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hungerhurtsbut starvingworks CharacterizingthePresentationof EatingDisordersOnline JessicaPater OliverHaimson NazaninAndalibi ElizabethMynatt WARNING Thispresentationincludesmedia thatcouldbeatriggerand/or disturbinginnature. 1in10Americanssufferfroman eatingdisorder AnorexiaNervosa BulimiaNervosa Binge-EatingDisorder OtherSpecifiedFeedingorEatingDisorder (OSFED) Cachexia Orthorexia http://anad.org Image:www.proana.com Motivation– UnderstandingEatingDisorders • Theincidenceofanorexiainyoungwomen 15-19hasriseneachdecadesince19301. • Anorexiahasthehighestmortalityrateof anypsychiatricdisorder2. • Awoman15-24is12x morelikelytodie thanawomanwithoutanorexia3. 1 Hoek&vanHoeken,2003 2 Arcelus,Mitchell&Wales,2011 3 Sullivan,1995 Motivation– ConnectivityPatterns 92%ofteensonlinedaily 24%reportbeingonline“almostconstantly”1 Platforms: Facebook71% Instagram52% Snapchat41% Twitter33% Vine24% Tumblr14% Priorworkshowsthispopulationusesocial platformstoaccessandpromoteeatingdisorder behaviors2 1 2 PewTeens,Social Media&TechnologyOverview2015 Pateretal.ThisDigitalLife:ANeighborhood-Based StudyofAdolescentsLivesOnline Motivation– Networks Borzekowski,Detal.e-Anaande-Mia:Acontentanalysis ofpro-eatingdisorderwebsites (2010) Shade, L.Weborexics:TheEthicalIssuesSurrounding Pro-AnaWebsites (2003) Motivation– HidinginPlainSight ResearchQuestions Howiseatingdisordercontentorganized withinsocialmediaplatforms? HowdoEDpostersrepresentthemselvesand aretheresimilaritiesacrossplatforms? Whatotherhealthissuesareself-disclosedin conjunctionwithED? Overview Methods HashtagAnalysis MediaAnalysis Challenges EthicalConsiderations Methods Selected3platforms:Instagram,Tumblr, Twitter UsecommonED-relatedtermstodo preliminarysearchforcontent TI anorexia,pro-ana, proana,bulimia, promia,promia,eating disorder, pro-ed TR anorexia,proana, bulimia, promia, eating disorder, anamia, proanamia,EDNOS, thinspo, thinspiration Createdanupdatedlistoftermstousefor datacollection;575totalpostsindataset Methods InductiveCoding • Hashtags • Media– image,video,gif,posttext Methods InductiveCoding • Hashtags • Media– image,video,gif,posttext Methods InductiveCoding • Hashtags • Media– image,video,gif,posttext Hashtags 6705totalhashtagscollected(457uniquetags) Total Hashtags Avg. tag/post Std. Dev. Range Tumblr 3433 20.2 7.9 2-33 Instagram 1939 12.3 8.1 1-30 Twitter 1333 5.4 3.9 1-18 Variabilityofagiventerm: anorexia ana anne annie anorecia anorectic anoressia anorexia anorexic anorexique anorexix Hashtags Hashtagswerethematicallycategorized. 15.0% Anorexia 7.1% Self-Injury 3.4% Food 9.5% Bulimia 5.2% Suicide/Death 3.3% Identity 8.9% GeneralEating 5.1% Recovery Disorders 3.3% MentalHealth 7.6% Weight 4.0% Body 1.7% SocialSupport 7.4 Inspiration 4.0% Depression 0.9% Fitness www.jesspater.com/data Media Archetypes • Thinspiration • EDJourney • Diet • Mismatches • SuicidalIdeation • Self-harm • OtherMentalHealthIndicators ThinInspirations…Thinspo Thinspo- SocialSupport EatingDisorderJourney EatingDisorderJourney Self-harm MentalHealthContent Depression MentalHealthContent Relatable,depression, anziety,selfharm, suicide, depressed, depressing, depression, quote, mentalillness, bulimia, bipolar, borderlinepersonality, eatingdiosrder, ana, anorexix,mia,ed,bd, bdp, bulimique, cutting, scars MentalHealthContent Depression– 40.6%ofallposts Excludingdepression– 18.9% Challenges Censorship ContextisImportant! ContextisImportant! asf EthicalChallenges • Outsiderstothecommunity • Researcherimpact • Userconsenttouseofdata • Whatdoesthecommunitythink? • JoinusatICWSM!! https://icwsmethics2016.wordpress.com FutureWork Validationwithclinicians Dopeoplewithdiagnosedeatingdisorders engagewiththesetypesofonlinebehaviors? Evaluatingdiagnostictoolsandscreeners IsitpossibletocaptureonlineED-related onlinebehaviorwithcurrentdiagnostictools? Thankyou Questions? JessicaPater [email protected] www.jesspater.com www.jesspater.com/data