by EBSCO Medical Review Board

Risk factors for teen suicidal behavior and self-harm have long been linked to mental health issues, substance abuse, and conditions like post-traumatic stress disorder. However, there are other factors related to a teen's environment that may also raise the risk, such as lack of a support system, poor coping skills, or a traumatic life event. Now, the internet is suspected to play a role as well.

Researchers wanted to explore the role of internet addiction in the development of self-harm and suicidal behavior among teens. Internet addiction is any online-related compulsive behavior that interferes with a person's daily life, job, and relationships. It is a growing public health issue among teens who have grown up in the age of technology. The study, published in The Journal of Pediatrics, indicates that internet addiction is prospectively associated with the incidence of self-harm and suicidal behavior in adolescents.

About the study

The prospective cohort study pooled 1,861 participants (mean age of 16 years and 82% male) attending high school in Taiwan. There was a history of self-harm or suicide attempts in 126 of the participants.

The study followed 1,507 participants without a history of self-harm or suicidal behavior for one year. During that time:

Those with an internet addiction had an increased risk of developing self-harm or suicidal behavior compared to those without internet addiction. In fact those with addiction were more than twice as likely to develop harmful behavior.

How Does This Affect You?

Cohort studies are observational studies. These studies simply observe events as they unfold, but do not interfere or introduce factors that can affect the outcome. A second issue is that the majority of participants in this study were male. This makes the data less applicable to all teens. Taiwan also has a high suicide rate when compared to other countries which may exaggerate the effects. A study that includes more female participants and more participants from other countries would make the results more reliable.

The internet is a useful tool for conducting academic and job-related research, playing games, and connecting with loved ones. However, if using the internet interferes with your teen's daily life, it may be time to take note. Common signs of addiction may be withdrawing from friends and hobbies, getting lower grades in school, loss of sleep, and unhealthy eating patterns. If your child shows signs of addiction or depression, talk to his or her doctor. Treatment may involve therapy and therapeutic activities, such as recreation therapy.


Centers for Disease Control and Prevention 

Healthy Children—American Academy of Pediatrics 


Depression in children and adolescents. EBSCO DynaMed Plus website. Available at: . Updated July 23, 2018. Accessed August 1, 2018.

Pan PY, Yeh, CB. Internet addiction among adolescents may predict self-harm/suicidal behavior: a prospective study. J Pediatr. 2018 Jun;197:262-267.

Revision Information

  • Reviewer: EBSCO Medical Review Board
  • Review Date: 07/2018