Social Media and Adolescent Mental Health

Proposed research topic:   Social media and adolescent mental health

Three academic search engines were used for this literature review – Ebscohost, BASE Digital Collections and Google Scholar – and the keywords employed were social media, mental health, adolescents and Internet.

The immediate inspiration for choosing this topic came from reading a key published research study – Social media’s enduring effect on adolescent life satisfaction – by Orben, Dienlin and Pryzbylski (2019). It was published online by PNAS (Proceedings of the National Academy of Sciences) in the United States in May this year. As its abstract states, the paper found that social media use is not… a strong predictor of life satisfaction across the adolescent population.

With this perhaps widely unexpected conclusion, at least in the popular sense, this large-scale Oxford study of over 12,000 young people understandably encouraged a closer look at the topic, not least with a view to trying to disentangle cause and effect in social-media phenomena.

On 22 November 2018, the Guardian newspaper had referred to social media as “widely blamed” when discussing recently released NHS figures, based on a sample of more than 9,000, that showed that one in eight people under the age of nineteen had some disorder or other. Emphasis has been added in line with the theme of this assignment.

Those young people aged between 11 and 16 with a disorder were much more likely… to have taken illicit drugs, drunk alcohol or tried a cigarette. Among these… the use of social media, widely blamed for causing much of the epidemic of mental illness in young people, was an important possible explanation too. While, for example, 29.4% of those aged 11 to 19 with a disorder spent more than four hours a day on social media, just 12% of those displaying no symptoms did the same thing. Those who have a disorder were much more likely to compare themselves with others on social media and to say that “likes, comments and shares impact my mood”.

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The secondary inspiration came from having read in the past of times and places where external social factors influenced widespread mental health effects. Hence the development of an interest in this area. Some more background elaboration is therefore required before moving on to the literature review necessary to any such research, not least because of the advent of YouTube stars and social media influencers.

As culture is usefully defined by the field of anthropology as a shared, learnt way of life, so ‘celebrity culture’ is commonly and reasonably equated with a popular obsession with the lives and lifestyles of the rich and famous. Both mainstream media and social media offer overwhelming evidence that there is a huge market for this subject matter but where does this obsession come from?

The artist Andy Warhol predicted in the 1960s that eventually everyone would have fifteen minutes of fame. Long before that, the Duchess of Windsor famously claimed one could never be too rich or too thin. Why do such widespread social values appeal to people?

An economy like ours, based on mass production of goods and services, requires mass consumption of the same goods and services to keep itself going. That requires a rapid turnover of fads and fashions to maintain popular interest in buying such products but what lies behind our willingness to consume the products associated with fads and fashions?

The invisible religion

In 1967, Thomas Luckmann wrote in the book of the same name that contemporary individualism contains elements that form an invisible religion, in the sense that the faith is not in an afterlife but in the individual life’s potential. He associated the modern western emphasis on self-fulfilment with social mobility, sexual liberation and the nuclear family.

If a person’s objective marginality in society is evident from external social controls – just think of all the hanging offences set out in early nineteenth-century law, when a poor person could be put to death for lots of different crimes – then subjective marginality is easier to observe if society becomes more free and open. This is because satisfactory personal achievement is not then guaranteed, despite the common message from ads, articles, TV shows and websites that buying the right products will make us, as individuals, successful, glamorous and popular.

Here we must repeat that the nature of mental illness is at times surely influenced by its social setting. For example, though the term is no longer used by the medical profession, hysteria was a blanket termfor conditions such as invalidity without a physical cause. The latter phenomenon is now very rare but it has been convincingly linked to women’s restricted lives in the nineteenth century (see Sulloway 1980: 59).

Furthermore, in the twentieth century, in concentration camps, mental illnesses were cured or their symptoms vanished because people did not have the time or space to be ill in such terrible circumstances. The Auschwitz survivor Primo Levi makes this point abundantly clear in his memoir, The Drowned and the Saved.

Gastric ulcers and mental illnesses were healed (or became asymptomatic) but everyone suffered from an unceasing discomfort that polluted sleep and was nameless. (Levi 1988: 65)

In this light, it can be persuasively argued that eating disorders have increased in frequency in the western world at least in part as compensatory mechanisms. That is to say, their pathological health effects may be perceived by the sufferers to be better than the great dread, which is ‘obesity’ or, more accurately, social undesirability. The same can be said about the rise of cosmetic surgery.

In other words, western societies have fostered unrealistic expectations when it comes to personal achievement emotional gratification (i.e. happiness). In other words, consumers are encouraged to react in an irrational way to the bombardment of ideal images (e.g. of celebrities on holidays or at premieres, or of models in air-brushed magazine and online photos and videos) that are widely and naively believed to be realistic.

The other side of this coin is a massive increase in obesity and sedentary living, especially but not exclusively in the lower socio-economic groups and in English-speaking countries, including Ireland. In December 2010 many newspapers reported the findings of the Association of Public Health Observatories that the English West Midlands, including the large city of Birmingham, was the fattest region in the EU (with 29% of the adult population obese), closely followed by the English North East (28%). In the UK, the prosperous English South East performed best (18%) but this was still a couple of points worse than the worst performing region in Sweden (Daily Mail 15/12/10). The European average was 14%. As for the United States, the situation is unsurprisingly even worse. The National Centre for Health Statistics (Hales et al 2017) found that 39.8% of American adults were obese.

The same pathology thus takes two forms – the ‘body beautiful’ or the body comforted (by eating, which ends up being just another drug). This pathology can be viewed, in a sociological sense, as a consequence of a sanitized society where facts of our human existence such as filth, pain and death are segregated from everyday life by modern plumbing, hospitals and morgues. Just because the average person doesn’t come into regular contact with them, however, does not mean they are no longer real.

Given such prior study and evaluation, it was thus very interesting to read the recent paper by Orben, Dienlin and Pryzbylski that suggested that the effects of social media use on teenage life satisfaction were limited and probably tiny, after a study involving 12,000 UK adolescents. Family, friends and school life all had a greater impact on well-being, claimed the University of Oxford research team. They nonetheless urged social media corporations to release more of their data on usage in order to understand more about the impact of technology on young people’s lives.

This study attempted to answer the question of whether teenagers who use social media more than average have lower life satisfaction or, in contrast, if adolescents with lower life satisfaction consequently use more social media. Past research on the relationship between screens, technology and children’s mental health had often been contradictory, based on limited evidence, the authors claimed. Their study concluded that most links between life satisfaction and social media use were trivial, accounting for less than 1% of a teenager’s wellbeing.

The study, which took place between 2009 and 2017, asked thousands of young people aged 10-15 to say how long they spent using social media on a normal school day and also to rate how satisfied they were with different aspects of their lives. They found more effects of time spent on social media in girls but these were miniscule and no larger than other effects found in boys.

The researchers dismissed the notion that time spent on social media was itself an issue, though, as one may legitimately observe, not least on the back of huge anecdotal evidence, that the problem of screen time’s interference with important activities like sleep, exercise and time with family and friends cannot be ignored. In addition the researchers merely stated it was now important to identify young people at greater risk from certain effects of social media and to find out other factors that were affecting their well-being.

As for the rest of the relevant literature on this topic it did not seem to make much sense to go back further than ten years. The obvious reason is the comparative absence of social media before then. The other is that the Internet was too young in general to identify long-term trends in usage.

Valkenburg and Peter (2009) observed that adolescents were currently the defining users of the Internet. They spent more time online than adults did and they used the Internet for social interaction more often. These authors pointed out that whereas several studies in the 1990s had suggested that Internet use was detrimental, more recent studies had tended to report opposite effects. Valkenburg and Peter offered an Internet-enhanced self-disclosure hypothesis as an explanation for the more positive trends, whereby increased opportunity through technology to share one’s thoughts, feelings and experiences (at least virtually) with others acted to reduce loneliness and alienation.

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As part of an EU-funded SEYLE project, Durkee et al (2012) investigated the prevalence of pathological and maladaptive internet use among adolescents in eleven European countries (Austria, Estonia, France, Germany, Hungary, Ireland, Israel, Italy, Romania, Slovenia and Spain) in relation to demographic, social factors and Internet accessibility. A total of 11,956 adolescents were recruited from randomly-selected schools for the survey.

The highest‐ranked online activities were watching videos, frequenting chat rooms and social networking. Significantly higher rates of playing single‐user games were found in males while social networking stood out among females. Students not living with a biological parent, with low parental involvement and/or parental unemployment showed the highest relative risks of both pathological and maladaptive use. Overall the survey yielded a prevalence of ‘pathological internet use’ of 4.4% among adolescents but that varied by country and sex. Adolescents lacking emotional and psychological support were found to be at the highest risk.

Mills (2014) found that, despite popular claims for the effects of Internet use on the adolescent brain, for example as is commonly seen in the mainstream or traditional media, experimental evidence for this remained scarce. Mills advocated the need for studies to investigate brain measures and their relationship to behaviour, cognition and well-being in a representative sample of the population. These studies should differentiate between different Internet activities. She also pointed out that even if Internet use was impacting the developing brain during adolescence, we should not forget that the brains of adults also remain capable of functional change.

In a BMJ editorial (2015), Bell, Bishop and Przybylski attacked non-peer-reviewed claims by Susan Greenfield, a senior research fellow at Lincoln College, Oxford, that that Internet use and computer games could have harmful effects on the brain, its emotions and consequent behaviour. These claims had again largely been aired in the mainstream media.

With regard to social interaction and empathy, adolescents’ use of social networking sites has been found to enhance existing friendships and the quality of relationships, although some individuals benefit more than others. The general finding is that those who use social networks to avoid social difficulties have reduced well-being, while use of social networks to deal with social challenges improves outcomes. 

The authors further criticised Greenfield for speculating that online interaction might be a “trigger” for autism.

This claim has no basis in scientific evidence and is entirely implausible in light of what we know of autism as a neuro-developmental condition that can be first diagnosed in the pre-school years.

The authors did concede at the same time that valid concerns continued to exist about digital technology.

Rather than technology affecting children’s capacities, the displacement of other activities seems to be an important source of negative effects. Low levels of physical activity associated with the passive use of digital technology have been linked to obesity and diabetes.For video games, the displacement of academic activities, rather than altered cognitive function, has been found to account for reduced school performance. 

Online safety was another important concern they addressed as needing to be understood in its widest sense i.e. the risks of bullying, grooming, sharing of sexual pictures, defamation, fraud and the impact of distressing material. Consequently, they concluded, safety needed to be tackled at individual, community, industry and policy levels.

With regard to the context of sampling in this field, Scharkow (2016) observes that the vast majority of empirical research on online communication relies on self-reporting measures instead of behavioural data. He claims previous research has shown that the accuracy of these self-report measures can be quite low and both over- and under-reporting of use are commonplace.

His study compares self-reports of Internet use with client log files from a large household sample. His results show that the accuracy of self-reported frequency and duration of Internet use is quite low and that survey data are only moderately correlated with log file data. Moreover, there are systematic patterns of misreporting, especially over-reporting, rather than random deviations from the log files.

Nonetheless it is very important to note that Scharkow does still find that self-reports for specific content such as social network sites or video platforms seem to be more accurate and less consistently biased than self-reports of generic frequency or duration of Internet use.

To conclude this review, an August 2019 article by Viner et al in the British medical journal The Lancet addressed what it called a growing concern about the potential associations between social media use and mental health and well-being in young people. Their study explored associations between the frequency of social media use and later mental health and well-being in adolescents. It carried out secondary analyses of publicly available data from the Our Futures study, a nationally representative, longitudinal research project involving 12, 866 young English people aged 13-16.

Broadly in line with the findings of studies we have already examined, it cautiously concluded that mental health “harms” related to very frequent social media use in girls might be due to a combination of exposure to cyber-bullying or displacement of sleep or physical activity, whereas other mechanisms appeared to be operative in boys. Interventions to promote mental health, they advised, should include efforts to prevent or increase resilience to cyber-bullying (ultimately, a social-media policing issue) and to ensure adequate sleep and physical activity in young people.

As we have already seen, the researchers of our key study dismissed the notion that time spent on social media was itself an issue, though, as others have also observed, the issue of screen time’s interference with important activities like sleep, exercise and time with family and friends cannot be dismissed. Most researchers now seem to agree it is now important to identify young people at greater risk from certain effects of social media and to find out other factors that are simultaneously affecting their well-being.

Bibliography

• Amy Orben, A. Dienlin, T. & Przybylski A. K. (2019) “Social media’s enduring effect on adolescent life satisfaction” PNAS 116 (21) 10226-10228. Available at: https://doi.org/10.1073/pnas.1902058116 [Accessed 13 Jul. 2019].
• Bell, V., Bishop, D., & Przybylski, A. K. (2015) “The debate over digital technology and young people” BMJ 351:h3064.
• Durkee, T. et al (2012). Prevalence of pathological internet use among adolescents in Europe: demographic and social factors. [online] Wiley Online Library. Available at: https://doi.org/10.1111/j.1360-0443.2012.03946.x [Accessed 2 Aug. 2019].
• Hales C. M., et al (2017) Prevalence of Obesity Among Adults and Youth: United States, 2015-2016 (PDF) (NCHS data brief, no. 288). Hyattsville, MD: National Centre for Health Statistics [online] Available at: https://www.cdc.gov/nchs/data/databriefs/db288.pdf [Accessed 6 Jul. 2019].
• Levi, P. (1988) The Drowned and the Saved Penguin, Harmondsworth.
• Luckmann, T. (1967) The Invisible Religion MacMillan, London.
• Mills, K. L (2014) “Effects of Internet use on the adolescent brain: despite popular claims, experimental evidence remains scarce” Trends in Cognitive Sciences Vol. 18, Issue 8, August 2014, pp. 385-387. [online] Available at: https://doi.org/10.1016/j.tics.2014.04.011 [Accessed 7 Jul. 2019].
• Scharkow, M. (2016) “The accuracy of self-reported internet use—a validation study using client log data” Communication Methods and Measures Vol. 10, Issue 1, pp. 13–27. Available at: https://doi.org/10.1080/19312458.2015.1118446 [Accessed 20. Jul. 2019]
• Sulloway, F. (1980) Freud, Biologist of the Mind Fontana, London.
• Valkenburg, P. M & Peter, J. (2009) “Social consequences of the Internet for adolescents: a decade of research” Current Directions in Psychological Science, 18 (2009), pp. 1-5
• Viner, R. M. et al (2019) “Roles of cyber-bullying, sleep and physical activity in mediating the effects of social media use on mental health and well-being among young people in England” Available at;  hhttps://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(19)30186-5/fulltext?utm_campaign=PHPfeature&utm_source=PHP&utm_medium=TLChild_socialmedia[Accessed 1. Jul. 2019]