Roles of cyberbullying, sleep, and physical activity in mediating the effects of social media use on mental health and wellbeing among young people in England: a secondary analysis of longitudinal data

Prevention of problematic smartphone use among adolescents: A preliminary study to investigate the efficacy of an intervention based on the metacognitive model

As there is a significant gap in the development of preventive interventions tailored to adolescents, this study develops and preliminarily investigates the efficacy of a preventive intervention towards Problematic Smartphone Use (PSU) by referring to the metacognitive model. Six classes, a total of 93 high school students (75 % females, Mage = 16.26, SD = 1.24), were randomly assigned to either the Training or No Training group. The intervention spanned five weekly sessions, incorporating cognitive behavioral therapy and the conceptual change model to modify metacognitive beliefs. Pre- and post-test measures included daily time spent on the mobile phone, risky behaviors related to smartphone use, and metacognitive beliefs about smartphone use. A mixed ANOVA indicated a significant reduction in daily time spent on the mobile phone and risky behaviors related to smartphone use only in the Training group, with large effect sizes. Findings are promising and discussed in terms of future improvement.

Associations of 24-hour movement behaviors with emotional and behavioral problems among Chinese adolescents

PURPOSE

The role of adherence to the recommendations for 24-hour movement behaviors (24-HMB), including physical activity (PA), screen time (ST), and sleep duration (SLP), in relation to emotional and behavioral problems in Chinese adolescents remains uncertain. This study aimed to investigate these associations and explore potential sex differences.

METHODS

This school-based cross-sectional study included 15,071 Chinese adolescents with a mean age of 14.53 (SD: 1.65) years. Data on emotional and behavioral problems and 24-HMB (including PA, ST, and SLP) were collected. Analysis was performed using general linear mixed models, with additional sex-stratified analyses conducted.

RESULTS

The number of 24-HMB recommendations met was negatively associated with total difficulties (β estimate=-0.96, 95% CI: -1.07 to -0.85) and positively related to prosocial behavior (β estimate = 0.41, 95% CI: 0.37 to 0.46) among adolescents. Compared with none of the recommendations met, meeting all recommendations (total difficulties: β estimate=-2.98, 95% CI: -3.41 to -2.55; prosocial behaviors: β estimate = 1.05, 95%CI: 0.87 to 1.24) demonstrated the strongest association with both difficulties and prosocial behaviors, followed by meeting recommendations for PA + ST (total difficulties: β estimate=-2.15, 95% CI: -2.41 to -1.90; prosocial behaviors: β estimate = 0.98, 95% CI: 0.87 to 1.09). These associations were consistently significant in both boys and girls.

CONCLUSION

Adherence to more 24-HMB recommendations, particularly meeting all recommendations or combined PA + ST recommendations, could improve emotional and behavioral well-being among adolescent girls and boys. The significance of balanced movement behaviors for promoting adolescent mental health merits increased attention.

Social Media Addiction and Poor Mental Health: Examining the Mediating Roles of Internet Addiction and Phubbing

Many researchers have examined the potential detrimental role of problematic social media use (often referred as 'social media addiction') on mental health. The present study investigated how social media addiction is associated with three components of mental health: depression, anxiety, and stress. In addition, structural equation modeling was used to test the mediating roles of internet addiction and phubbing among a sample of young adults (N = 603). Results showed that social media addiction was associated with poorer mental health via internet addiction and phubbing. More specifically, associations between social media addiction and stress, and social media addiction and anxiety were explained by both internet addiction and phubbing. The association between social media addiction and depression was explained by internet addiction only. These results remained consistent after controlling for gender, age, frequency of internet use, frequency of social media use, and frequency of smartphone use. These findings extend the extant literature by providing evidence for the dual roles of internet addiction and phubbing in explaining the relationship between social media addiction and poor mental health. Social media addiction did not directly influence poorer mental health but did via internet addiction and phubbing. Therefore, greater awareness of the inter-relationships between technology-based behaviors and their impact on mental health is needed among a wide range of stakeholders, and these inter-relationships need considering in the prevention and treatment of technology-based disorders.

The Impact of Exercise Training Plus Dietary Interventions on Ectopic Fat in Population with Overweight/Obesity with and without Chronic Disease: A Systematic Review, Meta-analysis, and Metaregression of Randomized Clinical Trials

Background

The growing prevalence of obesity and related chronic diseases has led to increased interest in interventions targeting ectopic fat reduction to which its accumulation is linked to metabolic dysfunction.

Objectives

This study aimed to evaluate the effects of combined exercise training combined with dietary interventions compared with dietary interventions alone on ectopic fat [visceral fat area (VFA), liver fat, intramuscular fat (IMF), pancreatic fat, renal sinus fat, and pericardial and epicardial fats] in adults with overweight and obesity, both with and without chronic diseases.

Methods

Web of Science, Scopus, and PubMed were searched for original articles up to 1 March, 2024, that included exercise compared with control interventions on body weight and ectopic fat in adults with overweight or obesity. Weighted mean differences (WMD) for body weight, liver fat, pancreatic fat, and renal sinus fat and standardized mean differences (SMD) for VFA, IMF, pericardial and epicardial fats, and 95% confidence intervals were determined using random-effects models.

Results

Thirty-two studies, including 1488 participants and 38 intervention groups, met the inclusion criteria. The combined intervention of exercise and diet did not reduce body weight (WMD = -0.23 kg, P = 0.180), liver fat (WMD = 0.05%, P = 0.730), IMF (SMD = -0.08, P = 0.640), pericardial and epicardial fats (SMD = -0.12, P = 0.280), pancreatic fat (WMD = -0.24%, P = 0.370), and renal sinus fat (WMD = 0.01 cm2, P = 0.170) when compared with a diet-only group. Interestingly, exercise combined with diet significantly reduced VFA in participants with obesity (SMD = -0.12, P = 0.040) and healthy males (SMD = -0.33, P = 0.001) when compared with a diet-only group.

Conclusions

The findings suggest that combined exercise and dietary interventions did not lead to significant reductions in most ectopic fat depots when compared with diet alone. However, a modest reduction in VFA was observed in participants with obesity and healthy males. These results highlight the nuanced impact of exercise in combination with dietary interventions and the need to consider specific fat depots and participant characteristics in obesity management strategies.The trial was registered at PROSPERO as CRD42024546770.

Social media use and associated mental health indicators among University students: a cross-sectional study

Social media has become more common in today's digital society, providing individuals with significant opportunities for social connection and information sharing. However, there are concerns about the potential effects of social media on mental health. This study aimed to assess the extent of social media use and its correlation with mental health indicators among health sciences students at Mogadishu University. A cross-sectional study was conducted among 268 participants selected using stratified random sampling. The findings revealed that 84.7% of the students spent more than three hours daily on social media. The high extent of social media use was significantly associated with sleep disturbance (AOR: 2.7; 95% CI: 1.04-7.04), mental exhaustion (AOR: 4.7; 95% CI: 1.80-12.46), social isolation (AOR: 7.4; 95% CI: 1.62-33.35), and anxiety (AOR: 22.2; 95% CI: 3.73-131.70). University students heavily use social media, which negatively impacts their psychological well-being. This highlights the need for responsible usage and institutional guidelines to mitigate these effects. Educating students on managing social media time and fostering healthy habits is essential to prevent health issues. Parents and lecturers should monitor usage and create schedules for study and social media.

Co-occurring cyber and in-person victimisation of bullying and sexual harassment: the associations to depressive symptoms in Swedish adolescents

BACKGROUND

Poor mental health has increased among adolescents in recent decades. Bullying and sexual harassment, both cyber and in-person, are each associated with increased depressive symptoms in adolescents and being victimised by co-occurring types is more common than just one single type of victimisation. The study aimed to investigate the association between co-occurring victimisation and depressive symptoms in adolescents when controlling for screen time, social support, physical activity, and personal relative affluence.

METHOD

Cross-sectional survey data from 1211 respondents (50.1% girls) aged 15-16 were used to conduct modified Poisson regression with robust error variance analyses for girls and boys separately. Four scales were used to measure cyber and in-person bullying and sexual harassment, and CESD-R10 was used to measure depressive symptoms.

RESULTS

About 47% of girls and 20% of boys experienced all four types of victimisation, and about 12% of girls and 25% of boys experienced none of them. When controlled for all included variables, all number of victimisation types of bullying and/or sexual harassment were associated with depressive symptoms in girls. In comparison, only four types of victimisation were associated with depressive symptoms in boys.

CONCLUSIONS

The study showed that co-occurring victimisation was associated with depressive symptoms even after controlling for other relevant factors in both genders. However, in girls, all numbers of victimisation were associated with depressive symptoms.

Smartphone screen time reduction improves mental health: a randomized controlled trial

BACKGROUND

Smartphone screen time has risen sharply in recent years. Even though an association between smartphone use and mental health is well documented, it is still unclear whether this is simply a correlation or causality. The aim of this study is to investigate the effects of smartphone screen time reduction on mental health indicators.

METHODS

This non-blinded, parallel randomized controlled trial (RCT) was performed to investigate the impact of a 3-week screen time reduction to ≤ 2 h/d in healthy students on stress (PSQ), well-being (WHO-5), depressive symptoms (PHQ-9), and sleep quality (ISI) at baseline (t0), post-intervention (t1), and at follow-up (t2 = 6 weeks after t1). For the intention to treat analysis, repeated measures ANOVAs and post-hoc tests (for time as well as group differences) were performed and effect sizes were presented as partial eta squared (η2 = time × group) and group-mean differences.

RESULTS

In total, 111 out of 125 healthy students (70 females; mean age = 22.68 ± 2.6 years; mean screen time = 276 ± 115.1 min/day) were randomly assigned to intervention-(n = 58; 3 weeks of screen time reduction to ≤ 2 h/day) or control group (n = 53). Although no differences were observed at baseline (t0), significant post-intervention (t1) effects of small to medium size were observed on well-being (η2 = .053), depressive symptoms (η2 = .109), sleep quality (η2 = .048), and stress (η2 = .085). Significant group differences (p ≤ .05) were found post-intervention (t1) for depressive symptoms (Mean Difference (MD) = 2.11, Standard Error (SE) = 0.63, 95% Confidence Interval (CI) [0.87, 3.36]), sleep quality (MD = 2.59, SE = 0.97, 95% CI [0.66, 4.51]), well-being (MD = -1.54, SE = 0.68, 95% CI [.-2.89, -0.18]), and stress (MD = 6.91, SE = 3.48, 95% CI [0.01, 13.81]). Screen time increased rapidly after the intervention and at follow-up the values were once again approaching the initial level.

CONCLUSIONS

The study highlights mental health improvements through smartphone screen time reduction. Three weeks of screen time reduction showed small to medium effect sizes on depressive symptoms, stress, sleep quality, and well-being. The results suggest a causal relationship, rather than a merely correlative one, between daily smartphone screen time and mental health.

TRIAL REGISTRATION

The study was preregistered on Open Science Framework (trial registration number: A9K76) on November 8, 2023.

Childhood Lifestyle Behaviors and Mental Health Symptoms in Adolescence

Importance

Mental health problems often arise during adolescence and early adulthood, affecting up to 25% to 30% of young people. Enhancing the ability to identify children and adolescents at increased risk of mental health problems and uncover factors that promote mental health from childhood to adolescence is important.

Objective

To investigate if cumulative lifestyle behaviors from childhood to adolescence are associated with perceived stress and depressive symptoms in adolescence.

Design, Setting, and Participants

Prospective cohort study in Finland using baseline data collected between October 2007 and November 2009 and 8-year follow-up data collected between December 2015 and December 2017 as part of the Physical Activity and Nutrition in Children (PANIC) study of children aged 6 to 9 years. Data were analyzed from January to February 2024.

Exposures

Cumulative physical activity (PA), sedentary behavior (SB), sleep, and diet quality from childhood to adolescence. PA and screen time (ST) assessed by a questionnaire; PA at different intensities, SB, and sleep duration assessed by a combined movement and heart rate sensor; diet quality assessed by 4-day food records and the Baltic Sea Diet Score computed at baseline, 2-year follow-up, and 8-year follow-up examinations.

Main Outcomes and Measures

Perceived stress assessed by the Finnish version of the Cohen Perceived Stress Scale, and depressive symptoms by the Beck Depression Inventory at 8-year follow-up examinations. Linear regression analyses were used to evaluate associations between cumulative lifestyle behaviors over 8 years with the outcomes.

Results

Altogether, 187 adolescents (97 boys [51.9%]; mean age, 15.8 [0.4] years) had valid data on self-reported lifestyle behaviors, and 170 adolescents had valid data on device-assessed lifestyle behaviors. Perceived stress scores ranged from 2 to 33 and depressive symptoms scores from 0 to 31. Self-reported total PA and supervised exercise were inversely associated with perceived stress (standardized regression coefficient [β] = -0.15; 95% CI, -0.31 to -0.01 and β = -0.15; 95% CI, -0.29 to -0.01, respectively) and depressive symptoms (β = -0.17; 95% CI, -0.31 to -0.02 and β = -0.14; 95% CI, -0.29 to -0.0, respectively). Total ST (β = 0.27; 95% CI, 0.13 to 0.41), computer use (β = 0.16; 95% CI, 0.01 to 0.30), and mobile device use (β = 0.28; 95% CI, 0.16 to 0.41) were positively associated with perceived stress. Total ST (β = 0.30; 95% CI, 0.15 to 0.44) and mobile device use (β = 0.33; 95% CI, 0.19 to 0.46) were positively associated with depressive symptoms.

Conclusions and Relevance

This cohort study of Finnish children and adolescents found that higher PA and lower ST from childhood were associated with perceived stress and depressive symptoms in adolescence. These findings emphasize reducing screen time and increasing PA to promote mental health in youth.

The youth mental health crisis: analysis and solutions

Background

Since the mid-20th century, mental illness has become a leading cause of health burden, particularly among adolescents and emerging adults, with most disorders emerging before the age of 25. Over the past two decades, mental ill health has surged to alarming levels, with evidence confirming that the increase is not just due to better awareness or diagnosis but reflects a genuine public health crisis.

Study design/method

We explore the evolving landscape of youth mental health and its contributing factors, including family dynamics, educational pressures, climate change, social media, and socio-economic challenges, potentially linked to neoliberal policies. A narrative review methodology was employed to analyze these factors and their role in the trends of mental ill-health among young people.

Study results

We document mental health trends since the mid-1990s, focusing on mental and substance use disorders among young people and their current needs. Potential new explanatory factors and megatrends, potentially flowing from a paradigm shift in the global political economy which has largely passed under the radar, yet which has produced fragmentation and inequality, are identified, with the COVID-19 pandemic further intensifying these trends. We discuss methodologies to estimate the contribution of these megatrends and outline potential barriers to implementation, along with strategies to overcome them.

Conclusion

This review calls for a comprehensive global action plan, emphasizing prevention, early intervention, and improved treatment strategies. In addition to strengthening prevention, which may take time and be elusive, immediate action is needed to innovate and expand services, which are currently under-resourced and overwhelmed.

Tracing knowledge diffusion trajectories in the research field of cyberbullying

In today's digital age, cyberbullying has emerged as a pervasive issue that affects individuals across various social media platforms and digital communication channels. This review explores the developmental trajectory of cyberbullying as an interdisciplinary academic field, employing a unique combination of co-word analysis and main path analysis (MPA) across a substantial body of 5183 documents. This integrated methodological approach allows for a nuanced examination of the evolution of themes and influential works within the realm of cyberbullying research. The findings highlight a complex landscape where initial focus areas, such as the behavioral and psychological triggers of cyberbullying, progressively expand towards exploring effective preventive measures and intervention strategies. Key themes identified include the impact of digital literacy, the dual role of social media as both a vector and a tool against cyberbullying, and the potential of technological advancements in detecting and mitigating cyberbullying. This comprehensive mapping and analysis deepens our understanding of cyberbullying and highlights the dynamic nature of this field, suggesting new directions for future research and practical applications to effectively address cyberbullying across various social and technological contexts. This study represents a pioneering effort in synthesizing a broad spectrum of research to offer detailed insights into the changing dynamics of cyberbullying, marking a significant contribution to both academic knowledge and practical approaches to handling cyberbullying.

Associations Between Social Media Use and Anxiety Among Adolescents: A Systematic Review Study

PURPOSE

Studies show mixed associations between adolescent social media use and anxiety. This systematic review evaluated research on social media and anxiety among adolescents for direction of associations, social media measures, demographic stratification, anxiety measures, and study quality.

METHODS

We searched for articles published in English before 2021 that tested associations between adolescent social media use and anxiety. Each study underwent screening and data extraction by two reviewers. Measures included direction of associations (positive, negative, null, mixed), social media measures, demographic group stratification, anxiety measures, and study quality (Strengthening of Reporting of Observational Studies in Epidemiology).

RESULTS

A total of 32 studies were included. Over half reported positive associations between social media use and anxiety (56.3%). Problematic use was the most common social media measure type (31.4%). Positive associations with anxiety were predominantly observed for measures of problematic use (75.0%) and screen time (72.7%). Among other social media measures, 40.9% showed positive associations. A total of 18 anxiety measures were used. Four studies (12.5%) stratified findings by gender identity. The mean Strengthening of Reporting of Observational Studies in Epidemiology score was 34.1 (standard deviation = 4.3) out of 46.

DISCUSSION

Future work should explore accurate social media use measures that are not based on problematic use.

Analysing Digital Engagement Patterns: A Machine Learning Investigation into Social Anxiety Among Adolescents with ADHD

Background: The relationship between screen time and mental health among adolescents, particularly those identified as "digital natives", has become increasingly pertinent, especially in the context of heightened digital engagement during the COVID-19 pandemic. This study aims to examine the associations between digital engagement patterns, ADHD severity, and anxiety symptoms in adolescents aged 11-18. Methods: A cross-sectional observational study was conducted with a sample of 97 adolescents diagnosed with ADHD. Participants completed validated questionnaires assessing daily digital activities and anxiety symptoms while caregivers provided additional contextual information. Data were analyzed using Random Forest regression to identify relationships between screen time, ADHD severity, and anxiety symptoms. Results: The findings indicate an average screen time of 6.6 h on weekdays and 8.1 h on weekends, with social media emerging as the primary activity, particularly among female participants. Notable gender differences were identified, with family dynamics influencing digital engagement; family disputes had a more significant impact on girls than boys. Furthermore, specific anxiety traits, i.e., physical symptoms and harm avoidance, significantly predicted time spent on social media across all genders considered in the study, while others, namely social anxiety and separation anxiety, were less valuable. Conclusions: This study highlights the complex interplay between screen time, ADHD, and anxiety symptoms in adolescents. These findings underscore the importance of tailored interventions that address the nuanced relationships between digital engagement and mental health in this population, warranting further research to develop effective management strategies.

Adolescents' Digital Technology Use, Emotional Dysregulation, and Self-Esteem: No Evidence of Same-Day Linkages

Concerns regarding the potential negative impacts of digital technology use on youth mental health and well-being are high. However, most studies have several methodological limitations: relying on cross-sectional designs and retrospective reports, assessing technology use as an omnibus construct, and focusing on between- instead of within-person comparisons. This study addresses these limitations by prospectively following young adolescents (n = 388) over a 14-day ecological momentary assessment study to test whether adolescents' digital technology use is linked with self-reported emotional dysregulation and self-esteem and whether these relationships are stronger for adolescent girls than boys. We found no evidence that adolescents experienced higher emotional dysregulation (b = - .02; p = .07) and lower self-esteem (b = .004; p = .32) than they normally do on days where they use more technology than they normally do (within-person). Adolescents with higher average daily technology use over the study period did not experience lower levels of self-esteem (between-person, b = - .02; p = .13). Adolescents with higher average daily technology use across the two-week period did report higher levels of emotional dysregulation (p = .01), albeit the between-person relation was small (b = .08). There was no evidence that gender moderated the associations, both between and within adolescents (bs = - .02-.13, p = .06 - .55). Our findings contribute to the growing counter-narrative that technology use does not have as large of an impact on adolescents' mental health and well-being as the public is concerned about.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-024-00282-w.

Social media misuse explained by emotion dysregulation and self-concept: an ecological momentary assessment approach

Studies suggested that emotion dysregulation and identity processes are involved in social media (SM) misuse, even if their proximal role has not been investigated. Previous studies rarely discriminated between specific activities or between types of SM. We recruited 50 young adults and implemented a momentary ecological assessment measurement. Four times by day, during seven days, we measured SM use, frequency of several activities on SM, emotion dysregulation, distress and clarity of self-concept. Daily time spent on Facebook, Instagram and TikTok were retrieved from devices. Intradaily changes in emotion dysregulation and clarity of self-concept predict changes in SM addiction symptoms and frequency of use according to the type of activity. Daily changes in time spent on SM were not predicted by emotion dysregulation, distress and self-concept clarity. Findings suggest that emotion dysregulation and poor self-concept clarity are proximal risk factors for SM misuse.

Exploring the Relationship Between Social Media Use and Symptoms of Depression and Anxiety Among Children and Adolescents: A Systematic Narrative Review

Social media use is ubiquitous to the lives of children and adolescents. The body of research investigating its potential impact on mental health has risen exponentially. We systematically reviewed the present literature exploring potential linkages between social media use and symptoms of depression and anxiety in this vulnerable group. Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses framework, articles were searched across Medline, EMBASE, CINAHL, and PsycINFO databases from inception to February 2024. Quantitative studies with social media as exposure and anxiety/depressive symptoms as outcomes in children and adolescents 5-18 years of age were included. Of the 4850 studies retrieved, 67 fulfilled the inclusion criteria. The most frequent measures of social media were "time spent on social media" and "frequency of use." Depressive symptoms were the outcome of 61 studies, whereas anxiety was measured in 27 studies. Most studies were of fair quality (n = 53). A meta-analysis was not possible due to study heterogeneity. Our review shows that (1) problematic social media use is associated with depressive and anxiety symptoms among children and adolescents, (2) duration of social media use was more consistently linked with anxiety and depression in girls compared with boys, and (3) mediating and moderating mechanisms were sleep deprivation, social comparison, and feedback-seeking behaviors, exercise, social support, and type of social media use. Qualitative work and robust large-scale longitudinal observations using a person-specific approach are needed to further our understanding of the impact of social media use on depression and anxiety in children and adolescents.

Association of electronic screen exposure with depression among women in early pregnancy: a cross-sectional study

BACKGROUND

Previous studies indicated that excessive engagement in digital devices could lead to negative psychological impacts in general population. We aimed to determine the association of electronic screen exposure with depression among women in early pregnancy.

METHODS

A cross-sectional study was conducted from June 2021 to June 2022. A total of 665 women in early pregnancy were recruited and the information included socio-demographic characteristics, screen exposure and Patient Health Questionnaire - 9 depression scale.

RESULTS

Among the women in early pregnancy, the total daily smartphone viewing time was the longest (median [P25-P75], 5 [3-6] hours/day) in the three types of electronic screen exposure. The total daily smartphone viewing time (P = 0.015, OR[95%CI] = 1.09[1.11-1.18]), smartphone (P = 0.016, OR[95%CI] = 1.24[1.04-1.47]) and television viewing time (P = 0.006, OR[95%CI] = 1.35[1.09-1.67]) before nocturnal sleep were significantly associated with depression among women in early pregnancy. The thresholds calculated by receiver operator characteristic curves were 7.5 h/day, 1.5 h/day and 1.5 h/day, respectively. In addition, women with higher scores of smartphone addiction were more susceptible to depression (P<0.001, OR[95%CI] = 1.11[1.07-1.16]). The top three smartphone usages in women with depression were watching videos (22.0%), listening to music (20.9%) and playing games (16.7%).

CONCLUSIONS

In conclusion, electronic screen exposure, including screen viewing time, smartphone addiction and problematic smartphone use was associated with depression among women in early pregnancy. Further studies are warranted to verify the conclusions.

Public health interventions to address digital determinants of children's health and wellbeing

The increasing use of digital media and devices by children has led to growing concerns that spending time online without sufficient guarding is having negative effects on their health and wellbeing. In this Viewpoint, we argue that children's use of digital technologies and engagement in digital environments should be recognised as important determinants of their health and that a public health approach is required to protect children from digital harms. Drawing on lessons from well-established approaches to address other public health challenges, we summarise three groups of public health interventions that can help delay media use among very young children, reduce digital media use among children of all ages, and mitigate any harmful consequences of children's digital media use. To build healthy digital environments for children now and future generations, we recommend a precautionary approach to governance that prioritises children's health and wellbeing, recognises their desire to enjoy the benefits of the digital world, and allows children to have a role in shaping their digital futures.

Screen Time and Mental Health in Canadian Youth: An Examination of Nationally Representative Data

As screens have become ubiquitous in modern-day society, investigating the effects of high screen time on mental health is highly warranted. In the past decade, many studies have determined that higher levels of screen time engagement are associated with adverse mental health outcomes like anxiety and depression. However, the nature of the relationship between screen time and mental health requires further investigation to gain a better understanding of its mechanisms and properties. The purpose of this study is to utilize a nationally representative data set to (1) examine how factors like sex, age, and socioeconomic status moderate the relationship between screen time and mental health in Canadian youth and (2) determine whether this relationship supports the Goldilocks hypothesis or an exposure-response curve. It was hypothesized that (1) young, female, lower socioeconomic status individuals will be more strongly associated with poor mental health, and that (2) mental health will peak at low screen time usage, therefore, supporting an exposure-response curve. A series of moderation analyses concluded that young, male, lower socioeconomic status individuals strongly moderated the relationship between screen time and poor mental health compared to their counterparts. Furthermore, three out of the four mental health (presence of mood disorder, presence of anxiety disorder, and depression severity) measures peaked at an average of 12 hours and 19 minutes of screen time per week, hence, supporting the exposure-response curve.

Cyberbullying Perpetration and Victimization as Risk Factors for Self-Harm: Results From a Longitudinal Cohort Study of 13-14-Year-Olds in England

PURPOSE

Cyberbullying is a crucial issue that affects adolescent mental health, with evidence to suggest that adolescents who are victims of cyberbullying are at higher risk for self-harm. However, longitudinal evidence is lacking, meaning the direction of effects cannot be established. This study investigated longitudinal associations between levels of cyberbullying involvement (bully, victim, or both), frequency, and self-harm a year later in an adolescent sample.

METHODS

Data were collected from Year 9 students (13-14-year-olds; N = 1,195) enrolled in 19 schools in Southwest England using an online questionnaire with a 1-year follow-up period (October 2019-October 2020). Multivariable logistic regression analysis was conducted to test for associations between different levels of cyberbullying involvement at baseline and the likelihood of self-harm a year later, adjusting for key covariates. A secondary regression analysis also explored the associations between the frequency of cyberbullying involvement at baseline and subsequent self-harm.

RESULTS

Compared to those with no cyberbullying involvement, individuals who were both victims and perpetrators (adjusted odds ratio = 2.94, 95% confidence interval: 1.99-4.34) as well as victims only (adjusted odds ratio = 2.81, 95% confidence interval: 1.95-4.04) showed an increased risk of subsequent self-harm. In terms of frequency, associations were found between frequent and occasional cyberbullying and self-harm for both victims and perpetrators; however, associations for the perpetrator group attenuated to the null following adjustment for covariates.

DISCUSSION

Our findings highlight cyberbullying in early adolescence as a risk factor for subsequent self-harm. Cyberbullying prevention should be a priority for school mental health interventions, with consideration that most perpetrators of cyberbullying may also be victims.

Exploring Multiple Perspectives on Psychological Health of Adolescents in Relation to Gender and School Grade - Jiangsu Province, China, 2022

What is already known about this topic?

Mental health issues in Chinese children and adolescents have emerged as a substantial public health concern, causing distress and strain among families and society.

What is added by this report?

This study examines the effects of gender and school grade on mental health symptoms and risky behaviors among Chinese children and adolescents, with a particular focus on the role of family and school environments.

What are the implications for public health practice?

Caregivers and educators should enhance their awareness and skills in supporting the mental health of children. These findings offer critical insights for the early detection and intervention of mental health issues in Chinese children and adolescents.

Adolescent Female Users' Avatar Creation in Social Virtual Worlds: Opportunities and Challenges

Many adolescent females are active online, finding creative ways to express themselves through evolving social media technologies. Social virtual worlds (SVWs), distinguished by extensive avatar customization features, provide them with unique opportunities to craft virtual identities and explore diverse facets of self-presentation. This study investigates adolescent females' construction of avatars in Zepeto, a South Korea-based global SVW platform. Employing social representation theory (SRT) as a theoretical framework, this study conducted in-depth interviews with adolescent female Zepeto users to uncover their perceptions of and motivations behind avatar creation in SVWs, as well as to explore how the interplay of virtual and real worlds presents them with various opportunities and challenges. While the prospects of SVWs remain uncertain, examining how these young users interpret and experience SVWs contributes to identifying potential strategies to enhance the sustainability of these platforms.

Smartphone use and well-being of adolescent girls: a population-based study

BACKGROUND AND OBJECTIVES

Recent studies have reported an increasing incidence of anxiety among adolescent girls, and associated this with self-reported social media use. This study aimed to measure smartphone and social media use objectively and to evaluate its associations with measures of mental health and well-being.

METHODS

In autumn 2022, we recruited a cohort of 1164 first-year female students from 21 socioeconomically diverse high schools. Students responded to an online survey comprising validated questionnaires (Bergen Social Media Addiction Scale (BSMAS), Generalised Anxiety Disorder-7, and Body Appreciation Scale 2) and visual analogue scales of current health, mood, tiredness, and loneliness. We also requested that they attach screenshots depicting their smartphone use.

RESULTS

Among participants (mean age 16.3 years), 16% (n=183) had possible social media addiction and 37% (n=371) exceeded the cut-off for possible anxiety disorders. The BSMAS scores were associated with higher anxiety (r=0.380) and poorer body image (r=-0.268), poorer health (r=-0.252), lower mood (r=-0.261), greater tiredness (r=0.347), and greater loneliness (r=0.226) (p<0.001 for all). Among the 564 adolescents (48%) who sent screenshots of their smartphone use, average daily use was 5.8 hours (SD 2.2), including 3.9 hours (SD 2.0) of social media. Participants who sent screenshots had a higher grade point average than participants without screenshot data, but similar BSMAS and well-being measures.

CONCLUSIONS

Consistent with other studies, we found social media addiction was common among adolescent girls and was associated with poorer mental health and well-being. Measures should be taken to protect adolescents from the potential harmful effects of social media use.

Social media threats and health among adolescents: evidence from the health behaviour in school-aged children study

BACKGROUND

Social media are immensely popular among adolescents. Thus, concerns have been raised about the threats adolescents encounter on social media and the possible negative health consequences, such as depressive symptoms and anxiety. This study investigated the prevalence of nine social media threats: (1) cyberbullying, (2) sexual harassment, (3) racism, (4) unauthorized distribution of sensitive material, (5) phishing attempts, (6) misinformation, (7) the sale or distribution of drugs, (8) harmful or dangerous social media challenges, (9) content causing appearance pressures. The study also investigated how individual and social factors, problematic social media use (PSMU), and online communication with strangers are associated with social media threat exposure, as well as the association between social media threats and self-rated health, depressive feelings, and anxiety symptoms.

METHODS AND FINDINGS

Nationally representative Health Behaviour in School-aged Children (HBSC) data from Finland were obtained from 2288 respondents aged 11, 13, and 15 years. Fixed effects regression models were applied. The most common threat, encountered daily and weekly, was misinformation. Regression models showed that individual and social factors, PSMU, and online communication with strangers explained adolescent exposure to social media threats in differing ways. Furthermore, certain factors (e.g., emotional intelligence, family support) were associated with encountering social media threats less frequently, whereas other factors (e.g., PSMU, online communication with strangers) were associated with more frequent encounters. Daily and weekly exposure to social media threats was systematically associated with poor self-rated health, frequent depressive feelings, and anxiety symptoms.

CONCLUSIONS

Our study highlights the need for intervention and health promotion efforts to mitigate adolescent exposure to social media threats and ensuing negative health consequences.

Examining the relationship between meeting 24-hour movement behaviour guidelines and mental health in Chinese preschool children

Background

Limited research has explored the relationship between adhering to 24-h Movement Behaviour guidelines and mental health in Chinese preschool children. The objectives of this study encompassed two primary goals: (1) to investigate the adherence of preschool children in China to the 24-h Movement Behaviour guidelines; and (2) to analyze the relationship between fulfilling various combinations of these guidelines and mental health, identifying the most advantageous combination.

Methods

Utilizing a convenience sampling approach, this study included 205 preschool children (117 boys and 88 girls, average age 4.8 ± 0.51 years) from five kindergartens in Hengyang, Hunan Province. The physical activity (PA) and sedentary behaviour of preschool children were objectively assessed using waist-worn accelerometers, while sleep duration and screen time were reported by the children's parents. To evaluate mental health, the parent version of the internationally validated Strength and Difficulties Questionnaire (SDQ) was employed, which measures externalizing problems, internalizing problems, and prosocial behaviour. Employing Mplus 8.0 for Structural Equation Modeling analysis, while controlling for demographic variables, the study explored the connection between preschool children's mental health and their adherence to the 24-h Movement Behaviour guidelines.

Results

Worryingly, merely 14.6% of preschoolers met the recommended guidelines for all three aspects (PA, sleep duration, and screen time). Positive correlations were identified between meeting PA guidelines and displaying prosocial behaviour (β = 0.184; p < 0.05), while screen time adherence exhibited a negative correlation with externalizing problems (β = -0.207; p < 0.05). Similarly, there was a negative association between sleep duration adherence and externalizing problems (β = -0.191; p < 0.05). Meeting all three recommended guidelines was notably linked to enhanced prosocial behaviour (β = 0.464; p < 0.05), while following the screen time and sleep duration guidelines was negatively associated with externalizing problems (β = -0.246; p < 0.05).

Conclusion

This study underscores the limited adherence of Chinese preschoolers to the comprehensive 24-h Movement Behaviour guidelines. Noteworthy findings include the positive influence of PA on prosocial behaviour, alongside the significant roles that sleep duration and screen time play in mitigating externalizing problems within this age group. Alignment with the 24-h Movement Behaviour guidelines is associated with more favorable mental health indicators in preschoolers.

The Impact of Social Media Use on Sleep and Mental Health in Youth: a Scoping Review

PURPOSE OF REVIEW

Social media use (SMU) and other internet-based technologies are ubiquitous in today's interconnected society, with young people being among the commonest users. Previous literature tends to support that SMU is associated with poor sleep and mental health issues in youth, despite some conflicting findings. In this scoping review, we summarized relevant studies published within the past 3 years, highlighted the impacts of SMU on sleep and mental health in youth, while also examined the possible underlying mechanisms involved. Future direction and intervention on rational use of SMU was discussed.

RECENT FINDINGS

Both cross-sectional and longitudinal cohort studies demonstrated the negative impacts of SMU on sleep and mental health, with preliminary evidence indicating potential benefits especially during the COVID period at which social restriction was common. However, the limited longitudinal research has hindered the establishment of directionality and causality in the association among SMU, sleep, and mental health. Recent studies have made advances with a more comprehensive understanding of the impact of SMU on sleep and mental health in youth, which is of public health importance and will contribute to improving sleep and mental health outcomes while promoting rational and beneficial SMU. Future research should include the implementation of cohort studies with representative samples to investigate the directionality and causality of the complex relationships among SMU, sleep, and mental health; the use of validated questionnaires and objective measurements; and the design of randomized controlled interventional trials to reduce overall and problematic SMU that will ultimately enhance sleep and mental health outcomes in youth.

School bullying in children and adolescents with neurodevelopmental and psychiatric conditions: a systematic review and meta-analysis

BACKGROUND

Bullying is a common form of violence among children and adolescents. Young people with neurodevelopmental or psychiatric conditions might have an increased risk of bullying victimisation and perpetration. We aimed to assess the odds of bullying involvement and its association with mental health measures in these populations.

METHODS

In this systematic review and meta-analysis, we searched PubMed, ERIC, Psychology and Behavioural Sciences Collection, Web of Science Core Collection, PsycArticles, and PsycInfo databases from inception up to Aug 8, 2023, and included articles reporting data on bullying outcomes of current bullying (within the past year) among children and adolescents (aged 4-17 years) with a diagnosis of a neurodevelopmental or psychiatric condtion provided by a health professional. Bullying type was classified as traditional (physical, verbal, or relational) or as cyberbullying (intentional and repeated harm inflicted through electronic devices and social media), and bullying involvement was classified as victimisation, perpetration, and perpetration-victimisation. Mental health measures were collected and the associations with bullying involvement assessed. We used random-effects meta-analyses to estimate prevalence and odds ratios (ORs) for bullying involvement. Heterogeneity was assessed using the I2 statistic, and publication bias was tested with Egger's regression. This study is registered with PROSPERO, CRD42021235043.

FINDINGS

We included 212 studies in the meta-analysis. The total sample comprised 126 717 cases (mean age 12·34 years [SD 1·82], 37·6% girls) and 504 806 controls (12·5 years [SD 1·86], 47·6% girls). For traditional bullying, the pooled prevalence was 42·2% (95% CI 39·6-44·9) for victimisation, 24·4% (22·6-26·3) for perpetration, and 14·0% (11·4-17·1) for perpetration-victimisation. For cyberbullying, the prevalence was 21·8% (16·0-28·9) for victimisation, 19·6% (13·4-27·7) for perpetration, and 20·7% (8·4-42·6) for perpetration-victimisation. Compared with controls, young people with neurodevelopmental or psychiatric conditions were more likely to be involved in traditional and cyberbullying as a victim (OR 2·85 [95% CI 2·62-3·09] and 2·07 [1·63-2·61]), perpetrator (2·42 [2·20-2·66] and 1·91 [1·60-2·28]), and perpetrator-victim (3·66 [2·83-4·74] and 1·85 [1·05-3·28]). Bullying involvement was associated with higher scores in mental health measures in young people with neurodevelopmental or psychiatric conditions, particularly internalising symptoms and externalising symptoms.

INTERPRETATION

Our study underscores bullying involvement as a prevalent risk factor in young people with neurodevelopmental or psychiatric conditions that might add to their disease burden through its negative effects on mental health. Interventions targeting these vulnerable populations are warranted to improve their mental health and their future social integration.

FUNDING

Instituto de Salud Carlos III, Spanish Ministry of Science and Innovation, and Consorcio Centro de Investigación Biomédica en Red.

Global time trends of perceived loneliness among adolescents from 28 countries in Africa, Asia, and the Americas

BACKGROUND

Perceived loneliness in adolescence is associated with a plethora of adverse outcomes. However, data on its temporal trends are scarce. Therefore, we aimed to examine the temporal trend of perceived loneliness among school-going adolescents aged 12-15 years from 28 countries in Africa, Asia, and the Americas, where temporal trends of loneliness are largely unknown.

METHODS

Cross-sectional data from the Global School-based Student Health Survey 2003-2017 were analyzed. Perceived loneliness referred to feeling lonely most of the time or always in the past 12 months. Crude linear trends of perceived loneliness by country were assessed by linear regression models.

RESULTS

Data on 180,087 adolescents aged 12-15 years were analyzed [Mean (SD) age 13.7 (1.0) years; 51.4 % females]. The overall prevalence of perceived loneliness was 10.7 %. Among the 28 countries included in the study, significant increasing and decreasing trends were observed in six counties each, with stable trends found in 16 countries. The most drastic increase and decrease were observed in Egypt between 2006 (7.9 %) and 2011 (14.3 %), and in Samoa between 2011 (23.3 %) and 2017 (8.0 %), respectively. Stable trends with high prevalence across time were also common.

CONCLUSION

Our data suggest that perceived loneliness among adolescents is a global phenomenon, which has seen little improvement if any in recent years. It would be prudent to implement nationwide policies to combat loneliness globally.

Bidirectional and cross-lag relationship between social media use and psychological wellbeing: evidence from an Indian adolescent cohort study

INTRODUCTION

In an online era like today, the relationship between social media and depression among adolescents and young adults is erratic and still continues to be a debatable subject. The study aims to examine the association and bi-directional relationship between social media usage and depressive symptoms among the adolescent boys and girls in India.

METHODS

The study uses data from two waves of Understanding the Lives of Adolescents and Young Adults (UDAYA) project survey conducted in two Indian states of Uttar Pradesh and Bihar. Depression was measured by a Patient Health Questionnaire. Logistic regression has been used for analyzing the data comprising the same time period, whereas the bidirectional relationship between two time periods has been evaluated by Cross-Lagged Path Model.

RESULT

Findings suggest that the percentage of moderate depressive symptoms increased from 1.7% to 3.0% from Wave 1 to Wave 2. Depression among adolescent girls increased slightly from wave 1 to wave 2 whereas a slight decrement was noticed in the moderate form of depressive symptom among adolescent girls using social media for the two waves. Socioeconomic factors like education, age, gender played an important role in affecting depression among adolescents in both the Wave of the survey. The path relationship reveals that social media users in Wave 1 [β=0.22, p<0.001] were positively associated with social media users in Wave 2. Similar patterns were observed for depressive symptoms at both the waves of the survey. However, cross lagged relations between social media use and depression could not be established between the survey periods.

CONCLUSION

A significant degree of association was found between social media use and depression among adolescent boys and girls in the study. The present study concludes that factors like age, gender and education showed significant relationships with social media use and depression.

Cyberbullying and mental health: past, present and future

Purpose

Cyberbullying has attracted the world's attention, and therefore researchers across the world have contributed to the literature on cyberbullying and mental health. Amongst others, they have conducted bibliometric analyses and associated cyberbullying with various factors but have not determined the impact of cyberbullying on people's mental health. Hence, the aim of this study was to conduct bibliometric analyses of cyberbullying and mental health to analyze the academic performance of the literature on impact of cyberbullying on people's mental health; and to propose future research avenues to make further contributions to this field of study.

Methodology

Spreadsheets and VOSviewer were used to conduct the bibliometric analysis. The data were extracted from the SCOPUS database which provided an extensive collection of data and journals.

Findings

Having explored the top active countries publishing on the impact of cyberbullying on people's mental health and the academic performance of such research articles by means of a qualitative bibliometric analysis, the results revealed that this research topic is still to be researched extensively. The study also suggests countries/regions where this research topic can be explored further, as well as possible journals for publication of research results, and further studies to be conducted.

Discussion

The literature presents a fragmented view on the impact of cyberbullying on people's mental health. Studies on cyberbullying are limited for the reasons as discussed in this article. Hence, bibliometric analysis was conducted to analyze the performance of academic literature on the impact of cyberbullying on people's mental health; the academic performance of research articles on cyberbullying and mental health; and to make proposals toward a future research agenda.

Suicide and Suicide Risk in Adolescents

Suicide is the second leading cause of death for 10- to 24-year-olds in the United States and is a global public health issue, with a recent declaration of a National State of Emergency in Children's Mental Health by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association. This clinical report is an update to the previous American Academy of Pediatrics clinical report, "Suicide and Suicide Attempts in Adolescents." Because pediatricians and pediatric health care providers are at the front line of care for adolescents amid a child and adolescent mental health crisis, and because of the chronic and severe shortage of mental health specialists, it is important that pediatric health care providers become facile with recognizing risk factors associated with suicidality and at-risk populations, screening and further assessment of suicidality as indicated, and evidence-based interventions for patients with suicidal ideation and associated behaviors. Suicide risk can be mitigated by appropriate screening, bolstering of protective factors, indicated treatment, community resources, and referrals to mental health providers when available.

Prevalence of cyberbullying victimisation and its association with family dysfunction, health behaviour and psychological distress among young adults in urban Selangor, Malaysia: a cross-sectional study

BACKGROUND

Cyberbullying is a growing public health concern with clear, negative impacts on the mental, physical and social health of targeted victims. Previous research on cyberbullying has largely focused on examining its occurrence among children and adolescents. The present study aims to examine the prevalence of cyberbullying victimisation and its association with family dysfunction, health behaviour and psychological distress among young adults in Selangor, Malaysia.

METHODS

A cross-sectional study was conducted in a locality within Selangor, sampling a total of 1449 young adults. The Cyberbullying and Online Aggression Survey was used to measure cyberbullying victimisation. The Family APGAR scale, General Health Questionnaire, Pittsburgh Sleep Quality Index and single-item measures were used to assess family dysfunction, psychological distress and health behaviour, respectively.

RESULTS

The 1-month prevalence of cyberbullying victimisation among young adults was 2.4%. The most common cyberbullying act experienced was mean or hurtful comments about participants online (51.7%), whereas the most common online environment for cyberbullying to occur was social media (45.8%). Male participants (adjusted OR (AOR)=3.60, 95% CI=1.58 to 8.23) had at least three times the odds of being cyberbullied compared with female participants. Meanwhile, participants with higher levels of psychological distress had increased probability of being cyberbullied compared with their peers (AOR=1.13, 95% CI=1.05 to 1.21).

CONCLUSIONS

As evident from this study, cyberbullying victimisation prevails among young adults and is significantly related to gender and psychological distress. Given its devastating effects on targeted victims, a multipronged and collaborative approach is warranted to reduce incidences of cyberbullying and safeguard the health and well-being of young adults.

A nationwide study on time spent on social media and self-harm among adolescents

Self-harm among adolescents has increased in many countries, but few studies have examined possible explanations. One explanation could be the changes in the way adolescents socialize and use of social media. We explored the relationship between past year self-harm and time spent on social media, employing data from a nationwide cross-sectional survey among students in grades 8 through 11 in Norway (N = 37,268). The association was estimated in logistic regression models and we adjusted for identified confounders and stratified on gender, age group and depressive symptoms. A total of 16.1% of the study population reported to have self-harmed in the past year. This proportion was elevated among those spending more than 3 h daily on social media (unadjusted OR = 2.74 (CI 2.58.-2.90)). Adjustment for confounders modified the association (OR = 1.49 (CI 1.39-1.60)). In stratified analyses, adjusted OR did not differ significantly by gender or age The association between time spent on social media and self-harm was weaker among adolescents with severe depressive symptoms (adjusted OR = 1.38 (CI 1.22-1.55)), than among those with mild or no symptoms (adjusted OR = 1.70 (CI 1.56-1.86)). Risk of self-harm was elevated among those who spent 3 or more hours daily on social media, also after controlling for other factors. Further studies are needed to explore the nature and underlying mechanisms of this association. Strengthening the evidence will help informing the development of adequate measures to prevent self-harm.

Gender differences in the relationships between meaning in life, mental health status and digital media use during Covid-19

BACKGROUND

The COVID-19 pandemic has had a significant impact on individuals' social lives, mental health status, and meaning in life (MIL). Globally, the use of different types of digital media has become a proxy for pre-COVID social lives for many people. This study investigated gender differences in the relationship between use of digital media, mental health status and MIL, during COVID-19 in Hong Kong.

METHODS

This cross-sectional study surveyed 1,488 young people recruited via city-wide random sampling in 2021. Respondents completed a phone survey on digital media use, Patient Health Questionnaire (PHQ-2), Generalized Anxiety Disorder (GAD-2), COVID-19 impact, meaning in life, and demographics. Gender differences in MIL were tested with an independent sample t-test. Gender-specific multiple linear regression models tested associations between MIL and explanatory variables of age, educational level, history of diagnosis, digital media use, and mental health status.

RESULTS

There was a significant gender difference in MIL (males (M = 12.90, SD = 4.12); females (M = 13.45, SD = 3.96); t (1485) = -2.656, p = .008). For males, all variables significantly associated to MIL (F (9, 759) = 15.731, p < .000, R2 = .157). However, for females, while the overall model for MIL was significant (F (9, 709) = 12.105, p < .001, R2 = .133), the only significant associated variable was mental health status.

CONCLUSION

Females had significantly better MIL under COVID-19 than males. Digital media use contributed to MIL in males but not females, and there were gender-specific associated factors of MIL.

COVID-19 Restrictions Resulted in Both Positive and Negative Effects on Digital Media Use, Mental Health, and Lifestyle Habits

While studies have reported effects on digital media during the COVID-19 restrictions, few have included data prior to the pandemic, and most have only measured screen time. We therefore investigated changes in specific digital media activities, as well as mental health and lifestyle habits, in a longitudinal study of adolescents spanning from before the pandemic (T1) to one month into restrictions (T2) and one year later when schools had reopened (T3). Adolescents (16-19 years) rated smartphone use, problematic/addictive media use, negative experiences (e.g., victimization), mental health (i.e., irritability, stress, and closeness), and protective lifestyle habits (i.e., sleep and exercise). Results showed initial decreases in irritability and negative digital experiences, increases in sleep and exercise, as well as a decrease in closeness during remote learning (T2). However, these changes returned to, or superseded, their initial levels at follow-up (T3). There were also increases in digital media use and stress at T3. Conclusively, by investigating specific digital media activities and collecting data both prior to and during different phases of the pandemic, we were able to find both positive and negative effects.

The association between social media use and physical activity among Canadian adolescents: a Health Behaviour in School-aged Children (HBSC) study

OBJECTIVE

To determine the association between social media use (SMU) and physical activity (PA) among Canadian adolescents.

METHODS

We used data from 12,358 participants in grades 6 to 10 who responded to the Canadian component of the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey. Social media intensity and problematic SMU were assessed using a 4-point mutually exclusive scale that contained three categories based on intensity (non-active, active, and intense SMU) and one category based on the presence of addiction-like symptoms irrespective of intensity (problematic SMU). PA was assessed for five domains (i.e., school curriculum, organized sport, exercise, outdoor play, and active transport) and dichotomized using the first quartile to represent high PA engagement in each domain. Meeting PA recommendation of 60 min per day of moderate-to-vigorous PA was calculated using the sum of the five domains. Logistic regression models were used to assess the association between SMU and PA, with active SMU used as the reference group for all models.

RESULTS

Non-active SMU was associated with lower odds of meeting the daily PA recommendations and of high engagement in all five domains of PA when compared to active SMU. Intense SMU was associated with higher odds of meeting the daily PA recommendations. Problematic SMU was not associated with meeting daily PA recommendations, but it was significantly associated with lower odds of high PA engagement in the exercise domain.

CONCLUSION

The findings of this study suggest that non-active SMU was significantly associated with lower PA levels. Problematic SMU was only significantly associated with lower PA levels in the exercise domain. Intense SMU was associated with higher odds of meeting the PA recommendation.

Effectiveness of a Judo Intervention Programme on the Psychosocial Area in Secondary School Education Students

Currently, many combat sports are pedagogically conceived as uneducational and unreliable for the development of young people. The present research aims to investigate the influence of a Judo intervention programme on the motivational climate towards sport, aggressive behaviour, emotional intelligence, and self-concept in secondary school students and to establish the relationships between them. This objective was broken down into (a) developing an explanatory model of the variables mentioned above and (b) testing the model equations through a multi-group analysis in terms of pre-test and post-test. The present study conducted a pre-post-test quasi-experimental design with a single experimental group. The sample consisted of a total of 139 adolescents (12.67 ± 1.066), 50.4% of whom were male (n = 70) and 49.6% female (n = 69). The results show that the intervention decreased all types of aggression and increased levels of emotional intelligence. An increase in social, physical and academic self-concept and decreases in the family and emotional areas were also observed. Finally, for the motivational climate, a tendency towards the ego climate to the detriment of the task climate was observed. It is concluded that the Judo intervention programme is effective in decreasing aggressive behaviour and effective in increasing levels of emotional intelligence and self-concept.

Smartphones, social Media and Adolescent mental well-being: the impact of school policies Restricting dayTime use-protocol for a natural experimental observational study using mixed methods at secondary schools in England (SMART Schools Study)

INTRODUCTION

Smartphone and social media use is prevalent during adolescence, with high levels of use associated with lower levels of mental well-being. Secondary schools in the UK have introduced policies that restrict daytime use of smartphones and social media, but there is no evaluation on the impact of these policies on adolescent mental well-being. The SMART Schools Study aims to determine the impact of daytime restrictions of smartphone and social media use on indicators of adolescent mental well-being, anxiety, depression, physical activity, sleep, classroom behaviour, attainment and addictive social media use.

METHODS AND ANALYSIS

This is a natural experimental observational study using mixed methods. Secondary schools within a 100 mile radius of the recruiting centre in the West Midlands (UK) have been categorised into two groups: Schools that restrict (intervention) and permit (comparator) daytime use of smartphones. We aim to recruit 30 schools (20 restrictive, 10 permissive) and 1170 pupils aged 12-13 and 14-15 years. We will collect data on mental well-being, anxiety and depressive symptoms, phone and social media use, sleep and physical activity from pupil surveys, and accelerometers. Policy implementation measures and data on individual pupil factors will be collected through school staff surveys, and website/policy analysis. Six case study schools will explore individual, school and family/home factors that influence relationships between school smartphone policies, smartphone/social media use, and mental well-being. Economic evaluation will be completed through a cost-consequence analysis from an education sector perspective.

ETHICS AND DISSEMINATION

Ethical approval was obtained from the University of Birmingham's Research Ethics Committee (ERN_22-0723). Parents/carers of pupil participants can complete a form to opt their child out of the study. Pupil, school staff and parent/carer participants are asked to complete online/written consent (or assent). Findings will be disseminated through policy briefings, resources for schools, social media, reports, and open access publications.

TRIAL REGISTRATION NUMBER

ISRCTN77948572.

Heavy social media use and psychological distress among adolescents: the moderating role of sex, age, and parental support

Background

Despite increasing evidence that social media use is associated with adolescents' mental well-being, little is known about the role of various factors in modifying the effect of this association during adolescence. This study examined the association between social media use and psychological distress among adolescents and explored whether sex, age, and parental support moderate this association.

Methods

Data came from a representative sample of middle and high school students in Ontario, Canada. Cross-sectional analyses included 6,822 students derived from the 2019 Ontario Student Drug Use and Health Survey.

Results

Our results showed that 48% of adolescents used social media for 3 h or more per day, and 43.7% had moderate to severe psychological distress, with a higher prevalence among females (54%) than males (31%). After adjustment for relevant covariates, heavy social media use (≥3 h/day) was associated with increased odds of severe psychological distress [odds ratio (OR): 2.01; 95% confidence interval (CI):1.59-2.55]. The association of social media use with psychological distress was modified by age (p < 0.05) but not sex or parental support. The association was stronger among younger adolescents.

Conclusion

Heavy social media use is associated with higher levels of psychological distress, with younger adolescents being the most vulnerable. Longitudinal studies are recommended for future research to examine in more depth the role of sex, age, and parental support in the association between social media use and psychological distress to better determine the strength and of the association.

Exploring the indirect effect of loneliness in the association between problematic use of social networks and cognitive function in Lebanese adolescents

BACKGROUND

Problematic use of social networks is a widespread problem that may exert deleterious impacts on cognitive functions. Moreover, studies have added an important link between loneliness and its harmful effect on cognitive functions. Other studies have also revealed that problematic use of social networks among teenagers has a pejorative influence on their social interactions, leading to increased social isolation. Therefore, the goal of our research was to investigate the link between problematic use of social networks and cognitive function in a group of Lebanese adolescents while also taking into consideration the indirect role of loneliness in this relationship.

METHODS

This cross-sectional study, which was carried out between January and April 2022, included 379 teenagers (aged between 13 and 17 years), from all Lebanese governorates. The PROCESS SPSS Macro version 3.4, model four was used to compute three pathways. Pathway A determined the regression coefficient for the effect of problematic use of social networks on loneliness; Pathway B examined the association between loneliness and cognitive function, and Pathway C' estimated the direct effect of problematic use of social networks on cognitive function.

RESULTS

Higher negative social comparison, addictive consequences of problematic use of social networks, and loneliness were significantly associated with worse cognitive function. Loneliness mediated the association between negative social comparison and worse cognitive function, as well as between addictive consequences of problematic use of social networks and worse cognitive function. In addition, higher financial burden was significantly correlated with worse cognitive function, whereas higher physical activity was related to better cognitive function.

CONCLUSION

In sum, the current study supports that problematic use of social networks is negatively associated with adolescents' cognitive function, where loneliness seems to play a pivotal role in this equation. The results thus endorse the importance of helping Lebanese adolescents to overcome problematic use of social networks and recover from their loneliness, to achieve a better cognitive/academic performance.

Time spent on social media use and BMI z-score: A cross-sectional explanatory pathway analysis of 10798 14-year-old boys and girls

BACKGROUND

The association between adolescent time spent on social media use and body mass index z-score (BMI z-score) is unclear. Pathways of association and sex differences are also unclear. This study examined the association between time spent on social media use and BMI z-score (primary objective) and potential explanatory pathways (secondary objective) for boys and girls.

METHODS

Data are from 5332 girls and 5466 boys aged 14 years in the UK Millennium Cohort Study. BMI z-score was regressed on self-reported time spent on social media use (h/day). Potential explanatory pathways explored included dietary intake, sleep duration, depressive symptoms, cyberbullying, body-weight satisfaction, self-esteem, and well-being. Sex-stratified multivariable linear regression and structural equation modelling were used to examine potential associations and explanatory pathways.

RESULTS

Using social media for ≥5 h/day (vs. <1 h/day) was positively associated with BMI z-score for girls (β [95% CI]) (0.15 [0.06, 0.25]) (primary objective, multivariable linear regression). For girls, the direct association was attenuated when sleep duration (0.12 [0.02, 0.22]), depressive symptoms (0.12 [0.02, 0.22]), body-weight satisfaction (0.07 [-0.02, 0.16]), and well-being (0.11 [0.01, 0.20]) were included (secondary objective, structural equation modelling). No associations were observed for boys and potential explanatory pathway variables were not examined.

CONCLUSIONS

In girls, high time spent on social media use (≥5 h/day) was positively associated with BMI z-score, and this association was partially explained by sleep duration, depressive symptoms, body-weight satisfaction, and well-being. Associations and attenuations between a self-reported summary variable of time spent on social media use and BMI z-score were small. Further research should examine whether time spent on social media use is related to other adolescent health metrics.

Exploring the potentially positive interaction between social media and mental health; the perspectives of adolescents

Adolescents are spending significant time online. Consequently, concerns are consistently raised about potential negative impacts on their mental health. Potentially, these concerns minimise their autonomy and reify the construction of the vulnerable adolescent. Using template analysis, we explored adolescents' perspectives (N = 54) of the relationship between social media and mental health. We centrally considered the wide array of uses made of different social media by the participants, focusing on their understandings of the potentially positive effects these might have. Focus group discussions showed social media could be used to reduce stress, have value for social connectivity, were an important source of information about mental health, and provided a platform for peer-to-peer support. Our conclusion indicated adolescents are generally socially competent online and are often experimenting with their emergent sense of agency.

Longitudinal Effects of Screen Time on Depressive Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior

Studies suggest that hourly digital screen time increases adolescents' depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected in three waves from a representative sample of Swedish adolescents (0, 3 and 12 months; n = 4793; 51% boys; 99% aged 13-15). Generalized Estimating Equations estimated the main effects and moderation effects, and structural regression estimated the mediation pathways. The results showed that problem-focused coping had a main effect on future depression (b = 0.030; p < 0.001) and moderated the effect of screen time (b = 0.009; p < 0.01). The effect size of this moderation was maximum 3.4 BDI-II scores. The mediation results corroborated the finding that future depression was only indirectly correlated with baseline screen time, conditional upon intermittent problem-coping interference (C'-path: Std. beta = 0.001; p = 0.018). The data did not support direct effects, emotion-focused coping effects, or reversed causality. We conclude that hourly screen time can increase depressive symptoms in adolescent populations through interferences with problem-focused coping and other emotional regulation behaviors. Preventive programs could target coping interferences to improve public health. We discuss psychological models of why screen time may interfere with coping, including displacement effects and echo chamber phenomena.

Impact of Social Media Use on Mental Health within Adolescent and Student Populations during COVID-19 Pandemic: Review

The COVID-19 pandemic has drastically changed our lives. By increased screen time during the pandemic, social media (SM) could have significantly impacted adolescents' and students' mental health (MH). This literature review aims to synthesize the research on the impact of SM usage on MH of adolescents and students during the first year of the COVID-19 pandemic. A review of the published literature was conducted in April 2021, through a search of PubMed and Web of Science Core Collection databases. The search yielded 1136 records, with 13 articles selected for this review. Most of the included studies observed the negative impact of SM use on MH of adolescents and students, most noticeably observed were anxiety, depression and stress. More active and prolonged SM usage was associated with a negative impact on MH of adolescents and students. Two studies recorded some potentially positive effects, such as support in coping and providing a sense of connection for those who were isolated due to social distancing measures. Since this review focuses on the early period of the pandemic, future studies should investigate the long-term impact of SM use on adolescents and students MH, with all relevant elements that can enable adequate public health response.

Digital self-harm and suicidality among adolescents

BACKGROUND

Research on digital self-harm - the anonymous online posting, sending, or otherwise sharing of hurtful content about oneself - is still in its infancy. Yet unexplored is whether digital self-harm is related to suicidal ideation or suicide attempts.

METHODS

In the current study, survey data were collected in 2019 from a national sample of 4972 American middle and high school students (M_age  = 14.5; 50% female). Logistic regression analysis was used to assess whether lifetime engagement in two different indicators of digital self-harm was associated with suicidal thoughts and attempts within the past year.

RESULTS

Logistic regression analysis showed that engagement in digital self-harm was associated with a five- to sevenfold increase in the likelihood of reporting suicidal thoughts and a nine- to 15-fold increase in the likelihood of a suicide attempt.

CONCLUSIONS

Results suggest a connection between digital self-harm and suicidality. As such, health professionals must screen for digital self-harm to address underlying mental health problems among youth that may occur prior to or alongside suicidality, and parents/caregivers must convey to children that they are available to dialog, support, and assist with the root issues that may eventually manifest as digital self-harm.

Perchlorate, nitrate, and thiocyanate and depression: the potential mediating role of sleep

Perchlorate, nitrate, and thiocyanate are common thyroid disruptors, but it is not clear whether they are related to depression. In this study, we aimed to investigate the association between perchlorate, nitrate, and thiocyanate and depression, and to explore the potential role of sleep in this process. We used data from the National Health and Nutrition Examination Survey (NHANES). From 2005 to 2016, 6 cycles cross-sectional data were combined. Urinary perchlorate, nitrate, and thiocyanate came from laboratory test; depression was diagnosed by the Nine-item Patient Health Questionnaire (PHQ-9). Weighted generalized liner models, restricted cubic splines, and mediation analysis were used in this study. Totally, 16,715 participants were involved in this study, of which 8295 (49.63%) were male and 8420 (50.37%) were female, with an average age of 46.19 ± 0.32 years. We found that urinary thiocyanate concentration was positively associated with depression (Odds ratios [ORs]: 1.49; 95% confidence intervals [95% CIs]: 1.16, 1.91), but not perchlorate (ORs: 0.71; 95% CIs: 0.52, 0.97) or nitrate (ORs: 0.89, 95% CIs: 0.66, 1.19). Sleep may play a potential mediating role between thiocyanate and depression (9.55%). In conclusion, higher concentrations of thiocyanate exposure may be associated with a higher risk of depression, and the sleep duration may be an important mediating factor.

Multidimensional self-rating biological rhythm disorder and its association with depression and anxiety symptoms among adolescents aged 11-23 years: a school-based cross-sectional study from China

BACKGROUND

Depression and anxiety are topical concerns worldwide, especially among adolescents. Besides, biological rhythm disorder as a candidate mechanism for mood disorders is highly prevalent, but relevant research among adolescents in China is presently limited. We conducted the present study to investigate the distribution of multi-dimensional self-rating biological rhythm disorder and the association of self-rating biological rhythm disorders with depression and anxiety symptoms among Chinese adolescents in different academic stages.

METHODS

In the cross-sectional study, 3693 students aged 11-23 from Zhengzhou City, Henan Province, China were included. The Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) were used to evaluate symptoms of depression and anxiety, respectively. Additionally, the Self-Rating of Biological Rhythm Disorder for Adolescents (SBRDA) was used to assess status of biological rhythm disorders. Multivariate logistic regression was developed to explore factors potentially associated with symptoms of depression and anxiety stratified by academic stages.

RESULTS

Among all participants, 44.14 and 36.15% suffered from depression and anxiety symptoms, respectively. On average, participants scored 74.66 ± 19.37 on the measure of total biological rhythm disorder. Adjusted for demographic confounding factors, the logistic regression analysis showed higher scores of total biological rhythm disorder were associated with more severe depression (OR = 14.38, 95%CI: 11.38-18.16) and anxiety symptoms (OR = 11.63, 95%CI: 9.14-14.81). The similar results were also found in the stratified analysis by academic stages.

CONCLUSIONS

Self-rating biological rhythm disorders are significantly associated with depression and anxiety symptoms among adolescents. Discrepancy across academic stages should also be taken into account in establishing public health strategies.

Development of An Ecological Momentary Assessment of the Impact of Social Media Use Among Suicidal Adolescents

OBJECTIVE

We aimed to develop an ecological momentary assessment (EMA) measure and sampling protocol to assess the near-term impact of experiences with social media use (SMU) that are associated with risk and protective factors for adolescent suicide.

METHODS

To develop the EMA measure, we consulted literature reviews and conducted focus groups with the target population, adolescents at risk for suicide. Subsequently, we refined the measure through interviews with experts and cognitive interviews with adolescents, through which we explored adolescents' thought processes as they considered questions and response options. Data were recorded, transcribed, and analyzed using thematic analysis.

RESULTS

The initial measure had 37 items assessing a range of harmful and beneficial aspects of SMU. Through expert and cognitive interviews, we refined the measure to 4 pathways assessing positive and negative experiences with SMU as well as positive and negative in-person interactions. Each pathway included a maximum of 11 items, as well as 2 items pertaining to SMU at nighttime to be assessed once daily. Acceptable targets the EMA measure's sampling protocol included a 10-day data collection window with text message-based prompts to complete the measure triggered 2-4 times daily.

CONCLUSIONS

By assessing a range of risk and protective factors for youth suicide, while using methods to reduce participant burden, we established content validity for the EMA measure and acceptability for the sampling protocol among youth at high risk of suicide.HIGHLIGHTSDevelopment of an ecological momentary assessment measure and sampling protocolExploring brief momentary assessment of social media's impact on adolescent suicidal riskMulti-phase approach to establishing content validity and an acceptable sampling protocol.

New evidence on technological acceptance model in preschool education: Linking project-based learning (PBL), mental health, and semi-immersive virtual reality with learning performance

Despite significant research on student learning performance, the literature on preschool education is limited. The learning performance of different institutes in China has not been satisfactory, and students are not given enough technological resources to help them improve their learning performance. Although Chinese preschool students are active learners, their learning performance is inadequate. As a result, this research aimed to discover how project-based learning, semi-immersive virtual reality, and mental health influence learning performance. For data collection, 800 questionnaires were distributed to high schools, and 290 valid questionnaires were considered for the data analysis using Smart PLS-SEM. According to the study's findings, project-based learning is critical for improving learning performance. This study's findings are significant because they show that mental health and semi-immersive virtual reality significantly mediate the relationship between project-based learning and learning performance. The study's findings are critical for educational institutions interested in improving student performance through project-based learning opportunities. Furthermore, because it employs an innovative technology acceptance model, this study has significant practical implications for project-based learning and student learning performance.