A Report on

Impact Of Social
Media on Youth

By To
Salil Vaidya Prerna Vanjani
2021KUEC2039 Assistant Proffessor
Batch B3 Humanities and Social Sciences
Electronics And Communications Engineering IIIT Kota
IIIT Kota
Indian Institute of Information Technology, Kota
Jaipur, Rajasthan

A Report on
Impact Of Social Media on Youth

By
Salil Vaidya
2021KUEC2039
Batch B3
Electronics And Communications Engineering
IIIT Kota
Preface

Socializing and networking was transformed in the technological era by the introduction of
social networking sites (SNSs). These online sites contain an abundance of information about
individual preferences, interests, types, and frequency of social interactions, etc. However,
scientific studies that have utilized SNS activity data to aid our understanding of mental
health disorders are scarce. This is partly due to the practicalities of accessing SNS data and
methodological issues of large-scale data collection, but also because the construct validity of
SNS measures is unknown. By and large, the literature to date has attempted to link various
SNSs measures to various mental health symptomologies, mostly collected using self-report
measures rather than data generated by SNSs. Although such research has demonstrated some
preliminary and putative associations between SNS activity and mental health measures, the
current literature is still in its infancy and arguably lacks rigor in design, offering limited
insights into its theoretical significance and plausibility. In this review, we will provide an
account of the theoretical importance of using data generated from SNSs in mental health
research and provide a brief overview of the literature published in this area to date.

The world of socializing and networking was reinvented in the technological era by the
introduction of online SNSs and other forms of digital social media such as MySpace, Bebo,
Hi5, Facebook, Twitter, YouTube, Google, Instagram, and Vine. The shift into the digital
online environment has left social networking users with digital footprints that generate a
relatively unique set of identifiers, both in online and offline worlds.

In 2012, Facebook (one such SNS) reached a staggering one billion monthly users meaning
that approximately 1/7th of the world’s population were regular Facebook users. Usage is
especially high among young people. Livingstone et al. reported that 26% of 9- to 10-year-
olds, 49% of 11- to 12-year-olds, 73% of 13- to 14-year-olds, and 82% of 15- to 16-year-olds
have their own profile on an SNS. Moreover, 51% of 13- to 18-year-olds log on to their
online social networking profile at least once a day, 34% log on more than once a day, and
22% check it more than 10 times per day . These figures provide insight into the extremely
popular online culture of SNSs, especially among young people.

Acknowledgements
I would like to express my deepest appreciation to all those who provided me the possibility
to complete this report.  A special gratitude I give to our project  manager, Miss Kritika
Rathore whose contribution in stimulating suggestions and encouragement,  helped me to
coordinate my project especially in writing this report.
Furthermore I would also like to acknowledge with much appreciation the crucial role of the
staff of IIIT Kota Library who gave the permission to use all required  materials to complete
the  research for the project.  A special thanks goes to my batchmates, Shivam Bhargava and
Hardik Nahta who helped me to bring the researched information together.  Last but not least,
many thanks go to the Dr. Prerna Vanjani, who have invested his full effort in guiding us. I
have to appreciate the guidance given by other supervisor as well as the panels especially in
our project presentation that has improved our presentation skills thanks to their comment
and advices.

Table of Elements
 Sr No Topic Pg No.

1 Preface i

2 Acknowledgements ii

3 Introduction 6

4 Description 8

5 Conclusion 15

6 Recommendation 17

7 Bibliography 19

8 Glossary 21

9 References 22

10 Index 24

11 Appendix 25

INTRODUCTION

Social media are responsible for aggravating mental health problems. This systematic study
summarizes the effects of social network usage on mental health. Fifty papers were
shortlisted from databases, and after the application of various inclusion and exclusion
criteria, 16 papers were chosen and all papers were evaluated for quality. Eight papers were
cross-sectional studies, three were longitudinal studies, two were qualitative studies, and
others were systematic reviews. Findings were classified into two outcomes of mental health:
anxiety and depression. Social media activity such as time spent to have a positive effect on
the mental health domain. However, due to the cross-sectional design and methodological
limitations of sampling, there are considerable differences. The structure of social media
influences on mental health needs to be further analyzed through qualitative research and

vertical cohort studies .

Human beings are social creatures that require the companionship of others to make progress
in life. Thus, being socially connected with other people can relieve stress, anxiety, and
sadness, but lack of social connection can pose serious risks to mental health.

Social media has recently become part of people's daily activities; many of them spend hours
each day on Messenger, Instagram, Facebook, and other popular social media. Thus, many
researchers and scholars study the impact of social media and applications on various aspects
of people’s lives [2]. Moreover, the number of social media users worldwide in 2019 is 3.484
billion, up 9% year-on-year [3-5]. A statistic in Figure 1 shows the gender distribution of
social media audiences worldwide as of January 2020, sorted by platform. It was found that
only 38% of Twitter users were male but 61% were using Snapchat. In contrast, females were
more likely to use LinkedIn and Facebook. There is no denying that social media has now
become an important part of many people's lives. Social media has many positive and
enjoyable benefits, but it can also lead to mental health problems. Previous research found
that age did not have an effect but gender did; females were much more likely to experience
mental health than males

Mental health is defined as a state of well-being in which people understand their abilities,
solve everyday life problems, work well, and make a significant contribution to the lives of
their communities . There is debated presently going on regarding the benefits and negative
impacts of social media on mental health. Social networking is a crucial element in protecting
our mental health. Both the quantity and quality of social relationships affect mental health,
health behavior, physical health, and mortality risk . The Displaced Behavior Theory may
help explain why social media shows a connection with mental health. According to the
theory, people who spend more time in sedentary behaviors such as social media use have
less time for face-to-face social interaction, both of which have been proven to be protective
against mental disorders ]. On the other hand, social theories found how social media use
affects mental health by influencing how people view, maintain, and interact with their social
network . A number of studies have been conducted on the impacts of social media, and it has
been indicated that the prolonged use of social media platforms such as Facebook may be
related to negative signs and symptoms of depression, anxiety, and stress . Furthermore,
social media can create a lot of pressure to create the stereotype that others want to see and
also being as popular as others.

Systematic studies can quantitatively and qualitatively identify, aggregate, and evaluate all
accessible data to generate a warm and accurate response to the research questions involved .
In addition, many existing systematic studies related to mental health studies have been
conducted worldwide. However, only a limited number of studies are integrated with social
media and conducted in the context of social science because the available literature heavily
focused on medical science . Because social media is a relatively new phenomenon, the
potential links between their use and mental health have not been widely investigated.
This paper attempt to systematically review all the relevant literature with the aim of filling
the gap by examining social media impact on mental health, which is sedentary behavior,
which, if in excess, raises the risk of health problems . This study is important because it
provides information on the extent of the focus of peer review literature, which can assist the
researchers in delivering a prospect with the aim of understanding the future attention related
to climate change strategies that require scholarly attention. This study is very useful because
it provides information on the extent to which peer review literature can assist researchers in
presenting prospects with a view to understanding future concerns related to mental health
strategies that require scientific attention. The development of the current systematic review
is based on the main research question: how does social media affect mental health?

DESCRIPTION
Although there has been some limited and preliminary work on the relationship between
SNSs and mental health, there appears to be a scarcity of mental health literature that extracts
large-scale data from SNSs in an attempt to better understand mental health disorders.
Literature does exist that employs self-report questionnaires to gather data about SNS usage.
This is important because it provides rationale for future research using data generated by
SNSs. SNSs have the potential to produce data on hundreds of thousands, if not millions of
people from different parts of the world. Although such large datasets have the potential to
produce spurious associations [e.g.,], these can be dealt with using hypothesis-driven
statistical analysis. Furthermore, SNSs usage data can be easily shared with other researchers
and so would move forward the drive to share datasets in an effort to replicate research and
reduce the number of false positives.
Using relatively small sample sizes (n > 500) and self-report methods of Facebook use, some
research studies have found that various parameters on Facebook (e.g., friend count, social
support, and time spent on Facebook) related to depressive symptoms or well-being; although
this is not entirely supported. Researchers have also found that various Facebook parameters
such as status updates were able to predict depressive symptoms. Additionally, Good et al
found that looking back over old posts and photos on a user’s own profile had a positive
effect on well-being and that reminiscing had more of a positive effect on well-being for
those who had mental health problems in the past compared to those with no previous mental
health problems. More recently, Frison and Eggermont found that passive Facebook use
(consuming other peoples information without interacting with them) was associated with
depressed mood in girls and active public Facebook use (interacting with other friends such
that the interactions are visible to others, e.g., status updates) was associated with depressed
mood in boys.

Other than the predominantly cross-sectional studies, a limited number of research studies
use stronger research designs such as longitudinal and experimental. Longitudinal studies
have an advantage over cross-sectional work in that they allow for an exploration into change
over time, causality, and the association between variables at different time points. For
example, Kross et al., over a period of 2 weeks, investigated the relationship between
Facebook use and subjective well-being five times a day. They found that increased use of
Facebook at one time-point predicted lower well-being at the next time point. Also by text
messaging participants, Verduyn et al. found that passive Facebook use (consuming
information from Facebook without interacting with other users) was associated with lower
well-being. Furthermore, an experimental study by Sagioglou and Greitemeyer asked
participants about their well-being immediately after Facebook use and found that longer use
predicted lower mood. This finding is particularly relevant as it implies causality as Facebook
use was measured directly prior to well-being.

There is considerable variability in the quality of the work that has been produced using self-
report methods of SNS usage and mental health. One of the main reasons for this is due to the
lack of validity in some of the reported measures. For example, Burke et al. found that there
was a significant correlation between self-report friend count and actual friend count (r =
0.96) and also between self-report time spent on Facebook and actual time spent on Facebook
(r = 0.45). Junco also investigated the difference between actual Facebook use (monitored by
computer monitoring software) and self-reported use. Although time spent on Facebook was
correlated for the two measures (r = 0.6), there was a significant difference between them.
That is, participants overestimated the time spent on Facebook (mean difference = 123 min
per day). It may be that self-report is a more reliable measure for simple measures such as
friend count but when looking at more complex measures it becomes less reliable.

Very few studies have taken a computational approach to utilizing Facebook parameters.
Kosinski et al. used the Facebook “like” feature, which allows users to specify what he/she
likes or has an interest in (e.g., type of music, music bands, movies, interests, past times,
places, etc.). Participants consented for researchers to extract data about their profile that is
automatically collected by Facebook. These researchers found that what someone “likes” on
Facebook can be used to predict, with a relatively high degree of accuracy, his/her sexual
orientation (0.88), race (0.95), and voting preferences (0.85). There are only a few studies in
mental health research, which have used more complex online behavior traits generated by
SNS data. For example, Burke et al. and Burke et al. discuss the concept of social support and
how it can be measured through Facebook behaviors such as the type and frequency of the
content produced and consumed. This is important because increased social support has been
linked to a decrease in depressive symptoms [e.g., Brown et al.]. An interesting example of
online data (not generated by SNSs) is given by Ayers et al. who found that Google searches
for certain mental health disorders varied by the seasons of the year.

It is not possible to reach any conclusions based on the limited amount of literature in relation
to mental health research. However, this is a very important area to examine in much greater
detail. Lessons can be learned from Facebook research in psychological and social science
contexts and used in designs for mental health research.

Concerns about social media effects on mental health are often presented in stark terms. For
instance, a recent press release of the American Association of Suicidology stated “…we do
know that social media—in all forms—can have a significant impact on mental health,
especially for young people.” Likewise, based on survey data from a large sample of
adolescents in 2017, the Royal Society for Public Health reported evidence for links between
social media use and mental health issues. However, that report was criticized by some
scholars for crude design, inconsistent results being overstated, and potential for demand
characteristics (participants guessing the study hypotheses and responding
accordingly) causing spurious results.

Many who are concerned about social media use point back to a 2011 report by the American
Academy of Pediatrics (AAP) who claimed “Facebook Depression” could develop among
youth who used social media too long. However, the report itself became controversial when
it was revealed that the AAP relied primarily on erroneous news reports rather than primary
sources to document their claims. One scholar—whose work was reported in a newspaper
article and on which AAP had relied--specifically disavowed that her research could be used
to support contentions of a Facebook Depression. Thus, common issues with public
overstatements of research results by advocacy groups have clouded the picture.

Research results from individual studies regarding social media impacts on mental health
have, in fact, been mixed. Although much of the public narrative on the effects of social
media implies that mere exposure is related to mental health issues, the best evidence
suggests that quality rather than quantity of use is more crucial. For instance, research
indicates that one mechanism is the use of social media for negative social comparison
which, alongside rumination, leads to later depression. By contrast, other research has found
that positive use of social media, such as through authentic self-presentation, is associated
with positive well-being in users . The idea that how one uses social media may be more
crucial than mere exposure differs from much of the warning-focused public dialogue and
appears worthy of further consideration.

On one hand, past evidence suggests rumination reflects psychopathology, whereas

authenticity is considered to be a positive quality. With that in mind, one phenomenon that
has received little research interest thus far is vague booking. Vague booking refers to social
media posts that contain little actual and clear information, but are worded in such a way as to
solicit attention and concern from readers (e.g. “Sometimes I just feel like…I don’t know,
sigh…”). Vague booking may be considered a form of “cry for help” insofar as such
behaviors are designed to elicit expressions of concern from others. In this sense, vague
booking may be viewed as both rumination as well as the absence of authentic self-
presentation (given the vagueness and potential manipulativeness of such comments). It is
possible, then, that vague booking could serve as a warning behavior for individuals who may
be experiencing some mental health issues in the context of social media use.

The Present Study

The present study seeks to expand upon previous research by examining links between social
media use and mental health related outcomes in a large sample of young adults. The results
of this study will contribute to the literature by examining several aspects of social media use
as well as multiple outcomes while controlling for theoretically relevant “third” variables.

Social Media Usage

Social media use involves several different aspects, each of which is important in different
ways. Confusion between different aspects of social media usage can result in confusion in
how research results have been communicated to the general public. The first aspect is mere
exposure or time spent with social media. Past research has indicated that mere exposure is a
poor indicator of mental health. However, it will be included here given continued public
claims that mere exposure is associated with decreased mental health.

Second, the importance of social media to an individual is a second component of social

media usage. Different individuals may consider social media use to be more to their core
motivations than casual users as theorized by Self Determination Theory [15]. Last, the
specific behavior of vague booking also will be measured and included for analysis.

Mental Health
Several behavioral indicators of mental health and well-being will be considered as
outcomes. These will include general mental health symptoms as well as outcomes that have
been theorized to be linked to social media use. These latter variables will include suicidal
ideation, social anxiety, loneliness, and decreased empathy.

Control Variables
It is now recognized that, for media effects research, it is essential to include theoretically
relevant control variables. For the present study, control variables will include gender
because women and men may differ with respect to both social media usage and mental
health issues. Histrionic personality symptoms will be included, given that such symptoms
may be related to vague booking behaviors as well as mental health symptoms. Indicators of
social functioning among friends in real life, perceived social support, and conflict with
parents and need to belong will also be included. Last, a measure of social desirability will be
included to control for this type of response set.
Methods

Participants
The sample consisted of 471 undergraduate students attending a university from the
southeastern region of the United States. Data from four participants were excluded from data
analysis due to incomplete responses to at least 20% of items on the questionnaires, thus
rendering our final sample size to 467 (335 females; 130 males; 2 unanswered). Their mean
age (yrs.) was 19.66 (SD = 3.92). Regarding ethnicity, participants self-identified as 60.2%
White, 16.5% Latino/a or Hispanic, 10.1% African American or Black, 6.6% Asian
American, and 6.2% other.

Measures
Unless indicated otherwise below, all measures used Likert-scale items.

General/Demographic Information
Participants self-reported their age, gender, ethnicity, current grade-point-average (GPA), and
time spent (face-to-face) with friends.

Vague booking
Three questions for this study assessed vague booking behavior. A sample item was, “I post
social networking updates that prompt friends to ask me what is going on.” Based on this
sample of participants, this scale had acceptable reliability (Cronbach alpha = .79).

Time Spent on Social Media

Exposure to social media was measured with a single-question to which participants
estimated how many hours they spent during an average day on social media with friends.

Social Media Importance

To assess the degree to which participants were emotionally connected to social media use,
participants completed the Social Media Use Integration Scale (SMUIS). The SMUIS
consists of 10 items assessing the emotional value of social media in their lives (sample item:
“I prefer to communicate with others mainly through social networking websites.”) Based on
this sample of participants, the SMUIS had acceptable reliability (Cronbach alpha = .90).

Mental Health Symptoms

The Brief Symptoms Inventory-18 (BSI-18) assesses three dimensions of psychological
distress: somatization, depression, and anxiety. For this study, a total score (the global
severity index [GSI]) calculated based on a summation of all three subscales. Based on this
sample of participants, the BSI-18 had acceptable reliability (Cronbach alpha = .90).
Social Support
To assess participants’ perceived social support from family, friends, and significant others,
they completed the Multidimensional Scale of Perceived Social Support (MSPSS).The
MSPSS consists of 12 statements. Based on this sample of participants, the MSPSS had
acceptable reliability (Cronbach alpha = .93).

Parent-Child Relationship
To measure participants’ perceptions of the quality of their relationship with their parents,
participants completed the nine items constituting the Parent-Child Conflict component of the
Family Dysfunction subscale from the Personality Inventory for Youth (PIY). Based on this
sample of participants, the Parent-Child Conflict scale had acceptable reliability (Kuder-
Richardson alpha = .82).

Social Anxiety
To assess social anxiety, participants completed the Liebowitz Social Anxiety Scale-Self-
Report Version (LSAS-SR). The LSAS-SR consists of 24 statements. Based on this sample of
participants, the LSAS-SR had acceptable reliability (Cronbach alpha = .90).

Histrionic Symptoms
To assess symptoms consistent with the Histrionic Personality Disorder (attention-seeking
and seductiveness), participants completed the Brief Histrionic Personality Scale (BHPS).
The BHPS consists of 11 statements. Based on this sample of participants, the BHPS had
acceptable reliability (Cronbach alpha = .81).

Needing to Belong
To assess participants’ need for belonging to a social group(s), they completed the Need to
Belong scale (NTB). The NTB consists of 10 statements. Based on this sample of
participants, the NTB had acceptable reliability (Cronbach alpha = .80).

Loneliness
To assess loneliness, participants completed the UCLA Loneliness Scale-3 (UCLALon-3 ).
The UCLALon-3 consists of 20 statements. Based on this sample of participants, the
UCLALon-3 had acceptable reliability (Cronbach alpha = .93).

Empathy
To assess participants’ ability to experience empathy, they completed the Interpersonal
Reactivity Index (IRI]). The IRI is composed of 4 subscales that measure distinct cognitive
and affective aspects of empathy. For our study, we only administered the empathy-concern
subscale because we deemed it to be the most applicable to our study’s purpose (assessing
compassion and concern for others). This subscale consists of 7 statements. Based on this
sample of participants, the IRI had acceptable reliability (Cronbach alpha = .80).
Socially Desirable Responding
To assess participants’ tendency to respond to items in a way that portrays them favorably,
participants completed the Marlowe-Crowne Social Desirability Scale – Short Form (M-C
SDS-SF). The 13-item M-C SDS-SF is an abbreviated version of the M-C SDS. Respondents
indicate their level of agreement to the statements using a true-false format. Based on this
sample of participants, the M-C SDS-SF had acceptable reliability (Kuder-Richardson
alpha = .69).

Statistical Analyses
Separate regression analyses were run for outcomes related to total mental health symptoms
(BSI), suicidal thoughts, social anxiety, loneliness and anxiety. Most analyses were
conducted with hierarchical multiple regression using pairwise deletion for missing data. Age
and gender were entered on the first step, school grades, time spent with friends in real life
(FRL), parent/child conflict, BHPS, NTB, perceived social support and social desirability on
the second step. The third step included social media variables of time online, vague booking
and social media importance. Because suicidal thoughts were non-normal in distribution,
similar analyses were run using Poisson regression.

CONCLUSION
Table 1 presents the results for all regression equations. Note that Poisson regressions are
non-hierarchical, thus ΔR 2 is not reported for this regression. Multicollinearity issues were
absent with all VIF data well below 2.0. Estimates are reported in terms of standardized
regression coefficients aside from the Poisson regression, for which Wald Chi-square is
reported.

Results indicated that social media variables were poor predictors of negative outcomes.
Exceptions were that vague booking slightly predicted both loneliness and suicidal thoughts.
Time spent online was not a predictor of any outcome, nor was social media importance.

Among other predictors, social desirability was consistently associated with less reporting of
negative symptoms as expected. Social support was a consistent protective factor for all
negative outcomes, including suicidal thoughts. Perceived parent/child conflict was predicted
mental health symptoms, suicidal thoughts and loneliness. Need to belong was associated
with most negative outcomes, aside from increased empathy and aside from suicidal
thoughts. Histrionic personality traits were actually protective for social anxiety and
loneliness, likely given the outgoing nature of such individuals, and were not associated with
other mental health problems.

Discussion
Whether social media is responsible for mental health problems among young individuals
remains an area of contention. Our study examined several aspects of social media use among
young adults and their relationship with various mental health problems including loneliness,
suicidal thoughts, decreased empathy, social anxiety and overall mental health. Our results
revealed that, overall, social media use is a poor predictor of mental health problems and
concerns about social media precipitating a mental health crisis may be unwarranted. The
exception was vague booking, which predicted loneliness and suicidal thoughts. It is possible
that some forms of social media use may function as a ‘cry for help’ among individuals with
preexisting mental health problems.

Our results are generally consistent with previous work] which suggests that how individuals
use social media is more critical than time spent online in regards to mental health. Other
research has identified some characteristics of negative social media use which may be
causative of further problems] and our research adds the dimension of vague booking which
may be a sequelae of preexisting mental health problems and potentially serve as an
identifiable risk marker for those problems.

Among other issues identified in this paper, perceived parent/child conflict appears to be one
of the stronger predictors of many mental health issues. Need to belong is also associated
with many problems (aside from increased empathy, though this may reflect an over-
eagerness to identify with others to gain their approval). By contrast, perceived social support
is a consistent protective factor.

Why the popular press, suicide advocates and policy makers continue to hone in on time
spent online as a cause of mental health problems is an interesting question, particularly
given lack of clear evidence for this relationship. It is possible that social media use may be
experiencing the effects of moral panic common to many forms of media such as video
games, comic books and rock music (all of which have also been blamed for mental health
problems.) We do not disregard the potential for some online behaviors to be associated with
mental health problems, rather propose that research focus on the behavior of individuals
rather than assuming media is the root cause of all socio-personal problems.
 RECOMMENDATION
 As we consider future research directions, the near ubiquitous social media use also
yields new opportunities to study the onset and manifestation of mental health
symptoms and illness severity earlier than traditional clinical assessments.
 There is an emerging field of research referred to as “digital phenotyping” aimed at
capturing how individuals interact with their digital devices, including social media
platforms, in order to study patterns of illness and identify optimal time points for
intervention (Jain et al. 2015; Onnela and Rauch 2016).
 Given that most people access social media via mobile devices, digital phenotyping
and social media are closely related (Torous et al. 2019). To date, the emergence of
machine learning, a powerful computational method involving statistical and
mathematical algorithms (Shatte et al. 2019), has made it possible to study large
quantities of data captured from popular social media platforms such as Twitter or
Instagram to illuminate various features of mental health (Manikonda and De
Choudhury 2017; Reece et al. 2017).
 Specifically, conversations on Twitter have been analyzed to characterize the onset of
depression (De Choudhury et al. 2013) as well as detecting users’ mood and affective
states (De Choudhury et al. 2012), while photos posted to Instagram can yield insights
for predicting depression (Reece and Danforth 2017). The intersection of social media
and digital phenotyping will likely add new levels of context to social media use in
the near future.
 Several studies have also demonstrated that when compared with a control group,
Twitter users with a self-disclosed diagnosis of schizophrenia show unique online
communication patterns (Birnbaum et al. 2017a), including more frequent discussion
of tobacco use (Hswen et al. 2017), symptoms of depression and anxiety (Hswen et
al. 2018b), and suicide (Hswen et al. 2018a).
 Another study found that online disclosures about mental illness appeared beneficial
as reflected by fewer posts about symptoms following self-disclosure (Ernala et
al. 2017). Each of these examples offers early insights into the potential to leverage
widely available online data for better understanding the onset and course of mental
illness.
 It is possible that social media data could be used to supplement additional digital
data, such as continuous monitoring using smartphone apps or smart watches, to
generate a more comprehensive “digital phenotype” to predict relapse and identify
high-risk health behaviors among individuals living with mental illness (Torous et
al. 2019).
 With research increasingly showing the valuable insights that social media data can
yield about mental health states, greater attention to the ethical concerns with using
individual data in this way is necessary (Chancellor et al. 2019).
 For instance, data is typically captured from social media platforms without the
consent or awareness of users (Bidargaddi et al. 2017), which is especially crucial
when the data relates to a socially stigmatizing health condition such as mental illness
(Guntuku et al. 2017).
 Precautions are needed to ensure that data is not made identifiable in ways that were
not originally intended by the user who posted the content as this could place an
individual at risk of harm or divulge sensitive health information (Webb et al. 2017;
Williams et al. 2017).
 Promising approaches for minimizing these risks include supporting the participation
of individuals with expertise in privacy, clinicians, and the target individuals with
mental illness throughout the collection of data, development of predictive algorithms,
and interpretation of findings (Chancellor et al. 2019).
 In recognizing that many individuals living with mental illness use social media to
search for information about their mental health, it is possible that they may also want
to ask their clinicians about what they find online to check if the information is
reliable and trustworthy.

 Alternatively, many individuals may feel embarrassed or reluctant to talk to their

clinicians about using social media to find mental health information out of concerns
of being judged or dismissed. Therefore, mental health clinicians may be ideally
positioned to talk with their patients about using social media and offer
recommendations to promote safe use of these sites while also respecting their
patients’ autonomy and personal motivations for using these popular platforms.

 Given the gap in clinical knowledge about the impact of social media on mental
health, clinicians should be aware of the many potential risks so that they can inform
their patients while remaining open to the possibility that their patients may also
experience benefits through use of these platforms.

 As awareness of these risks grows, it may be possible that new protections will be put
in place by industry or through new policies that will make the social media
environment safer. It is hard to estimate a number needed to treat or harm today given
the nascent state of research, which means the patient and clinician need to weigh the
choice on a personal level. Thus, offering education and information is an important
first step in that process.

BIBLIOGRAPHY
1. Mohamad M, Juahir H, Ali NAM, Kamarudin MKA, Karim F, Badarilah
N: Developing health status index using factor analysis. J Fund Appl. 2017, 9:83-
92. 10.4314/jfas.v9i2s.6

2. Bartosik-Purgat M, Filimon N, Kiygi-Calli M: Social media and higher education: An

international perspective. Econ Sociol. 2017, 10:181-191. 10.14254/2071-
789X.2017/10-1/13

3. Digital News Report. (2019). Accessed: March 15,

2020: http://www.digitalnewsreport.org/.

4. Petrosino A, Boruch RF, Soydan H, Duggan L, Sanchez-Meca J: Meeting the

challenges of evidence-based policy: the Campbell collaboration. Ann Am Acad Pol
Soc Sci. 2001, 578:14-34. 10.1177/000271620157800102

5. Kim HH: The impact of online social networking on adolescent psychological well-

being (WB): a population-level analysis of Korean school-aged children. Int J
Adolesc Youth. 2017, 22:364-376. 10.1080/02673843.2016.1197135

6. Iannotti RJ, Janssen I, Haug E, et al.: Interrelationships of adolescent physical

activity, screen-based sedentary behavior, and social and psychological health. Int J
Public Health. 2009, 54:191-198. 10.1007/s00038-009-5410-z

7. Muris P, Steerneman P: The revised version of the Screen for Child Anxiety Related
Emotional Disorders (SCARED‐R): first evidence for its reliability and validity in a
clinical sample. Br J Clin Psychol. 2001, 40:35-44.

8. The World health report: 2004: changing history. (2004). Accessed: March 10,
2020: https://www.who.int/whr/2004/en/.

9. Martinsen EW: Physical activity in the prevention and treatment of anxiety and

depression. Nord J Psychiatry. 2008, 62:25-29. 10.1080/08039480802315640

10. Berryman C, Ferguson C, Negy C: Social media use and mental health among young
adults. Psychiatr Q. 2018, 89:307-314. 10.1007/s11126-017-9535-6

11. Coyne SM, Rogers AA, Zurcher JD, Stockdale L, Booth M: Does time spent using
social media impact mental health?: An eight year longitudinal study. Comput Hum
Behav. 2020, 104:106160. 10.1016/j.chb.2019.106160

12. Escobar-Viera C, Whitfield D, Wessel C, et al.: For better or for worse? A systematic

review of the evidence on social media use and depression among lesbian, gay, and
bisexual minorities. JMIR Ment Health. 2018, 5:10496.

13. Rahman NI, Ismail S, Seman TNAT, et al.: Stress among preclinical medical students
of University Sultan Zainal Abidin. J Appl Pharm Sci. 2013, 3:76-81.

14. O'Reilly M, Dogra N, Hughes J, Reilly P, George R, Whiteman N: Potential of social

media in promoting mental health in adolescents. Health Promot Int. 2018, 34:981-
991.
 15. O’Reilly M, Dogra N, Whiteman N, Hughes J, Eruyar S, Reilly P: Is social media bad
for mental health and wellbeing? Exploring the perspectives of adolescents. Clin
Child Psychol Psychiatry. 2018, 23:601-613. 10.1177/1359104518775154

16. O’Reilly M: Social media and adolescent mental health: the good, the bad and the
ugly. J. Ment. Health. 2020, 1:7. 10.1080/09638237.2020.1714007

17. Feder KA, Riehm KE, Mojtabai R: Is there an association between social media use
and mental health? the timing of confounding measurement matters—reply [Online
ahead of print]. JAMA Psychiatry. 2019, 10.1001/jamapsychiatry.2019.4499

18. Karim F, Mohamad M, Muhammad N: Mental health mediate social support to

predict quality of life among drug-abuse inmates. Indian J Public Health Res Dev.
2019, 10:776-781. 10.5958/0976-5506.2019.00797.6

19. Rasmussen E, Punyanunt-Carter N, LaFreniere J, Norman M, Kimball T: The serially

mediated relationship between emerging adults’ social media use and mental well-
being. Comput Hum Behav. 2020, 102:206-213. 10.1016/j.chb.2019.08.019

20. Keles B, McCrae N, Grealish A: A systematic review: the influence of social media
on depression, anxiety and psychological distress in adolescents. Int J Adolesc Youth.
2019, 25:79-93. 10.1080/02673843.2019.1590851

21. Nereim C, Bickham D, Rich M: Social media and adolescent mental health: who you
are and what you do matter. J Adolesc Health. 2020, 66:118-
119. 10.1016/j.jadohealth.2019.11.237

22. Mehmet M, Roberts R, Nayeem T: Using digital and social media for health
promotion: a social marketing approach for addressing co-morbid physical and mental
health. Aust J Rural Health. 2020, 1:1-10. 10.1111/ajr.12589

23. Odgers CL, Jensen MR: Adolescent mental health in the digital age: facts, fears, and
future directions. J Child Psychol Psychiatry. 2020, 61:336-348. 10.1111/jcpp.13190

24. Twenge J, Martin G: Gender differences in associations between digital media use
and psychological well-being: evidence from three large datasets. J Adolesc. 2020,
79:91-102. 10.1016/j.adolescence.2019.12.018

GLOSSARY
Facebook  a popular free social networking website that enables users to share information
and photos and keep in touch with family and friends.

Social networking sites an online platform that allows users to create a public profile and
interact with other users
 Mental health a person’s condition with regard to their psychological and emotional well-
being.

Psychiatry the study and treatment of mental illness

Friendship a relationship between people who are friends

Depression a common and serious medical illness that negatively affects how you feel, the
way you think and how you act.

Vague booking the practice of making a post on social media, primarily Facebook, that is
intentionally vague but highly personal and emotional.

Suicide death caused by injuring oneself with the intent to die. A suicide attempt is when
someone harms themselves with any intent to end their life, but they do not die as a result of
their actions.

Empathy the ability to imagine how another person is feeling and so understand his/her
mood

Social media a computer-based technology that facilitates the sharing of ideas, thoughts, and
information through virtual networks and communities

Adolescent a young person who is no longer a child and not yet an adult, between the ages
of about 13 and 17

Youth the period of your life when you are young, especially the time before a child
becomes an adult

Harassment unwanted behavior, physical or verbal (or even suggested), that makes a
reasonable person feel uncomfortable, humiliated, or mentally distressed.

Body Image how an individual sees their own body and how attractive they feel themselves
to be.

Symptoms a change in your body that is a sign of illness

REFERENCES
1. Lee, D. Facebook Surpasses One Billion Users as it Tempts New Markets. BBC News.
(2012).

2. Livingstone S, Haddon L, Gorzig A, Olafsson K. Risks and Safety on the Internet: The
Perspective of European Children: Full Findings. London: LSE, EU Kids Online (2011).
 3. Common sense media. Is Social Networking Changing Childhood? San Francisco, CA
(2009).

4. Fan X, Miller BC, Park E, Winward B, Christensen M, Grotevant HD, et al. An exploratory
study about inaccuracy and invalidity in adolescent self-report surveys. Field
Methods (2006) 18(3):223–44. doi: 10.1177/152822X06289161

5. Back MD, Stopfer JM, Vazire S, Gaddis S, Schmukle SC, Egloff B, et al. Facebook profiles
reflect actual personality, not self-idealization. Psychol Sci (2010) 21:372–4.
doi:10.1177/0956797609360756

6. Wilson RE, Gosling SD, Graham LT. A review of Facebook research in the social
sciences. Perspect Psychol Sci (2012) 7(3):203–20. doi:10.1177/1745691612442904

7. Buffardi LE, Campbell WK. Narcissism and social networking web sites. Pers Soc Psychol
Bull (2008) 34:1303–14. doi:10.1177/0146167208320061

8. Sweney M. Facebook Quarterly Report Reveals 83m Profiles are Fake. The
Guardian (2012

9. Kosinski M, Stillwell D, Graepel T. Private traits and attributes are predictable from digital
records of human behavior. Proc Natl Acad Sci U S A (2013) 110:5802–5.
doi:10.1073/pnas.1218772110

10. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustün TB. Age of onset of
mental disorders: a review of recent literature. Curr Opin Psychiatry (2007) 20:359–64.
doi:10.1097/YCO.0b013e32816ebc8c

11. Ginsberg J, Mohebbi MH, Patel RS, Brammer L, Smolinski MS, Brilliant L. Detecting
influenza epidemics using search engine query data. Nature (2009) 457:1012–4.
doi:10.1038/nature07634

12. Kim J, Lee J-ER. The Facebook paths to happiness: effects of the number of Facebook
friends and self-presentation on subjective well-being. Cyberpsychol Behav Soc
Netw (2011) 14:359–64. doi:10.1089/cyber.2010.0374

13. Pantic I, Damjanovic A, Todorovic J, Topalovic D, Bojovic-Jovic D, Ristic S, et al.

Association between online social networking and depression in high school students:
behavioral physiology viewpoint. Psychiatr Danub (2012) 24:90–3.

14. Rosen LD, Whaling K, Rab S, Carrier LM, Cheever NA. Is Facebook creating “iDisorders”?
The link between clinical symptoms of psychiatric disorders and technology use, attitudes
and anxiety. Comput Human Behav (2013) 29:1243–54. doi:10.1016/j.chb.2012.11.012
15. Wright KB, Rosenberg J, Egbert N, Ploeger NA, Bernard DR, King S. Communication
competence, social support, and depression among college students: a model of Facebook
and face-to-face support network influence. J Health Commun (2013) 18:41–57.
doi:10.1080/10810730.2012.688250

INDEX

Adolescent...............................................................................................................................18, 19

Body Image...................................................................................................................................

Depression..........................................................................................................................8, 19, 24

Empathy..................................................................................................................................12, 19

Friendship.....................................................................................................................................

Harassment...................................................................................................................................

Mental health.....................................................................................................................5, 18, 19

Psychiatry...................................................................................................................17, 18, 19, 20

Social media..............................................................................................................5, 9, 17, 18, 19

Suicide...........................................................................................................................................

Symptoms...............................................................................................................................11, 19

Vaguebooking.....................................................................................................................9, 10, 19

Youth.......................................................................................................................0, 11, 17, 18, 19

APPENDIX

It can be expected that future research regarding the potential effects of online social
networking on mental health is going to be faced with numerous difficulties. First, so far,
many authors investigating this issue have used a cross-sectional study approach in their
methodology, followed by correlation analysis. The existence of a correlation does not
necessarily equal causality. For example, Facebook and self-esteem may be related in terms
of Facebook usage, causing lower self-esteem, but this may also mean that people with low
self-esteem use Facebook more often. In other words, it is very difficult, and sometimes
impossible, to conclude which variable is the cause and which is the effect. In the future,
longitudinal designs would be much more helpful in determining the effects of SNS use on
mental health. Ultimately, the data obtained from experimental studies would enable us to
draw definite conclusions on this relationship.

It should be noted that most of the research done so far on social networking and mental
health was done on a healthy population (i.e., high school students, university students,
adolescents in general). When it is stated that, for example, “time spent on social networking
is related to depression,” the authors usually mean that this time correlates with physiological
mood oscillations (measured with various psychological scales), rather than depression as a
clinical entity. In fact, to our knowledge, no research of this sort has so far been conducted on
psychiatric patients. Therefore, a possible connection between social networking and mental
health issues can only be discussed in terms of normal physiological (psychophysiological)
variations of psychic functions.

We should always have in mind that not all of the social networks are the same. The largest
and most popular SNS, Facebook, is based on creating and updating personal profiles, where
users can upload photos, videos, comments, statuses, and notes. Another popular SNS,
Twitter, is based on a different concept: users post and read short text messages (“tweets”) in
which they express their thoughts and opinions. Most of the studies mentioned in this text
have been focused on Facebook as the predominant SNS, and even in the studies where
authors in the title state the term “social networking,” in most cases, Facebook is the primary
target of investigation. In fact, after searching the available scientific databases, we were
unable to find a single study that was primarily focused on Twitter and its potential impact on
mental health. In the future, it can be expected that Twitter will also become the subject of
many research efforts.

Many studies simply do not test various potential confounding factors that may influence
conventional correlation in terms of enhancing or reducing it. For example, it may well be
possible that people with some personality disorders (which are quite frequent and often
undiagnosed) spend much more time on online social networks compared to the general
population because computer-mediated communication enables them to be socially more
successful. These individuals, if included in a research study, will probably influence the
results of self-esteem, depression, addiction, and other questionnaires. In other words, any
future study on this topic, in order to meet quality standards, will need to have established
precise inclusion and exclusion criteria in order to make the study sample as homogenous as
possible. These criteria are often difficult to define and even more difficult to implement, so
the other possible approach would be to use a large study sample. This would also have to be
combined with additional statistical tests such as multivariate regression analysis.

Most of the research on social networking and mental health has so far been performed using
conventional psychiatric questionnaires, such as the above-mentioned Rosenberg Self-Esteem
Scale, the Beck Depression Inventory, and others. Today, it is not uncommon that for
assessment of the same psychiatric sign/symptom, several different scales exist. For example,
for quantification of depressive symptoms, the researcher may choose between scales such as
the Beck Depression Inventory, the Centre for Epidemiological Studies—Depression Scale
(CES-D), the Hamilton Rating Scale for Depression (HAM-D), the Zung Self-Rating
Depression Scale, the Montgomery–Åsberg Depression Rating Scale (MADRS), and so on.
Although these scales are established tools in psychology and psychiatry research, sometimes
when designing a study, it is difficult to determine which scale has the best sensitivity for the
given population/study sample. This may be especially the case when being used in the
general population or in different age groups such as high school students, university
students, and so on. In the future, there may be a need to design and implement novel,
advanced scales that would be adjusted to evaluate potential mental problems in light of the
rapid development of information technology, or at least to compare the existing ones in
terms of establishing a set of recommendations for their application in these new conditions.
In conclusion, it is clear that during the past 10 years, online social networking has caused
significant changes in the way people communicate and interact. It is unclear, however,
whether some of these changes affect normal aspects of human behavior and cause
psychiatric disorders. In the future, additional research will be needed to identify and describe
the potential relationship between the use of SNS and various mental health issues.