UNIVERSITY OF NEW YORK IN PRAGUE

Department of Psychology

Depression and Anxiety Levels Related to The Use of Social Media

During The COVID-19 Pandemic

Master’s Thesis

Supervisor: Submitted by:

Simon Weissenberger Ph.D. Anastassiya Taisumova

Prague 2021
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Declaration

I hereby declare that I wrote this thesis individually based on literature and resources

stated in the reference’s section.

Date: 10.05.2021 Signature:

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Acknowledgments

I would like to thank the people who supported me throughout my years of

education. This was a challenging experience for me. The most unexpected event

Covid-19 Pandemic forced many people to change their plans and the way of life. I was

not an exception. Despite all the difficulties that I had to face tin the last year, I

successfully finished my work. However, it would not be possible without the warm

support of my family and friends. Therefore, I would like to thank them for cheering me

up when I felt hopeless, for helping me believe in myself, for helping me to find the

strength, and for simply being there for me. I would also like to thank my supervisor

Simon Weissenberger Ph.D. for his helpful advice and support during the work on my

thesis.
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Table of Contents

Abstract……….……………………………………………………………………... 6
Chapter I Introduction……………………………………………………………. 7

Chapter II Literature Review……………………………………………………… 10

2.1 Social Media...........................…………………………………….. 10
2.1.1 Social Media Definition.............................................................. 10
2.1.2 Web 2.0………………............................................................... 11
2.1.2.1 Electronic word-of-mouth.................................................... 13
2.1.2.2 Consumer-generated content................................................. 14
2.1.3 Social Network Sites…............................................................... 16
2.1.4 Digital Natives…….…............................................................... 17
2.1.5 Social Media Use……................................................................ 18
2.1.5.1 Measures of Social Media Use……..................................... 19
2.1.5.1.1 Daily Time Spent on Social Media……......................... 19
2.1.5.1.2 Frequency Spent on Social Media……........................... 20
2.1.5.1.3 Multiple Platform Use………….……........................... 20
2.1.5.1.4 Problematic Social Media Use….……........................... 21
2.1.5.1.5 Social Media Intensity………….……........................... 21
2.1.6 Social Media Use during the COVID-19 Pandemic................... 22
2.2 Anxiety……............................…………………………………….. 23
2.2.1 State-Anxiety…………............................................................... 24
2.2.1.1 State-Anxiety Measures........................................................ 25
2.2.1.1.1 State-Trait Anxiety Inventory......................................... 26
2.2.2 Anxiety during the Pandemic..................................................... 27
2.3 Fear of Missing Out................…………………………………….. 28
2.3.1 Measures of Fear of Missing Out…………................................ 29
2.3.1.1 Fear of Missing Out Scale..................................................... 30
2.3.2 Fear of Missing Out during the Pandemic.................................. 30
2.4 Depression………...................…………………………………….. 31
2.4.1 Measures of Depression………..…………................................ 33
2.4.1.1 Beck’s Depression Inventory II............................................ 33
2.4.2 Depression during the Pandemic…………................................ 34
2.5 Social Media Use and Mental Health……………………………… 35
2.5.1 Benefits of Social Media Use on Mental Health........................ 36
2.5.2 Risks of Social Media Use on Mental Health............................ 38
2.6 Hypotheses……………………………..………………………….. 42

Chapter III Method..……………………………………………………………… 43

3.1 Introduction……………………………………………………… 43
3.2 Design……………………………………………………………. 43
3.3 Participants………………………………………………………. 43
3.4 Measures………………………………………………………..... 48
3.5 Procedure………………………………………………………… 52
3.6 Analysis………………………………………………………….. 52

Chapter IV Findings……………………………………………………………… 53
4.1 Introduction……………………………………………………… 53
4.2 Descriptive Statistics of Main Variables………………………… 53
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4.3 Normality Assessment of Main Variables……………………...…. 57

4.4 Composite Measure of Social Media Use……………………......... 69
4.5. Composite Measure of Social Media Use into Categories…….….. 74
4.6. Normality Assessment on Depression and Anxiety per
Composite Measure of Social Media Use…….…….……………. 74
4.7. Test of hypotheses…………………………………….…………… 85

Chapter V Discussion…………………………………………………………….. 88
Limitations……………………………………………………………. 93

Chapter VI Conclusions………………………………………………………..…. 93
6.1 Main conclusions……………………………………………….… 93
6.3 Suggestions for future research………………………………..…. 94

References………………………………………………………………………….. 96
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Abstract

The use of social media increased significantly in the last decades. Social media

provides a large number of advantages. It allows people to connect, receive social support,

and share their stories and experiences. However, despite the great benefits, social media also

has a negative influence on its users. It was discovered that the use of social media can lead

to increased levels of depression and anxiety among people who use it. Furthermore, the use

of social media increased drastically during the Covid-19 pandemic. Additionally, the

phenomenon known as fear of missing out could be the mediator between social media use

and depression as well as state anxiety.

This is a quantitative, correlational, and confirmatory study. This study was aimed to

evaluate whether there are social media differences in depression and anxiety during the

pandemic. Additionally, it was aimed to evaluate whether fear of missing out is a mediator

between social media use and depression and anxiety. This study was carried out in 237

participants randomly selected from social media users in different continents. The Beck’s

Depression Inventory-II was used to access depression levels in the participant. For the

anxiety measures, the State-Trait Anxiety Inventory was used. The fear of mission out was

measured with the Fear of Missing Out scale, and other measures of patterns of social media

use. The results showed a statistically significant positive relationship between social media

use and depression as well as anxiety. In addition, findings pointed out that fear of missing

out had a statistically significantly mediating effect on the relationship between social media

use and depression as well as state anxiety. I concluded that there is converging evidence on

the association between heavy social media use and higher odds of suffering from depression

and anxiety.

Keywords: Depression, Anxiety, State Anxiety, Social Media, Fear of Missing Out.
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Introduction

In the last decades, rapid technological development has led to a sharp increase in

Internet use around the world. For instance, the Internet World Stats (2020) pointed out that

the number of Internet users in the year 2020 reached almost 5 billion people. Su-l Hou

(2017) explained that with the increase of Internet users, the number people using social

media increased as well. Likewise, Puukko et al. (2020) stated that during the last decades,

social media use has risen significantly. For instance, Clement (2020) indicated that in May

2020, there were registered more than four billion active social media users. In addition,

social media has reached many parts of the world. Clemet (2020) reported that in 2020, the

penetration rate of global social media accounted for 49% of the global population. In other

words, almost half of the population on the planet was using social media networks. The use

of social media platforms and apps in 2020 increased by ten percent compared to 2019

(Kemp, 2020). However, the increase in social media use is related to access to technological

advances such as smartphones and internet access. According to Kemp (2020), the biggest

increase was in the use of social media on smartphones and mobile phones. The number of

people who used these devices in 2020 was 70% more than in 2019. Furthermore, the use of

personal computers increased by 47% compared to the year 2019 (Kemp, 2020). Moreover,

46% of females and 41% of males reported spending more time on social media during the

Covid-19 pandemic (Kemp, 2020). Similarly, 16% of respondents, reported uploading more

videos on social media platforms (Kemp, 2020).

The use of social media platforms has a large number of advantages. It allows people

to connect with other people, get social support, and share their stories (Utz & Breuer, 2017).

Social media have no physical obstacles such as distance or state of health. Social media

enable people to see each other despite their geographical location or the institutions they are
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at. Thus, even if an individual is hospitalized due to different reasons, she still can have the

support from the family and friends with help of social media. Furthermore, many

professionals and businesses use social media to access and share different types of

information. For example, it was found that such platforms as LinkedIn can be beneficial for

one’s career opportunities (Davis, Wolff, Forret & Sullivan, 2020). In spite of the fact of

benefits of social media use, there is a piece of evidence that proves the opposite effect.

According to Utz and Breuer (2017), social media users reported experiencing more stress

than non-users.

Particularly, 2020 was a hard year for many individuals worldwide. The World Health

Organization declared Covid-19 a pandemic after the number of people infected reached two

hundred thousand and expanded to 160 countries (Spinelli & Pellino, 2020). The pandemic

affected normal life in the communities. People started to experience range of psychological

problems due to social distancing, self-isolation, quarantine, and use of social media (Khan,

Mamun, Griffuths & Ullah, 2020). Furthermore, depression, confusion, anxiety and stress

increased significantly, even among people without a previous history of mental health

problems (Khan, et al., 202).

Authors such as First et al. (2020) indicated that exposure to social media during the

Covid-19 pandemic can lead to growth of levels of stress and depression. In addition, First et

al. (2020) found that interpersonal online communication was linked with higher levels of

stress among people exposed to the Covid-19. The research that was studding the association

between social media use during Covid – 19, revealed that the use of social media could lead

to higher levels of depression among users (First et al., 2020).

In addition, Przybylski et al. (2013) mentioned that there is a phenomenon called fear

of missing out that has appeared due to the use of social media. Przybylski et al. (2013)
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described fear of missing out as an anxiety that others are having gratifying experiences that

one is missing. However, Przybylski et al. (2013) explained that it might have negative

effects on mental health.

The aim of the study was to assess whether there are social media use differences on

depression and anxiety during the pandemic. In addition, I aimed to evaluate whether fear of

missing out is a mediator between social media use and depression as well as state anxiety.

The use of social media could be harmful to some individuals. Additionally, the use of social

media increased drastically in the last decades. Moreover, during the COVID-19 pandemic,

many countries placed measures requiring social distancing, promoting online shopping,

moving many services into the online interface, and spreading the COIVD-19 fear among

individuals. Thus, it is important to know, how the use of social media affects one’s mental

health during the worldwide COVID-19 pandemic. Additionally, it is noteworthy to

remember, that the COID-19 pandemic is the first global pandemic in the digital era when

information travels across the globe with incredible speed and people from different parts of

the world are able to connect with each other via social media platform.

In this study, I operationalized social media use in terms of daily time spent on social

media, frequency spent on social media, multiple platform use, problematic social media use

and social media intensity. In addition, I adopted Beck et al. (1996) definition of depression

that includes somatic-affective and cognitive aspects. Furthermore, I implemented

Spielberg’s (1977) operational definition of state anxiety as a temporary condition

experienced in a specific situation. Moreover, I adopted Przybylski et al. (2013) definition of

fear of missing out who stated that is a persistent worry that others could have pleasing

experiences while the individual is ofline.

It was hypothesized that the levels of depression and anxiety among excessive social

media users will be higher than among people who spent less time on the social media.
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Additionally, it was hypothesized that the fear of missing out will be the mediator between

the social media use and levels of depression and anxiety.

Literature Review

2.1 Social Media

Social media includes many interactive platforms, where individuals are able to

connect and share information. Authors such as Obar and Wildman (2015) mentioned that

social media imply a technology using computers to communicate and share information. It

would be impossible to imagine modern society without social media. Obar and Wildman

(2015) indicated that the reason people use social media is to stay connected with their

friends and families. It is used by schools and universities to share the news and teach

students. All latest news spread through social media. Moreover, social media allows users to

create their own online identities and express themselves. Obar and Wildman (2015)

explained that it is a form of expression through online communities. Social media opens the

door to endless opportunities where anyone can be anything. For instance, Obar and Wildman

(2015) noted that via social media platforms, users can share their success stories, promote

their content via blogs, apps, and use platforms for career purposes. Many businesses are

built on social media. In other words, social media became an inseparable part of peoples’

lives. However, it is relevant to acknowledge definitions of social media.

2.1.1 Social Media Definition

Social media is a relatively new term that is gaining growing attention from

researchers around the globe. Due to its complexity and diversity, Carr & Hayes (2015)

explained that it is hard to propose one definition that will define social media. Despite the
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complexity, several definitions of social media exist. Carr and Hayes (2015) look at Social

Media from four different categories. Those categories include public relationships,

information technology, educational purposes, and circulation of news. Integrating the

dimensions mentioned earlier, according to Carr and Hayes (2015) describe Social Media as

“internet-based, disentranced, and persistent channels of mass communication facilitating

perceptions of interactions among users, deriving value primarily from user-generated

content” (p.49).

Other researchers look at social media as a tool of communication. For example,

Kietzmann et al. (2011) defined Social Media as a collaborative online platform, which

allows users to create, share, and discuss information. Kietzmann et al. (2011) believed that

social media became a new landscape for communication. For instance, old-style social

media communication offered consumers to learn the information and buy the product. In

contrast, modern social media platforms allow users to learn about the product and to discuss

the product with other consumers.

Similarly, Kaplan and Haenlein (2010) mentioned that the initial purpose of the

internet was to help users to exchange information. Many years after the development of the

internet, the degree of exchanged content increased significantly and entered a new level of

user communication. Furthermore, Kaplan and Haenlein (2010) understood social media as a

cluster of online applications founded on the technical fundamentals of Web 2.0 These

applications allow users to create and interchange content.

2.1.2 Web 2.0

Kaplan & Haenlein (2010) use the term Web 2.0 in their definition of social media as

it is an inseparable part of today’s world of communication. It is important to note that

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O’Reilly (2005) defined Web 2.0 for the first time as a platform without a hard boundary. On

this platform, users can create and use data. The new Web 2.0 was also designed to gather

collective intelligence. For example, such websites as Google, Yahoo!, eBay, Amazon, or

Wikipedia. Furthermore, O’Reilly (2005) stated that the new Web 2.0 is more than one

device. The web platforms can be used on different devices such as mobile phones, tablets, or

smartwatches.

Later, Web 2.0 was compared to “online links between people” (Newman, et al.,

2016, p. 591). Newman (2020) clarify that Web 2.0 gave people the opportunity to be

connected with friend, events, other people and online groups.

Furthermore, many social services on the Web 2.0 platform can interoperate (Newman, et al.,

2016). An example of such interoperation could be Facebook and Instagram. First, the user

has to agree to connect personal or business profiles on Facebook and Instagram. Next, every

time one is sharing the post on one of the social platforms, he can re-share this post on

another platform without any additional clicks. In addition, it is extremely simple to share

posts from one social media to another. For example, users are able to share their own content

or borrowed content from LinkedIn on their Facebook page with one simple click.

Another innovation that came with Web 2.0 is cloud storage services. Web 2.0

includes a large variety of modern social media platforms. Thus, it provides consumers with

an enormous number of recourses (Hardey, 2011). For example, many celebrities,

manufacturers, and even politicians use social media to promote themselves. Hardey (2011)

mentioned that some manufacturers use social media interaction with their customers to

create a new design for their products (Williams et al., 2012). Electronic word of mouth tends

to be more influential on people. It is assumed to be based on individual experiences and not

influenced by the producers.

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2.1.2.1 Electronic word-of-mouth

Allsop et al. (2007) explained that word of mouth has been an important channel

where people shared their satisfaction with the product or recommended product to their

acquaintances. For instance, an informal meeting with colleagues discussing about a product

that someone has bought. However, word of mouth goes beyond sharing satisfaction with

products. It also reaches satisfaction with institutions. Allsop et al. (2007) stated that word of

mouth has a strong influence when deciding whether to trust the institutions. Nevertheless,

the new technological advances transformed the traditional word of mouth into an electronic

one.

Electronic word of mouth presents the numerous significant advantages compared to

traditional word-of-mouth. Cheung and Thadani (2012) indicated that it can travel much

further and much faster than traditional word of mouth. Web 2.0 provides individuals with

numerous interactive platforms, where people can share their experiences immediately

(Williams et al., 2012). Furthermore, electronic word of mouth has a strong influence as it is

assumed to be biased and not influenced by the producers (Cheung & Thadani, 2012).

Paradoxically, while deciding on the purchase, individuals rely on the opinion of people they

do not know more than reliable media sources (Cheung & Thadani, 2012). According to

Cheung and Thadani (2012), about 90% of people consult online before purchasing the

product. Coincidentally, the conversations about the product become more powerful than the

opinion about the product itself (Williams et al., 2012).

Another valuable advantage of electronic word of mouth is the diversity of created

online information (Cheung & Thadani, 2012). Using Web 2.0, individuals can create

different variations of feedback. The users can share the content in formats such as video,
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audio, blogs, and ads (Williams et al., 2012). Thus, the users create the large amount of

different types of information, related to the curtain topic.

Furthermore, the sources of electronic word-of-mouth can be classified. As stated by

Kaosiri, Fiol, and Tena (2017), there are two sorts of sources in electronic word-of-mouth: a)

strong-tie sources, and b) weak-tie sources. Kausiri et al. (2017) further explained that

strong-tie sources include family, friends, and relatives. For example, a sibling who is the

source advising to avoid buying a certain product. In addition, Kaosiri et al. (2017) explained

that a weak-tie source involves acquaintances or unknown people, for instance, a stranger

with a video on YouTube, who recommends buying a certain product. In addition, Kaosiri et

al. (2017) stated that both sources remain trustworthy, as the information provided is

voluntary and not affected by the producer. Thus, it’s noticeable that consumers are

generating a great quantity of content on social media platforms. This content is so-called

consumer generated content.

2.1.2.2 Consumer-generated content

Nowadays, consumer-generated content is gaining interest from research in the

marketing domain. Social media provide users with a powerful ability to create their own

content. In contrast, in the past, most of the online content was created by corporations

(Thomas, 2020). However, Millennials started to change the trend and Generation Content,

known as Generation C, completed the transformation. Thus, Williams et al. (2012) indicated

that this trend created a new way of communication.

The conversations and feedback provided by users on social media are called

consumer-generated content. Williams et al. (2012) defined consumer-generated content as a

“form of electronic word-of-mouth given that the resulting advertising is created by

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consumers and not considered commercially motivated” (p. 129). For instance, a full review

of a new-released smartphone. The advantage is that consumer-generated content is accepted

by users as a valuable source of information. Kaosiri et al. (2017) noted that it gained great

significance for consumer decision-making. Therefore, it is a cheaper strategy than traditional

advertising that companies are adopting to promote their products.

Kaosiri et al. (2017) suggest that consumer-generated content is valuable not only for

those who are planning the purchase but also important for individuals who are interested in

the first-hand opinion. Social media platforms help users to find answers to the questions they

have doubts about. Furthermore, they can find out about the latest experiences with the

product and elaborate in the conversation about common interests (Kaosiri, et al., 2017).

When social media users unite based on common interests, they build a consumer-to-

consumer interaction (Thomas, 2020). An example of such interaction can be the group on

Facebook. Such online communities increase the power of consumer-generated content and

electronic word-of-mouth exponentially (Thomas, 2020).

Besides, the platform used for consumer-generated content plays an important role.

Yang et al. (2019) stated that user communication on trademark groups on social media is

different than the reviews on official pages of brands. There are certain limitations that

impose certain restrictions. According to Yang et al. (2019), customer feedback on the web

pages is structured and often includes only text. In contrast, Yang et al. (2019) indicated that

the reviews on social media platforms do not have structure. For instance, Facebook allows

users to have more flexibility on the content that users can post. In addition, Yang et al.

(2019) mentioned that these platforms can incorporate visual content and are more

interactive. On social media platforms such as Facebook or Twitter, visual content and

comments are very popular. Nevertheless, it is relevant to address social sites.

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2.1.3 Social Network Sites

Social network sites are online platforms for communication. For instance, Boyd and

Ellison (2007) defined social network sites as internet-based services which permit users to

build opened or private profiles, create a list of friends or connections, and interact with other

people. Nowadays, there are many social network sites that individuals can choose from. In

addition, Boyd and Ellison (2007) defined networking as the initiation of interactions, often

involving strangers.

Importantly, social network sites allow people to connect with individuals they would

not be able to connect with in face-to-face interaction. Thus, social network sites enlarge the

possibility to meet more people than one would be able to meet face-to-face (Boys, Ellis,

2007). Another feature of social network sites concerns profile visibility. Boyd & Ellis (2007)

state that some accounts allow users to hide their information from particular groups of

people. In contrast, other social networking sites are transparent.

Once an individual joined the social network website, he or she is offered to identify

people they might know or could be interested to connect to (Boyd & Ellison, 2007).

Furthermore, Boyd and Ellison (2007) clarify that the type of offered connection could be

one-directional or bi-directional. An example of a bi-directional connection could be a friend,

with whom an individual is able to communicate in the form of messages and comments and

have access to their shared content. In contrast, the one-directional connection could be a fan

page where users can only access shared content without the possibility to talk to the page

owner or leave a comment on their posts.

In addition, a survey on social network site features revealed that most social network

sites share common features such as comments, content sharing, notifications, and personal
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profiles (Tapiador & Crrera, 2012). For example, on Facebook or Instagram, people can share

content that could include text, pictures, videos, or mixed. Furthermore, Boyd and Ellison

(2007) point out that most social network sites enable users to communicate through public

comments or private messages. For example, one of the popular messengers called

WhatsApp, allows users to communicate privately or in group messages, audio or video calls

(Blabst & Diefenbach, 2017).

According to Clement (2020), the most popular social networking site worldwide in

2020 was Facebook. In the year 2020, 2.7 million people were actively using Facebook. The

second popular network was YouTube and WhatsApp. These platforms had two million

active users (Clement, 2020). The third most used social media was Facebook Messenger.

Among the most popular networking sites in 2020 were also WeChat, Instagram, Tik Tok,

QQ, Douyin, Sina Weibo, QZone, Snapchat, Reddit, Pinterest, Telegram, and Twitter

(Clement, 2020).

2.1.4 Digital Natives

The first generation who integrated the worldwide web into their lives was the so-

called millennials (Williams, Crittenden, Keo & McCarty, 2012). Individuals born between

the early ’80s and late ’90s are called Millenials (Roberts, Newman & Schwartzstein, 2012).

According to Williams et al. (2012), millennials succeeded better in implementing advanced

technology in their every-day-life compared to previous generations. Millennials born after

1990 are called Generation C. The term Generation C is used to refer to an individual born

during the rise of digital technology (Hardey, 2011). Hardey (2011) states that Generation C

does not refer to individuals born between specific dates but rather those shaped by specific

technological developments. According to Williams et al. (2012), Generation C is

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characterized by the preferences for content creation, active communication, control over

their lives, and creative workspace.

The first Web users were passive (Williams et al., 2012). Individuals used the Web

mostly to find the information that interests them. This type of Web use is called WEB 1.0

(Williams et al., 2012). Web 1.0 is considered one-way communication. Unlike previous

generations, Generation C is an active user. They use interactive platforms to create their

content and actively participate in online debates. Thus, Generation C gave rise to active

communication where the user is the creator and consumer of the content. This new online

interaction is called Web 2.0 (Williams et al., 2012).

2.1.5 Social Media Use

Although the primary aim of social networking platforms is to socialize, a growing

quantity of people seem to use them to obtain news. Aditionally, sites for sharing media, such

as YouTube, are distinguished as important news informants (Pew, 2012). During the last

several years, microblogs such as Twitter have been discovered to be used for newsgathering

and marketing (Mitchell et al., 2013). Wikipedia is another recognized social media source

that is frequently utilized a jumping-off point. When students are looking for information,

they frequently begin with Wikipedia, which frequently offers a summary of a new ideas as

well as valuable pieces of information (Head & Eisenberg, 2010). There are other uses of

social media such as sex and information behavior.

Users' gender differences seem to have an impact on their online knowledge

behavior. Male students, on average, use cyberspace channels more often than their women

colleagues (Li & Kirkup, 2007). Surprisingly, Jones et al. (2009) state that the previous use of

the Internet was for a large number of recreational events and news sources, while the current
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use is mainly for maintaining connections and scholarly reasons. In relation to social media

use, it seems that female students accommodate social networking sites more often than male

students (Nadkarni & Hofmann, 2012). Female students tend to devote more time and make

more friends on those pages (Moore & McElroy, 2012). Male students, in contrast to their

female peers, prefer to use social networking platforms for more specific purposes and fewer

for interactive determinations (Lin & Lu, 2011). According to research, the interests of both

gender groups are similar to traditional gender stereotypes (Harp & Tremayne, 2006). In

terms of online shopping conduct, female shoppers seem to have a greater influence than

male shoppers (Garbarino & Strahilevitz, 2004).

2.1.5.1 Measures of Social Media Use

There are several measures of social media use. Traditionally, there have been

observational or behavioral measures in terms of time and frequency spent on social media.

However, there are also self-reported measures based on valid psychometric scales that are

also employed to assess social media use. This study included measures of social media use

such as daily time and frequency, spent on social media, multiple platform use, problematic

platform use, and social media intensity.

2.1.5.1.1 Daily Time Spent on Social Media

Time spent on social media is a popular measurement taken to evaluate social media

use. For instance, Shensa et al. (2018) employed time spent on social media as a self-report

measure. The operationalization of social media use in terms of time is another approach used

by other researchers such as Junco (2013) or Scharkow (2016). However, there are some

criticisms since these types of measurements do not capture the psychological aspects of

social media use. For instance, Jenkins-Guarnieri et al. (2013) stated that there no emotional
 20

connection nor motivation addressed when measuring only time. Therefore, other types of

measures have been suggested for considering these psychological aspects. Nonetheless, time

spent on social media and regularity of use are implied considerations for most measurement

patterns.

2.1.5.1.2 Frequency of Social Media Use

Frequency of use is another popular measure to assess social media use. For example,

Shensa et al. (2018) used it to explore weekly site checks on social media platforms. To

ensure the study was as representative as possible, Shensa et al. (2018) included the most

popular social media platforms such as Instagram, Facebook, Twitter, LinkedIn, YouTube,

Google+, Vine, Tumblr, Pinterest, Snapchat, and Reddit. Other researchers such as Scharkow

(2016), used a similar approach to evaluate the extent of usage of social media. However,

there are also other measures such as multiple platform use.

2.1.5.1.3 Multiple Platform Use

Another measure commonly used to evaluate the extent of use of social media is

Multiple platform use. Researchers such as Shensa et al. (2018) used the responses from other

measures such as the frequency expended on social media and transformed the responses to

evaluate the extent of use of social media platforms. Likewise, Junco (2013) utilized a similar

approach to evaluate social media platforms. Nevertheless, this type of measure only

accounts for face-value social media usage, disregarding the psychological aspects of its use.

Therefore, there are other types of self-reported measures, such as problematic social media

use, that consider these aspects.

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2.1.5.1.4 Problematic Social Media Use

Problematic social media use is a measure that Shensa et al. (2018) adapted from

Andreassen et al.’s (2012) Bergen Facebook Addiction Scale. In the Bergen Facebook

Addiction scale, Andreassen et al. (2012) worded a question such as the following: “How

often … thinking about Facebook?”. In the adaptation, Shensa et al. (2018) reworded the

questions referring to Facebook into social media, for example, “How often … thinking about

social media”. Employing Shensa et al.’s (2018) adaptation, allowed the scale to embrace

general attitudes towards addiction in multiple social media platforms. Andreassen et al.

(2012) mentioned that the Bergen Facebook Addiction scale aims to evaluate the core

elements of addiction to Facebook. Moreover, Andreassen et al. (2012) explain that it is a

multidimensional measure that includes aspects of addiction such as salience, tolerance,

mood modification, relapse, withdrawal, and conflict (p. 505). Using Shensa et al.’s (2018)

adaptation, the problematic social media use measure attempts to evaluate the central

elements of dependance to multiple social media platforms.

2.1.5.1.5 Social Media Intensity

Social media intensity is a measure that Shensa et al. (2018) improved version of

Ellison et al. (2007) Facebook Intensity scale. In the adaptation, Shensa et al. (2018)

reworded the items referring to “Facebook” into “social media”. For instance, Ellison et al.

(2007) worded a question such as the following: “Facebook is part of my everyday activity”

(Question 1). However, Shensa et al. (2018) reworded it into the following: “Social media

Social media has become part of my daily routine” (Question 3). Using Shensa et al.’s (2018)

adaptation changed the scale to include an emotional relationship to multiple social media

platforms and social media integration into subject’s activities. Ellison et al. (2007) indicated

that the Facebook Intensity scale is unidimensional and aims to assess the emotional
 22

relationship to Facebook and Facebook’s incorporation to the subject’s activities. Employing

Shensa et al.’s (2018) adaptation, the social media intensity scale is designed to evaluate the

emotional connection to social media platforms among with the extent of the integration of

social media into the regular subject’s activities.

2.1.6 Social Media Use during the COVID-19 Pandemic

Baker (1991) demonstrated how a shortage of credible knowledge would impede

successful crisis responses. Additionally, Cato et al. (2020) noted that this is particularly

troublesome as crisis responses need large-scale control of individual actions, as was evident

during the COVID-19 pandemic. Although the growth and increased accessibility of the

internet and social media has made it possible to access a broader range of facts in recent

years, it has also created a new topic of infodemics (Vosoughi et al. 2018). An infodemic is

characterized as an excess of knowledge which may or may not be accurate, making it

impossible for users to search for dependable sources and credible advice in times of need

(WHO, 2019). Due to the fact that the dissemination of disinformation will result in unhelpful

individual behavior of people as individuals and as groups that intensifies disasters, such as

the COVID-19 pandemic. Therefore, it is critical to contain infodemics (WHO, 2019).

Existing research indicates that social media platforms may be a significant cause of the

spread of false information about COVID-19. Perhaps predictably, Hua and Shaw (2020)

reported that individuals have extensively exploited the internet to seek information related to

the signs of COVID-19 and preventive actions, as well as the supply of basic needs such as

groceries and home supplies. Nevertheless, the material found online can contain errors. For

instance, Li et al. (2020) revealed that every fourth video of the twelve most common videos

on YouTube relating to COVID-19 contained errors. Li et al. (2020) states that 27% of videos

included in the research contained false information. However, those videos had largest
 23

numbers of views. Furthermore, about 16.1 percent of tweets with a COVID-19-related

hashtag are simply advertisements that redirect people to unrelated topics (Mourad et al.,

2020). Additionally, Islam, et al., (2020) revealed that as a result of the widespread belief that

consumption of heavily concentrated alcohol could disinfect the body and destroy the

coronavirus, 800 people have died and 6,000 have been hospitalized worldwide (p.1624).

According to the WHO (2020), "the infodemic is intensified by the emergency's global scope

and propagated by the interconnected manner through which knowledge is disseminated and

absorbed through social networking networks and other channels."(para. 3) Having said that,

it is unknown to which degree social media use impacts peoples’ health behaviors. This link

is critical because social media can have both beneficial and harmful impacts on society. On

the one hand, the use of social media has the potential to increase individuals' risk tolerance

and perceived capacity to cope, as well as to promote defensive behaviors such as social

distancing. On the other hand, if users are exposed to false facts, such as bogus remedies, this

may result in exaggerated or misguided reactions. Therefore, it is essential to review the

impact of social media use on anxiety. However, to do so effectively, it is first necessary to

define the condition itself.

2.2 Anxiety

Anxiety can be characterized as a constant feeling of worry. Authors such as

Greenberg et al. (1999) indicated that anxiety can be thought of as the pathological equivalent

of natural fear. In addition, Greenberg et al. (1999) indicated that there are certain

manifestations of anxiety through mood, perception, behavior, and bodily function

disturbances. The combination of some symptoms can help in detecting whether a person is

suffering from anxiety. For example, a subjective sense of agitation along with instabilities of

sleep, attention, common and/or work-related functioning is a typical symptom of a number

 24

of anxiety disorders (Markowitz et al., 1989). Moreover, Markowitz et al. (1989) explained

that despite the similarity of anxiety disorders, these disorders often manifest differently,

progress differently, and require different treatments. Furthermore, Markowitz et al. (1989)

indicated that patients often present with key concerns for their physical health.

There are certain examples of anxiety disorders. For instance, Greenberg et al. (1999)

exemplified them such as “panic disorder, agoraphobia, generalized anxiety disorder, specific

phobia, social phobia, obsessive-compulsive disorder, extreme stress disorder, and post-

traumatic stress disorder” (p. 428). Additionally, Greenberg et al. (1999) indicated that there

are adjustment disorders that exhibit anxiety-like characteristics, as well as disorders

associated with common psychiatric problems and substance-induced anxiety disorders.

Munir et al. (2019) indicated that certain criteria are used for the diagnosis of anxiety

disorders. For instance, symptomatic conditions involve extreme fear and concern for

minimum six months, as well as difficulties managing the worrying. Furthermore, Munir et

al. (2019) indicated that there must be for at least six months, three or more of the of the

symptoms: “restlessness, feeling tense or on edge, quickly fatigued, difficulties focusing or

mind-wandering, irritability, muscle pain, sleep disruption, and irritability” (p. 581)

However, there are different types of anxiety. State anxiety is one type of anxiety that can

manifest.

2.2.1 State-Anxiety

Cattell (1966) presented for the first time in the literature the terms state and trait

anxiety. Afterwards, Spielberger (1979) expanded the terms. The differences between the two

are related to personality states and traits. Overall, Thorne (1966) explained that personality

states can be thought of as crossing parts of a “stream-of-life” in an individual. In addition,

Spielberger (1972) noted that they might be additional emotional responses serving as
 25

manifestations of personality states. An emotional state occurs at a certain period of time and

at a certain strength frequency. Anxiety states are described by individual feelings of

tightness, anticipation, edginess, and concern, as well as by autonomic anxious system

stimulation or excitement (Spielberger et al., 1983).

Spielberger et al. (1983) demonstrated that state and trait fear are similar to kinetic

and potential energy in many ways. According to Spielberger et al. (1983), state anxiety is

analogous to kinetic energy in that it corresponds to a palpable response or mechanism

occurring at a certain time and strength level. Trait-anxiety, on the other hand, is not

transitory. Spielberger et al. (1983) referred to trait anxiety concerning human variations in

response. Additionally, Spielberger et al. (1983) defined potential energy as variations in the

amount of kinetic energy associated with a given physical unit that can be emitted when a

suitable force is applied. Trait-anxiety refers to individual variations in their proclivity to

react to difficult circumstances with differing degrees of state anxiety. An example of state

anxiety would be a particular situation that made one anxious, whereas trait anxiety is one’s

response to the situation causing distress. However, Spielberger et al. (1983) observed that

regardless of whether individuals who differ in trait-anxiety exhibit corresponding variations

in state-anxiety, the extent to which one observes a particular event as emotionally unsafe, or

frightening is dependent on the degree whenever everyone else distinguishes the event as

mentally hazardous or intimidating. Spielberger et al. (1983) added that an individual's view

of a situation as risky is strongly affected by prior experience. There are several measures of

state-anxiety.

2.2.1.1 State-Anxiety Measures

One of the first measures to measure state-trait anxiety was Taylor’s (1953) Manifest

Anxiety Scale. Taylor (1953) defined anxiety as a personality trait to react differently to
 26

difficult circumstances. However, this measure only considers trait anxiety. In addition,

Spielberger et al. (1983) reviewed Taylor’s (1953) scale and suggested an instrument to

evaluate anxiety as a broader construct including state anxiety.

However, other instruments that evaluate state anxiety exist. For instance, Cattell and

Scheier (1961) established the IPAT anxiety scale, a survey to empirically measure anxiety

states. Spielberger (1969) indicated that the scale was developed using phenomenological and

physiological variables associated with anxiety. However, the scale was focused on the

psychiatric assessment of anxiety symptoms in patients.

Additionally, different measure for state anxiety were developed. Spielberger et al.

(1983) developed the State-Trait Anxiety Inventory, and it has become one of the most

popular measures to evaluate state and trait anxiety inventory has become one of the most

popular measures to evaluate state and trait anxiety.

2.2.1.1.1 State-Trait Anxiety Inventory

Spielberger et al. (1983) mentioned that the State-Trait Anxiety Inventory is a

multidimensional measure that evaluates state and trait anxiety. Moreover, Spielberger et al.

(1983) explained that state anxiety means noticeable reactions or processes that are occurring

at a given moment with a certain degree of intensity. It is important to note that the measure

was created considering the most relevant aspects of anxiety including personality traits and

states related to anxiety. Spielberger et al. (1983) indicated that although the inventory was

developed using items from other measures, there was an emphasis on the timing of the

feelings. For instance, feeling upset at the current moment or in general. In addition,

Spielberger et al. (1983) indicated that the items in the inventory tap the relevant aspects of

anxiety. During the pandemic, it is important to acknowledge whether individuals are

suffering from state anxiety.

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2.2.2 Anxiety during the Pandemic

During the pandemic, nervousness and fear became widespread phenomena

worldwide. For instance, according to Brooks et al. (2020), recent research studies revealed

that individuals who were isolated and quarantined reported elevated levels of anxiety,

frustration, uncertainty, and tension. Furthermore, the large body of research that has

investigated psychiatric conditions associated with the COVID-19 pandemic has shown that

affected patients exhibit a variety of signs of behavioral trauma including emotional pain,

unhappiness, tension, state fluctuations, touchiness, sleeplessness, consideration deficit

hyperactivity disorder, post-traumatic stress disorder, and rage (Brooks et al, 2020; Rubin &

Wessely, 2020). Additionally, research indicates that prolonged media attention can result in

distress (Neria & Sullivan, 2011). Nonetheless, it is hart to correctly assess the neurological

and emotive consequences of COVID-19 in the present setting. The research performed in

China, which was one of the first countries to be impacted by the recent Covid-19 outbreak,

indicated that society's terror towards the virus's mysterious presence can result in serious

mental health issues (Shigemura et al., 2020).

Moreover, COVID-19 can disturb the psychological well-being of people at multiple

levels of culture, varying from diseased individuals and healthcare employees to relatives,

infants, offspring, people with psychological disorders, and also personnel in unrelated

industries, caused the virus's rapid spread, and high mortality rate (Bao et al, 2020). There are

other disorders, such as depression, which might be important to explore concerning the

mental health of individuals during the pandemic.

Furthermore, many countries announced quarantine due to the Covid-19 pandemic.

Physical isolation and traveling restrictions had dramatic influences on individuals’ well-

being. Thus, many individuals felt a stronger need to stay connected. The researched revealed

that peoples’ use of social media increased dramatically during the Covid-19 pandemic.
 28

Likewise, the research found links between increased social media, problematic social media

use, and the fear of missing out (Gioia et al, 2021). Yu et al. (2020) indicated that isolation

and quarantine caused individuals to increase their social media use due to the so-called fear

of missing out.

2.3 Fear of Missing Out

Przybylski et al. (2013) were one of the first researchers to introduce the construct of

fear of missing out (FOMO). Przybylski et al. (2013) defined it as a “pervasive apprehension

that others might be having rewarding experiences from which one is absent” (p. 1841).

Przybylski et al. (2013) explained that the construct belongs to self-determination theory. In

other words, Neumann (2020) clarified that fear of missing out is a motivator dependent on

challenges to fundamental human needs such as relatedness, sovereignty, and competence.

Neumann (2020) suggested, however, that the construct can be interpreted more generally as

an emotional and perceptive involvement focused on the presumed disjunction between

individuals' present and future experiences, as well as between their experiences and those of

their immediate and extended social environments. Thus, Browne et al. (2018) suggest that

when identifying fear of missing out, two fundamental categories of mechanisms play a

significant part: affective and cognitive components. According to Browne et al. (2018), the

affective aspect primarily represents the subjective reaction that people are experiencing.

Moreover, the emotional components are typically unhelpful and are powered by anxiety,

apprehension, guilt, jealousy, and other negative feelings. Additionally, Browne et al. (2018)

described the cognitive aspect as having two subsections: group association and thoughts

which tend to be contrary to fact. Przybylski et al. (2013) added that social comparison

indicates to the supposed disjunction of one’s perceptions and those of their immediate and
 29

extended social setting. As a result, Neumann (2020) described counterfactual thoughts as the

perceived disjunction between an individual's present and future experiences.

Despite the fact that the construct's label explicitly indicates that “fear” is the primary

affective component, Neumann (2020) noted that the most of prior studies have defined fear

of missing out's affective component as a condition of anxiety, apprehension, and uneasiness.

Neumann (2020) said that while anxiety lasts longer than fear and is concerned with a

potentially unpleasant yet unknown possible experience or occurrence, it can emerge from

initial fear. Neumann (2020) demonstrated that people who chose to spend time home alone

rather than socialize with peers and friends may have an original frightful response to

potential societal isolation due to their lack of participation in social activities and therefore

social exclusion. As a result, people can continue to feel fear by visualizing that others are

having greater enjoyment or are more incorporated than they are.

Neumann (2020) demonstrated that the cognitive aspect of fear of missing out entails

unconscious thoughts that evaluate an individual's life in two distinct ways: a) in comparison

to the experiences of others; and b) in comparison to the opportunity for perceived superior

experiences. As a result, fear of missing out is inextricably linked to peer distinction and

counterfactual thinking. Therefore, it is important to measure the fear of missing out with

valid tools.

2.3.1 Measures of Fear of Missing Out

Regarding measures of fear of missing out, there are instruments to assess the

construct such as Li, Griffiths, Niu, and Mei’s (2020) Trait-State Fear of Missing Out scale.

This scale is two-dimensional instrument, aimed to measure the traits related to fear of

missing out. It is seeing as more robust tool to assess the fear of missing out (Li et al, 2020).
 30

Nonetheless, one of the most popular measures of fear of missing out is still Przybylski et

al.’s (2013) Fear of Missing Out scale.

2.3.1.1 Fear of Missing Out Scale

Przybylski et al. (2013) stated that the Fear of Missing Out scale is a unidimensional

measure that evaluates the consuming feeling that someone else (for example, a peer) is

having a better experience or a more satisfying lifestyle than the other person. Przybylski et

al. (2013) mentioned that the scale tapped fears, troubles, and anxieties that individuals have

related to being in touch or not with occurrences, experiences, and communications with

social circles.

The scale includes affective and cognitive components. Przybylski et al. (2013)

indicated that affective aspect taps on apprehension, fear, and uneasiness. Concerning the

cognitive aspect, it includes comparison with others and actual experiences compared with

potential ones.

2.3.2 Fear of Missing Out during the Pandemic

The pandemic has impacted the mental health of people. Holmes et al. (2020) pointed

out that the consequence of the COVID-19 pandemic on people's lives is highly significant

and requires scientific investigation in the area of research on psychological well-being. The

lockdowns and isolation from others impacted individuals’ mental health. For instance,

Brooks et al. (2020) indicated that the sense of alienation and separateness has had a

detrimental effect on individual's relations and happiness, developing poor mental effects.

Furthermore, Aquila et al. (2020) explained that the effects in some cases had fatal accidents.

In this sense, the impact of fears on human behavior and functioning is a hot topic of

discussion. As a result, an interactive paradigm for comprehending terror perceptions during

 31

the COVID-19 pandemic, as well as a multidimensional evaluation for COVID-19-related

fears, was recently presented (Schimmenti et al., 2020). Additionally, anxiety associated with

interpersonal characteristics (for example fear of losing connections and not meaning

anything to other people), which is caused by the failure to meet one’s mental demand as a

consequence of the pandemic, was seen as a critical topic for civic well-being (Casale &

Flett, 2020). By and large, challenging and unpredictable circumstances exacerbate fear and

highlight the importance of individuals receiving social reinforcement by exchanging

common interactions with others (Schachter, 1959). Undeniably, as it was mentioned above,

the disruption of individual's normal life and decreased interpersonal interactions can result in

dissatisfaction and a feeling of loneliness, which can result in elevated levels of distress

(Braunack-Mayer et al., 2013). A two-month follow-up survey of Italians after the Covid-19

lockout revealed a rise in stress and depression (Roma et al., 2020). Relevant to the present

analysis, this new research has demonstrated an association between fewer coping

mechanisms and intensified depression at in the future. This finding indicates that the way

people cope with their loneliness, and their necessity to interact, be a part of, and be a

member of a group, might likely have been critical problems throughout the COVID-19

pandemic.

2.4 Depression

Depression is a common mental health problem. Gotlibe et al. (1996) stated that it is

often regarded as the most often diagnosed psychiatric illness. According to the World Health

Organization (2001), 340 million people worldwide suffer from a form of chronic depression.

In addition, the World Health Organization (2020) stated that depression is among the

primary causes of incapacity and the popular causes of global health issues.

Surprisingly, Rosenfeld (1999) stated that there is an epidemy of depression in the

United States of America, estimating that 10% of the population suffers from a depressive
 32

condition. Furthermore, Marsella et al. (1987) mentioned that one of every four Americans

will develop depressive symptoms severe enough to warrant therapy at any point during their

lives. Given its pervasive occurrence, it is unsurprising that depression has been dubbed "the

common cold of mental health disorders" affecting both rich and poor, younger and older

alike (Rosenfeld, 1999, p.10). Depression indications range in magnitude from temporary

sadness or gloominess to profound despair, severe guilt, hopelessness, and suicidal thoughts.

Additionally, Rosenfeld (1999) indicated that persistent depression can manifest mental and

bodily signs such as exhaustion, sleeplessness, low sex drive, constant despair, severe aches

and discomfort, and extreme increase or decrease of weight. Depression is, without a doubt, a

complex, multifaceted condition consisting of a variety of fundamental aspects.

In addition, Spielberger et al. (2003) indicated that somatic symptoms and

performance deficits are necessary components of this diagnosis rather than just considering

depressive affective emotions and self-deprecating cognitions. Furthermore, depression was

identified in the first edition of the American Psychiatric Association's (1952) Diagnostic and

Statistical Manual of Mental Disease (DSM) as a disturbing psychological illness

characterized by dysphoria and lack of confidence "that cannot be described or broken down

into simple components" (Moran & Lambert, 1983, p. 264). The description of depression

mentioned above, involved the presentation of bodily indications of depression, remained

largely intact in the DSM-II (American Psychiatric Association, 1968). Furthermore, DSM-II

served as the foundation for the Hamilton’s (1960) Depression Rating Scale and the original

Beck Depression Inventory (Beck et al., 1961). Spielberger et al. (2003) also noted that the

quality of the elements in psychometric assessments used to diagnose depression reflects the

concept of depression and the guidelines for diagnosing it as a psychiatric syndrome.

Therefore, it’s important to evaluate different measures of depression.

 33

2.4.1 Measures of Depression

There are several measures of depression. For instance, Hamilton’s (1960) Rating

Scale for Depression and the Beck et al. (1961) Depression Inventory focused on somatic

symptoms. Nonetheless, there are other measures such as Zung’s (1986) Self-rating

Depression scale, Radloff’s (1977) Center for Epidemiological Studies Depression Scale, and

Lubin’s (1981) Depression Adjective Check List. However, one of the most popular

measures of depression is Beck’s Depression Inventory since it includes cognitive-affective

and physical indicators of depression.

Beck et al. (1996) pointed out that the cognitive-affective displays of depression are

the core features of depressive disorders. For instance, it is common to observe individuals

suffering from depression with recursive automatic thoughts feeding their depression. The

negative thoughts make individuals feel depressed and they self-evaluate negatively repeating

the loop over and over. Therefore, the Beck’s Depression Inventory is preferred over

another type of self-report measure.

2.4.1.1 Beck’s Depression Inventory II

Beck et al. (1996) indicated that Beck’s Depression Inventory-II is a multidimensional

self-report tool that evaluates the presence and harshness of depression and its symptoms.

Moreover, Beck et al. (1996) pointed out that the measure meets the criteria to diagnose

depressive disorders in adolescents and adults. There are certain aspects of depression that the

instrument evaluates. Beck et al. (1996) explained that it includes two dimensions that

involve somatic and cognitive-affective depressive symptoms. Beck et al. (1996) indicated

that the somatic symptoms fatigue and loss of energy among others. In addition, Beck et al.

(1996) explained that the cognitive-affective symptoms imply pessimism and worthlessness
 34

among others. Importantly, Beck et al. (1996) explained that affective symptoms might

change compared to non-affective ones. Beck’s Depression Inventory-II is among the most

popular measures of depression. It’s important to know whether individuals during the

pandemic are suffering from depression.

2.4.2 Depression during the Pandemic

During the pandemic, Lai et al. (2019) indicated that COVID-19 appears to be linked

with the psychiatric disease based on preliminary data from existing research. In addition, Lai

et al. (2019) pointed out that 50.4% of medical staff in China, who worked with people ill

with COVID-19 stated experiencing depressive symptoms. Anxiety was also found to be

more prevalent in students studying medicine in China, according to a report (Cao et al.,

2020). Another researcher such as Xiao et al. (2019) discovered that sleep deprivation was

connected with increased anxiety levels and pressure amongst Chinese medical care

employees. However, Lai et al. (2019) explained that until now, the majority of research on

psychological well-being and COVID-19 has been done in China. In addition, Lai et al.

(2019) mentioned that studies have been conducted on particular populations, such as

university students and health care staff. Whereas Ettman et al. (2020) explained that the

majority of published research on behavioral health in the United States used determined

samples. Furthermost pertinent to current research, Nelson et al. (2020) reviewed 9009

completed surveys circulated via social media to ascertain questions related COVID-19,

signs, and reactions to the pandemic outbreak. Nelson et al. (2020) discovered that 67.3% of

study population were extremely or quite nervous with COVID-19. Furthermore, 48.8% self-

isolated in the majority of the cases to escape COVID-19. Therefore, a negative impact of the

pandemic on psychological health was revieled, particularly on the odds of suffering from

depression and anxiety.

 35

2.5 Social Media Use and Mental Health

Firth et al. (2015) and Glick et al. (2016) discovered a tendency which is important

for the research on mental health. The researchers (Firth et al. 2015, Glick et al. 2016)

pointed out that people suffering from mental disorders are using more and more

smartphones. Likewise, Trefflich et al. (2015) indicated that there is evidence that people

with psychiatric illness highly use social media, including research examining usage with

these common platforms through a variety of contexts and disorders. In addition, Treffich et

al. (2015) showed that almost fifty percent of a group of clinical patients used social media

noting that younger people are using it more often. Similarly, Miller et al. (2015) indicated

that 47% of hospitalized and unhospitalized individuals suffering from schizophrenia disorder

testified that they use social media platforms. Additionally, Miller et al. (2015) revieled that

79% of the subjects mentioned at least weekly use of social media websites. Social media

usage has risen among medical demographics in recent years, as shown by a 2017 survey that

found similar degrees of social media use (around 70%) between people suffering from

severe psychological disorders in care and low-income communities (Brunette et al. 2019).

Consequently, there are certain advantages of social media use on mental health. For

instance, Naslund et al. (2016) pointed out that more than 70% of people suffering from

serious mental disorders are getting mental health support through social media. Similarly,

middle-aged and older adults suffering from psychological disorders who sought assistances

from friends, organizations, reported to use social media in 72% of cases (Aschbrenner et al.,

2018). Another survey showed similar findings, where 68% of people with episodeds of

neurosis were utilizing social media every day (Abdel-Baki et al., 2017).

Furthermore, Gay et al. (2016) reported that people who according to the self-report

questionnaire were indicating themselves as having signs of schizophrenia indicated that

 36

browsing social media platforms was among their most frequent habits while the use of

digital technology, accounting for about two hours per day. About 97% of teens and young

adults aged 12 to 21 with signs of psychological illnesses and temper disorders identified

spending time on social media, where the average of more than 2.5 hours of daytime

(Birnbaum et al., 2017). Likewise, Aschbrenner et al. (2019) indicated that 98% of teens

between the ages of 13 and 18 enrolled from local psychological health facilities testified

exploiting social media. They also indicated YouTube as being the most common channel,

trailed by Instagram and Snapchat. This kind of support that individuals suffering from a

mental health disorder receive could not be possible unless they use social media. Naslund et

al. (2019) pointed out that it simplifies interpersonal interactions, availability of peer

assistance and enhances commitment and permanence in the aids that they seek.

2.5.1 Benefits of Social Media Use and Mental Health

Particular benefits from social media use were identified for people with mental

illness. For example, the chance to network with different individual in other locations. This

ease of contact on demand can be particularly beneficial for individuals with mental

disabilities who have difficulty communicating in face-to-face environments. For instance,

Torous and Keshavan (2016) explained that compromised social processing is a mutual

shortage among people suffering from schizophrenia spectrum disorders. Thus, social media

can assist these individuals in communicating and engaging with others. Surprisingly, Miller

et al. (2015) proposed it in one study, in which people suffering from schizophrenia revealed

that social media improved their ability to communicate and interact. Therefore, it is an

alternative approach of communication for the ones who are suffering from a mental health

issue. As with other forms of online contact, Berger et al. (2005) explained that the ability to
 37

communicate privately can be a critical aspect of social media, specifically for people dealing

with extremely defaming mental health problems.

According to Spinzy et al. (2012) and Gowen et al. (2012), people suffering from

serious psychological disorders and young adults with psychological disorders are more

likely to cultivate online collaborations and engage with others on social media with the same

effectiveness as regular individuals. These findings are relevant since Badcock et al. (2015)

explained that the ones who suffer from severe mental illnesses usually have low number of

social connections in the real-life setting and frequently negatively impacted by the high rates

of separation. For instance, Brusilovskiy et al. (2016) reported that 47% of patients getting

psychological health care use social media networks as a minimum on the weekly basis to

feel more connected. Other authors such as Gowen et al. (2012) reported that the majority of

young individuals suffering from severe mental illness used social media to make them feel

less alone. Having a mental health issue and feeling isolated does not contribute to improving

the condition. Therefore, having adequate support becomes relevant. In addition,

Brusilovskiy et al. (2016) discovered that increased use of social media was correlated with

amplified group involvement, as measured by shopping, jobs, and related activities.

Moreover, access to peer support plays an important role. For instance, Bucci et al.

(2019) indicated that social media contributes to facilitating access to peer support. In

addition, Davidson et al. (2006) explained that it works as a system of providing and getting

support in the ones who are struggling with a mental health issue. Surprisingly, the ones who

have struggled in the past with mental health issues can support others. Therefore, social

media should not be seen exclusively as a way of getting support. Davidson et al. (2006)

indicated that friendship and hope work in these cases when facing similar challenges.
 38

There are studies that provide evidence of the benefits of online peer support. For

instance, Naslund et al. (2014) found that YouTube comments made by people who self-

reported to have a significant psychological illness revealed ways to decrease lonliness, offer

motivation, gain comfort and improve by shared reciprocity. Likewise, Chang (2009) found,

in other peer-support groups, various types of support such as informational one on drug use

or esteem one including supportive comments.

Other examples are found in other studies. For example, Berry et al. (2017), the ones

who publicly share mental health issues on Twitter obtained guidance and learn about the

views of others. Other authors such as Naslund et al. (2014) indicated that relevant motives to

employ social media platforms were posting shared stories about dealing with mental illness

and ways to hear about coping mechanisms from others. Likewise, Saha et al. (2019) found

that mental health promotion programs on Twitter, which reveals that inspirational messages

and advice are the most viewed.

As regards engagement and permanence in psychological health services, Lal et al.

(2018) indicated that people suffering from psychological disorders seek information in

social media about these issues. Other authors such as Birnbaum et al. (2017) indicated that

they connect through social platforms with the ones who provide mental health services.

Although there is plenty of confirmation of the benefits of using social media on

psychological health, there are certain risks to consider.

2.5.2 Risks of Social Media Use on Mental Health

There are certain risks from using social media on mental health. Naslund et al. (2019)

pointed out that based on a review of 43 research projects in young participants, it was found
 39

three clusters of risks such as the following: a) influence on signs, b) fronting aggressive

communications and: c) effects on daily routines.

On the influence on signs, researchers such as Andreassen et al. (2016), Kross et al.

(2013), and Woods and Scott (2016) indicated that subjects who heavily use social media and

during prolong periods, tend to suffer from mental health issues and low quality of wellbeing.

Consistently, Stiglic and Viner (2019) pointed out that increase in of social media use

increases anxiety and signs of depression. In addition, Lin et al. (2016) pointed out that the

frequency of the use of social media platforms positively associated with higher levels of

depression. Likewise, Vannucci et al. (2017) stated that greater time spent on social media

was positively correlated with more anxiety symptoms. Interestingly enough, Primack et al.

(2017) explained that the large variety of social media networks visited by young adults was

positively associated with negative outcomes in their mental health. In addition, Primack et

al. (2017) stated that participants visiting more than 7 different social media platforms

increased 3 times the odds of suffering from depression and anxiety. Other studies found

consistent confirmation on the harmful effect of social media use on anxiety and depression.

For instance, Hoare et al. (2016) discovered a moderate positive relationship between total

time spent on social media use and increased anxiety. Authors such as Costigan et al. (2012)

discovered an affirmative relationship between social media use and depression in 3 studies.

Likewise, Hoare et al. (2016) discovered a positive relationship between depression and the

use of social media platforms. Similarly, Suchert et al. (2015) found a positive association

between social media use and depression. In addition, Shensa et al. (2018) found significant

differences in the ones with heavy usage of social media and higher symptoms of depression.

Likewise, Shensa et al. (2018) discovered that participants who highly use social media suffer

severely from anxiety.

 40

Other authors such as Twenge and Campbell (2018) suggested that mental health

issues among youth attributed to social media use might be caused by the deficiency of real-

life interactions. Likewise, Bucci et al. (2019) pointed out that mental health issues related to

social media use could increase loneliness. Similarly, Woods and Scott (2016) explained that

social media use could have detrimental consequences on wellbeing.

As regards fronting aggressive communications, well-liked social media sites may

build scenarios in which people can become victimized as a result of offensive remarks or

tweets. Cyberbullying is a form of virtual aggression with the goal to bully a certain

individual, which is deemed to be more harmful than spontaneous intimidating commentaries

made on the Internet (Hamm et al., 2015). Notably, cyberbullying on social media has a clear

damaging result on psychological wellbeing, manifesting as a rise in depressive symptoms

and a deterioration of symptoms of anxiety, as shown by a study of 36 findings involving

youngsters and adolescents (Hamm et al., 2015). Additionally, cyberbullying

overwhelmingly affects women, as shown by a countrywide questionnaire on teens in the

United States of America, which found that women had higher chances to become a target of

cyberbullying (Alhajji et al. 2019). Although Hamm et al. (2015) indicated that the majority

of researchers identified cross-sectional correlations between cyberbullying and depressive or

anxiety symptoms, Machmutow et al. (2012) discovered that cyberbullying was associated

with substantially greater depression over time.

Concerning the consequences to daily life, individuals' use of social media will also

have an influence on their interactions when they are disconnected from social media. Torous

and Keshavan (2016) indicated that several studies have outlined the dangers associated with

social media use in terms of privacy, discretion, and possible outcomes associated with public

disclosure of individual health data. Additionally, the accuracy of health-related information

 41

available on the social media platforms is questionable. It is also not clear whether the social

media users are aware of the possibility to get misleading information on the social media

(Moorhead et al., 2013; Ventola, 2014). Furthermore, there may be potential dangers linked

to social media use for individuals coping with psychological illness. For instance, Naslund

and Aschbrenner (2019) pointed out that based on experiences of social media consumers

who have severe psychiatric problems, such as schizophrenia spectrum disorders, bipolar

disorder, or major depression, almost every third respondent shared fears related to their

confidentiality while exploiting social media.

Authors such as Twenge and Campbell (2018) indicated that the detrimental outcomes

of social media on mental health could be attributed to the lack of face-to-face interactions

among youth. Others such as Bucci et al. (2019) explained that the lack of this type of

interaction can increase loneliness. Likewise, Woods and Scott (2016) pointed out that the

lack of face-to-face interactions might affect other features of wellbeing and mental health.

Since one of the preventive measures to fight the pandemic was to implement lockdowns,

participants faced a lack of face-to-face interactions. In addition, other restrictions increased

the lack of mobility and face-to-face interactions.

As regards, fear of missing out as a mediator between social media use and mental

health problems such as anxiety and depression, Guangzhe et al. (2020) pointed out that fear

of missing out significantly mediated between problematic smartphone use and depression.

Desjarlais and Willoughby (2010) suggested that psychopathological issues such as anxiety

and depression could lead to fear of missing out due to the perceived social deficits. In the

same line of thought, Oberst et al. (2016) found that fear of missing out was a statistically

significant mediator between anxiety/depression and mobile phone use. To summarize the

evidence, as Przybylski et al. (2013) suggested, that fear of missing out is a mediator between
 42

social media engagement and deficits in psychological needs and psychopathological

problems.

2.6 Hypotheses

The purpose of the study was to evaluate whether there are differences in depression

and anxiety levels among people who actively use social media during the pandemic. In

addition, its purpose was to evaluate whether fear of missing out is a mediator between social

media use and depression as well as state anxiety. Thence, I intended to answer the following

research questions: Are there social media use differences on depression and state anxiety

during the pandemic? Is the fear of missing out a mediator between social media use and

depression as well as state anxiety? I aimed to answer the research questions hypothesizing

the following:

Ha1: There are social media use differences on depression during the pandemic.

It was expected that people who spend more time using social media will have higher

scores of depression scores in comparison with individuals who spend less time using

social media.

Ha2: There are social media use differences on state anxiety during the pandemic.

It was expected that heavy social media users will also have greater anxiety levels

compared to those individuals who use social media on moderate level.

Ha3: Fear of missing out is a mediator between social media use and depression.

There is a link between fear of missing out and the levels of depression in social

media users.

Ha4: Fear of missing out is a mediator between social media use and state anxiety.

There is a link between fear of missing out and the levels of anxiety in social media

users.
 43

Method

3.1 Introduction

This part of the thesis describes the method and includes the research design, subjects,

instruments, procedure, and data analyses.

3.2 Design

This research study employed a quantitative, correlational, and confirmatory design to

empirically evaluate the research questions. It is an appraisal of the relationship between

social media use and mental health issues such as depression and anxiety. In addition, it is an

assessment of the mediating effect of fear of missing out on social media use and depression

as well as anxiety.

3.3 Participants

For the purpose of current research project, I gathered a probability sample of 237

participants drawn from a study population of 600 social media users. I employed a 95%

confidence level and 5% of margin of error to compute a minimum sample size of 235

subjects to be included in the study. The inclusion criteria to qualify to participate in the

study were the following: a) Users of at least one platform of social media (Facebook,

WhatsApp, etc.); b) Good understanding of the English language; c) Older than 18 years old;

d) Agree to participate in the study; e) Agree to participate voluntarily. The sample was

composed of 78.53% females and 20.94% of males. In addition, there was one participant

(0.52% of the sample) in the other category. (see Figure 1)

 44

Figure 1

Gender of Participants

As regards the age of subjects, the mean was 34.48 years old (SD = 9.68, S2 = 93.78).

The youngest subject was 18 years old and the oldest one 67.

With respect to the area of origin of the participants, the majority was from Europe

(51.31%), America (39.27%), Asia (7.33%) and a minority from Africa (1.05%) and

Oceania/Australia (1.05%). (see Figure 2)

Figure 2

Area of Origin of Participants

 45

Regarding the marital status of participants, almost half of the sample (49.74%) was

single whereas 42.93% was married. Interestingly enough, only a minority of the sample

(7.33%) was divorced, and none was widowed.

Concerning the children of participants, most of the sample (64.40%) did not have

children. Out of the subjects who have children, the majority (76.12% of the sample) have

one child (37.31%) or two children (38.81%). (see Figures 3 and 4)

Figure 3

Subjects with children

Figure 4

Number of Children of Participants

 46

With respect to subjects studying at the university, most of them (62.83%) were not

enrolled in any university. Out of the participants who were studying at the university, most

of them (40.85%) were studying a Ph. D. program whereas 22.54% were enrolled in a

Bachelor’s program. (see Figures 5 and 6)

Figure 5

Subjects currently Studying at the University

Figure 6

Study Program enrolled by Subjects at the University

 47

Concerning subjects in the workforce, most of them (80.10% of the sample) were

currently working. Out of the participants who were currently working, most of them

(76.97%) had a part-time work schedule. (see Figures 7 and 8)

Figure 7

Subjects in the Workforce

Figure 8

Work Schedule of Participants

 48

3.4 Measures

The self-report measures employed in this research project were the following: a)

Beck’s Depression Inventory II, b) State-Trait Anxiety Inventory; c) Fear of Missing Out

scale; d) time spent of on social media; e) frequency spent on social media; f) multiple

platform use; g) Problematic Social Media Use scale and h) Social Media Intensity scale.

As regards Beck’s Depression Inventory II, Beck et al. (1996) stated that it is a

multidimensional self-report measure that evaluates the presence and severity of depression

symptoms. In addition, Beck et al. (1996) mentioned that it includes two dimensions that

involves somatic and cognitive-affective depressive symptoms. Moreover, Beck et al. (1996)

stated that sample items of the instrument were such as “I do not feel sad”, or “I dislike

myself”. Furthermore, Beck et al. (1996) pointed out that the scale involves 21 items that are

rated based on a list of four statements that are sorted based on the severity of the depressive

symptoms. With respect to its psychometric soundness, Beck et al. (1996) provided evidence

of high construct validity in comparison to the Beck’s Depression Inventory I. As regards the

reliability of the instrument, Beck et al. (1996) mentioned that its internal consistency was

falling between 0.92 and 0.94 based on the sample. In addition, its test-retest stability was

high.

With respect to the State-Trait Anxiety Inventory, Spielberger et al. (1983) indicated

that it is a multidimensional measure that evaluates state and trait anxiety. In the current

study, it was considered only state anxiety. Moreover, Spielberger et al. (1983) explained that

state anxiety means noticeable reactions or processes that are occurring at a given moment

with a certain degree of intensity. Furthermore, Spielberger et al. (1983) indicated that sample

items of the measure are such as “I am tense” or “I am worried”. In addition, Spielberger et

al. (1983) pointed out that the scale contains 20 items that are rated on a 4-point Likert scale

that ranges from 1 (not at all) to 4 (very much so). With respect to the psychometric
 49

soundness of the scale, Spielberger et al. (1983) mentioned that the instrument is highly valid.

Furthermore, Spielberger et al. (1983) stated that the measure is highly reliable with its

internal consistency with a median coefficient of 0.90.

Concerning the Fear of Missing Out scale, Przybylski et al. (2013) mentioned that it is

a unidimensional measure that evaluates the consuming feeling that someone else (e. g.

peers) is having more or something better than the person. In addition, Przybylski et al.

(2013) pointed out that sample items of the measure involved some of them such as “When I

miss out on a planned get-together it bothers me”. Furthermore, Przybylski et al. (2013)

indicated that the scale includes 10 items that are rated on a 5-point Likert scale that varies

from 1 (Not at all true of me) to 5 (Extremely true of me). As regards its psychometric

soundness, Przybylski et al. (2013) indicated that the scale is highly valid and has a good

internal consistency (α = 0.90).

Regarding social media use, I considered different measures to gather patterns of

social media use. I took into account the time and frequency spent on social media, the

multiple platform use, the problematic social media use, and the social media intensity.

As regards time spent on social media, it was asked from the participants to self-report

the daily time (in minutes) that they spend on any platform of social media that was non-work

related.

With respect to frequency spent on social media, it was inquired subjects to report the

weekly site checks on the most popular social media platforms such as Facebook, Google+,

Twitter, Instagram, LinkedIn, YouTube, Vine, Tumblr, Pinterest, Reddit, Snapchat, and VK.

Based on Shensa et al. (2018) answer categories, the response options ranged from “I don’t

use this platform” to “5 or more times a day”. Shensa et al. (2018) coded each of the response

options into an average weekly site check estimate varying from 0 to 35. Since there was
 50

included the 12 most popular social media platforms, the total weekly site checks ranged

from 0 to 420.

Regarding the multiple platform use, I adopted the Shensa et al. (2018) approach

taking the responses obtained in the frequency spent on social media. Furthermore, it was

transformed into 0 when participants responded: “I don’t use this platform” and all other

responses were coded into 1. Since there were 12 social media platforms, the total scores

ranged from 0 to 12.

Concerning the problematic social media use, I implemented Shensa et al. (2018)

adaptation of the Andreassen et al. (2012) Bergen Facebook Addiction Scale. In the

adaptation, Shensa et al. (2018) reworded the questions referring to Facebook into social

media. For instance, Andreassen et al. (2012) worded a question such as the following: “How

often during … spent a lot of time thinking about Facebook?”. However, Shensa et al. (2018)

reworded into the following: “How often during… spent a lot of time thinking about social

media”. Using Shensa et al. (2018) adaptation, allowed the scale to embrace general attitudes

towards addiction in multiple social media platforms. Andreassen et al. (2012) mentioned that

the Bergen Facebook Addiction scale aims to evaluate the core elements of addiction to

Facebook. In addition, Andreassen et al. (2012) detailed that it is a multidimensional measure

that includes aspects of addiction such as salience, patience, state alteration, decline,

withdrawal, and struggle. With Shensa et al. (2018) adaptation, the problematic social media

use scale aimed to evaluate the central elements of addiction to multiple social media

platforms. Furthermore, Andreassen et al. (2012) detailed that the scale contains 6 questions

that are answered using a 5-point Likert scale that varies from 1 (very rarely) to 5 (very

often). In Shensa et al. (2018) adaptation, it was used the same 5-point Likert scale. With

respect to the psychometric soundness, Andreassen et al. (2012) and Shensa et al. (2018)

indicated that the scales are highly valid and reliable. For instance, Andreassen et al. (2012)
 51

pointed out that the internal consistency was 0.83 in the original sample. Whereas Shensa et

al. (2018) stated that there was 65% of the variance explained by the one-factor solution. In

addition, Shensa et al. (2018) noted that the internal consistency of the scale was 0.89.

With reference to the Social Media Intensity scale, I implemented Shensa et al. (2018)

adaptation of the Ellison et al. (2007) Facebook Intensity scale. In the adaptation, Shensa et

al. (2018) reworded the items referring to Facebook into social media. For example, Ellison

et al. (2007) worded a question such as the following: “Facebook is part of my everyday

activity”. Nevertheless, Shensa et al. (2018) reworded into the following: “Social media is

part of my everyday activity”. Employing Shensa et al. (2018) adaptation, allowed the scale

to encompass an emotional connection to multiple social media and the social media

integration to the subject’s activities. Ellison et al. (2007) indicated that the Facebook

Intensity scale is unidimensional and aims to assess the emotional connection to Facebook

and Facebook’s integration to the subject’s activities. With Shensa et al. (2018) adaptation,

the social media intensity scale aimed to evaluate the emotional connection to social media

platforms and the extent of the integration of social media into the regular subject’s activities.

Likewise, Ellison et al. (2007) detailed that the scale contains 6 items that are rated using a 5-

point Likert scale that varies from 1 (strongly disagree) to 5 (strongly agree). In Shensa et al.

(2018) adaptation, it was used the same 5-point Likert scale. Concerning the psychometric

soundness, Shensa et al. (2018) indicated that the scale is highly valid and reliable. Shensa et

al. (2018) stated that there was 72% of the variance was explained by the one-factor solution.

In addition, Shensa et al. (2018) noted that the internal consistency of the scale was 0.92.
 52

3.5 Procedure

The first step was to gather a list of the study population. In total, 600 participants

were sampled from around the world. After the participants were randomly selected, I sent

the invitations explaining the aim of the study and the link to the online questionnaire to 240

selected subjects. The informed consent was anonymously obtained online from 237

participants. After agreeing with the consent form and conditions to participate in the study

(inclusion criteria), the participants could answer the questionnaire. Otherwise, no items were

shown. The second step in the study was to collect the responses from participants. The

responses were collected from November 2020 to April 2021. Collected responses were

tabulated and stored separately from informed consent forms. The third and last step in the

study was to conduct the data analyses.

3.6 Analysis

The first step in the data analyses was to create a composite measure of social media

use. The composite measure was based on the different patterns of social media use such as

the time and frequency spent on social media, multiple platform use, problematic social

media use, and the social media intensity. In order to create the composite measure, I

performed a principal component analysis. This approach was preferred rather than obtaining

the z-scores since the variables were not normally distributed. After getting a one-component

solution, I obtained the component scores using the Anderson-Rubin method. This method

provides component scores with a mean of 0 and a standard deviation of 1. Afterward, the

component scores were transformed into nominal categories based on social media use. If the

scores were falling under -1 standard deviation, they were categorized as low social media
 53

usage. The ones falling between -1 and +1 standard deviation were classified as normal social

media usage. The ones falling over +1 standard deviation were categorized as high social

media usage.

The second step in the data analyses involved the differences in depression and state

anxiety based on social media usage. There were performed 2 Kruskal-Wallis tests to

evaluate the differences since the main variables were not normally distributed.

The third and final step was to evaluate the mediating effect of Fear of Missing Out

on the relationships between the composite measure of social media use and depression as

well as state anxiety.

Findings

4.1 Introduction

The findings involve reporting the descriptive statistics and normality assessment of

main variables, the composite measure of social media use and test of hypotheses.

4.2 Descriptive Statistics of Main Variables

The descriptive statistics were computed for the main variables such as depression,

state anxiety, fear of missing out, and the ones that belong to the patterns of social media use

(daily time and frequency spent on social media, multiple platform use, problematic social

media use, and social media intensity).

Concerning depression, the central tendency and spread indices were computed on a

sample of 235 participants. It was found two missing scores in the data. The mean depression

score (M = 11.93) was higher than the median and mode ones (Mdn = 10; Mo = 2).

Depression scores varied from a minimum of 0 to a maximum of 46. It is important to note

 54

that there was a moderate spread of depression scores present in the data. It was found a

moderate standard deviation of 9.23 and a variance of 85.18. (see Table 1)

Table 1

Descriptive Statistics of Depression, State Anxiety, Fear of Missing Out and Patterns of

Social Media Use

n M Mdn Mode SD S2 Min Max

Depression 235 11.93 10 2 9.23 85.18 0 46

State
215 44.20 42 41 13.24 175.20 20 76
Anxiety

Fear of
200 21.21 19.50 16 7.71 59.42 10 50
Missing Out

Daily time

spent on
201 224.85 150 120 361.28 130520.91 3 4140
Social

Media

Frequency

spent on
197 56.55 51 56 37.55 1410.10 0 221.5
Social

Media

Multiple

Platform 237 4.86 4 3 3.51 12.34 0 12

Use

Problematic

Social 199 13.97 13 8 5.43 29.49 6 30

Media Use
 55

Social

Media 193 20.07 20 19 4.76 22.64 7 30

Intensity

Notes. n = sample size; M = Mean; Mdn = median; SD = standard deviation; S2 = variance;

Min = minimum; Max = maximum

As regards state anxiety, the descriptive statistic indices were calculated based on

a sample of 215 subjects. There were 22 participants who didn’t provide data for this

variable. It was discovered that the central tendency indices of state anxiety were very

similar (M = 44.20; Mdn = 42.00; Mo = 41.00). Furthermore, state anxiety scores ranged

moderately (Min = 20; Max = 76). Moreover, it was noticed a moderate standard

deviation and variance (SD = 13.24, S2 = 175.20). (see Table 1)

Concerning fear of missing out, the descriptive statistical indices were computed on a

sample of 200 subjects. There were 37 participants who did not provide answers for this

variable. It was noticed that the mean score of fear of missing out (M = 21.21) was higher

than its median and mode scores (Mdn = 19.50; Mo = 16). Surprisingly, the fear of missing

out scores ranged moderately. The sample comprised participants scoring from 10 to 50 in

the scale. In addition, the moderate standard deviation and variance were 7.71 and 59.42

respectively. (see Table 1)

With respect to the patterns of social media use, it was computed the descriptive

statistic indices of daily time spent on social media. The indices are based on a sample of 201

participants since 36 were missing data. The mean of daily time spent on social media (M =

224.85 minutes) was larger than its median and mode scores (Mdn = 150 minutes; Mo = 120

minutes). In addition, the daily time spent on social media varied largely (Min = 3; Max =
 56

4140). Furthermore, it was noticed a large standard deviation and variance (SD = 361.28, S2 =

130520.91). (see Table 1)

Regarding frequency spent on social media, the descriptive indices were calculated

based on 197 subjects. There were 40 participants who did not provide responses

concerning this variable. It was observed that the mean score of the frequency spent on

social media (M = 56.55 site checks per week) was slightly higher than its median and mode

scores (Mdn = 51 site checks per week; Mo = 56 site checks per week). Interestingly

enough, the site checks per week ranged moderately. The minimum and maximum of site

checks per week was 0 and 221.50 respectively. Furthermore, the moderate standard

deviation and variance were 37.55 and 1410.10 site checks per week respectively. (see

Table 1)

Concerning other patterns of social media use, it was calculated the descriptive

statistic indices of multiple platform use. The indices are based on the whole sample of 237

subjects. The mean of multiple platform use (M = 4.86 platforms checked per week) was

larger than its median and mode scores (Mdn = 4 platforms checked per week; Mo = 3

platforms checked per week). Likewise, the number of platforms checked per week ranged

moderately (Min = 0; Max = 12). Additionally, it was observed a moderate standard deviation

and variance present in the data (SD = 3.51, S2 = 12.34). (see Table 1)

With respect to the problematic social media use, it was computed the descriptive

indices based on a sample of 199 subjects. There was missing data from 38 participants

regarding this variable. It was observed that the mean score of problematic social media use

(M = 13.97) was larger than its median and mode scores (Mdn = 13; Mo = 8). Surprisingly,

the problematic social media use scores ranged moderately. The minimum score of

problematic social media use was 6 whereas the maximum one was 30 Furthermore, it was

found a moderate standard deviation of 5.43 and variance of 29.49. (see Table 1)
 57

Regarding other patterns of social media use, it was computed the central tendency

and spread indices of social media intensity. There were included 193 participants for the

computation of these indices. There were missing data from 44 subjects. The mean of social

media intensity (M = 20.07) was slightly larger than its median and mode scores (Mdn = 20;

Mo = 19). Moreover, social media intensity scores varied moderately (Min = 7; Max = 30). In

addition, it was discovered a moderate standard deviation and variance in the data (SD = 4.76,

S2 = 22.64). (see Table 1)

4.3 Normality Assessment of Main Variables

The normality assessments were performed on the main variables. The first cluster of

normality assessments were carried out on variables such as depression, state anxiety and fear

of missing out.

A Shapiro Wilk’s test was carried out a on the variable depression showing that the

scores were not normally distributed, p < .001. Likewise, state anxiety scores were not

normally distributed, as evaluated by the Shapiro Wilk’s test, p < .001. Similarly, the Shapiro

Wilk’s test showed that fear of missing out scores were not normally distributed, p < .001.

(see Table 2)

Table 2

Test of Normality of Depression, State Anxiety and Fear of Missing Out

Shapiro-Wilk

Statistic df

Depression 0.92*** 191

State Anxiety 0.97*** 191

 58

Fear of Missing Out 0.92*** 191

Note. * p ≤ .05 ** p ≤ .01 ***p ≤ .001

As regards the appearance of the distribution of depression scores, it was noted that

the non-normal distribution presented positive skewness (γ1 = 1.08, SE = 0.18) as well as

positive kurtosis (β2 = 1.10, SE = 0.35). Furthermore, state anxiety scores created a positively

skewed (γ1 = 0.41, SE = 0.18) and platykurtotic distribution (β2 = -0.62, SE = 0.35). In

addition, it was noted that the non-normally distributed fear of missing out scores were

scattered in a positively skewed (γ1 = 1.09, SE = 0.18) and leptokurtotic distribution (β2 =

1.07, SE = 0.35). (see Table 3)

Table 3

Skewness and Kurtosis in the Distribution of Depression, State Anxiety and Fear of

Missing Out

γ1 SE γ1 β2 SE β2

Depression 1.08 0.18 1.10 0.35

State Anxiety 0.41 0.18 -0.62 0.35

Fear of Missing
1.09 0.18 1.07 0.35
Out

Notes. γ1 = skewness; SE γ1 = standard error of skewness; β2 = kurtosis; SE β2 = standard

error of kurtosis

In addition, a visual inspection of histograms and normal Q-Q plots indicated that

depression, state anxiety and fear of missing out were not normally distributed (see Figures 9

to 14)
 59

Figure 9

Histogram of Scores in Depression

Figure 10

Normal Q-Q Plot of Scores in Depression

 60

Figure 11

Histogram of Scores in State Anxiety

Figure 12

Normal Q-Q Plot of Scores in State Anxiety

 61

Figure 13

Histogram of Scores in Fear of Missing Out

Figure 14

Normal Q-Q Plot of Scores in Fear of Missing Out

 62

The second cluster of normality assessments were carried out on the patterns of social

media use. It involved assessing variables such as daily time and frequency spent on social

media, multiple platform use, problematic social media use and social media intensity.

A Shapiro Wilk’s test was performed on the variable daily time spent on social media

indicating that the scores were not normally distributed, p < .001. Similarly, frequency spent

on social media scores were not normally distributed, as assessed by the Shapiro Wilk’s test,

p < .001. In addition, the Shapiro Wilk’s test pointed out that multiple platforms use scores

were not normally distributed, p < .001. Likewise, after conducting a Shapiro Wilk’s test on

the variable problematic media use, the results showed that the scores were not normally

distributed, p < .001. Nevertheless, social media intensity scores were normally distributed

based on a Shapiro Wilk’s test, p = .06. (see Table 4)

Table 4

Test of Normality of Patterns of Social Media Use

Shapiro-Wilk

Statistic df

Daily time spent on social 0.36***

191
media

Frequency spent on social 0.89*** 191

media

Multiple platform use 0.89*** 191

Problematic social media 0.95*** 191

use

Social Media Intensity 0.99 191

 63

Note. * p ≤ .05 ** p ≤ .01 ***p ≤ .001

Regarding the shape of the distribution of daily time spent on social media, it was

witnessed that the non-normal distribution showed positive skewness (γ1 = 7.74, SE = 0.18)

as well as leptokurtosis (β2 = 73.51, SE = 0.35). In addition, frequency spent on social media

scores were scattered in a positively skewed (γ1 = 1.53, SE = 0.18) and platykurtotic

distribution (β2 = 3.59, SE = 0.35). Moreover, it was witnessed that the non-normally

distributed multiple platforms use scores were scattered in a positively skewed (γ1 = 1.40, SE

= 0.18) and leptokurtotic distribution (β2 = 3.54, SE = 0.35). Likewise, the non-normal scores

from problematic social media use presented positive skewness (γ1 = 0.54, SE = 0.18) but

negative kurtosis (β2 = -0.49, SE = 0.35). However, the normally distributed scores of social

media intensity were scattered in a negatively skewed (γ1 = -0.25, SE = 0.18) and

platykurtotic distribution (β2 = -0.13, SE = 0.35). (see Table 5)

Table 5

Skewness and Kurtosis in the Distribution of Patterns of Social Media Use

γ1 SE γ1 β2 SE β2

Daily time spent

7.74 0.18 1.10 0.35
on social media

Frequency spent on
1.53 0.18 3.59 0.35
social media

Multiple platform
1.40 0.18 3.54 0.35
use

Problematic social
0.54 0.18 -0.49 0.35
media use
 64

Social Media
-0.25 0.18 -0.13 0.35
Intensity

Notes. γ1 = skewness; SE γ1 = standard error of skewness; β2 = kurtosis; SE β2 = standard

error of kurtosis

Furthermore, a visual inspection of histograms and normal Q-Q plots indicated that

daily time and frequency spent on social media, multiple platform-use and problematic social

media use were not normally distributed (see Figures 15 to 22)

Figure 15

Histogram of Scores in Daily Time Spent on Social Media

 65

Figure 16

Normal Q-Q Plot of Scores in Daily Time Spent on Social Media

Figure 17

Histogram of Scores in Frequency Spent on Social Media

 66

Figure 18

Normal Q-Q Plot of Scores in Frequency Spent on Social Media

Figure 19

Histogram of Scores in Multiple Platform Use

 67

Figure 20

Normal Q-Q Plot of Scores in Multiple Platform Use

Figure 21

Histogram of Scores in Problematic Social Media Use

 68

Figure 22

Normal Q-Q Plot of Scores in Problematic Social Media Use

However, a visual inspection of histograms and normal Q-Q plots indicated that social

media intensity scores were normally distributed (see Figures 23 to 24)

Figure 23

Histogram of Scores in Social Media Intensity

 69

Figure 24

Normal Q-Q Plot of Scores in Social Media Intensity

4.4 Composite Measure of Social Media Use

Since the different patterns of social media use were not normally distributed, it was

performed a principal component analysis as an alternative approach. The principal

component analysis was conducted on the 5 social media measures in 237 subjects. Prior the

analysis, it was conducted the suitability of the statistical procedure. Based on the visual

inspection of the correlation matrix, it showed that all items had at least one correlation

coefficient greater than 0.2. (see Table 6)

Table 6

Correlation Matrix of Patterns of Social Media Use in the Composite Measure

Daily time Frequency Multiple Problematic Social

spent on spent on platform social media

social media social media use media use intensity

 70

Daily time spent

on social media

Frequency spent
0.32
on social media

Multiple platform
0.28 0.67
use

Problematic
0.24 0.44 0.31
Social Media Use

Social Media
0.28 0.48 0.30 0.53
Intensity

The overall Kaiser-Meyer-Olkin measure of sampling adequacy (KMO) index was

0.72. In addition, the individual KMO indices were all greater than 0.6. Based on Kaiser’s

(1974) categorization, the indices ranged from mediocre to meritorious. (see Table 7)

Table 7

Anti-image Correlation Matrix of Patterns of Social Media Use in the Composite Measure

Daily time
Frequency Problemat
spent on Multiple Social media
spent on social ic social
social platform use intensity
media media use
media

Daily time

spent on 0.89a

social media
 71

Frequency

spent on -0.11 0.68 a

social media

Multiple
-0.09 -0.60 0.66 a
platform use

Problematic

Social -0.06 -0.18 -0.02 0.77 a

Media Use

Social

Media -0.12 -0.26 0.04 -0.39 0.74 a

Intensity

Notes. a = measures of sampling adequacy

Furthermore, the data were factorizable since the Bartlett's Test of Sphericity was

statistically significant (p < .001).

The principal component analysis indicated that one component that an eigenvalue

greater than one. In addition, it explained 51.42% of the total variance. When conducting a

visual inspection on the screen plot, it was suggested that it should be retained only one

component (Cattell, 1966). (see Figure 25)

 72

Figure 25

Scree Plot of Patterns of Social Media Use in the Composite Measure

Moreover, the one-component solution met the interpretability criterion. As such, one

component was retained.

The one-component solution accounted for 51.42% of the total variance. It was not

employed any rotation. The solution showed a simple structure (Thurstone, 1947). In

addition, no patterns of social media use were dropped. The interpretation of the data was

consistent with the composite measure of social media use that was intended to measure, with

strong loadings of social media use on the unique component. The communalities and

loadings of the components of the solution are presented in Table 8.

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Table 8

Unrotated Structure Matrix for Principal Component Analysis of Patterns of Social Media Use

in the Composite Measure

Items Unrotated Component Coefficients

Component 1 Communalities

Daily time

spent on 0.54 0.29

social media

Frequency

spent on 0.84 0.71

social media

Multiple
0.73 0.54
platform use

Problematic

Social 0.71 0.50

Media Use

Social

Media 0.73 0.53

Intensity

In addition, component scores were obtained using the Anderson-Rubin method.

Anderson-Rubin method allowed obtaining component scores with a mean of 0 and standard

deviation of 1.
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4.5 Composite Measure of Social Media Use into Categories

Component scores were transformed into nominal categories based on social media

use. The nominal categories on social media use were arranged based on the following:

a. Low social media usage: component scores under -1 standard deviation

b. Normal social media usage: component scores between -1 and +1 standard deviation

c. Heavy social media usage: component scores over +1 standard deviation

After the component scores were transformed, 26 participants fell into the low usage

category (76% females, mean age of 40.88, and 69.2% married). Whereas 25 subjects were

categorized as heavy social media users (88% females, mean age of 26.88, and 80% single).

The majority of the sample (140 participants) were classified as normal social media users

(77.7% females, mean age of 34.62, and 50.4% single).

4.6 Normality Assessment on Depression and Anxiety per Composite Measure of Social

Media Use

Concerning depression, the Shapiro Wilk’s test indicated that the scores were not

normally distributed among low social media users (p = .004) neither in normal social media

users (p < .001). However, depression scores were normally distributed among heavy social

media users, as assessed by the Shapiro Wilk’s test, p = .14. (see Table 9)
 75

Table 9

Test of Normality of Depression per Composite Measure of Social Media Use

Shapiro-Wilk

Statistic df

Depression on low social

0.87** 26
media users

Depression on normal
0.93*** 140
social media users

Depression on heavy
0.94 25
social media users

Note. * p ≤ .05 ** p ≤ .01 ***p ≤ .001

As regards the appearance of the distribution of depression scores in low social media

users, it was noted that the non-normal scores were positively skewed (γ1 = 1.39, SE = 0.46)

and presented positive kurtosis (β2 = 2.02, SE = 0.89). In addition, depression scores in

normal social media users were scattered on a distribution with positive skewness (γ1 = 1.00,

SE = 0.20) and leptokurtosis (β2 = 1.10, SE = 0.41). Interestingly enough, normally

distributed depression scores in heavy social media users showed positive skewness (γ1 =

0.64, SE = 0.46) and negative kurtosis (β2 = -0.28, SE = 0.90). (see Table 10)
 76

Table 10

Skewness and Kurtosis in the Distribution of Depression per Composite Measure of Social

Media Use

γ1 SE γ1 β2 SE β2

Depression on low
1.39 0.46 2.02 0.89
social media users

Depression on

normal social 1.00 0.20 1.10 0.41

media users

Depression on

heavy social 0.64 0.46 -0.28 0.90

media users

Notes. γ1 = skewness; SE γ1 = standard error of skewness; β2 = kurtosis; SE β2 = standard

error of kurtosis

In addition, a visual inspection of histograms and normal Q-Q plots indicated that

depression scores on low and normal social media users were not normally distributed (see

Figures 26 to 29)
 77

Figure 26

Histogram of Depression Scores in Low Social Media Users

Figure 27

Normal Q-Q Plot of Depression Scores in Low Social Media Users

 78

Figure 28

Histogram of Depression Scores in Normal Social Media Users

Figure 29

Normal Q-Q Plot of Depression Scores in Normal Social Media Users

 79

Nonetheless, a visual inspection of histograms and normal Q-Q plots indicated that

depression scores on heavy social media users were normally distributed (see Figures 30 to

31)

Figure 30

Histogram of Depression Scores in Heavy Social Media Users

Figure 31

Normal Q-Q Plot of Depression Scores in Heavy Social Media Users

 80

As regards state anxiety, the Shapiro Wilk’s test pointed out that the scores were not

normally distributed among low social media users (p = .007) neither in normal social media

users (p = .011). Nevertheless, state anxiety scores were normally distributed among heavy

social media users, as assessed by the Shapiro Wilk’s test, p = .13. (see Table 11)

Table 11

Test of Normality of State Anxiety per Composite Measure of Social Media Use

Shapiro-Wilk

Statistic df

State Anxiety on low

0.88** 26
social media users

State Anxiety on normal

0.98** 140
social media users

State Anxiety on heavy

0.94 25
social media users

Note. * p ≤ .05 ** p ≤ .01 ***p ≤ .001

As regards the shape of the distribution of state anxiety scores in low social media

users, it was noted that the non-normal scores were positively skewed (γ1 = 1.48, SE = 0.46)

and had positive kurtosis (β2 = 2.74, SE = 0.89). Furthermore, state anxiety scores in normal

social media users were scattered on a distribution with positive skewness (γ1 = 0.35, SE =

0.20) but negative kurtosis (β2 = -0.52, SE = 0.41). Surprisingly, normally distributed state

anxiety scores in heavy social media users presented negative skewness (γ1 = -0.02, SE =

0.46) and negative kurtosis (β2 = -1.36, SE = 0.90). (see Table 12)
 81

Table 12

Skewness and Kurtosis in the Distribution of State Anxiety per Composite Measure of

Social Media Use

γ1 SE γ1 β2 SE β2

State Anxiety on

low social media 1.49 0.46 2.74 0.89

users

State Anxiety on

normal social 0.35 0.20 -0.52 0.41

media users

State Anxiety on

heavy social -0.02 0.46 -1.36 0.90

media users

Notes. γ1 = skewness; SE γ1 = standard error of skewness; β2 = kurtosis; SE β2 = standard

error of kurtosis

Moreover, a visual inspection of histograms and normal Q-Q plots pointed out that state

anxiety scores on low and normal social media users were not normally distributed (see

Figures 32 to 35)
 82

Figure 32

Histogram of State Anxiety Scores in Low Social Media Users

Figure 33

Normal Q-Q Plot of State Anxiety Scores in Low Social Media Users
 83

Figure 34

Histogram of State Anxiety Scores in Normal Social Media Users

Figure 35

Normal Q-Q Plot of State Anxiety Scores in Normal Social Media Users

However, a visual inspection of histograms and normal Q-Q plots indicated that state

anxiety scores on heavy social media users were normally distributed (see Figures 36 to 37)
 84

Figure 36

Histogram of State Anxiety Scores in Heavy Social Media Users

Figure 37

Normal Q-Q Plot of State Anxiety Scores in Heavy Social Media Users
 85

4.7 Test of Hypothesis

In order to test whether there are differences on depression and anxiety on social media

use, there were carried out several Kruskal-Wallis H tests.

A Kruskal-Wallis H test indicated that there were statistically significant differences in

depression scores between different social media usage, χ2(2) = 9.53, p = .009. Therefore, the

first alternative hypothesis could be accepted, and the fist null hypothesis could be rejected.

The mean rank depression score of low social media usage (mean rank = 68.98) was lower

than the one of normal (mean rank = 97.49) and heavy social media usage (mean rank =

115.76). (see Table 13)

Table 13

Kruskal-Wallis H Test on Social Media Use Differences on Depression

n mean rank df χ2

Depression on low
26 68.98 2 9.53**
social media users

Depression on

normal social 140 97.49

media users

Depression on

heavy social 25 115.76

media users

Notes. df = degrees of freedom; χ2 = chi-square; * p ≤ .05 ** p ≤ .01 ***p ≤ .001

Other Kruskal-Wallis H test pointed out that there were statistically significant

differences in state anxiety scores between different social media usage, χ2(2) = 10.32, p =
 86

.006. Therefore, the second alternative hypothesis could be accepted, and the second null

hypothesis could be rejected. The mean rank state anxiety score of low social media usage

(mean rank = 66.35) was lower than the one of normal (mean rank = 98.33) and heavy social

media usage (mean rank = 113.78). (see Table 14)

Table 14

Kruskal-Wallis H Test on Social Media Use Differences on State Anxiety

n mean rank df χ2

State Anxiety on

low social media 26 66.35 2 10.32**

users

State Anxiety on

normal social 140 98.33

media users

State Anxiety on

heavy social 25 113.78

media users

Notes. df = degrees of freedom; χ2 = chi-square; * p ≤ .05 ** p ≤ .01 ***p ≤ .001

In order to test whether fear of missing is mediating between social media use and

anxiety as well as depression, there were carried out several mediation analyses.

A mediation analysis was carried out by the criterion depression from the predictor

social media use as well as by the mediator fear of missing out. The total effects model of the

predictor social media use to predict the criterion depression was statistically significant, R2 =

0.10, F(1, 189) = 20.00 , p < .001. Furthermore, the predictor social media use added
 87

statistically significantly to the prediction of the criterion depression, t (189) = 4.47, p < .001.

Additionally, I assessed the prediction of the mediator fear of missing out by the predictor

social media use. I discovered that the predictor social media use to predict the mediator fear

of missing out was statistically significant, R2 = 0.26, F(1, 189) = 65.50, p < .001. Moreover,

the predictor social media use added statistically significantly to the prediction of the

mediator fear of missing out, t (189) = 8.09, p < .001. Furthermore, I predicted the criterion

depression based on the predictor social media use while controlling for the mediator fear of

missing out. I found that the prediction of the criterion depression based on the predictor

social media use and the mediator fear of missing out was statistically significant, R2 = 0.28,

F(2, 188) = 36.65, p < .001. Furthermore, the mediator fear of missing out added statistically

significantly to the prediction of the criterion depression, t (188) = 6.95, p < .001. Moreover,

I assessed the direct effect of the predictor social media use on the criterion depression while

controlling for the mediator fear of missing out. However, the predictor social media use did

not add statistically significantly to the prediction of the criterion depression while

controlling for the mediator fear of missing out, t (188) = 0.78, p = .43. There was evidence

that the indirect effect of the predictor social media use on the criterion depression through

the mediator fear of missing was statistically significant, Z = 5.25, p < .001. Thus, the third

alternative hypothesis could be accepted, and the third null hypothesis could be rejected.

A second mediation analysis was carried out by the criterion state anxiety from the

predictor social media use as well as by the mediator fear of missing out. The total effects

model of the predictor social media use to predict the criterion state anxiety was statistically

significant, R2 = 0.10, F(1, 189) = 21.19 , p < .001. Furthermore, the predictor social media

use added statistically significantly to the prediction of the criterion state anxiety, t (189) =

4.60, p < .001. Additionally, I evaluated the prediction of the mediator fear of missing out by

the predictor social media use. I found out that the predictor social media use to predict the
 88

mediator fear of missing out was statistically significant, R2 = 0.26, F(1, 189) = 65.50, p <

.001. Moreover, the predictor social media use added statistically significantly to the

prediction of the mediator fear of missing out, t (189) = 8.09, p < .001. Likewise, I predicted

the criterion state anxiety based on the predictor social media use while controlling for the

mediator fear of missing out. I found that the prediction of the criterion state anxiety based on

the predictor social media use and the mediator fear of missing out was statistically

significant, R2 = 0.28, F(2, 188) = 36.26, p < .001. Furthermore, the mediator fear of missing

out added statistically significantly to the prediction of the criterion state anxiety, t (188) =

6.80, p < .001.

Additionally, I assessed the direct effect of the predictor social media use on the

criterion state anxiety while controlling for the mediator fear of missing out. However, the

predictor social media use did not add statistically significantly to the prediction of the

criterion state anxiety while controlling for the mediator fear of missing out, t (188) = 0.96, p

= .34. There was evidence that the indirect effect of the predictor social media use on the

criterion state anxiety through the mediator fear of missing was statistically significant, Z =

5.18, p < .001. Thus, the fourth alternative hypothesis could be accepted, and the fourth null

hypothesis could be rejected.

Discussion

Concerning the association between the patterns of social media use and depression, I

found statistically significant differences in depression based on social media usage.

Depression was measured by The Beck Depression Inventory, which was part of the

questionnaire given to the participants of the current study. The depression in heavy social

media users was higher compared to low social media users. This finding is convergent with
 89

evidence provided by Kross et al. (2013), Woods and Scott (2016) who indicated that heavy

social media users tend to have increased mental health issues and low well-being.

The increased levels of depression in the studies mentioned above could be explained

by the lack of face-to-face interactions among the individuals. It is important to remember

that even a small interaction that happens between people on daily basis, for example during

commuting or shopping, has a positive effect on one’s well-being. During social distancing,

many people were deprived of those interactions. It is possible, that some individuals

attempted to compensate for the lack of social interaction by using social media. However,

the conversation on social media platforms cannot replace real face-to-face interactions. The

conversations on social media lack emotions and could lead to misinterpretation of written

information. Additionally, the conversation on social media could last longer. For example,

one could wait for the response longer than expected, while during a face-to-face

conversation the time of response is usually minimal. Thus, even though one is still

interacting on social media with other people, the depression levels of heavy social media

users are still higher than the depression levels among individuals who use social media less

frequently as was found in the current study. Furthermore, this finding is consistent with

Stiglic and Viner (2019) in which the use of social media tends to increase depressive

symptoms. Likewise, the finding is also convergent with evidence provided by Lin et al.

(2016), Primack et al. (2017), Costigan et al. (2012), Hoare et al. (2016), Suchert et al.

(2015), and Shensa et al. (2015).

In regard to the relationship between the patterns of social media use and state

anxiety, I found that the differences in state anxiety based on social media usage reached

statistical significance. State anxiety in heavy social media users was significantly higher

compared to the ones who do not use so much social media. This finding is consistent with

Woods and Scott (2016), Kross et al. (2013), and Andreassen et al. (2016) who pointed out
 90

that mental health issues such as anxiety increases based on extensive social media usage.

Moreover, this finding is consistent with the evidence provided by Vannucci et al. (2017),

Primack et al. (2017), Hoare et al. (2016), and Shensa et al. (2018).

It is possible to suggest that the attempt to compensate for the lack of social

interaction using social media could also lead to anxiety. When one is engaging in an online

conversation by texting, there is always a possibility of misinterpretation. It is possible that

the individual could understand the meaning of the message differently than the one who

wrote it. Additionally, one could be anxious about the possibility that the reader will

misinterpret the message or that the message will contain errors. It is also difficult to know

how one reacts to the received information. During face-to-face interaction, people use

additional cues to understand the person they are talking to. People use facial expressions,

gestures, posture, and other cues to better understand each other. Online conversation lacks

such advantages, which could be frustrating for some individuals. Thus, the heavy use of

social media could lead to higher anxiety levels as shown by Stiglic and Viner (2019) who

pointed out the increase of anxiety based on heavy social media use. Similarly, the

participants of the current study, who reported spending more time on social media had

higher levels of anxiety than those who spent less time using social media.

With respect to the mediation effect of fear of missing out between social media use

and depression, it was found that fear of missing out was a statistically significant mediator.

This finding is convergent with evidence provided by Guangzhe et al. (2020) and Oberst et

al. (2016) who also discovered that fear of missing out is a significant mediator.

The fear of missing out is the feeling that other individuals are having rewarding

experiences, while other is away or lacks such possibilities. It is possible to suggest that

seeing online content of people who are having a good time with friends or traveling could

provoke increased depression in people who lack such rewarding experiences. For example,
 91

during the COVID-19 pandemic, some countries were closed for traveling and social services

while other countries continued with a normal lifestyle. Thus, the acknowledgment that

people were able to live their “normal lives” in the countries that did not have any or minimal

anti-epidemic restrictions, could increase the depression in those social media users who

lived in the countries which were closed on quarantine. An example could be an individual

who was planning a trip to meet friends and who was not able to travel due to COVID-19.

Thus, seeing the online content of the friends who met at the destination could increase the

feeling of depression. Additionally, it is important to remember that people have the tendency

to provide information on social media that does not correspond to reality. For example, one

would create online content that would represent the individual as more successful or happier

than he or she is. Thus, viewing such content would provoke depression among the viewers

who are already distressed. Thus, the discomfort caused by the COVID-19 could increase

distress and lead to increased levels of depression among social media users.

Regarding the mediation effect of fear of missing out between social media use and

state anxiety, it was discovered that fear of missing out was a statistically significant mediator

in the current study. These results were consistent with Oberst et al. (2016) who found that

fear of missing out is a significant mediator. The mediating effect of the fear of missing out

on anxiety among social media users could be explained by the suggestion that one is having

a feeling that they are missing out on rewarding experiences. For example, being exposed to

a large amount of online content showing that other people are having rewarding experiences

could cause one to feel that one’s life is wasted away due to the COVID – 19 restrictions. An

example could be an individual who was not able to travel to meet friends. Witnessing the

online content shared by the friend who met, could increase the anxiety levels by growing the

feeling that one is missing out on the important and rewarding life event. Additionally, it

should be mentioned that many people were exposed to a number of difficulties due to the
 92

COVID-19 pandemic. Some people lost their jobs, many people had to work or study from

home, a large number of people were self-distancing or isolated from others. All these

experiences could negatively affect one’s well-being. In addition, exposure to online content

which shows that someone is more successful, meeting a lot of people, or someone who got a

new job could cause additional stress and anxiety.

It is important to note that there are a few studies providing evidence on fear of missing out

as a mediator on these relationships. Since fear of missing out is a relatively new construct in

the literature, there are few studies providing empirical evidence on the associations

presented in this study. However, it should be pointed out that the fear of missing out should

not be underestimated, especially in terms of social media use. The fear of missing out is the

feeling that one is missing out on rewarding experiences while other individuals are having a

“good time”. It is also important to acknowledge that user-generated content is not always

reflecting the real situation and usually tends to be more desirable for the audience.

Nonetheless, such unrealistic content could have a dramatic effect on its viewers and lead to

increased depression and anxiety. Additionally, it is worthy to acknowledge the increase of

this gap between unrealistic content on social media and real-life conditions during the

COVID - 19 pandemic.

Although the detrimental effects of social media on mental health were expected as

studies assessed pointed out in the literature review, the isolation during the pandemic and the

lack of face-to-face interactions might have dramatically increased social media usage,

especially in young participants.

It is also important to note that in my research most heavy users were mostly females

in their twenties. In addition, this age group was the one who suffered from depression and

state anxiety symptoms. Although gender differences were not assessed in this study, this

interesting finding is consistent with Rideout and Fox’s (2018) study. Rideout and Fox
 93

(2018) found that females have higher odds of seeking online information about depression

or anxiety as well as connecting with other people online with similar worries.

Limitations

To fully understand the results of the study, it is important to note the study's

limitations. One of the limitations of the current study was the lack of control over the

responses collected from participants who completed the online questionnaire. Most online

surveys have this limitation since it is difficult to assure whether the participant is actually the

one who answered the online questionnaire. Another limitation of online surveys is the

honesty of the answers. The participants could not answer honestly some of the questions or

reported lower time spent on social media. Additionally, the self-report measures require

good internal knowledge, which could be an issue in some cases. The language of the survey

could also be a limitation. Even though the survey was administered only to English-speaking

individuals, not all of them were native English speakers. A further limitation was the

missing data. Some participants did not provide all the responses although it was initially

requested. Moreover, the sample size was relatively small. Furthermore, the study population

and sample included mostly female participants. This issue could have misrepresented the

answers provided by male subjects.

 94

Conclusions

6.1 Main conclusions

The results of this study in agreement with evidence provided in previous studies

allowed to conclude that there is converging evidence that heavy social media usage

increases the risk of suffering from depression and state anxiety. There is also a high degree

of confidence to conclude that fear of missing out is a mediator between social media use and

depression as well as state anxiety. There is no certainty whether these conclusions could be

applicable to the different age groups since depression and state anxiety differences based on

social media users were not controlled by age groups. However, it is possible to conclude that

heavy social media users who suffered from depression and state anxiety were mostly single

females in their twenties. In comparison, the low social media users who did not suffer from

depression either state anxiety were mostly married females in their forties.

6.2 Suggestions for future research

For future research, it is noteworthy to carry out this study on the larger population

sample. In addition, the sample of the study should consist of severe age groups and gender

discrepancy should be eliminated or minimized. This would allow the researcher to compare

the social media use and depression and anxiety levels between age groups and assess gender

differences. Additionally, the new research could also concentrate on the new emerging

social media platforms. It would be useful to compare the levels of depression and anxiety

between the users of social media platforms that tend to be more addictive and those that are

less addictive. For example, to compare the depression and anxiety among the people who

use such platforms as TickTock or Minds.com. Moreover, the content of social media

platforms could be assessed to learn more about the effect of the following content on one's
 95

mental health. For example, educational content could be compared to popular content. In

addition, I suggest carrying out an experiment putting subjects in a simulated lockdown for

certain time and evaluate social media use, depression and anxiety before, during and after

the lockdown with different age groups and equally represented genders.
 96

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