Looking at several dozen teen suicide "clusters" that struck various U.S. communities, researchers found evidence that local newspaper coverage might have contributed in some cases.
In general, the study found, the initial suicide in those clusters garnered more newspaper stories -- with more explicit details -- when compared with isolated teen suicides.
Experts said the findings do not prove that the newspaper stories were to blame. But the study, reported online May 2 in The Lancet Psychiatry, adds to evidence that certain types of media coverage of a suicide can sometimes create a ripple effect.
"We've had so many studies now, and the more you find the same result, the greater the validity," said Jill Harkavy-Friedman, vice president of research at the American Foundation for Suicide Prevention in New York City.
"This particular study is extremely rigorous and well done," added Harkavy-Friedman, who was not involved in the research.
No one is saying that newspaper stories alone would drive a teenager to suicide, said lead researcher Madelyn Gould, of Columbia University and the New York State Psychiatric Institute in New York City.
"This won't emerge in young people without underlying risk factors," Gould said.
But if vulnerable teens read details about another young person's suicide, they might identify with that situation and be affected, she added.
This ripple effect might be heightened for young people using newer forms of Internet media, said the authors of an accompanying journal commentary. "It makes intuitive sense ... that less regulated, more volatile, and more interactive media might have an even greater effect, particularly because young people are not only major consumers of these forms of media, but also the creators of their content," wrote Jane Pirkis and Jo Robinson from the University of Melbourne in Australia.
For the study, Gould's team used state death data to find 48 teen suicide clusters that occurred across the United States between 1988 and 1996. Each cluster involved a community where between three and 11 teenagers killed themselves within a six-month period.
The researchers then examined local newspaper coverage of the first suicide in those clusters, and compared it with coverage of isolated teen suicides that occurred in the same state.
Overall, the initial suicide in a cluster gained more newspaper attention compared with isolated suicides -- over seven stories, on average, versus five, the study found. And those stories were more likely to appear on the front page, with photos, and contain graphic details about the method of suicide.
According to the U.S. Centers for Disease Control and Prevention, about 4,600 young people aged 10 to 24 die by suicide each year in the United States. Many more -- about 157,000 per year -- end up in the emergency room because of self-inflicted injuries.
But until now, little has been known about the factors that might drive teen suicide clusters, Gould said.
"Although we're all aware of clusters, and towns have been traumatized by them," she said, "we don't understand what triggers them."
The good news, she said, is that media coverage of suicides is something that can be changed. And efforts are already underway.
The Foundation for Suicide Prevention and other groups, including media organizations, collaborated on recommendations for journalists on how to report on suicide responsibly. The guidelines, available online, advise against "sensationalist" headlines and language, or descriptions of the suicide method. They also encourage reporters to interview suicide prevention experts, rather than relying on police or first responders for quotes.
Harkavy-Friedman said the recommendations have had a "very positive impact" on how media outlets cover suicide.
And Gould said it's important for everyone -- not only journalists -- to be aware that the way they talk about suicide matters.
Harkavy-Friedman agreed. "The way we talk about mental health, in general, makes a difference to the person on the other side," she said. Psychiatric problems should be acknowledged and discussed sensitively, she added, not dismissed as shameful.
The American Foundation for Suicide Prevention has more on preventing and coping with suicide.