Cerebrum Winter 2020

Young people at the highest risk for depression, who tend to have poorer social support networks and fewer friends on and off line, tend to use social media more passively.

But is social media the smoking gun behind the apparently deteriorating mental health of adolescence, or just a coincidental phenomenon? Sorting out those questions turns out to be no simple task, with decidedly mixed results. While many studies have found social media use to have significant negative mental health effects, some have found no effects, and still others have shown a protective effect. The only thing that seems clear at this point is that the relationship of social media to mental health is not at all clear. chicken-or-egg issue of which came first. Cross-sectional studies, which comprise the bulk of current research, capture a moment in time and can show only an association between two or more things, in this case time spent on social media and psychological symptoms. But just because social media use appears at the same time as depression or anxiety doesn’t mean that social media is the cause of depression or anxiety. It may be that teens who are already depressed or anxious turn to social media more frequently. Proving causality requires long-term tracking, and results from these kinds of studies examine the social media-mental health interaction over time found a heightened risk of depression in adolescents who spent three or more hours a day on social media. Kira Riehm and colleagues at Johns Hopkins University examined data from a nationally representative cohort of 6,595 US adolescents, tracking self- reported mental health symptoms and social media across a three-year period (mental health as baseline in year 1; social media use in year 2, and mental health again in year 3). Even a half hour Which Came First? A big question is causality, the are just beginning to appear. One of the first studies to

of social media use, compared to none, was correlated with greater depression symptoms one year later, particularly so-called “internalizing” behaviors such as withdrawal, avoidance, and loneliness. In an interview, RIehm emphasized that while her team’s study doesn’t prove causality, it does provide clues about the temporal course of depressive symptoms as they relate to time on social media. Patricia Conrod, Ph.D., and colleagues at the University of Montreal found that depression symptoms increased with every hour of increased time on social media, and corresponding drops in self-esteem seemed to explain the changes. The report is based on data collected over four years from 3,826 adolescents (mean age of 12.7) enrolled in a preventative clinical trial in metro Montreal schools. A follow-up report from the same group found that anxiety also increased in concert with increased time on social networking sites. Data on substance use in relation to social media is forthcoming. In contrast to these findings, psychologist Sarah Coyne, Ph.D., and colleagues at Brigham Young University found no association between time spent on social media and depression or anxiety at an individual level among 500 adolescents followed for 8 years, from age 13 to 20. It’s Complicated Each new study “adds to our general understanding that it’s complicated,” Paul Weigle, M.D., a child and adolescent psychiatrist who co-chairs the American Academy of Child and Adolescent Psychiatry’s media committee, said in an interview. “[Social media use] doesn’t affect all teens the same, and overall, is neither good nor bad for the mental health of teens.” That doesn’t mean, Weigle was quick to add, that using social media doesn’t have significant effects on mental health. Rather, he said, “the effects

on young people depend both on the characteristics of the teen and the characteristics of how they use social media.” Young people who have strong social support networks and are at low risk for depression (based on recognized risk factors) tend to use social networks more actively, engaging with others and posting frequently. For them, social media may boost self-esteem and have a protective effect against mental illness, Weigle said. In contrast, he continued, young people at the highest risk for depression, who tend to have poorer social support networks and fewer friends on and off line, tend to use social media more passively, scrolling and “lurking” rather than contributing in an engaged manner. When they do post, they are more likely to get negative feedback, probably due to the types of things they post. They are also more likely to engage in risky online behaviors like cyberbullying (both as perpetrators and victims) and “sexting,” sharing sexually explicit photos or posts. For these already high-risk kids, social media use appears to increase the risk of depression still further. All Screen Time is Not Equal These observations, borne out by recent research, that it’s not just how much social media is used, but rather how it is used, are in line with emerging insights about the much broader category of “screen time,” which also includes video gaming, watching television or movies, video chatting, and scrolling the Web for any use, educational or otherwise. “All media is not created equally,” says Pamela Hurst-Della Pietra, M.D., president and founder of Children and Screens, a nonprofit foundation focused on digital media and child development. “An hour Skyping with grandma is not the same as playing a violent video game or multi-tasking online or

DANA FOUNDATION CEREBRUM | WINTER 2020 19

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