Harmful ideations, particularly those that become delusional in nature, can lead to significant mental health conditions. These ideations often arise from a combination of personal vulnerabilities, environmental influences, and sociocultural factors. Once these thoughts become fixed, they can dominate an individual’s cognitive landscape, influencing behaviour and emotions detrimentally. Additionally, the transmissibility of such ideations can lead to clustered outbreaks, notably in environments like schools or universities, where individuals are in close contact and susceptible to social influence. It is useful to contextualise such harmful ideations by comparison with others, and with similar phenomena. Portraying transgender ideation as amongst its peers in the harmful ideation pantheon provides a useful perspective.

Types of Harmful Ideations

  1. Suicidal Ideation
    • Definition: Suicidal ideation involves persistent thoughts about ending one’s own life. These thoughts can range from fleeting considerations to detailed plans.
    • Manifestation: Suicidal ideation can stem from a variety of factors, including depression, anxiety, trauma, or significant life stressors. When these thoughts are ruminated upon, they can become more fixed and lead to a higher risk of suicide attempts.
    • Example: The phenomenon of “suicide clusters” is well-documented. For instance, in Palo Alto, California, there have been multiple instances of teenage suicide clusters, which have been attributed to a combination of academic pressure, social contagion, and media coverage.
  2. Body Dysmorphic Disorder (BDD)
    • Definition: BDD involves an obsessive focus on perceived defects or flaws in physical appearance, which are often minor or not observable to others.
    • Manifestation: Individuals with BDD may engage in repetitive behaviors like mirror checking, excessive grooming, or seeking constant reassurance about their appearance. This can lead to significant distress and impairment in daily functioning.
    • Example: The rise of social media and the pervasive culture of appearance perfection have exacerbated BDD cases. For instance, “Snapchat dysmorphia,” where individuals seek cosmetic surgery to resemble filtered versions of themselves, has become increasingly prevalent.
  3. Obsessive-Compulsive Disorder (OCD)
    • Definition: OCD is characterized by unwanted and intrusive thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) aimed at reducing the distress caused by these thoughts.
    • Manifestation: Common obsessions include fears of contamination, harm, or symmetry, which can lead to compulsions like excessive cleaning, checking, or arranging.
    • Example: During the COVID-19 pandemic, there was a notable increase in contamination-related OCD, with individuals developing extreme cleaning rituals and avoidance behaviors in response to fears of contracting the virus.
  4. Transgender Ideation
    • Definition: Transgender Ideation is the process by which an individual comes to contemplate or believe themselves to be transgender. This ideation involves the initial formation and subsequent rumination on the notion that one’s perceived sex differs from their actual sex.
    • Manifestation: If not dismissed, these thoughts may become persistent, potentially leading to Gender Incongruence (feeling that sex and gender are not aligned) which in turn can lead to significant distress (Gender Dysphoria). The affirmation of incongruent gender identities risks legitimising gender incongruence in the mind, especially in minors during identity formation, and can cement these identities prematurely, risking further psychological, social and medical implications.
    • Example: The phenomenon of “rapid-onset gender dysphoria” (ROGD) has been reported, where adolescents, particularly females, suddenly identify as transgender. This has raised concerns about the role of social influence and peer groups in the development and affirmation of these identities.
  1. Phobias
    Phobias are characterized by an intense, irrational fear of specific objects, situations, or activities. These fears can become so overwhelming that they interfere with an individual’s daily life and functioning.
  1. Social Phobia (Social Anxiety Disorder)
    • Definition: Social phobia involves an intense fear of social situations where one may be judged, embarrassed, or scrutinized by others.
    • Manifestation: Individuals with social phobia may avoid public speaking, attending social gatherings, or even eating in public. This avoidance can lead to isolation and significant distress.
    • Example: The rise of online interactions has paradoxically exacerbated social phobia for some individuals. While the internet offers a way to avoid face-to-face interactions, it can also increase anxiety about real-world social situations due to a lack of practice and increased reliance on digital communication.
  2. Agoraphobia
    • Definition: Agoraphobia involves a fear of situations where escape might be difficult or help unavailable in the event of a panic attack. This can include open spaces, crowds, or traveling away from home.
    • Manifestation: Agoraphobia can lead to severe restrictions in movement, with individuals often becoming housebound.
    • Example: During the COVID-19 pandemic, agoraphobia cases surged as individuals became accustomed to staying at home and developed intense fears about venturing outside due to the virus.
  3. Specific Phobias
    • Definition: Specific phobias are intense, irrational fears of particular objects or situations, such as spiders (arachnophobia), heights (acrophobia), or flying (aviophobia).
    • Manifestation: Encountering the feared object or situation can trigger immediate anxiety or panic attacks. Individuals often go to great lengths to avoid their phobia triggers.
    • Example: The portrayal of certain phobias in media, such as shark attacks in movies, can exacerbate fears and contribute to the development of phobias in susceptible individuals.

6. Self-Harming
Self-harming behaviors involve deliberately inflicting harm on oneself, often as a way to cope with emotional distress, trauma, or psychological pain. These behaviors can become compulsive and are associated with various mental health disorders.

  1. Cutting
    • Definition: Cutting involves using sharp objects to make cuts on the skin, typically on areas like the arms, legs, or abdomen.
    • Manifestation: Individuals may cut as a way to express or manage overwhelming emotions, feel a sense of control, or release tension. Over time, cutting can become a habitual response to stress.
    • Example: Online communities and social media platforms can create environments where self-harming behaviours are discussed and even normalized, leading to increased prevalence among impressionable adolescents.
  2. Burning
    • Definition: Burning involves using heat or chemicals to inflict burns on the skin.
    • Manifestation: Similar to cutting, burning is often used as a coping mechanism to deal with emotional pain or numbness. The act of burning can provide a temporary sense of relief or distraction.
    • Example: Cases of burning as self-harm have been reported in schools where peer influence and shared experiences of distress contribute to the adoption of such behaviours.
  3. Hair Pulling (Trichotillomania)
    • Definition: Trichotillomania is characterized by the recurrent, compulsive pulling out of one’s hair, leading to noticeable hair loss.
    • Manifestation: Individuals with trichotillomania may pull hair from their scalp, eyebrows, eyelashes, or other body areas. This behaviour is often a response to stress or anxiety and can lead to significant distress and impairment.
    • Example: Increased academic and social pressures in competitive school environments have been linked to higher instances of trichotillomania among students.
  4. Self-Poisoning
    • Definition: Self-poisoning involves the deliberate ingestion of toxic substances or overdosing on medications.
    • Manifestation: This behaviour is often associated with severe emotional distress, suicidal ideation, or a cry for help. Self-poisoning can result in serious medical emergencies and long-term health consequences.
    • Example: There have been reports of self-poisoning clusters in certain communities, where exposure to peers engaging in such behaviours can influence others to do the same.

Transmission of Harmful Ideations

The transmission of harmful ideations can occur through several mechanisms:

  1. Social Contagion
    • Social contagion refers to the spread of behaviours, attitudes, or ideations through a population via social interactions. This is particularly relevant in closely-knit communities like schools or universities.
    • Example: The Werther effect, named after the protagonist of Goethe’s novel “The Sorrows of Young Werther,” describes an increase in suicides following media coverage of a suicide. This effect demonstrates how exposure to suicidal behaviour can influence vulnerable individuals.
  2. Peer Influence
    • Adolescents and young adults are particularly susceptible to peer influence due to their developmental stage. Peer groups can reinforce certain behaviours or ideations, leading to their normalization.
    • Example: The rise in self-harm behaviours among teenagers has been linked to peer influence and social media communities that discuss and sometimes glorify self-injury.
  3. Media and Technology
    • The role of media, including social media, in disseminating harmful ideations is significant. Constant exposure to certain narratives or images can reinforce and perpetuate these thoughts.
    • Example: Pro-anorexia (pro-ana) websites and social media accounts promote restrictive eating and weight loss as lifestyle choices, significantly impacting individuals with eating disorders.

Related Behaviours

The extent to which harmful adolescent behaviors such as drug abuse, promiscuity, involvement in crime, dangerous driving, or engagement in dangerous sports can be attributed to socially transmitted ideation is significant. Adolescence is a developmental stage characterized by heightened susceptibility to peer influence and social norms. The behaviors of peers and the broader social environment can strongly shape an adolescent’s actions and decisions.

Drug Abuse

  1. Peer Influence and Social Norms
    • Adolescents are more likely to experiment with drugs if their peers do so. The desire to fit in, gain social acceptance, or emulate admired peers can drive drug use.
    • Example: Studies have shown that teenagers who perceive drug use as common among their friends are more likely to use drugs themselves. Peer pressure and the normalization of drug use within certain social circles can lead to increased substance abuse.
  2. Media and Popular Culture
    • Media portrayals of drug use can glamorize and normalize the behavior. Music, movies, and social media often depict drug use as a desirable or acceptable activity, influencing adolescents’ attitudes and behaviors.
    • Example: The portrayal of drug use in music videos and movies can create a perception that such behavior is common and acceptable, leading to increased experimentation among teenagers.

Promiscuity

  1. Sexual Norms and Peer Pressure
    • Adolescents are influenced by the sexual behaviors and attitudes of their peers. The perception that peers are sexually active can lead to pressure to engage in similar behaviors to avoid being seen as different or inexperienced.
    • Example: Research has shown that adolescents who believe their peers are sexually active are more likely to initiate sexual activity themselves. Peer discussions about sex and shared experiences can reinforce these behaviors.
  2. Media Influence
    • Media and popular culture often depict casual sex and promiscuity as normal and desirable, which can influence adolescents’ attitudes toward sex.
    • Example: Television shows and movies that portray casual sex without consequences can lead adolescents to adopt more permissive attitudes towards sex and increase their likelihood of engaging in promiscuous behavior.

Involvement in Crime

  1. Peer Influence and Group Dynamics
    • Adolescents are more likely to engage in criminal behavior if they associate with peers who commit crimes. The desire to gain acceptance or status within a peer group can lead to participation in illegal activities.
    • Example: Gangs and delinquent peer groups often recruit vulnerable adolescents, providing a sense of belonging and identity that can encourage criminal behavior.
  2. Environmental and Societal Factors
    • Socioeconomic factors and community norms can also play a role in influencing adolescent crime. Adolescents in high-crime neighborhoods may see criminal behavior as a viable means of achieving economic or social goals.
    • Example: Adolescents in economically disadvantaged areas with high crime rates are more likely to engage in criminal activities, influenced by the norms and behaviors prevalent in their communities.

Dangerous Driving

  1. Peer Influence and Risk-Taking Behavior
    • Adolescents are more likely to engage in risky driving behaviors, such as speeding or driving under the influence, if their peers do so. The thrill-seeking nature of adolescence and the desire to impress peers can contribute to dangerous driving.
    • Example: Studies have shown that teenagers are more likely to take risks while driving when they have peers in the car. Peer presence can increase the likelihood of speeding and other dangerous driving behaviors.
  2. Media Influence
    • Media portrayals of reckless driving in movies and video games can glamorize dangerous driving behaviors and influence adolescents’ perceptions of risk.
    • Example: Car racing movies and video games that depict high-speed chases and reckless driving can lead adolescents to underestimate the dangers of such behaviors and mimic them in real life.