‘13 Reasons Why’ and Young Adults’ Risk of Suicide

By Michael Rozansky. Original post for the Annenberg Public Policy Center.  

One of the most heavily watched and debated fictional portrayals of suicide in recent years was the Netflix series “13 Reasons Why,” which raised outcries about potential contagion stemming from its portrayal of a female high-school student’s suicide.

Google searches about suicide spiked after the release of Season 1, physicians said that several children created lists of “13 reasons why” they wanted to kill themselves, and one hospital saw an increase in admissions of children who exhibited suicidal behavior. But two studies conducted after the series was released found some beneficial effects.

Given the series’ popularity and its potentially harmful effects, researchers at the University of Vienna, the University of Leuven, the University of Michigan, and the Annenberg Public Policy Center (APPC) conducted a study to more fully understand the effects of the show through a survey of U.S. young adults, ages 18 to 29, before and after the May 2018 release of its second season.

In the study, published today in the journal Social Science & Medicine, researchers found that:

  • Viewers who stopped watching the second season partway through reported greater risk for future suicide and less optimism about the future than those who watched the entire season or didn’t watch it at all;
  • Students – who were nearly 60 percent of the sample – were at an overall higher risk for suicide. Of the viewers who dropped out of watching the series midway, students were at a significantly higher suicide risk than non-students (see Figure 1);
  • The show appeared to have a beneficial effect on students who saw the full second season: They were less likely to report recent self-harm and thoughts of ending their lives than comparable students who didn’t watch the series at all. And viewers in general were more likely to express interest in helping a suicidal person, especially compared with those who stopped watching;
  • Netflix’s warning about the show’s potentially disturbing content that preceded Season 2 mainly appeared to increase viewing but did not appear to prevent vulnerable viewers from watching the season.

“Although there’s some good news about the effects of ‘13 Reasons Why,’ our findings confirm concerns about the show’s potential for adverse effects on vulnerable viewers,” said Dan Romer, APPC’s research director and the study’s senior author. “It would have been helpful had the producers done more to enable vulnerable viewers to watch the entire second season, which is when the show had its more beneficial effects.”

Fig. 1: Predicted suicide risk

Background on the study

Suicide is the second-leading cause of death among 15- to 29-year-olds. Media portrayals of suicide have been shown to have helpful and harmful effects. Stories of suicide in news and fictional media can elicit suicide – especially when they explicitly show suicide methods – in a phenomenon called the Werther effect, after Goethe’s novel “The Sorrows of Young Werther.” By contrast, news stories about people who have overcome a suicidal crisis have had a positive impact, a more recently documented phenomenon that is known as the Papageno effect, after the character in Mozart’s opera “The Magic Flute.”

For this study the researchers surveyed 18- to 29-year-olds, who reported having access to Netflix, both shortly before the second season was launched and a month later. A total of 729 respondents completed both the initial internet survey and the follow-up, which used validated scales to measure future suicide risk, hopelessness, recent self-harm, and related outcomes. Women were over represented in this sample (82 percent), perhaps because “13 Reasons Why” involved a female protagonist.

An indicator of distress

“13 Reasons Why” seemed to be particularly upsetting for young people who were already at a higher risk of suicide and who empathized with the main character, 17-year-old Hannah, who is bullied and sexually assaulted before deciding to end her life. As the researchers wrote, “We hypothesized that watching only some of the series could be an indicator of distress that led those viewers to discontinue exposure to the upsetting content.” The results appeared to support that idea, in that those who watched only some of the second season showed elevated risk of future suicide, an outcome that was stronger for current students.

At the same time, students who watched the entire second season reported less self-harm after watching than those who did not watch at all. Thus the findings suggest that over the course of a month following the second season, the show exerted a beneficial effect on some students.

The researchers added: “One explanation for the beneficial finding is that those at higher risk who persisted to the end were able to empathize with the challenges faced by the main characters and to take away a life-affirming lesson applied to their own lives.” The second season may have conveyed this message with more effectiveness than the first season, which mainly focused on the harm that the suicide inflicted on the victim’s friends and family.

“Given that we know that the Werther effect is a real phenomenon with detrimental consequences, the public outcry about potential contagious effects as a response to the first season is justified,” said the study’s lead author, Florian Arendt of the University of Vienna, Austria. “However, the second season appeared to have more content that could engender a beneficial effect than the first season, and this may have helped those who watched it in its entirety to walk away with more beneficial outcomes.”

Viewers who watched the full second season were also more likely to be sympathetic to a hypothetical friend who appeared to be suicidal. Here again the findings suggest that the show may have succeeded in creating empathy for those in a suicidal crisis.

Evidence the show “can harm some… and may actually help others”

In an accompanying commentary on the study in Social Science & Medicine, Anna S. Mueller of the University of Chicago’s Department of Sociology and Comparative Human Development said the findings “offer the strongest evidence to date that 13RW can harm some youth and the results demonstrate that it may actually help others, which is rarely considered in the media and suicide literature.”

Mueller, who was not connected with the study, said, “It also has important implications for what scholars should do next.” That includes “unpacking how exposure to suicide – whether through media or a personal relationship – transforms an individual’s vulnerability to suicide.”

What should Netflix do?

Romer said, “Producers of shows such as ‘13 Reasons Why’ need to be aware of the potential effects of their shows, particularly on vulnerable audiences. One way to do this would be to make the series less aversive to people who are sensitive to a story about suicide, because they may not get to the parts of the story that have more uplifting effects.”

The researchers noted that the study had limitations, including the one-month time frame for the observed effects. Also, it did not assess respondents’ experiences surrounding sexual assault, an important element in the series in both seasons, which could have influenced reactions.

Romer and Arendt’s co-authors are Patrick E. Jamieson, director of the Annenberg Health and Risk Communication Institute at the Annenberg Public Policy Center; Sebastian Scherr, of the School for Mass Communication Research, University of Leuven, Belgium; and Josh Pasek, of the Department of Communication Studies and Center for Political Studies, Institute for Social Research, University of Michigan.

The study “Investigating harmful and helpful effects of watching season 2 of 13 Reasons Why: Results of a two-wave U.S. panel survey,” is published in Social Science & Medicine.

 

Winners and Losers:
 The Psychology of Attitudes Toward 
Foreign Trade

Post developed by Katherine Pearson and Diana Mutz

Foreign trade is a complex issue, but the public still has strong opinions about the issue. Diana Mutz demonstrated that social psychology can help to understand attitudes about trade when she delivered the 2019 Miller Converse lecture. A recording of her talk “Winners and Losers: The Psychology of Attitudes Toward Foreign Trade” is available below.

Most people rely on small-scale social experiences to understand large-scale interactions such as international trade. From this understanding, people tend to embrace beliefs about trade that are not necessarily accurate. For example, folk beliefs suggest that impersonal transactions are more dangerous than personal ones, that trade is zero-sum, and that trade “deficits” mean that a country is losing more jobs as a result of imports than it gains due to exports. These beliefs are inaccurate, yet understandable, generalizations from the world of face-to-face social exchange.

Contrary to popular wisdom, trade preferences do not reflect people’s economic self-interest. Mutz demonstrates that, surprisingly, these attitudes are not influenced by a person’s occupation, industry of employment, community job loss, geographic location, or individual job loss. Instead, perceptions of what is in the collective economic interest determine attitudes toward trade. Coverage of trade in the media has a large influence on these perceptions. Media coverage of foreign trade was mostly negative until 2016. As media coverage of trade has become more balanced since 2016, support for trade has also increased.

Politicians from all parties have been unwilling to champion trade when running for office because foreign trade is seen as a political liability in the United States. As the world economy changes, Mutz asserts that leaders will need to advocate for trade and for safeguards against its negative effects. She cautions that it’s unhelpful to leave the public out of that conversation altogether as has been common in the past.

For an additional perspective, Mutz compares attitudes about trade in the United States and Canada. She finds that attitudes about trade in the two countries are different due to differing attitudes toward competition. Americans value competition more, and believe in the fairness of unequal outcomes. In the U.S., nationalism reduces support for foreign trade, but in Canada the opposite is true. Canadians who hold the strongest beliefs about national superiority want to promote more trade and immigration.

Differing perspectives on trade in these countries can be explained by variation in two different types of ingroup favoritism. First, Americans in Mutz’s studies systematically preferred trade agreements in which their fellow Americans benefited more than trading partners. In fact, there was no level of job benefits to foreign countries that would justify the loss of even a single American job. This was not the case among Canadians. In addition, Americans demonstrated their competitive attitudes toward trade by demonstrating greater support for trade agreements that not only benefit their country but also disadvantage the trading partner. Canadians, in contrast, preferred the kind of “win-win” trade agreement that economists suggest benefits all countries involved.

Attitudes about race drive attitudes about trade and Mutz finds that the reverse may also be true. In a study that asked respondents to select which students should be admitted to college, participants who had just watched an ad against foreign trade were less supportive of admitting Asian-American students, as well as students from Asia.

Mutz concludes that, while many of these results are distressing, attitudes remain malleable. Efforts to change opinions toward trade that emphasize similarity and shared values are more effective than efforts emphasizing pocketbook gains. Since 2016, her data shows that there has been an increase in support for foreign trade and a realization that it comes with benefits as well as negative consequences.

Divided by Culture: Partisan Imagery and Political Evaluations

Post developed by Katherine Pearson and Stuart Soroka

When you think of a Prius, what political party comes to mind? What about country music? Increasingly, Americans associate partisan leanings with otherwise non-political objects. Dan Hiaeshutter-Rice, Fabian G. Neuner, and Stuart Soroka examine the consequences of these associations in their paper “Divided by Culture: Partisan Imagery and Political Evaluations”, which they will present at the Midwest Political Science Association meeting on Saturday, April 6, 2019.

The cultural and political divide in America receives considerable media and scholarly attention. Republicans and Democrats have different preferences for everyday things like cars and drinks – most people are familiar with stereotypes of latte-drinking liberals or truck-loving conservatives. These differences even extend to their children’s names, the places they live, and the amount they give to charity.

The authors of this paper took a closer look at the extent to which non-political objects, activities, and places are associated with partisanship and ideology. Participants in the study were first prompted to list objects and activities they associate with either liberalism or conservatism. Following this open-ended question, respondents were asked to rate a list of 26 objects and activities based on ideology or partisanship.

The results of the open-ended question are illustrated in the figure below, which shows the words most strongly associated with Democrats (blue) and Republicans (red).  The figure makes clear the ease which which respondents name objects and activities often associated with the two partisan groups.

Hiaeshutter-Rice, D., Neuner, F., Soroka, S. 2019, “Divided by Culture: Partisan Imagery and Political Evaluations”, paper presented to the 77th Annual MPSA Conference, Chicago, IL, April 4-7, 2019.

In subsequent studies, the authors examined  respondents’ reactions to a series of photos of political candidates standing in front of different backgrounds, including a NASCAR race, an organic food store, and a shooting range. Not all treatments made a difference, but the shooting range (and another image of a gun shop) in particular affected the way that respondents perceived the candidates’ ideology and policy proposal.

As more politicians use social media to share images of their campaigns, it is essential to be aware of the ways in which voters evaluate candidates. Nonverbal political communication conveys information that can help shape public opinion and political behavior. Will voters be manipulated by objects and scenery in political messages? The authors suggest that even as respondents can attach partisanship to wide range of non-political activities, their candidate-photo experiment finds only limited effects of hypothetical press-conference backgrounds. They conclude on a comforting note: “The fact that voters are readily able to attach partisanship to objects and activities, but yet barely take this information into account when rating candidates and policies, may be good news for representative democracy.”