Social Media, Smartphone Use and Self-harm in Young People (3S-YP)

Self-harm is when somebody hurts their body as a way of coping with difficult feelings. Self-harm is becoming increasingly common in young people, particularly in adolescent females. The rise in self-harm has been linked to increasing use of social media and internet technology among young people. However, the evidence is limited to associations with poorer mental health outcomes rather than identifying particular aspects of using these technologies that can negatively impact on mental health.

This study aims to investigate how the use of social media and a smartphone may increase the risk of self-harm in young people by exploring changes in usage in the period leading up to an episode of self-harm. The information from this study will allow us to understand whether there are certain behaviours that are more likely to occur before an episode of self-harm. This will inform new strategies to identify and provide support to vulnerable young people. For example, linking young people with crisis support or empowering young people to make changes, manage their own risks and build resilience.

This study will recruit young people aged 13-25 years old who have accessed mental health services provided by an NHS Trust in South-East London. Young people will be invited to provide information on their mental health and social media and smartphone use over a period of six months.

Study Overview

• Status: Completed
• Conditions: Self-Harm, Deliberate

• Study Type: Observational
• Enrollment (Actual): 388

Contacts and Locations

Study Locations

• United Kingdom
  • London, United Kingdom
    • South London and Maudsley NHS Foundation Trust

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 13 years to 25 years (Child, Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Clinical sample

Description

Inclusion criteria

• Identified via SLaM's C4C patient research participation register or referral to the study team by their clinician.
• Aged 13-25 years old at the time of study approach.
• Accessed mental health services at SLaM in the last 12 months.
• Has capacity to consent (and an adult with parental responsibility for young people aged 13-15 years old). Mental capacity will be assumed unless evidence from a clinician or during contact with the study team suggests otherwise.

Exclusion criteria

• Unable to complete the questionnaires via the study software application or online survey platform.
• Admitted to an inpatient psychiatric ward, sectioned under the Mental Health Act or in prison at the time of approach.
• Clinician advises it is not appropriate to approach.

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-harm event	Self-reported and clinician-reported self-harm events	6 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sleep disturbance symptoms	Symptoms of sleep disturbance measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Short Form V1.0 4a / Pediatric Sleep Disturbance Short Form V1.0 4a. Scores range between 4-20, with higher scores indicative of possible sleep disturbance.	6 months
Depression symptoms	Symptoms of depression measured using the Patient Health Questionnaire. Scores range between 0-27, with higher scores indicative of possible depression.	6 months
Anxiety symptoms	Symptoms of anxiety measured using the Generalized Anxiety Disorder Scale. Scores range between 0-21, with higher scores indicative of possible generalised anxiety disorder.	6 months
Loneliness symptoms	Symptoms of loneliness measured using the Three-Item Loneliness Scale. Scores range between 3-9, with higher scores indicative of possible loneliness.	6 months
Experiences of being bullied	Experiences of being bullied measured using an Eight-Item Bullying Checklist derived from the Revised Olweus Bully/Victim Questionnaire. Scores range between 8-40, with higher scores indicative of more experiences of being bullied.	6 months

Collaborators and Investigators

• Sponsor: King's College London
• Investigators: Principal Investigator: Rina Dutta, King's College London

Publications and helpful links

General Publications

• Bye A, Carter B, Leightley D, Trevillion K, Liakata M, Branthonne-Foster S, Williamson G, Zenasni Z, Dutta R. Observational prospective study of social media, smartphone use and self-harm in a clinical sample of young people: study protocol. BMJ Open. 2023 Feb 1;13(2):e069748. doi: 10.1136/bmjopen-2022-069748.
• Bye A, Carter B, Leightley D, Trevillion K, Liakata M, Branthonne-Foster S, Cross S, Zenasni Z, Carr E, Williamson G, Vega Viyuela A, Dutta R. Cohort profile: The Social media, smartphone use and Self-harm in Young People (3S-YP) study-A prospective, observational cohort study of young people in contact with mental health services. PLoS One. 2024 May 22;19(5):e0299059. doi: 10.1371/journal.pone.0299059. eCollection 2024.

Helpful Links

• Related Info

Study record dates

Study Major Dates

• Study Start (Actual): June 3, 2021
• Primary Completion (Actual): June 30, 2023
• Study Completion (Actual): July 31, 2023

Study Registration Dates

• First Submitted: October 7, 2020
• First Submitted That Met QC Criteria: October 22, 2020
• First Posted (Actual): October 23, 2020

Study Record Updates

• Last Update Posted (Actual): May 2, 2025
• Last Update Submitted That Met QC Criteria: May 1, 2025
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Keywords: Adolescent; Smartphone; Mental health; Young adult; Social media
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior
• Other Study ID Numbers: 269104

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Data will not be made available to other researchers.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No