Problematic social media use

Problematic social media use, also known as social media addiction or social media overuse, is a proposed form of psychological or behavioral dependence on social media platforms, similar to gaming disorder, Internet addiction disorder, and other forms of digital media overuse.[4] It is generally defined as the problematic, compulsive use of social media platforms that results in significant impairment in an individual's function in various life domains over a prolonged period. This and other relationships between digital media use and mental health have been considerably researched, debated, and discussed among experts in several disciplines, and have generated controversy in medical, scientific, and technological communities. Research suggests that it affects women and girls more than boys and men and that it appears to affect individuals based on the social media platform used. Such disorders can be diagnosed when an individual engages in online activities at the cost of fulfilling daily responsibilities or pursuing other interests, and without regard for the negative consequences.

See also: Digital media use and mental health, Problematic smartphone use, and Gaming disorder

Problematic social media use
Other namesSocial media addiction, social media overuse
SpecialtyPsychiatry, psychology
Risk factorsLower socioeconomic status,[1] female sex[2]
PreventionParental engagement and support[3]

Excessive social media use has not been recognized as a disorder by the World Health Organization or the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). However, the related diagnosis of gaming disorder has been included in the International Classification of Diseases (ICD-11). Controversies around problematic social media use include whether the disorder is a separate clinical entity or a manifestation of underlying psychiatric disorders. Researchers have approached the question from a variety of viewpoints, with no universally standardized or agreed definitions. This has led to difficulties in developing evidence-based recommendations.

Signs and symptoms

Problematic social media use is associated with mental health symptoms, such as anxiety and depression, in children and young people.[5] A 2019 meta-analysis investigating Facebook use and symptoms of depression showed an association, with a small effect size.[6] Social media may also be utilized in some situations to improve mood.[5] In a 2018 systematic review and meta-analysis, problematic Facebook use was shown to have negative affects on well-being in adolescents and young adults, and psychological distress was also found with problematic use.[7] Frequent social media use was shown in a cohort study in 15- and 16-year-olds to have a modest association with self-reported symptoms of attention deficit hyperactivity disorder followed up over two years.[8]

A 2016 technical report by Chassiakos, Radesky, and Christakis identified benefits and concerns in adolescent mental health in regard to social media use. It showed that the amount of time spent on social media is not the key factor, but rather how time is spent. Declines in well-being and life satisfaction was found in older adolescents who passively consumed social media; however, these were not shown in those who were more actively engaged. The report also found a U-shaped, curvilinear relationship between the amount of time spent on digital media with risk of depression developing, at both the low and high ends of Internet use.[9]

Social anxiety

Social media allows users to openly share their feelings, values, and thoughts. This digital world provides a communication dialog into emotions. Social media also contributes to discrimination and cyberbullying. Users suffering from mental illnesses often withdraw from in-person communication and continue their communication online. Many activities and social groups are different when using social media.[10] Although using social media can satisfy personal communication needs, those who use them at higher rates are shown to have higher levels of psychological distress.[11]

Mechanisms

A 2017 review article noted the "cultural norm" among adolescence of being always on or connected to social media, remarking that this reflects young people's "need to belong" and stay up-to-date, and that this perpetuates a "fear of missing out". Other motivations include information seeking, identity formation, as well as voyeurism and cyber-stalking. For some individuals, social media can become "the single most important activity that they engage in". This can be related to Maslow's hierarchy of needs, with basic human needs often met from social media. Positive-outcome expectations and limited self-control of social media use can develop into "addictive" social media use. Further problematic use may occur when social media is used to cope with psychological stress, or a perceived inability to cope with life demands.[12]

Cultural anthropologist Natasha Dow Schüll noted parallels to the gambling industry inherent in the design of various social media sites, with "'ludic loops' or repeated cycles of uncertainty, anticipation and feedback" potentially contributing to problematic social media use.[13]

Griffiths also postulated in 2014 that social networking online may fulfill basic evolutionary drives, after mass urbanization worldwide. The basic psychological needs of "secure, predictable community life that evolved over millions of years" remain unchanged, leading some to find online communities to cope with the new individualized way of life in some modern societies.[14]

A secondary analysis of a large English cross-sectional survey of 12,866 13 to 16 year olds published in Lancet found that mental health outcomes problematic use of social media platforms may be in part due to exposure to cyberbullying, as well as displacement in sleep architecture and physical exercise, especially in girls.[15]

In 2018, Harvard University neurobiology research technician Trevor Haynes postulated that social media may stimulate the reward pathway in the brain.[16] An ex-Facebook executive, Sean Parker, has also espoused this theory.[17]

Platform-specific risks

Individual studies have shown differences in motivations and behavioral patterns among different social media platforms, especially in problematic use.[18][19] In the United Kingdom, a study of 1,479 people between 14 and 24 years old compared psychological benefits and problems of the five largest social media platforms: Facebook, Instagram, Snapchat, Twitter, and YouTube. It concluded that YouTube was the only platform with a net positive rating based on 14 questions related to health and well-being, followed by Twitter, Facebook, Snapchat, and Instagram. Instagram had the lowest rating; it was identified to have some positive effects such including self-expression, self-identity, and community, but these were outweighed by its negative effects on sleep, body image, and "fear of missing out".[20]

Limiting the Use of Social Media

The researchers conducted a study on 108 female and 35 male undergraduate students at the University of Pennsylvania and encouraged the students to install Facebook, Instagram, and Snapchat on their iPhone. This study observed the student’s well-being on the scale of “social support,” “fear of missing out,” “loneliness,” “anxiety,” “depression,” “self-esteem,” and “autonomy and self-acceptance.” The researcher observed that a decrease in social media use by 10 minutes improved the well-being and depression symptoms of the severely and mildly depressed participants, and significantly reduced the loneliness over the three weeks.[21]

Scales and Measures

Problematic Social Media Use has been a concern for over a decade. There have been several scales developed and validated that help to understand the issues regarding problematic social media use. One of the first scales was an eight-item scale that was used for Facebook use.[22] The Facebook Intensity Scale (FBI) was used multiple times and showed good reliability and validity. This scale only covered three areas of social media engagement, which left the scale lacking. Although the FBI was a good measure it lacked the needed component of purpose of use. The Multi-dimensional Facebook Intensity Scale (MFIS) investigated different dimensions of use that include overuse and reasons for use.[23] The MFIS is composed of 13 items and has been used on several samples. The MFIS also had good reliability and validity, but the scale was directed toward the use of Facebook, and social media is far more than just one platform. The Social Networking Activity Intensity Scale (SNAIS) was created to look at the frequency of use of several platforms and investigated three facets of engagement with a 14-item survey. This scale looked at the purposes of use both entertainment and social function, and the scale as a whole had acceptable reliability and validity.[24] The Social Media Disorder Scale (SMD) is a nine-item scale that was created to investigate addiction to social media and get to the heart of the issue.[25] This scale has been used in conjunction with multiple scales and does measure social media addiction. The SMD has been tested and good reliability and validity. This tool can be used by itself or in conjunction with other measures for future research and appears to be a reliable scale. There are many other scales that have been created, however there is not one single scale that is being used by all researchers.[26][27]

Diagnosis

A scale developed by Andreasson and colleagues proposed the following potential factors indicating possible dependence on social media:[28]

  1. Mood swings: the first stage, when a person feels more secure and satisfaction when using social media;
  2. Relevance: when social media starts to dominate a person's thoughts to the detriment of other activities;
  3. Tolerance: increased time spent on social media, when a person is looking for feelings previously associated with social media, and is simultaneously losing control of the time spent
  4. Withdrawal: anxiety when a person is not connected to the Internet, with associated changes in sleeping or eating patterns, as well as signs of depression.

Griffiths developed six possible components in relation to social network sites and addiction:[14]

  1. Salience: when social media becomes the most important part of a person's life;
  2. Mood modification: when a person develops escapism, potentially feeling "high", "buzzed", or "numb" when using social media;
  3. Tolerance: when increased time spent on social media is required to develop the same moods the person experienced;
  4. Withdrawal symptoms: unpleasant feelings or physical sensations when the person is unable to use the media to the extent required;
  5. Conflict: when social media use causes conflict in interpersonal dynamics, takes away from other activities, and becomes pervasive;
  6. Relapse: the tendency for previously affected individuals to revert to previous patterns of excessive social media use.

Management

No established treatments exist, but from research from the related entity of Internet addiction disorder, treatments have been considered, with further research needed.[29] Screen time recommendations for children and families have been developed by the American Academy of Pediatrics.[30][31]

Possible therapeutic interventions published by Andreasson include:

  • Self-help interventions, including application-specific timers;
  • Cognitive behavioral therapy; and
  • Organizational and schooling support.[32]

Medications have not been shown to be effective in randomized, controlled trials for the related conditions of Internet addiction disorder or gaming disorder.[32]

Technology firms

As awareness of these issues has increased, many technology and medical communities have continued to work together to develop novel solutions. Apple Inc. purchased a third-party application and incorporated it as "screen time", promoting it as an integral part of iOS 12.[33] A German technology startup developed an Android phone specifically designed for efficiency and minimizing screen time.[34] News Corp reported multiple strategies for minimizing screen time.[35] Facebook and Instagram have announced "new tools" that they think may assist with addiction to their products.[36] In an interview in January 2019, Nick Clegg, then head of global affairs at Facebook, claimed that Facebook committed to doing "whatever it takes to make this safer online especially for [young people]". Facebook committed to change, admitting "heavy responsibilities" to the global community, and invited regulation by governments.[37]

Governmental response

On July 30, 2019, U.S. Senator Josh Hawley introduced the Social Media Addiction Reduction Technology (SMART) Act that is intended to crack down on "practices that exploit human psychology or brain physiology to substantially impede freedom of choice". It specifically prohibits features including infinite scrolling and Auto-Play.[38][39]

History

While associations between digital media use and mental health symptoms or diagnoses have been observed, causality has not been established, with nuances and caveats published by researchers often misunderstood by the general public and misrepresented by the media.[40] As of a review published in 2016, Internet addiction and social media addiction are not well-defined constructs, with no gold standard diagnostic criteria or universally agreed theories on the interrelated constructs.[41]

The proposed disorder is generally defined when "excessive use damages personal, family and/or professional life" as proposed by Griffiths, a chartered psychologist focusing in the field of behavioral addictions—namely, gambling disorder, gaming addiction, Internet addiction, sex addiction, and work addiction.[41]

Several studies have shown that women are more likely to overuse social media while men are more likely to overuse video games.[42] This has led multiple experts cited by Hawi and colleagues to suggest that digital media overuse may not be a singular construct, with some calling to delineate proposed disorders based on the type of digital media used.[43] A 2016 psychological review stated that "studies have also suggested a link between innate basic psychological needs and social network site addiction [...] Social network site users seek feedback, and they get it from hundreds of people—instantly. It could be argued that the platforms are designed to get users 'hooked'."[32]

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