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 (Reuters Health) - Keywords related to self-injury were searched more than 42 million times in the past year, according to a new study, but what those searches turned up was mostly myths and misinformation.

Researchers cataloged and analyzed websites related to nonsuicidal self-injury - which is physically injuring oneself intentionally without attempting suicide - and found less than 10 percent of the sites were endorsed by health or academic institutions.

"For many people it's  a first step and if what they're getting is poor quality that's a bit worrisome," said lead author Stephen Lewis, from the Department of Psychiatry at the University of Guelph in Canada.

He and his colleagues write in JAMA Pediatrics that between 14 and 21 percent of teens and young adults engage in nonsuicidal self-injury. The injuries can be inflicted by various methods, including cutting and burning.

People self-injure for a number of reasons, Lewis told Reuters Health, including as a way of dealing with negative emotions, to punish oneself or simply to feel something.

Because others may not understand self injury or those who do it may prefer to not talk about it in person, Lewis said people may turn to the Internet for information .

"It seems to be more salient for those issues that are more stigmatized and more difficult to talk about in off-line interactions," he said.

To assess the information likely to come up in an online search, Lewis and his colleagues used a Google keywords program to identify 92 terms related to nonsuicidal self-injurythat get at least 1,000 hits each month. They then analyzed content on websites displayed in the first page of Google search results for each term.

"We wanted to understand what people are actually getting access to," Lewis said. "We wanted to focus on the first page of results because that's where people tend to click."
About 22 percent of the websites contained health information, but only about one in 10 of those was endorsed by a health or academic institution.

The other websites contained pictures of self-injuries, did not pertain to the topic at all or were collections of blogs and articles.

The researchers then dug deeper into the health information websites. They found approximately one myth about nonsuicidal self-injury per website.

For example, a site may have stated that people who engage in this behavior have a mental illness, have a history of abuse or are primarily women. Each of those claims has been debunked, according to Lewis.

He said there are a few different ways to address the issue of misinformation about nonsuicidal self-injury online, including getting credible sites at the top of search pages.
"I think one thing that can be done is make sure there are good quality resources out there," he said. "We know there are. We developed one."

The website by Lewis' group is at www.sioutreach.org. Other credible sources the team recommends in their report are: www.crpsib.com, by a Cornell University research group, and www.selfinjury.com www.selfinjury.com.

Another possibility for improving the quality of information available, Lewis said, is to give pediatricians a list of trustworthy resources.

Apart from the misinformation, there is a positive side to the new findings, one self-injury researcher who wasn't involved in the new study told Reuters Health.

"My take away is that it's good that awareness is starting to grow," said Janis Whitlock, a research scientist at the Bronfenbrenner Center for Translational Research at Cornell University in Ithaca, New York.

"Of course, with the proliferation of information there is going to be the proliferation of things that aren't quite true," Whitlock said.

"That seems to be the nature of the web," she said. "There is nothing you can't find. We all have to be educated searchers."

SOURCE: bit.ly/QjkjIt JAMA Pediatrics, online March 24, 2014.

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