Positive and negative uses of social media among adolescents hospitalized for suicidal behavior

The impact of social media use on depression, anxiety, and well-being for teens/young people: using hypnosis to build a strong sense of self

The national conversation continues to focus on the negative impact of social media on teens/young people. The lingering effects of the pandemic revealed sharp increases in the common practice of "compare and despair" as well as higher rates of loneliness, isolation, depression, and self-harming behaviors. In May 2023, the US Surgeon General warned that social media "is the defining public issue of our time" and is driving the teen mental health crisis. These concerns for the mental health of humans across the globe are real and dramatic. Social media's impact on young people can be neutral, negative, positive or shades of each. The hypnosis community has an opportunity to be a more vital presence in helping young people navigate, manage, and reduce negative social media impact and to harness social media's very positive contributions, many of which are well documented. This article focuses on assessing social media use in teens and young adults, identifying developmental tasks being practiced on social media, and how factors such as time spent on social media and social media experiences have promoted trauma, stress, depression and anxiety. In addition, it will consider some of the ways in which the isolating effects of COVID-19 have further impacted well-being. Finally, the article will discuss how hypnotherapists can leverage social media to foster stronger ego strengthening using therapeutic interventions that employ hypnosis, hypnotherapy techniques and interventions, hypnotic scripts, and social media to lower mental health risks in teens/young adults.

Positive and negative social media experiences and proximal risk for suicidal ideation in adolescents

BACKGROUND

Social media (SM) has received considerable attention as a potential risk factor for adolescent suicide. Few empirical studies, however, have examined adolescents' daily negative and positive experiences on SM and its proximal impacts on suicidal ideation (SI), particularly using intensive monitoring designs.

METHOD

Adolescents (N = 60; 14-17 years; 49% girls; 62% LGBTQ+) recruited using SM across the United States and participated in an 8-week intensive monitoring protocol. Ecological momentary assessment (three brief surveys per day) asked about negative and positive SM experiences and SI (passive and active). Multilevel modelling was used to evaluate the within-person relationships between daily SM experiences (e.g. individual fluctuations compared to a person's average) and SI, controlling for average levels of SM experiences, SM use screen time, and lifetime SI.

RESULTS

Significant within-person effects of negative and positive SM experiences were associated with days when adolescents had SI. Specifically, on days when teens endorsed more frequent negative SM experiences than usual, they were more likely to report SI. However, more positive SM experiences than usual were associated with a lower likelihood of having SI. There were no significant effects of SM use ('screen time') on SI or on the reverse associations of SI on next-day SM experiences.

CONCLUSIONS

Results indicate that SM experiences may be dynamic and modifiable risk and protective factors for SI in adolescents, whereas there is no effect of SM screen time on SI. Our results highlight that targeting negative SM experiences and augmenting the positive experiences on SM may be critical targets to improve teens' mental health and prevent suicide, rather than focusing on limiting SM screen time.

The use of information and communication technologies by adolescents living with a mental illness in the past 5 years: Scoping review

The use of information and communication technologies (ICT) is a huge part of adolescents' lives, especially by those living with a mental illness. However, very few studies explore their experience with the use of ICT and how it affects their health. The purpose of this study was to better understand the use of ICT by adolescents living with a mental illness. A scoping review was undertaken using Arksey and O'Malley's method to explore this understudied topic. The following databases were searched: Medline, CINAHL and Psychology and Behavioural Sciences Collection. Studies published between 2017 and 2022 were included. Data were analysed using a data extraction and an analysis grid developed by the research team. Of 1984 articles, only seven met the inclusion criteria. These articles allowed for a better understanding of the type of mental illness these young ICT users had, the type of ICT they use and their overall experience using ICT. The diagnoses most associated with the use of these ICT were suicidal ideation, depression, anxiety and eating illnesss. Types of ICT used were very diverse and adolescents had both positive and negative experiences using these ICT. Very few interventions using ICT were developed according to the needs of adolescents with mental illness. These adolescents often cope with the help of ICT and can have an overall positive experience. Their experience can also be negative as some of them were exposed to suicide-related and violent content. Future research is needed to better understand the best ICT interventions for these young people.

What methods are used in research of firsthand experiences with online self-harming and suicidal behavior? A scoping review

BACKGROUND

Online self-harming and suicidal behavior is a novel and rapidly increasing phenomenon warranting comprehensive mapping of used research methods.

AIM

To identify and map how knowledge on online self-harming and suicidal behavior is gathered, including how data are collected e.g. questionnaires and interviews.

METHODS

The review follows the Joanna Briggs Institute Manual for Scoping Reviews in tandem with Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A keyword search of three electronic databases was conducted on two occasions, yielding 5422 records. Following duplicate removal, the records were screened based on the following inclusion criterions; (1) in English or Nordic language and published between 2011-2022, (2) presenting results for self-harming and/or suicidal behavior on social media and (3) using tools for either interview or questionnaire aiming at assessment of the experience of online self-harming and suicidal behavior from the perspective of the person who engages in the behavior. A total of 64 articles were included.

RESULTS

45 used questionnaires, 17 used interviews, and two studies mixed the two approaches. 17% of the studies had made some effort to ensure validity within the questionnaires and 15.8% gave full access to the interview guide.

CONCLUSION

Research into online self-harming and suicidal behavior is characterized by a lack of validated measurements and methodological transparency. The results emphasize a need for further development, testing, and validation of questionnaires and greater openness and reflexivity in qualitative methodology to enable cross-study comparison and advance knowledge of this complex phenomenon.

The Influence of Joe Wicks on Physical Activity During the COVID-19 Pandemic: Thematic, Location, and Social Network Analysis of X Data

BACKGROUND

 Social media (SM) was essential in promoting physical activity during the COVID-19 pandemic, especially among people confined to their homes. Joe Wicks, a fitness coach, became particularly popular on SM during this time, posting daily workouts that millions of people worldwide followed.

OBJECTIVE

 This study aims to investigate the influence of Joe Wicks on SM and the impact of his content on physical activity levels among the public.

METHODS

 We used NodeXL Pro (Social Media Research Foundation) to collect data from X (formerly Twitter) over 54 days (March 23, 2020, to May 15, 2020), corresponding to the strictest lockdowns in the United Kingdom. We collected 290,649 posts, which we analyzed using social network analysis, thematic analysis, time-series analysis, and location analysis.

RESULTS

 We found that there was significant engagement with content generated by Wicks, including reposts, likes, and comments. The most common types of posts were those that contained images, videos, and text of young people (school-aged children) undertaking physical activity by watching content created by Joe Wicks and posts from schools encouraging pupils to engage with the content. Other shared posts included those that encouraged others to join the fitness classes run by Wicks and those that contained general commentary. We also found that Wicks' network of influence was extensive and complex. It contained numerous subcommunities and resembled a broadcast network shape. Other influencers added to engagement with Wicks via their networks. Our results show that influencers can create networks of influence that are exhibited in distinctive ways.

CONCLUSIONS

Our study found that Joe Wicks was a highly influential figure on SM during the COVID-19 pandemic and that his content positively impacted physical activity levels among the public. Our findings suggest that influencers can play an important role in promoting public health and that government officials should consider working with influencers to communicate health messages and promote healthy behaviors. Our study has broader implications beyond the status of fitness influencers. Recognizing the critical role of individuals such as Joe Wicks in terms of health capital should be a critical area of inquiry for governments, public health authorities, and policy makers and mirrors the growing interest in health capital as part of embodied and digital experiences in everyday life.

Perceived functions and importance of digital media use and adolescent depression and suicidal ideation

INTRODUCTION

Although social media (SM) use is nearly ubiquitous among adolescents, there is a lack of clarity concerning the relationship between SM use and mental health outcomes like depression and suicidal ideation (SI), which increase during adolescence. Much of the previous literature has focused on the frequency of SM use; however, the current study examined the relationship between the perceived importance of three types of interactions and functions of SM use and depressive symptoms and suicidal ideation.

METHODS

A sample of 4057 adolescents (M age = 14.6; 47.0% girls; 69.0% Non-Hispanic/Latine White) were recruited via an online survey manager between February and March 2019. Participants completed the Adolescent Digital Technology Interactions and Importance (ADTI) Scale, which assessed the perceived importance of bridging online and offline experiences (bridging), going outside one's identity or offline experience (identity), and facilitating social connections (social). Participants also completed measures of depressive symptoms and SI and a self-report measure of SM use. A series of path analyses were conducted to examine the relationship between bridging, identity, social, and depressive symptoms and SI.

RESULTS

After accounting for covariates (gender identity, racial identity, age, and SM use), bridging was negatively associated with depressive symptoms, whereas identity was positively associated with depressive symptoms. Bridging and social connection were negatively associated with SI, whereas identity was positively associated with SI. Gender moderated these relationships; however, racial identity did not.

CONCLUSION

The results highlight the importance of understanding adolescent SM use beyond screen time in relation to depression and SI.

Digital Media-related Problems Contributing to Psychiatric Hospitalizations Among Children and Adolescents Before and After the Onset of the COVID-19 Pandemic

The role of digital media in crises leading to youth psychiatric admissions is understudied and digital media use increased during the COVID-19 pandemic. In this cross-sectional study, demographics, clinical characteristics, and digital media-related problems (DMRPs; sub-coded as cyberbullying, online communication problems, triggering content, and limit-setting problems) were extracted from hospital records of youth (n = 1,101) admitted to a pediatric psychiatric unit from May 2018 to November 2021. DMRPs were identified in 127 admissions (11.5%), led by the online communication problems and limit-setting subtypes (both 4-5%). Significantly more overall problems were identified following the pandemic onset (13.9% of admissions vs. 9.1% before, p < 0.05). The limit-setting subtype specifically increased post-COVID-19 (6.0% vs. 2.7%, p < 0.01), and was associated with prior admissions, suicide attempts, and impulse control/behavioral disorders. Online communication problems were significantly more common among girls and youth with a history of trauma. Interventions in acute settings to mitigate consequences of DMRPs are needed.

Psychometric Properties of the Moral Disengagement through Technologies Questionnaire (MDTech-Q) in a Sample of Chilean University Students

In the virtual environment, hostile and aggressive comments that could negatively affect university students who often use different digital platforms are frequently observed, more than other age groups who have little or no supervision. In this sense, moral disengagement (MD) has been linked to different negative behaviors that manifest in physical interactions and which currently take place on the Internet, creating the need for instruments that specifically address MD online. The aim of this study is to adapt and validate the Moral Disengagement through Technologies Questionnaire (MDTech-Q) with Chilean university students. The sample comprised 527 university students (43.14% men, 56.86% women), with an average age of 22.09 years (SD (Standard Deviation) = 3.59) enrolled in 12 universities. First, a linguistic adaptation of the scale took place, and the surveys were applied considering ethical principles. Then, two confirmatory factor analyses (CFA) were performed, which considered four correlated factors, and provided satisfactory indices, agreeing with the original theoretical proposal, and demonstrating suitable reliability by internal consistency. In relation to the analyses of invariance according to sex and social media use, the MDTech-Q is stable up to scalar invariance. This study provides evidence of the psychometric quality of the MDTech-Q for its use on Chilean university students.

A rise in social media use in adolescents during the COVID-19 pandemic: the French validation of the Bergen Social Media Addiction Scale in a Canadian cohort

INTRODUCTION

Social media use has grown dramatically since its inception in the early 2000s and has further increased during the COVID-19 pandemic. Problematic use of social media (PUSM) is a type of behavioural addiction which has generated increasing interest among mental health clinicians and scholars in the last decade. PUSM is associated with multiple psychiatric conditions and is known to interfere with patients' daily functioning. There is no single accepted definition of PUSM, nor means of measuring it, in the literature. The Bergen Social Media Addiction Scale (BSMAS) is a helpful tool for identifying PUSM. This paper aims to validate BSMAS and to translate it from English into French, with the goal of making this clinical screening tool for PUSM available in French-language contexts.

METHOD

This study explored the psychometric validity of the French version of the BSMAS in a sample of 247 adolescents, who were either psychiatric inpatients (the hospitalized group, n = 123) or recruited in local high schools (the community group, n = 124).

RESULTS

The adolescents in the sample reported an increase in their social media use during the COVID-19 pandemic. This increase was more pronounced in the hospitalized group. Confirmatory factorial analysis showed an excellent fit, very good internal consistency and established convergent validity for the French version of the BSMAS. A total of 15.4% of the hospitalization group and 6.5% of the community group met the recommended clinical cutoff of 24 on the BSMAS, suggesting problematic use of social media.

CONCLUSIONS

The French version of BSMAS is a psychometrically validated and clinically useful tool to screen for PUSM in adolescents.

Interpretable machine learning-based approaches for understanding suicide risk and protective factors among South Korean females using survey and social media data

OBJECTIVE

We aimed to identify and understand risk and protective factors for suicide among South Korean females by linking survey and social media data and using interpretable machine learning approaches.

MATERIALS AND METHODS

We collected a wide range of potential factors including the material, psychosocial, and behavioral data from a detailed survey, which we then linked to data from social media. In addition, we adopted interpretable machine learning approaches to (1) predict the suicide risk, (2) explain the relative importance of factors and their interactions regarding suicide, and (3) understand individual differences affecting suicide risk.

RESULTS

The best-performing machine learning model achieved an AUC of 0.737. Adverse childhood experiences, social connectedness, and mean positive sentiment score of social media posts were the three risk factors that had a monotonic or unimodal relationship with suicide, and satisfaction with life, narcissistic self-presentation, and number of close friends on social media were the three protective factors that had a monotonic or unimodal relationship with suicide. We also found several meaningful interactions between specific psychiatric symptoms and narcissistic self-presentation.

CONCLUSIONS

Our findings can help governmental organizations to better assess female suicide risk in South Korea and develop more informed and customized suicide prevention strategies.

Review: Digital experiences and their impact on the lives of adolescents with pre-existing anxiety, depression, eating and nonsuicidal self-injury conditions - a systematic review

BACKGROUND

Published systematic reviews provide evidence linking positive and negative digital experiences to adolescent mental health. However, these reviews focus on the general public rather than the digital experiences of adolescents with different pre-existing mental health conditions and so may be limited in their clinical relevance. We review publications relating to anxiety, depression, eating disorders and nonsuicidal self-injury to identify common and condition-specific digital experiences and how these may be implicated in the origins and maintenance of these mental health conditions.

METHODS

A systematic literature search using a combination of mental health, digital experience (including social media use), and age of the target population terms was conducted on four databases. Detailed findings from the included studies were summarised using a combination of thematic and narrative methods.

RESULTS

Five qualitative and 21 quantitative studies met the eligibility criteria for inclusion (n = 5021). Nine studies included adolescents with depression, one with eating problems, two with nonsuicidal self-injury and 14 with multiple emotional health conditions. The review identified six themes related to the target populations' digital experiences: (a) social connectivity and peer support; (b) escape and/or distraction; (c) social validation and social comparison; (d) accessing/creation of potentially harmful content; (e) cyberbullying; and (f) difficulties with self-regulation during engagement with digital media.

CONCLUSIONS

Digital practices of adolescents with pre-existing clinical vulnerabilities are complex and encompass a range of positive and negative experiences, which appear to have common elements across different clinical populations. The literature is currently too limited to identify disorder-specific practices, with too few direct or indirect comparisons between conditions.

Trajectories of Perceived Technological Impairment and Psychological Distress in Adolescents

Fears that digital technologies harm adolescents' mental health abound; however, existing research is mixed. This study examined how perceived technological impairment (i.e., perceptions of digital technology interfering with daily life) related to psychological distress across five years in adolescence. A latent curve model with structured residuals was applied to disentangle between-from within-person associations, in which it was tested whether (a) adolescents who increased in their perceptions of technological impairment over time also increased in psychological distress (between-person) and (b) if an adolescent who reported greater perceptions of technological impairment relative to their underlying trajectory at one wave consequently reported greater distress at the subsequent wave (within-person). These associations were tested in a sample of 2104 adolescents (Mage = 12.36; 52% girls; 48% Non-White). Perceived technological impairment and psychological distress increased together over time. Girls and older adolescents (13-15 at baseline) reported greater initial levels of perceived impairment. Younger adolescents (9-12 at baseline) increased more steeply in perceived impairment over time. There was no evidence of longitudinal within-person associations. The findings suggest that although there is evidence of between-person associations in which increases in perceived technological impairment coincide with increases in psychological distress, the absence of within-person associations cautions against a cause-and-effect narrative between digital technology use and mental health.

Adolescent Experiences With Social Media and Suicidality

OBJECTIVE

Examine social media experiences of the suicidal adolescent presenting to the emergency department with an acute mental health crisis.

METHODS

We used qualitative interviews to obtain in-depth understanding of both negative and positive impacts of social media use on acute adolescent suicidal behavior. A bilingual transcriptionist transcribed audio recordings. Three investigators independently reviewed transcripts to identify themes and develop initial coding scheme through "open coding." Using grounded theory, data collection proceeded along with cultivation of themes until thematic saturation was achieved. Thematic saturation was determined when no new themes were generated from the data. Data were coded in Dedoose software to facilitate reporting of themes and quotes. Techniques to ensure trustworthiness included iterative data collection, use of a coding framework, and multiple coders.

RESULTS

Seventeen interviews were conducted from May to October 2020. Median participant age was 15 years. Twenty-four percent were of Hispanic ethnicity and 82% identified as cisgender. Major themes include distraction from negative emotions; facilitated communication resulting in improved social connectedness; metric of connectedness; comparison of self to others; and desensitization and normalization to suicidal acts. Minor theme of increased time on social media is also discussed. These themes echoed components of current suicide theory.

CONCLUSIONS

Acutely suicidal adolescents report social media experiences that reflect themes of social alienation and learned capacity for suicidal acts. Themes echo components of current suicide theory. Our participants also reported positive uses of social media. These protective experiences should be leveraged to inform strategies to interrupt behaviors leading to acute suicidality.

Reactions to naturalistic smartphone deprivation among psychiatrically hospitalized adolescents

The standard of care among youth who are psychiatrically hospitalized typically involves smartphone confiscation for the duration of treatment. However, very little is known regarding how youth respond to this period of smartphone "deprivation," factors that may influence this response, and ensuing clinical effects. The present exploratory mixed-methods study sought to elucidate the experience of psychiatrically hospitalized adolescents as it relates to smartphone deprivation, and to evaluate the impact of this widespread treatment approach. Psychiatrically hospitalized adolescents (N = 181; Mean age = 15.29 years) completed qualitative and quantitative measures assessing the experience of smartphone deprivation during hospitalization. Associations among reactions to smartphone deprivation and smartphone and social media use patterns were explored. Analyses additionally evaluated whether reactions to smartphone deprivation were associated with clinical symptom severity (e.g., suicidal ideation, internalizing and externalizing symptoms) and readiness for psychotherapy. Negative reactions to smartphone deprivation were significantly positively correlated with daily smartphone hours, addictive patterns of use, and both negative and positive emotional responses to social media use. Reactions to smartphone deprivation were not associated with clinical symptom severity. However, negative reactions to smartphone deprivation were associated with lower readiness for therapy, while positive reactions were associated with greater readiness. This preliminary work illustrates the complexities of smartphone use in adolescents and the potential positive and negative effects of smartphone deprivation during psychiatric hospitalization. Future prospective research with adolescents should clarify optimal smartphone access during inpatient hospitalization.

The Influence of Social Media on Adolescent Suicide: Is It All Bad?

Current daily practices in many emergency departments throughout the United States include providing emergency stabilization and psychiatric care for adolescents presenting with suicidal ideations and attempts. Upon presentation for care, standard nursing practices are to initiate suicide precautions. These precautions include removing all personal items from the patient, including cell phones or other electronic devices and with it, their access to social media. Although many believe this removal gives adolescents a necessary break from their peers and the social pressures associated with adolescence in the 21st century, is this practice supported by current evidence? And does it benefit adolescents, or provide additional psychological stress and anxiety, thus exacerbating their current state of crisis? The current literature review examines these questions and reveals contradictory evidence supporting detrimental and constructive effects of social media removal during adolescent emergency treatment for suicidal behaviors. [Journal of Psychosocial Nursing and Mental Health Services, 61(4), 12-17.].

A Functional Approach to the Assessment of Non-Suicidal Self-Injury on YouTube

This research explores representations of non-suicidal self-injury (NSSI) on social media. The current study aims to examine the applicability of a functional model of NSSI to videos posted on YouTube by analyzing the 100 most viewed YouTube videos relating to NSSI at a point in time in 2018. Motivations for continued engagement in NSSI were examined for each content creator who posted one of the top 100 most viewed videos relating to NSSI. Categorizations of a content creator's motivation were based on Nock and Prinstein (2004) four-function model (FFM) of NSSI, in which the motivations, or functions, of NSSI are categorized by two dichotomous factors: (a) positive (i.e., involves the addition of a favorable stimulus) or negative (i.e., involves the removal of an aversive stimulus) and (b) automatic (i.e., intrapersonal) or social (i.e., interpersonal). Uploaders most endorsed automatic negative reinforcement (50%), followed by automatic positive (26%), social positive (3%), and social negative (3%). Considering the growing number of children and adolescents with near constant access to internet and social media, there may be implications for further development of safety measures for social media platforms. The results of this study may be valuable for parents, health care professionals, and educators, who should be aware of available social media content relating to NSSI and consider implementing additional media-literacy and media-safety education in school curriculums and programming for children and adolescents. Furthermore, health care professional should be aware that misconceptions of NSSI may have an impact on patients' willingness to seek treatment, or the attitude with which treatment is sought.

Healthy Food on Instagram Social Network: Vegan, Homemade and Clean Eating

Social media platforms have become part of many people's lives. Users are spending more and more time on these platforms, creating an active and passive digital footprint through their interaction. This footprint has high research potential in many research areas because understanding people's communication on social media is essential in understanding their values, attitudes, experiences and behaviors. Researchers found that the use of social networking sites impacts adolescents' eating behavior. If we define adolescents as individuals between ages 10 and 24 (WHO's definition), 76% of USA young people at age 18-⁠24 use Instagram, so the Instagram social network analysis is important for understanding young people's expressions in the context of healthy food. This study aims to identify the main topic associated with healthy food on the Instagram social network via hashtag and community analysis based on 2,045,653 messages created by 427,936 individual users. The results show that users most associate Healthy food with healthy lifestyle, fitness, weight loss and diet. In terms of food, these are foods that are Vegan, Homemade, Clean and Plant-based. Given that young people change their behavior in relation to people's behavior on social networks, it is possible to use this data to predict their future association with healthy food characteristics.