strong Fears, Weak Ties, and Nonsuicidal Self-Injury: Medical Inquiries About Injury, Wound, and Scar Care from a Self-Harm Subreddit.

Abstract

Through the theoretical lens of the Strength of Weak Ties Theory, this study examined medical advice sought within a self-harm subreddit. Using a social constructionist epistemology and employing a Reflexive Thematic Analysis, we explored 596 inquiries for medical advice about nonsuicidal self-injury-related injuries, wounds, and scar care. Five overarching themes were identified: (a) pleading for wound care help from weak-ties, (b) expressing fear of hospitalization deterring requests to strong-ties, (c) seeking validation for harm-reduction from weak-ties (d) asking weak-ties how to navigate unexpected outcomes, and (e) requesting help from weak-ties to conceal wounds, injuries, and scars from strong-ties. Our findings align with previous research by describing Reddit as a valuable resource when strong-ties are inaccessible or unapproachable. They extend the existing literature by highlighting users' frequently asserted preference for online medical inquiries due to stigma and involuntary hospitalization fears often associated with medical and mental health providers. We discuss the need for injury and wound care best practices in accessible spaces while offering theoretical and practical implications for key stakeholders. Given the frequent spread of mis/disinformation on user-generated social networks, we also emphasize the importance of users' verifying the accuracy of medical advice received before implementing suggestions received online from anonymous weak ties connections. Ultimately, this study highlights the nuances between online medical inquiries, social support, and barriers to accessible and empathetic healthcare for individuals engaging in nonsuicidal self-injury.