Exploring Indicators of Digital Self-Harm with Eating Disorder Patients: A Case Study

Digital self-harm encompasses a variety of activities, including the use of social media to facilitate or amplify mental illness-related behaviors. To understand the extent of these behaviors and their impacts, we conducted an in-depth case study with three patients who are in recovery from an eating disorder. We collected survey data, conducted interviews reflecting back to their technology use during their active disease state, and reviewed up to 18 months of their social media data leading up to the start of their initial point of recovery. Through the triangulation of this data, we explore the role of social media and social technologies in relation to their eating disorder. By utilizing this methodology, we were able to provide a contextually rich and nuanced lens for exploring the impacts of digital self-harm on this group of patients. We found that patients acknowledged that the eating disordered content on social media had a negative impact on their health, often contributing to a worsening of the physical manifestations of their disorder. Conversely, while they actively consumed this content, our participants did not produce online content related to eating disordered activities or behaviors. Finally, we discuss the patterns within their social media data and how platform designers and operators could use these findings in the future through design considerations for future platform-based interventions.