News stories on suicide, fictional content may increase risk for contagion
HansaBhargava, M.D., FAAP and KristopherKaliebe, M.D.
Mastering the Media
Contrast two headlines:
One active terrorist endangers city.
Two active terrorists endanger city.
In the first scenario, did you feel 50% less afraid?
This example from behavioral economist Daniel Kahneman demonstrates that fear conjured
by the news is not proportional to the actual risk. Research by Kahneman and others
demonstrates the impact of hardwired cognitive systems on information processing,
which leaves all humans susceptible to distorted viewpoints and emotionally driven
These attentional economics cause viewers and readers to pay more attention to dramatic,
terrible stories. Thus, “if it bleeds, it leads” the news. Conversely, and crucially,
positive events and gradual progress are less newsworthy.
Once familiar with unfortunate events from the news, we then overestimate their likelihood.
This is a more significant issue for children. Developing brains have less ability
to keep perspective. Children and adolescents have less life experience and are more
likely to catastrophize, overgeneralize and discount the positive. Fictional content,
especially if the child associates with the characters, can have a strong effect.
A key example of this is a study in the Journal of the American Academy of Child and Adolescent Psychiatry (http://bit.ly/2IgAB1e)that showed a spike in suicides following the release of the Netflix series “13 Reasons
Why,” a show about a teenage girl who commits suicide and leaves behind recordings
explaining her decision.
Suicide has risen over the last two decades and is the third leading cause of death
for people ages 10 to 24.
Suicide contagion was first described following publication of a Goethe novel in 1774.
These days, contagion appears to travel through news broadcasts as well as fictional
Simple changes in reporting suicide have proven effective in reducing contagion. In
2008, the World Health Organization and the International Association for Suicide
Prevention published Preventing Suicide, A Resource for Media Professionals (http://bit.ly/2MrkfYN). Following are highlights of the guidelines.
Educate the public about suicide and provide information about where to seek help.
Avoid language that sensationalizes or normalizes suicide or presents it as a solution
Avoid prominent placement and undue repetition.
Avoid explicit description of method used and detailed information about the site
of the suicide.
Exercise caution with photographs or video footage.
Take particular care in reporting celebrity suicides.
What can physicians learn from successful efforts by journalists to reduce suicide
For our patients and families:
Pediatricians can help reduce suicide contagion by individually and collectively alerting
the public about risky programming.
Data on suicide contagion are the most emotionally powerful example of how media content
can negatively affect individuals. Pediatricians can encourage families to use the
AAP Family Media Use Plan (http://bit.ly/AAPMediaPlan) to reduce exposure to negative media.
Pediatricians can advocate for the news and entertainment industries to adopt the
No Notoriety Protocol, which aims to reduce terrorism and mass shootings (http://nonotoriety.com).
The 2012 AAP Periodic Survey of Fellows indicated 22% of pediatricians are experiencing
burnout, and 45% agreed they had experienced burnout in the past. Because pediatricians
cannot avoid bad news at work, their personal media plan should be a counterbalance.
If you still are not convinced, take a one-week news fast and see how you feel.
Learning of disasters and personal tragedies raises stress and anxiety. Repetition
of bad news through multiple sources and 24/7 reporting enhances our perception that
awful news is everywhere. Details that conjure images and provide specifics have more
impact. Our feelings are most powerful when we associate with the characters or victims.
This is true for suicide contagion, effects of mass shootings and terror, and quite
likely reflects general realities about how all of us react.
The news and entertainment business is replete with negativity and economic models
predicated on stirring up innate fears and tribal instincts. When pediatricians understand
this, we can communicate with families that the news is much worse than reality and
focus on continuing to make great progress in the world.
Dr. Bhargava is a member of the AAP Council on Communications and Media (COCM) Executive
Committee. Dr. Kaliebe is a liaison from the American Academy of Child and Adolescent
Psychiatry to COCM.