Mediated roles of generalized trust and perceived social support in the effects of problematic social media use on mental health: A cross-sectional study

Association between problematic social networking use and anxiety symptoms: a systematic review and meta-analysis

A growing number of studies have reported that problematic social networking use (PSNU) is strongly associated with anxiety symptoms. However, due to the presence of multiple anxiety subtypes, existing research findings on the extent of this association vary widely, leading to a lack of consensus. The current meta-analysis aimed to summarize studies exploring the relationship between PSNU levels and anxiety symptoms, including generalized anxiety, social anxiety, attachment anxiety, and fear of missing out. 209 studies with a total of 172 articles were included in the meta-analysis, involving 252,337 participants from 28 countries. The results showed a moderately positive association between PSNU and generalized anxiety (GA), social anxiety (SA), attachment anxiety (AA), and fear of missing out (FoMO) respectively (GA: r = 0.388, 95% CI [0.362, 0.413]; SA: r = 0.437, 95% CI [0.395, 0.478]; AA: r = 0.345, 95% CI [0.286, 0.402]; FoMO: r = 0.496, 95% CI [0.461, 0.529]), and there were different regulatory factors between PSNU and different anxiety subtypes. This study provides the first comprehensive estimate of the association of PSNU with multiple anxiety subtypes, which vary by time of measurement, region, gender, and measurement tool.

The relationship between loneliness and problematic social media usage in Chinese university students: a longitudinal study

BACKGROUND

A significant number of cross-sectional studies have explored the correlation between loneliness and problematic social media use. However, the causal relationship between these two key variables remains controversial, and the developmental relationship over time is unclear.

METHODS

We conducted a one-year longitudinal study with 538 Chinese college students using questionnaires and employing cross-lagged and latent growth models to investigate the causal relationship and developmental dynamics between loneliness and problematic social media use.

RESULTS

The results indicate that (a) loneliness and problematic social media use mutually and positively influence each other, establishing a bidirectional causal relationship; (b) Chinese college students experience a gradual increase in levels of loneliness and problematic social media use during their time in college; and (c) the intercept and slope of loneliness significantly and positively affect the intercept and slope of problematic social media use, and conversely, the intercept and slope of problematic social media use significantly and positively influence the intercept and slope of loneliness.

CONCLUSION

These findings reveal the longitudinal relationship between loneliness and problematic social media use among Chinese college students and offer insights for researchers and educators to intervene in college students' loneliness and problematic social media use from a developmental perspective.

Analysis of Prescription Compliance and Influencing Factors in Cardiac Rehabilitation after Surgery in Children with Congenital Heart Disease Based on Generalized Trust Theory

AIMS

To understand the compliance, influencing factors, and action path of family cardiac rehabilitation exercise prescriptions for children after congenital heart disease surgery.

METHODS AND RESULTS

A random sampling method was used to select 200 pediatric patients and their parents from a pediatric hospital in Shanghai. Among them, 57 cases (28.5%) of children's families followed the cardiac rehabilitation exercise prescription. Path analysis showed that peak oxygen uptake exerted a negative impact on the compliance of family cardiac-rehabilitation prescriptions for patients after congenital heart disease surgery through doctor-patient trust, with a standardized path coefficient of -0.246 (P = 0.001). Disease-related knowledge exerted a positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after congenital heart surgery through doctor-patient trust, with a standardized path coefficient of 0.353 (P < 0.001). The dimension of friend support in social support had a direct positive effect on the compliance of family cardiac-rehabilitation prescriptions for children after cardiac surgery, with a standardized path coefficient of 0.641 (P = 0.006).

CONCLUSION

The compliance of cardiac rehabilitation exercise prescription in children with congenital heart disease is not good and is affected by many factors, and there is a complex path relationship between various factors; the kilogram oxygen consumption of the child, the disease-related knowledge of the caregiver, and social support all play important roles in the compliance of the child's family's health prescription.

REGISTRATION

SCMCIRB-K2021002-1.

Association between WeChat use and mental health among middle-aged and older adults: a secondary data analysis of the 2020 China Family Panel Studies database

OBJECTIVE

This study focused on the association between WeChat use, the most popular social software in China, and the mental health of middle-aged and older adults.

DESIGN

Nationwide cross-sectional study.

SETTING

The China Family Panel Studies (CFPS) database.

PARTICIPANTS

The study sample included 11 127 middle-aged and elderly people aged 45 and above identified from the 2020 CFPS database.

RESULTS

WeChat usage was negatively associated with depression (OR: 0.782, p<0.01), as was the WeChat Moments sharing (OR: 0.846, p<0.01). 10.310% of the relationship between WeChat usage and depression came from the effects of interpersonal relationships (5.720%) and social trust (4.590%), with significant indirect effects (B=-0.028, p<0.01). Sixteen per cent of the relationship between WeChat Moments sharing and depression came from the effect of interpersonal relationships (6.800%) and social trust (9.200%), and the indirect effect was also significant (B=-0.032, p<0.01).

CONCLUSIONS

WeChat use may empower middle-aged and elderly to maintain close social relationships and trust contributing to their mental health.

Mobile phone addiction and mental health: the roles of sleep quality and perceived social support

As a global phenomenon, mobile phone addiction has become an increasingly common issue among Chinese university students. Although previous research explored the link between mobile phone addiction and mental health, the possible mechanism underlying the above association is unclear. We administered a cross-sectional survey to 585 participants from two universities in Kunming, southwest China, from October 2021 to January 2022. Our results suggested that mobile phone addiction was negatively associated with mental health, and sleep quality partially mediated the relationship between mobile phone addiction and mental health. Furthermore, perceived social support positively moderated the direct effect of sleep quality on mental health, as well as the indirect effect of mobile phone addiction on mental health. These findings provide a new insight into the underlying mechanism by which mobile phone addiction affects university students' mental health. The results emphasize a necessary task for administrators, health workers, and family members to attach importance to the overuse of mobile phones among university students.

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.

Effect of Social Media Addiction on Executive Functioning Among Young Adults: The Mediating Roles of Emotional Disturbance and Sleep Quality

Introduction

The increased research examining social media addiction with its negative consequences has raised concerns over the past decade. However, little research has investigated the association between social media addiction and executive functioning as well as the mechanisms underlying this relationship.

Methods

Using a survey, the present study examined the association between social media addiction and executive functioning via emotional disturbance and sleep quality among 1051 Chinese young adults, aged 18 to 27 years old (M=21.02 years [SD=1.89]; 34.41% male).

Results

The results showed that social media addiction had a significant negative association with executive functioning but positive associations with emotional disturbance and poor sleep quality. Structural equation modeling suggested that there was a significant direct effect between social media addiction and executive functioning. Indirect effects via two paths (ie, emotional disturbance alone, and both emotional disturbance and sleep quality) were also statistically significant.

Discussion

The findings indicate that both emotional disturbance and poor sleep quality are risk-enhancing mediators in the relationship between social media addiction and executive functioning. Intervention programs (eg, emotional regulation strategies) should be considered to reduce the adverse effects of social media addiction on cognitive impairment among young adults.

Family Matters More Than Friends on Problematic Social Media Use Among Adolescents: Mediating Roles of Resilience and Loneliness

Problematic social media use (PSMU) among adolescents has raised global concern in the current digital age. Despite the important role of perceived social support in adolescents' PSMU has been examined, possible different influences between perceived support from family and friends are still unknown. To address the gap, the present study aimed to examine how perceived support from family and friends is associated differently with PSMU and the mediating roles of resilience and loneliness therein. A sample of 1056 adolescents was recruited to complete standard questionnaires. Mediation analysis showed that resilience and loneliness mediated this association partially between perceived support from family and PSMU but totally between perceived support from friends and PSMU. Further, ANOVA-based analysis showed that influences of perceived support from family and friends on PSMU were mutually independent, and there was no interaction between them. Our results not only highlight different and independent impacts of perceived support from family and friends on PSMU, but also clarify the mediating mechanisms linking perceived social support to adolescent PSMU.

Internalizing symptoms, rumination, and problematic social networking site use: A cross national examination among young adults in seven countries

BACKGROUND

As daily engagement with social networking sites (SNS) increases globally, identifying and understanding the risk factors associated with problematic SNS use is of utmost importance. Researchers are interested in understanding internalizing symptoms as both a risk factor and a negative consequence of problematic SNS use. Prior research has proposed rumination alongside internalizing symptoms as a risk factor, though limited research has examined these associations across different cultures.

OBJECTIVE

The present study examined the indirect associations between internalizing symptoms (specifically depressive and social anxiety symptoms) and problematic SNS use via rumination among a cross-cultural sample.

METHOD

Participants were 8,912 (70.8 % female; Mean age = 20.25, SD = 3.95) college students recruited across seven countries (U.S., Canada, Spain, England, Argentina, Uruguay, and South Africa) who completed measures of internalizing symptoms, rumination, weekly SNS use, and problematic SNS use.

RESULTS

We found that higher internalizing symptoms were associated with more problematic SNS use via higher ruminative thinking. Specifically, problem-focused thoughts (a rumination subtype) uniquely accounted for 22.89% and 28.15% of the total effect of depressive and social anxiety symptoms on problematic SNS use, respectively. Other rumination subtypes (i.e., anticipatory thoughts and repetitive thinking) also demonstrated significant indirect effects, though weaker effects than for problem-focused thoughts. Findings were invariant across countries.

CONCLUSIONS

These findings provide support for further exploring the role rumination plays in determining and comparing problematic SNS use cross-culturally in longitudinal and experimental work.

The double-edged impact of Internet use on mental health outcomes among Filipino university students: the mediating role of online social support

Introduction

Evidence supports both the positive and negative effects of Internet use on mental health outcomes, but it remains unclear on the role of online social support in this relationship. This study examined the link between daily hours of general Internet use and bidimensional mental health (BMMH) through the pathway of online social support (OSSS).

Methods

Drawing from a sample of 247 Filipino university students, this cross-sectional study tested two simple mediation models that considered mental wellbeing and psychological distress as outcome variables.

Results

Findings show that the total effect of Internet use is positive and negative for mental wellbeing and psychological distress, respectively. Online social support mediated the favorable effects of Internet use on BMMH outcomes. However, the introduction of OSSS as a mediator yielded residual direct effects with opposing signs for both models. The resultant inconsistent mediation in the models signifies the double-edged impact of Internet use on mental health, with favorable effects transmitted through online social support.

Discussion

Findings highlight the importance of online social support as a pathway to harness the positive effects of Internet on mental health. Recommendations to improve online social support for students are discussed herein.

How do digital lives affect resident mental health in the digital era? Empirical evidence based on Chinese general social survey

Having good mental health means we are better able to connect, function, cope and thrive. The widespread application of digital technology in daily life provides new ways and promising tools for residents to maintain their mental health. Given the importance of mental health for everyone, and the fact that mental health problems are prevalent worldwide, this study discusses how digital lives affects the mental health of residents. The results suggest that digital lives are significantly and positively associated with mental health. Mechanisms analysis identifies personal perceptions (self-rated physical exercise and subjective wellbeing) as the important paths for digital lives to promote mental health, while social perceptions (social trust and social fairness) play a suppressing effect on the relationship between them. The results of further discussion show that the degree of the influence of digital lives on mental health of individuals is heterogeneous among different regions. Due to the difference in development level, the positive impact of digital lives is greater in urban areas than in rural areas, and it is stronger in western regions than in eastern and central regions. This study enriches the nascent research stream of digitalization, explores new paths of harnessing digital technologies for mental health, and offers useful insights for the government to guide them in formulating digital development strategies and achieving the Healthy China Strategy.

Burden of mental distress in the US associated with trust in media for COVID-19 information

During the COVID-19 pandemic, news and social media outlets have played a major role in dissemination of information. This analysis aimed to study the association between trust in social and traditional media and experiences of mental distress among a representative sample of US adults. Data for this study came from National Pandemic Pulse, a cross-sectional, nationally representative survey that sampled participants on the Dynata platform. Participants included 6435 adults surveyed between 15–23 December 2020. Ordinal logistic regression analyses examined the associations of trust in (i) social media, (ii) print media, (iii) broadcast TV and (iv) cable TV, for COVID-19-related information with self-reported mental distress (4-item Patient Health Questionnaire), controlling for sociodemographics and census region. Compared with those who distrusted social media, those who trusted social media had 2.09 times (95% CI = 1.84–2.37) greater adjusted odds of being in a more severe category of mental distress. In contrast, compared with those who distrusted print media, those who trusted print media had 0.80 times (95% CI = 0.69–0.93) lower adjusted odds of being in a more severe category of mental distress. No significant associations were found between mental distress and trust in broadcast or cable TV for accessing news about COVID-19. Trust in different news outlets may be associated with mental distress during public health emergencies like the COVID-19 pandemic. Future studies should explore mechanisms behind these associations, including adherence to best practices for crisis reporting among different media sources and exposure of individuals to misinformation.

Mediated effects of insomnia in the association between problematic social media use and subjective well-being among university students during COVID-19 pandemic

Recently, the use of social media has penetrated many aspects of our daily lives. Therefore, it has stimulated much debate and polarisation regarding its impact on mental well-being. The present study investigated the association between problematic use of social media, subjective well-being, and insomnia's potential mediator. A proportionate random sample was collected from a Univerity in Algeria between March and April 2020.The participants (n=288; mean [SD] age = 20.83 [2.13]) involved 101 (35.1%) males. Nearly three-fourths of the participants (n=214; 74.3%) used up more-than three hours daily surfing on social media. Their mean (SD) score was 15.64 (4.80) on the Bergan Social Media Addiction Scale, 16.19 (9.15) on the Arabic Scale of Insomnia, and 28.13 (7.90) on the overall subjective well-being. Structural equation modeling (SEM) revealed an indirect correlation between problematic use of social media and the overall subjective well-being of users. Similarly, the indirect but not direct effects were found for the overall subjective well-being subdomains. Moreover, all SEM models have a satisfactory fit with the data. Based on the results, it can be concluded that insomnia appears to play an important role in mediating the association between subjective well-being and problematic social media use. This suggests the importance of tackling the issues of insomnia and problematic use of social media for university students. It also has important implications in dealing with the misuse of social media, especially during the covid-19 pandemic.

Changes of Health Outcomes, Healthy Behaviors, Generalized Trust, and Accessibility to Health Promotion Resources in Taiwan Before and During COVID-19 Pandemic: Comparing 2011 and 2021 Taiwan Social Change Survey (TSCS) Cohorts

PURPOSE

The present study compared two nationally representative cohort datasets concerning Taiwan residents' healthy behaviors, subjective health outcomes, generalized trust, and accessibility to health promotion resources.

PATIENTS AND METHODS

The Taiwan Social Change Survey (TSCS) was conducted in two waves ten years apart: 2011 cohort (n = 1021; 48.4% males) and 2021 cohort (n = 1425; 47.4%) cohorts. Descriptive statistics were calculated to compare the two TSCS datasets. Then, multiple regression models were constructed with health outcome as the dependent variable, and demographics and other key components as independent variables.

RESULTS

The 2011 TSCS cohort showed higher prevalence for cigarette smoking (30.8% vs 25.2%; p=0.002), alcohol drinking (52.5% vs 24.3%; p<0.001), exercise habits (52.7% vs 48.0%; p=0.02), and better fruit and vegetable accessibility (Mean=3.91 vs 3.82; p=0.04). The 2021 TSCS cohort reported higher body mass index (Mean=24.20 vs 23.63; p<0.001), less residency in urban areas (22.4% vs 31.1%; p<0.001), better jogging accessibility (4.14 vs 4.05; p=0.006), higher generalized trust (2.26 vs 2.17; p=0.001), and greater internet usage (3.43 vs 2.89; p<0.001). The regression model showed that exercise habits (standardized coefficient=0.20 and 0.10; p<0.001) and generalized trust (standardized coefficient=0.11 and 0.11; p=0.004 and <0.001) were consistently associated with health outcomes in both cohorts. Additionally, internet use (standardized coefficient=-0.07; p=0.026) and alcohol drinking behaviors (standardized coefficient=-0.07; p=0.0022) were negatively associated with health outcomes in the 2021 cohort.

CONCLUSION

The present study demonstrated the trends and changes over 10 years regarding multiple health-related components among Taiwan residents. The study's findings provide insight into education promotion programs to reduce unhealthy behaviors as well as enhancing generalized trust building and developing healthy behaviors for Taiwan residents.

Established Adults, Who Self-Identify as Smartphone and/or Social Media Overusers, Struggle to Balance Smartphone Use for Personal and Work Purposes

Smartphone ownership and use continues to proliferate, allowing people to easily access online communication, entertainment, and information. Importantly, individuals can perceive that they overuse their smartphone and/or the social media applications (apps) they access on their devices. Much of the research on smartphone overuse has focused on youth and emerging adults, with little research focusing on individuals in the established adulthood stage of life. This study examines smartphone use among established adults who perceive that they overuse their smartphone and/or social media. As part of a larger study, we conducted in-depth interviews with 21 individuals (30-45 years old) who self-identified as smartphone and/or social media overusers. Data were collected through a pre-survey, 1-hour interview, and smartphone use screenshots. Audio-recorded interviews were transcribed and then coded using NVivo software. Participants' average age was 35.9 years (SD = 4.1). The majority of the sample were female (67%), White (76%), and had a master's degree or higher (76%). Participants spent an average of 215 min on their smartphone daily, primarily using social media, video conferencing, and texting apps. Issues with smartphone use occurred when there was an unclear separation between work and personal use. Participants felt pressure to always respond quickly to work emails. An effort was made to limit smartphone use for work and during family time to be present for their family. Established adults strive to balance smartphone use for personal and work purposes. Creating boundaries for how and when established adults use their smartphone may help them find this balance.

The Relationship of Social Media Addiction With Internet Use and Perceived Health: The Moderating Effects of Regular Exercise Intervention

The popularity of online social media in recent years has not only brought information and social convenience to people's lives, but has also given rise to many problems, among which social media addiction (SMA) has become a concern of many scholars and experts. Past research has shown that regular exercise (REx) can have many health benefits for the body, so numerous scholars and experts believe that this may be one possible strategy for reducing the health effects of online community addiction and Internet use (IU). Therefore, this study adopted a secondary data research approach to explore and predict the effect of age on social media use and personal health, and therefore included age as a control variable to investigate whether the intervention of REx, excluding the effect of age, moderates the effect of SMA on IU and on perceived health (PH). The participants of this study were adults aged 18 years or older in Taiwan, using the 2019 “Survey Research Data Archive,” Vol. 7, No. 5 data. A total of 1,933 questionnaires were retrieved, and after elimination of invalid responses, 1,163 data were analyzed using Partial Least Squares Structural Equation Modeling, PLS-SEM. The results were as follows: (1) SMA positively affected IU, (2) SMA could negatively affect PH, (3) there was no statistical effect of IU on PH, (4) SMA did not indirectly affect PH through IU, (5) REx had a moderating effect on SMA and IU, and (6) REx did not regulate the effect of SMA on PH. First, from these results, it is clear that the negative health effects of SMA may not be simply due to prolonged IU. Secondly, while it is true that the moderating effect for people with low levels of SMA can reduce IU, for people with high levels of SMA, the moderating effect of REx becomes a catalyst for increased Internet usage behavior. Finally, we draw conclusions based on the results of the study and propose directions and recommendations for follow-up research.

Problematic Social Media Use and Depressive Outcomes among College Students in China: Observational and Experimental Findings

Aims: Problematic social media use is increasing in China and could be a risk factor for depression. We investigated cross-sectional associations between problematic social media use and depressive outcomes among Chinese college students with potential mediation by perceived social support, social media violence, and loneliness. Thereafter, we evaluated the effectiveness of a one-month group counseling intervention in reducing depressive symptoms related to social media addiction. Methods: Depressive symptoms, social media addiction, perceived social support, social media violence, and loneliness were self-reported among 21,000 college students in Shaanxi province, China. A randomized controlled trial was designed based on the results of the observational study and Satir Transformational Systemic Therapy (STST) among 60 college students assigned to intervention (N = 30) or control/no treatment (N = 30). Self-administered surveys were completed at baseline (T1), at the end of the 1-month intervention (T2), and at 2-month follow-up post-intervention (T3). Results: After controlling for relevant covariates, more problematic social media use was associated with more depressive symptoms (β = 0.18, p < 0.001) and depression (OR = 1.08, 95% CI: 1.075, 1.092). Multiple mediation analyses found that perceived social support, social media violence, and loneliness significantly mediated associations between problematic social media use and depressive symptoms (model fit: RMSEA = 0.065, GFI = 0.984, CFI = 0.982). Bootstrapping revealed significant indirect effects of problematic social media use on depressive symptoms through the mediators named above (0.143, 95% CI: 0.133, 0.156). The subsequently informed intervention significantly reduced depressive symptoms at T2 (mean difference: −12.70, 95% CI: −16.64, −8.76, p < 0.001) and at T3 (mean difference: −8.70, 95% CI: −12.60, −4.80, p < 0.001), as well as levels of social media addiction, perceived social support, social media violence, and loneliness. Conclusions: Problematic social media use is a risk factor for depressive outcomes among Chinese college students, and perceived social support, social media violence, and loneliness mediate this association. STST-based group counseling may reduce depressive symptoms related to high social media usage in this population.

Evaluating the relationship between social media use frequency and entrepreneurial perceptions and attitudes among students

Despite studies published in the last decade linking entrepreneurship and the use of social media, to date, no study has analyzed in depth the relationship between the frequency of use among different social media sites and the intensity of entrepreneurial attitudes and perceptions. Due to the increasing use of social media as a teaching tool in higher education, this study seeks to address this knowledge gap. Consequently, the objective of this research is to analyze whether the frequency of social media use, among Twitter, Facebook, Instagram, WhatsApp and YouTube, is linked with perceptual discrepancies regarding entrepreneurial subjective norms, attitudes toward entrepreneurship and the intention to undertake, differentiating this relationship by gender and age group. A total of 246 business and engineering students from Chile were evaluated through online surveys, and Mann–Whitney and Spearman's correlation tests were performed. The findings highlight that higher exposure on these social media platforms is related to better entrepreneurial attitudes and perceptions, and this association differs according to students' gender and age group; in particular, Facebook shows more positive correlations in younger and male students, and WhatsApp and YouTube show more positive correlations in older and female students. This research extends the understanding of the relation between exposure to social media and variables with a considerable influence on undertaking entrepreneurship. Universities should integrate social media use as a teaching tool among students to aid in their entrepreneurial learning and strengthen new ventures. The main limitation of the study is that the sample includes business and engineering students in Chile. Future studies should ask students from different countries; likewise, it is important to use qualitative methodologies to determine why social media may affect entrepreneurial perceptions and attitudes.

Patients' Self-Disclosure Positively Influences the Establishment of Patients' Trust in Physicians: An Empirical Study of Computer-Mediated Communication in an Online Health Community

With the development of telemedicine and e-health, usage of online health communities has grown, with such communities now representing convenient sources of information for patients who have geographical and temporal constraints regarding visiting physical health-care institutions. Many previous studies have examined patient-provider communication and health-care service delivery in online health communities; however, there is a dearth of research exploring the relationship between patients' level of self-disclosure and the establishment of patients' trust in physicians. Consequently, this study aims to explore how patients' self-disclosure affects the establishment of patients' trust in physicians. "Good Doctor," which is a China-based online health community, was used as a data source, and a computer program was developed to download data for patient-physician communication on this community. Then, data for communications between 1,537 physicians and 63,141 patients were obtained. Ultimately, an empirical model was built to test our hypotheses. The results showed that patients' self-disclosure positively influences their establishment of trust in physicians. Further, physicians' provision of social support to patients showed a complete mediating effect on the relationship between patients' self-disclosure and patients' establishment of trust in physicians. Finally, evidence of "hope-for-help" motivation in patients' messages weakened the effect of patients' self-disclosure when physicians' social support was text-based, but strengthened it when physicians' social support was voice-based.

Cyberchondria, Fear of COVID-19, and Risk Perception Mediate the Association between Problematic Social Media Use and Intention to Get a COVID-19 Vaccine

Vaccination is the most effective way to control the COVID-19 pandemic, but vaccination hesitancy threatens this effort worldwide. Consequently, there is a need to understand what influences individuals’ intention to get a COVID-19 vaccine. Restriction of information gathering on societal developments to social media may influence attitudes towards COVID-19 vaccination through exposure to disinformation and imbalanced arguments. The present study examined the association between problematic social media use and intention to get the COVID-19 vaccine, taking into account the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception. In a cross-sectional survey study, a total of 10,843 residents of Qazvin City, Iran completed measures on problematic social media use, fear of COVID-19, cyberchondria, COVID-19 risk perception, and intention to get a COVID-19 vaccine. The data were analyzed using structural equation modeling (SEM). The results showed that there was no direct association between problematic social media use and intention to get a COVID-19 vaccine. Nonetheless, cyberchondria, fear of COVID-19, and COVID-19 risk perception (each or serially) mediated associations between problematic social media use and intention to get a COVID-19 vaccine. These results add to the understanding of the role of problematic social media use in COVID-19 vaccine hesitancy, i.e., it is not the quantity of social media use per se that matters. This knowledge of the mediating roles of cyberchondria, fear of COVID-19, and COVID-19 risk perception can be used by public health experts and policymakers when planning educational interventions and other initiatives in COVID-19 vaccination programs.

Suicidal Ideation during the COVID-19 Pandemic among A Large-Scale Iranian Sample: The Roles of Generalized Trust, Insomnia, and Fear of COVID-19

The novel 2019 coronavirus disease (COVID-19) is still not under control globally. The pandemic has caused mental health issues among many different cohorts and suicidal ideation in relation to COVID-19 has been reported in a number of recent studies. Therefore, the present study proposed a model to explain the associations between generalized trust, fear of COVID-19, insomnia, and suicidal ideation during the COVID-19 pandemic among a large-scale Iranian sample. Utilizing cluster sampling with multistage stratification, residents from Qazvin province in Iran were invited to participate in the present study. Adults aged over 18 years (n = 10,843; 6751 [62.3%] females) completed ‘paper–and-pencil’ questionnaires with the assistance of a trained research assistant. Structural equation modeling (SEM) was applied to understand the associations between generalized trust, fear of COVID-19, insomnia, and suicidal ideation. Slightly over one-fifth of the participants (n = 2252; 20.8%) reported suicidal ideation. Moreover, the SEM results indicated that generalized trust was indirectly associated with suicidal ideation via fear of COVID-19 and insomnia. Furthermore, generalized trust was not directly associated with suicidal ideation. The proposed model was invariant across gender groups, age groups, and participants residing in different areas (i.e., urban vs. rural). Generalized trust might reduce individuals’ suicidal ideation during the COVID-19 pandemic period via reduced levels of fear of COVID-19 and insomnia. Healthcare providers and policymakers may want to assist individuals in developing their generalized trust, reducing fear of COVID-19, and improving insomnia problems to avoid possible suicidal behaviors.

Associations of depressive symptoms and perceived social support with addictive use of social media among elderly people in Turkey

BACKGROUND

The aim of this study was to investigate the relationship of addictive use of social media (AUSM) with depressive symptoms, perceived social support and demographic variables among people aged 65 years and older.

METHODS

People aged 65 years and older who use social media constituted the study sample. The data were obtained from social networking sites via Google survey link. Bergen social media addiction scale (BSMAS) for determining AUSM, Multidimensional Scale of Social Support for determining social support, Geriatric Depression Scale to identify depressive symptoms and sociodemographic data form were administered to the participants.

RESULTS

The mean age of the sample was 68.86 ± 2.0 years. AUSM showed significant differences depending on gender, marital status, economic status, educational level, settlement, occupation, and time spent in social media (P = 0.00). AUSM had correlations with both sub-dimensions of perceived social support and depressive symptoms (P < 0.01). In the regression analysis, it was found that the depressive symptoms, social support from family (P = 0.00) and from a significant other (P = 0.001) had significant effects on AUSM.

CONCLUSIONS

When evaluating elderly individuals with depressive symptoms, it is important to evaluate these individuals in terms of social media addiction. Interventions to improve social support systems, especially for older people with little perceived social support can help prevent the development of AUSM.

Widowhood and Health Status Among Chinese Older Adults: The Mediation Effects of Different Types of Support

Although many studies have suggested that widowhood is related to worse health conditions among older adults, few have examined the mediation effects of social support between widowhood and health. Employing mediation analysis to a sample of data from the 2014 wave of China Longitudinal Aging Social Survey (CLASS), this study examined the mediation effects of social support, including emotional support, instrumental support, and companionship, in the widowhood-health association among older adults. The results indicated that the negative effect of widowhood on older adults' health was in part attributable to decreased emotional support and companionship. Specifically, emotional support exerted a significant role in the widowhood-mental health association, and companionship exerted a significant role in widowhood-physical health and widowhood-mental health associations. In the subsample analysis, the mediation effects were only significant among female older adults, and among rural older adults. Our findings highlight the importance of emotional support and companionship in maintaining health among widowed older adults and strategies should pay more attention to female and rural widowed older adults.

Problematic social media use and social support received in real-life versus on social media: Associations with depression, anxiety and social isolation

Social media platforms allow people to connect with each other and obtain social rewards. In some individuals, these reinforcing rewards can induce maladaptive, problematic social media use, with symptoms similar to substance use disorders. This problematic social media use has been associated with poorer mental health. Previous studies have demonstrated that social support can protect against poor mental health. People can receive social support both in real-life and on social media, however, so we investigated whether these two types of social support mediate the relationship between problematic social media use and poor mental health. We conducted an online survey, collecting measures of problematic social media use and mental health (depression, anxiety, and social isolation), as well as measures of real-life social support and social support received on social media. We then performed a path analysis on these data. Our analysis revealed that problematic social media use was significantly associated with decreased real-life social support and increased social support on social media. Importantly, real-life social support was then associated with reduced depression, anxiety, and social isolation, while social support on social media was not associated with these mental health measures. Our findings reveal the value of real-life social support when considering the relationship between problematic social media use and mental health. Implications for further research and practice are discussed.

Mediated roles of generalized trust and perceived social support in the effects of problematic social media use on mental health: A cross-sectional study

BACKGROUND

Current literature lacks evidence concerning how problematic social media use associates with mental health. To address the gap, the present study used mediation models to examine whether generalized trust and perceived social support (PSS) are potential mediators in the relationship between problematic social media use and mental health.

METHODS

The sample comprised Iranian adults (n = 1073; 614 females). The participants completed a number of scales to assess problematic social media use (Bergen Social Media Addiction Scale), generalized trust (Generalized Trust Scale), PSS (Multidimensional Scale of Perceived Social Support, happiness (Oxford Happiness Questionnaire Short Form), depression and anxiety (Hospital Anxiety and Depression Scale), and mental quality of life (Short Form-12).

RESULTS

Problematic social media use had negative effects on happiness and mental quality of life via the mediators of generalized trust (bootstrapping SE = 0.017; effect = -0.041; 95% CI = -0.079, -0.012) and PSS (bootstrapping SE = 0.023; effect = -0.163; 95% CI = -0.211, -0.119). Problematic social media use had positive effects on anxiety and depression via the mediators of generalized trust (bootstrapping SE = 0.022; effect = 0.064; 95% CI = 0.026, 0.113) and PSS (bootstrapping SE = 0.024; effect = 0.052; 95% CI = 0.009, 0.102).

CONCLUSIONS

Problematic social media use, generalized trust and PSS are important factors for an individual's mental health. Health-care providers may want to assist individuals regardless of having mental health problems in reducing their problematic social media use and improving their generalized trust and social support.