Problematic social media use in childhood and adolescence

At the time of writing, about 4.59 billion people use social media with many adolescents using their social media accounts across a myriad of applications and platforms. According to recent statistics, in 2022 individuals spent an average of 151 minutes on social media each day, illustrating the global relevance of social media (Dixon, 2022a,b). One of the pressing questions, internationally, is whether social media use is harmful and/or addictive. This question is of particular importance because many teenagers - and younger adolescents - spend considerable time on these platforms, which have increasingly become an integral part of their lives. Moreover, considering lifespan development, adolescents may be particularly vulnerable to specific features and advertisements shown to them on social media platforms. Growing prevalence of poor mental health in young people has led to recent recommendations in the United States to routinely screen for anxiety in 8-18 year olds, and for depression and suicide risk for adolescents between 12-18 years of age (US Preventive Services Task Force et al., 2022 a,b) - the conditions often accompanying problematic social media use. The present work not only provides insights into the current state of the literature but provides also recommendations.

24-month outcomes of an eHealth universal program for students and parents to prevent adolescent alcohol use: A cluster randomized controlled trial in schools

Background

Parents play a critical role in delaying adolescent initiation of alcohol and other drug use. However, the majority of prevention programs focus on adolescents only. This study tested the acceptability and effectiveness of an eHealth universal program for students and parents to prevent adolescent alcohol use.

Methods

A cluster randomized controlled trial (RCT) was conducted between 2018 and 2020 with students from one grade level (aged 12-14 years) from 12 Australian secondary schools randomly allocated to the intervention or control conditions. Students accessed a web-based program in class and parents accessed the program online at their convenience. Data were collected via online questionnaires from students (N = 572) and parents (N = 78) at baseline, and 12- and 24- months post baseline. Multilevel, mixed effects regression models were used to analyse student data.

Findings

More students in the control group reported having at least one standard alcoholic drink and engaging in heavy episodic drinking in the previous 12 months at both 12- and 24-month follow up compared to students in the intervention, however, these differences were not statistically significant. Students in the intervention group reported greater increases in alcohol-related knowledge, compared to the control students. Qualitative data from parents indicated that they found the program useful, however, the number of parents who enrolled in the research study (13.9 %) was low. Parent engagement increased following implementation of an interactive parent/adolescent homework task.

Conclusions

Small sample size, low prevalence of alcohol use and parental engagement, and relatively short follow-up period may have contributed to lack of observed intervention effect, other than on alcohol-related knowledge. Parents who engaged with the program found it useful, however, implementation strategies that encourage parent-child interaction and communication may increase parent engagement for future programs.

Adolescents' Alcohol Use: Does the Type of Leisure Activity Matter? A Cross-National Study

The main objective of this study was to analyze the relationship between structured, unstructured, and family leisure activities on the frequency of adolescent alcohol intake across three different countries (Spain, Peru, and The Netherlands). The self-control of adolescents was also investigated as a moderator in the relationship between leisure activities and alcohol consumption.

METHODOLOGY

This research involved 4608 adolescents aged between 12 and 17 from three countries (Spain, Peru, and The Netherlands). In Spain and Peru, data was collected through a self-report questionnaire which was part of the Your Life project. In The Netherlands, a self-questionnaire was used, collected by the University of Utrecht. A multiple logistic regression was performed for each country.

RESULTS

The results showed that participation in unstructured leisure activities increased the likelihood of drinking more frequently and more heavily in all three countries. Structured leisure activities, in general, did not have a significant predictive effect on alcohol consumption in any of the countries. Family leisure activities reduced the risk of engaging in yearly alcohol use and yearly binge drinking among adolescents, especially in The Netherlands and Spain. The protective effect of family leisure and unstructured leisure risk on yearly alcohol use applied especially to Dutch adolescents with a low level of self-control.

DISCUSSION

The article emphasizes the need for parents to engage in leisure activities with their child; participation in unstructured activities is not to be encouraged.

The relative relation between body satisfaction, body investment, and depression among dutch emerging adults

BACKGROUND

Depression is one of the biggest global health problems, especially among emerging adults (18 to 25). A negative body image is a well-known risk factor for the development of depressive symptoms. However, little is known about how different aspects of body image relate to depressive symptoms. Therefore, the current study explores the relation between body satisfaction, body investment, and depressive symptoms, moderated by sex and physical activity, among a non-clinical sample of emerging adults.

METHODS

Cross-sectional data from 410 Dutch emerging adults (M_age = 21.95 years, SD = 1.98, 80.60% women) within a convenience sample was used within a hierarchical multiple regression analysis.

RESULTS

Results showed that a higher body satisfaction and more body investment were related to fewer depressive symptoms. This relation was somewhat stronger for body investment than for body satisfaction. Furthermore, the relation between lower body satisfaction and more depressive symptoms was stronger for participants with a lower level of physical activity. No other moderation effects were found.

LIMITATIONS

This results should be seen within the light of their limitations. This study used cross-sectional data and therefore no causal relations can be determined. Also, the sample was biased in which mostly highly educated females participated.

CONCLUSIONS

However, this research is unique for adding different concepts of body image in one model. The findings propose that interventions regarding depressive symptoms among emerging adults should focus, next to body satisfaction, on the emotional investment in the body and the enhancement of physical activity.

Parental alcohol-specific rules effectively reduce adolescents' tobacco and cannabis use: A longitudinal study

AIMS

The current study aimed to longitudinally examine the direct and indirect effects (via alcohol use) of parental alcohol-specific rule-setting on adolescent tobacco and cannabis use. Based on the gateway hypothesis, we expected parental alcohol-specific rules to affect adolescent tobacco and cannabis use through adolescent alcohol use.

DESIGN AND PARTICIPANTS

A longitudinal design including three waves and 906 Dutch adolescents (Mage = 13.51 years, SD = 0.60) was used to apply zero-inflated Poisson models (ZIP).

MEASUREMENTS

Self-report questionnaires measured adolescents' perceived rules about alcohol at T1, cigarette use at T1 and T3 (frequency of life-time and current smoking), cannabis use at T1/T3 (frequency of yearly and monthly use) and frequency of monthly alcohol use at T1/T2.

FINDINGS

Stricter alcohol-specific rules at T1 predicted lower incidence and prevalence rates of cigarette (life-time: β = -0.20, p < .00; current: β = -0.21, p = .04) and cannabis use (monthly: β = -0.43, p = .02; yearly: β = -0.28, p = .19) two years later (T3). This direct effect was no longer significant when alcohol use at T1 was controlled for. Moreover, a significant indirect effect of alcohol-specific rules at T1 on tobacco and cannabis use T3 via monthly alcohol use T2 was found.

CONCLUSIONS

The current study demonstrated that strict rules regarding alcohol may not only reduce alcohol but subsequently also other substance use such as tobacco and cannabis. Thus, interventions targeting the prevention of alcohol use, which appears to serve as a gateway, also affects the involvement in other substances.

Normative, passionate, or problematic? Identification of adolescent gamer subtypes over time

BACKGROUND AND AIMS

For most youngsters, gaming is a fun and innocent leisure activity. However, some adolescents are prone to develop problematic gaming behavior. It is therefore important to have a comprehensive understanding of psychosocial and game-related characteristics that differentiate highly engaged gamers from problematic gamers. To that end, this study evaluated the stability and consistency of Internet gaming criteria (as suggested by the DSM-5) and psychosocial characteristics in a two-wave longitudinal study including 1928 young adolescents (mean age = 13.3 years, SD = 0.91, 57% boys).

METHODS

A confirmatory factor analysis revealed good stability of the Internet gaming disorder (IGD) construct over time. Latent class analyses revealed three classes for boys (recreational, engaged, and problematic) and two classes for girls (recreational and engaged).

RESULTS

Significant differences between classes emerged for problem criteria (conflict and problems in social life), gaming duration, impulsivity, social competence, and attention/hyperactivity. The absence of a problematic gaming class for girls suggests that girls are less likely to develop problematic gaming behavior.

DISCUSSION

The IGD criteria as proposed by the DSM-5 are a helpful tool to identify problematic gamers, although the results of this study suggest that using a strict cut-off point might result in false positives, particularly for boys. Problem criteria appeared to be the most sensitive and specific in identifying the problematic gamer, whereas escapism criteria were the least specific and sensitive. Careful consideration of the current proposed criteria to identify problematic gaming behavior could benefit the research and clinical field.

The impact of heavy and disordered use of games and social media on adolescents' psychological, social, and school functioning

AIM

To extend the scholarly debate on (a) whether or not the compulsive use of games and social media should be regarded as behavioral addictions (Kardefelt-Winther et al., 2017) and (b) whether the nine DSM-5 criteria for Internet gaming disorder (IGD; American Psychiatric Association [APA], 2013) are appropriate to distinguish highly engaged, non-disordered users of games and social media from disordered users, this study investigated the impact of engaged and disordered use of games and social media on the psychosocial well-being and school performances of adolescents.

METHODS

As part of the Digital Youth Project of the University of Utrecht, a three-wave longitudinal sample of 12- to 15-year-old adolescents (N = 538) was utilized. Three annual online measurements were administered in the classroom setting, including IGD, social media disorder, life satisfaction, and perceived social competence. Schools provided information on students' grade point average.

RESULTS

The symptoms of disordered use of games and social media showed to have a negative effect on adolescent's life satisfaction, and the symptoms of disordered gaming showed a negative impact on adolescents' perceived social competence. On the other hand, heavy use of games and social media predicted positive effects on adolescents' perceived social competence. However, the heavy use of social media also predicted a decrease in school performances. Several gender differences in these outcomes are discussed.

CONCLUSION

The findings propose that symptoms of disordered use of games and social media predict a decrease in the psychosocial well-being and school performances of adolescents, thereby meeting one of the core criteria of behavioral addictions.

Internet-Based Universal Prevention for Students and Parents to Prevent Alcohol and Cannabis Use Among Adolescents: Protocol for the Randomized Controlled Trial of Climate Schools Plus

Background

Early initiation of alcohol and cannabis use markedly increases the risk of harms associated with use, including the development of substance use and mental health disorders. To interrupt this trajectory, effective prevention during the adolescent period is critical. Despite evidence showing that parents can play a critical role in delaying substance use initiation, the majority of prevention programs focus on adolescents only. Accordingly, the Climate Schools Plus (CSP) program was developed to address this gap.

Objective

This paper outlines the protocol for a cluster randomized controlled trial (RCT) of the CSP program, a novel internet-based program for parents and students to prevent adolescent substance use and related harms. The CSP program builds on the success of the Climate Schools student programs, with the addition of a newly developed parenting component, which allows parents to access the internet-based content to equip them with knowledge and skills to help prevent substance use in their adolescents.

Methods

A cluster RCT is being conducted with year 8 students (aged 12-14 years) and their parents from 12 Australian secondary schools between 2018 and 2020. Using blocked randomization, schools are assigned to one of the two groups to receive either the CSP program (intervention) or health education as usual (control). The primary outcomes of the trial will be any student alcohol use (≥1 standard alcoholic drink/s) and any student drinking to excess (≥5 standard alcoholic drinks). Secondary outcomes will include alcohol- and cannabis-related knowledge, alcohol use-related harms, frequency of alcohol consumption, frequency of drinking to excess, student cannabis use, parents’ self-efficacy to stop their children using alcohol, parental supply of alcohol, and parent-adolescent communication. All students and their parents will complete assessments on three occasions—baseline and 12 and 24 months postbaseline. In addition, students and parents in the intervention group will be asked to complete program evaluations on two occasions—immediately following the year 8 program and immediately following the year 9 program.

Results

Analyses will be conducted using multilevel, mixed-effects models within an intention-to-treat framework. It is expected that students in the intervention group will have less uptake and excessive use of alcohol compared with the students in the control group.

Conclusions

This study will provide the first evaluation of a combined internet-based program for students and their parents to prevent alcohol and cannabis use.

Trial Registration

Australian New Zealand Clinical Trials Registry ACTRN12618000153213; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374178 (Archived by WebCite at http://www.webcitation.org/71E0prqfQ)

Registered Report Identifier

RR1-10.2196/10849

Climate schools plus: An online, combined student and parent, universal drug prevention program

Early initiation of substance use significantly increases one's risk of developing substance use dependence and mental disorders later in life. To interrupt this trajectory, effective prevention during the adolescent period is critical. Parents play a key role in preventing substance use and related harms among adolescents and parenting interventions have been identified as critical components of effective prevention programs. Despite this, there is currently no substance use prevention program targeting both students and parents that adopts online delivery to overcome barriers to implementation and sustainability. The Climate Schools Plus (CSP) program was developed to meet this need. CSP is an online substance use prevention program for students and parents, based on the effective Climate Schools prevention program for students. This paper describes the development of the parent component of CSP including a literature review and results of a large scoping survey of parents of Australian high school students (n = 242). This paper also includes results of beta-testing of the developed program with relevant experts (n = 10), and parents of Australian high school students (n = 15). The CSP parent component consists of 1) a webinar which introduces shared rule ranking, 2) online modules and 3) summaries of student lessons. The parent program targets evidence-based modifiable factors associated with a delay in the onset of adolescent substance use and/or lower levels of adolescent substance use in the future; namely, rule-setting, monitoring, and modelling. To date, this is the first combined parent-student substance use prevention program to adopt an online delivery method.

A systematic review of combined student- and parent-based programs to prevent alcohol and other drug use among adolescents

ISSUES

Alcohol and other drug use among adolescents is a serious concern, and effective prevention is critical. Research indicates that expanding school-based prevention programs to include parenting components could increase prevention outcomes. This paper aims to identify and describe existing combined student- and parent-based programs for the prevention of alcohol and other drug use to evaluate the efficacy of existing programs.

APPROACH

The PsycINFO, Medline, Central Register of Controlled trials and Cochrane databases were searched in April 2015 and additional articles were obtained from reference lists. Studies were included if they evaluated a combined universal intervention for students (aged 11-18 years old) and their parents designed to prevent alcohol and/or other drug use, and were delivered in a school-based setting. Risk of bias was assessed by two independent reviewers. Because of the heterogeneity of the included studies, it was not possible to conduct a meta-analysis and a qualitative description of the studies was provided.

KEY FINDINGS

From a total of 1654 screened papers, 22 research papers met inclusion criteria, which included 13 trials of 10 programs. Of these, nine programs demonstrated significant intervention effects in terms of delaying or reducing adolescent alcohol and/or other drug use in at least one trial.

CONCLUSION

This is the first review of combined student- and parent-based interventions to prevent and reduce alcohol and other drug use. Whilst existing combined student- and parent-based programs have shown promising results, key gaps in the literature have been identified and are discussed in the context of the development of future prevention programs. [Newton NC, Champion KE, Slade T, Chapman C, Stapinski L, Koning I, Tonks Z, Teesson M. A systematic review of combined student- and parent-based programs to prevent alcohol and other drug use among adolescents. Drug Alcohol Rev 2017;36:337-351].

Context Effects of Alcohol Availability at Home: Implicit Alcohol Associations and the Prediction of Adolescents' Drinking Behavior

OBJECTIVE

Recent studies suggest that the predictive effect of implicit alcohol associations is context dependent. Findings indicate that implicit associations are more easily retrieved in an alcohol-associated setting or context (e.g., bar) compared with a neutral setting. In line with this reasoning, we hypothesized that alcohol availability at home might moderate the relationship between implicit alcohol associations and future drinking behavior of adolescents.

METHOD

Participants were 262 at-risk adolescents (235 boys, 27 girls, adolescents with externalizing behavioral problems) with a mean age of 14.11 years (SD = 0.86, age range: 12-16 years) at baseline. Adolescents completed a questionnaire and a modified version of the Implicit Association Test (i.e., Single Category Implicit Association Test; SC-IAT).

RESULTS

Stronger implicit alcohol associations predicted increase in frequency of alcohol use, only in adolescents who indicated that alcohol was available at home. No moderating effects were found for increase in quantity of alcohol use and problematic alcohol use, suggesting that implicit alcohol associations particularly influence the decision of whether to drink in adolescence.

CONCLUSIONS

The findings illustrate that the availability of alcohol in the home setting influences adolescents' implicit alcohol associations and consequently affects the frequency of alcohol use. In this way, alcohol availability at home may be an important contextual factor to consider when examining the effect of implicit alcohol associations on the future drinking behavior of adolescents.

Unfinished Business or, Why Is It So Difficult to Implement an Evidence-Based Alcohol-Use Intervention Program?

Though many evidence-based interventions targeting adolescent alcohol drug use are available, it is unknown if these interventions are put to practice. In this article, we discuss some critical issues associated with the implementation of an evidence-based alcohol prevention program in the Netherlands. Tips that may potentially contribute to a successful implementation of this specific intervention are provided.