A pilot evaluation of associations between displayed depression references on Facebook and self-reported depression using a clinical scale

Indirect Identification of Perinatal Psychosocial Risks from Natural Language

During the perinatal period, psychosocial health risks, including depression and intimate partner violence, are associated with serious adverse health outcomes for birth parents and children. To appropriately intervene, healthcare professionals must first identify those at risk, yet stigma often prevents people from directly disclosing the information needed to prompt an assessment. In this research we use short diary entries to indirectly elicit information that could indicate psychosocial risks, then examine patterns that emerge in the language of those at risk. We find that diary entries exhibit consistent themes, extracted using topic modeling, and emotional perspective, drawn from dictionary-informed sentiment features. Using these features, we use regularized regression to predict screening measures for depression and psychological aggression by an intimate partner. Journal text entries quantified through topic models and sentiment features show promise for depression prediction, corresponding with self-reported screening measures almost as well as closed-form questions. Text-based features are less useful in predicting intimate partner violence, but topic models generate themes that align with known risk correlates. The indirect features uncovered in this research could aid in the detection and analysis of stigmatized risks.

The Role of Family Health in Mediating the Association between Smartphone Use and Health Risk Behaviors among Chinese Adolescent Students: A National Cross-Sectional Study

The direct impact of smartphones on health risk behaviors of adolescent students has been verified. However, the mediating mechanisms that underly this relationship remain largely unknown. Therefore, the aim of the study is to explore the role of family health in mediating the relationship between the frequency of smartphone use and adolescent students' health risk behaviors. A questionnaire was used to collect cross-sectional data from 693 adolescent students aged 12-18 in China and a structural equation model was analyzed. Among the nine health risk behaviors, the most frequent health risk behaviors in Chinese adolescent students were non-compliance walking behaviors (M=Mean; SD = Standard deviation) (M ± SD) (2.78 ± 1.747), eating unhygienic food (M ± SD) (2.23 ± 1.299), being subjected to physical violence (M ± SD) (2.19 ± 0.645), and leaving home (M ± SD) (2.13 ± 0.557). The SEM results showed that the adolescent students' smartphone use had a positive impact on delaying the age of first alcohol consumption (β = 0.167, CI:0.067 0.287) and a negative impact on the non-compliance walking behaviors (β = 0.176, CI:0.011 0.266). Family health plays an indirect-only mediated role (the proportions of indirect-only mediated roles are 11.2%, 12.4%, and 11.5%) in the relationship between smartphone use and adolescent students' partial health risk behaviors: (CI: -0.042 -0.002), (CI: -0.049 -0.005), and (CI: -0.043 -0.002). These findings provided a theoretical and practical basis for better interventions in adolescent health risk behaviors.

Substance use and sentiment and topical tendencies: a study using social media conversations of youth experiencing homelessness

Purpose

This study investigates associations between Facebook (FB) conversations and self-reports of substance use among youth experiencing homelessness (YEH). YEH engage in high rates of substance use and are often difficult to reach, for both research and interventions. Social media sites provide rich digital trace data for observing the social context of YEH's health behaviors. The authors aim to investigate the feasibility of using these big data and text mining techniques as a supplement to self-report surveys in detecting and understanding YEH attitudes and engagement in substance use.

Design/methodology/approach

Participants took a self-report survey in addition to providing consent for researchers to download their Facebook feed data retrospectively. The authors collected survey responses from 92 participants and retrieved 33,204 textual Facebook conversations. The authors performed text mining analysis and statistical analysis including ANOVA and logistic regression to examine the relationship between YEH's Facebook conversations and their substance use.

Findings

Facebook posts of YEH have a moderately positive sentiment. YEH substance users and non-users differed in their Facebook posts regarding: (1) overall sentiment and (2) topics discussed. Logistic regressions show that more positive sentiment in a respondent's FB conversation suggests a lower likelihood of marijuana usage. On the other hand, discussing money-related topics in the conversation increases YEH's likelihood of marijuana use.

Originality/value

Digital trace data on social media sites represent a vast source of ecological data. This study demonstrates the feasibility of using such data from a hard-to-reach population to gain unique insights into YEH's health behaviors. The authors provide a text-mining-based toolkit for analyzing social media data for interpretation by experts from a variety of domains.

Seeking and Sharing Mental Health Information on Social Media During COVID-19: Role of Depression and Anxiety, Peer Support, and Health Benefits

This study conducted a cross-sectional online survey (N = 865) to determine whether self-ratings of depression and anxiety, perceived peer support, and perceived health benefits of social media predicted mental health–related information seeking and sharing behaviors during the COVID-19 pandemic. Hierarchical regression models showed only depression self-ratings, anxiety self-ratings, and perceived health benefits predicted information seeking, whereas depression self-ratings, anxiety self-ratings, perceived peer support, and perceived health benefits all predicted information sharing. There was a statistically significant positive interaction of anxiety self-ratings and perceived peer support on information sharing. Participants’ experience of COVID-19 predicted both information seeking and sharing. Mental health–related information seeking and sharing differed across social media platforms, with YouTube, Facebook, and Instagram used most for information seeking and Facebook, Instagram, and Twitter used most for information sharing. Findings suggest social media mental health–related seeking and sharing behaviors have the potential to facilitate coping surrounding mental health.

Seeking Help From Trusted Adults in Response to Peers' Social Media Posts About Mental Health Struggles: Qualitative Interview Study Among Latinx Adolescents

BACKGROUND

Rather than confiding in adults about their mental health struggles, adolescents may use social media to disclose them to peers. Disclosure recipients are tasked with deciding whether to alert an adult and, if so, whom to alert. Few studies have examined how adolescents decide on a trusted adult to help a friend who posts on social media about his/her mental health struggles. Moreover, Latinx adolescents are underrepresented in research on social media use, which creates gaps in understanding how social media may influence their well-being.

OBJECTIVE

This qualitative study presents findings from semistructured interviews with Latinx adolescents to investigate how they seek out trusted adults when a friend posts on social media about their mental health struggles. Specifically, we sought to determine which adult ties they activated, the resources they believed the adult could provide, and the support they expected the adult to provide.

METHODS

We recruited participants through a nonprofit organization serving the Latinx community (primarily of Mexican origin) located in Milwaukee, Wisconsin. We conducted 43 semistructured interviews, each lasting 60-90 minutes, with Latinx adolescents (25 females, 18 males) aged 13-17 years. All interviews were conducted in English, at the adolescents' request. Using a grounded theory approach, we identified the nature of the relationship between the trusted adult and either the disclosure recipient or distressed friend, and the resources and support the trusted adult is expected to provide.

RESULTS

Participants nominated adults who were emotionally or physically proximate to either the disclosure recipient or distressed friend, particularly parents (of the recipient and friend) and school staff. However, some felt that not all parents and school staff were emotionally proximate. Adolescents sought trusted adults with access to two resources: experiential knowledge and authority. Some, particularly males, avoided adults with authority because of the risk of punishment and others thought their immigrant parents did not have relevant experiential knowledge to assist them. Interviewees felt that trusted adults with either resource could provide emotional and instrumental support either directly or indirectly, while those with experiential knowledge could provide informational support. Notably, interviews did not problematize the fact that the disclosure occurred on social media when deliberating about adults.

CONCLUSIONS

To assist a distressed friend posting on social media, Latinx adolescents look not only for trusted adults who are emotionally and physically proximate but also those who have key resources that facilitate support. Efforts should focus on connecting adolescents with trusted adults and training adults who hold positions of authority or experiential knowledge to offer both direct and indirect support. Additionally, efforts should consider how immigrant experiences shape parent-child relations and address the potential long-term consequences of oversurveillance of Latinx youth, particularly males, by school staff for their access to social support.

Adolescent Health on Social Media and the Mentorship of Youth Investigators: Five Content Analysis Studies Conducted by Youth Investigators

Although the literature on adolescent health includes studies that incorporate youth perspectives via a participatory design, research that is designed, conducted, and presented by youth remains absent. This paper presents the work of 5 youth investigators on the intersecting topics of adolescent health and social media. Each of these youths was equipped with tools, knowledge, and mentorship for scientifically evaluating a research question. The youths developed a research question that aligned with their interests and filled a gap that they identified in the literature. The youths, whose projects are featured in this paper, designed and conducted their own research project, drafted their own manuscript, and revised and resubmitted a draft based on reviewer input. Each youth worked with a research mentor; however, the research questions, study designs, and suggestions for future research were their own.

Displayed Depression Symptoms on Facebook at Two Time Points: Content Analysis

Background

Depression is a prevalent and problematic mental disorder that often has an onset in adolescence. Previous studies have illustrated that depression disclosures on social media are common and may be linked to an individual’s experiences of depression. However, most studies have examined depression displays on social media at a single time point.

Objective

This study aims to investigate displayed depression symptoms on Facebook at 2 developmental time points based on symptom type and gender.

Methods

Participants were recruited from an ongoing longitudinal cohort study. The content analysis of text-based Facebook data over 1 year was conducted at 2 time points: time 1 (adolescence; age 17-18 years) and time 2 (young adulthood; ages 20-22 years). Diagnostic criteria for depression were applied to each post to identify the displayed depression symptoms. Data were extracted verbatim. The analysis included nonparametric tests for comparisons.

Results

A total of 78 participants’ Facebook profiles were examined, of which 40 (51%) were male. At time 1, 62% (48/78) of the adolescents had a Facebook profile, and 54% (26/78) displayed depression symptom references with an average of 9.4 (SD 3.1) references and 3.3 (SD 2.3) symptom types. Of the 78 participants, 15 (19%) females and 12 (15%) males displayed depression symptom references; these prevalence estimates were not significantly different by gender (P=.59). At time 2, 35 young adults displayed symptoms of depression with an average of 4.6 (SD 2.3) references and 2.4 (SD 1.3) symptom types. There were no differences in the prevalence of symptoms of depression displayed between males (n=19) and females (n=16; P=.63).

Conclusions

This content analysis study within an ongoing cohort study illustrates the differences in depression displays on Facebook by developmental stage and symptom. This study contributes to a growing body of literature by showing that using social media to observe and understand depression during the emerging adult developmental period may be a valuable approach.

A Systematic review of the validity of screening depression through Facebook, Twitter, Instagram, and Snapchat

BACKGROUND

The aim of this study was to determine the validity of using social media for depression screening.

METHOD

Article searches on PubMed and PsycINFO from database inception to August 20, 2019 were completed with a search string and filters.

RESULTS

15 articles made the inclusion criteria. Facebook, Twitter, and Instagram profiles of depressed people were distinguishable from nondepressed people shown by social media markers. Facebook studies showed that having fewer Facebook friends and mutual friends, posting frequently, and using fewer location tags positively correlated with depressive symptoms. Also, Facebook posts with explicit expression of depressive symptoms, use of personal pronouns, and words related to pain, depressive symptoms, aggressive emotions, and rumination predicted depression. Twitter studies showed that the use of "past focus" words, negative emotions and anger words, and fewer words per Tweet positively correlated with depression. Finally, Instagram studies showed that differences in follower patterns, photo posting and editing, and linguistic features between depressed people and nondepressed people could serve as a marker.

LIMITATIONS

The primary articles analyzed had different methods, which constricts the amount of comparisons that can be made. Further, only four social media platforms were explored.

CONCLUSION

Social media markers like number and content of Facebook messages, linguistic variability in tweets and tweet word count on Twitter, and number of followers, frequency of Instagram use and the content of messages on Instagram differed between depressed people and nondepressed people. Therefore, screening social media profiles on these platforms could be a valid way to detect depression.

Responses to Concerning Posts on Social Media and Their Implications for Suicide Prevention Training for Military Veterans: Qualitative Study

BACKGROUND

A "concerning post" is a display of a user's emotional crisis on a social media platform. A better understanding of concerning posts is relevant to suicide prevention, but little is known about social media users' attitudes and responses to concerning posts. Military veterans in the United States are disproportionately affected by suicide, often use social media, and may have exposure to individuals with elevated suicide risk via concerning posts.

OBJECTIVE

The objective of the study was (1) to obtain insight into whether and how US military veterans respond to members of their social network on social media (ie, "friends") who are experiencing substantial emotional distress, and (2) to identify potential interventions that could assist in users' response to concerning posts.

METHODS

We recruited veterans through Facebook and conducted semistructured interviews with 30 participants between June and December 2017. We used a summary template for rapid analysis of each interview, followed by double-coding using a codebook based on topic domains from the interview guide. Members of the research team met regularly to discuss emerging patterns in the data, generate themes, and select representative quotes for inclusion in the manuscript.

RESULTS

Veterans were reluctant to disclose emotional and health issues on Facebook, but they were open to reaching out to others' concerning posts. There was a complex calculus underlying whether and how veterans responded to a concerning post, which involved considering (1) physical proximity to the person posting, (2) relationship closeness, (3) existing responses to the post, and (4) ability to maintain contact with the person. Veterans desired additional training, backed by community-based veteran organizations, in how to respond to concerning posts from peers.

CONCLUSIONS

There is a need to incorporate features that will help veterans effectively respond to concerning posts from peers into suicide prevention training and to expand access for veterans to such training.

Exploring the Spatial Distribution Characteristics of Emotions of Weibo Users in Wuhan Waterfront Based on Gender Differences Using Social Media Texts

The benefits of the natural environment in urban space have been explored in numerous studies. However, only a few statistics and studies have been conducted on the correlation between emotion and urban waterfront space, especially considering gender differences. Taking Wuhan city as an example, this study puts forward a new approach and perspective. Text emotion analysis is combined with the spatial analysis technique based on big data of social media. Based on the emotions of the public of different genders in urban space, suggestions are provided for urban planning and development from the perspective of POI (Point of Interest). The main steps are: (1) Analyzing the emotional score of Weibo texts published by citizens in the waterfront area of 21 lakes in Wuhan City; (2) exploring the public emotion characteristics of different genders in the urban waterfront; (3) classifying the waterfront according to the emotional response (score) of the public of different genders; (4) exploring the relationship between different POI types and waterfront types and proposing planning suggestions. The results of this study provide evidence for gender differences and spatial distribution of public emotions in the Wuhan waterfront area. It can help decision-makers to judge the prior protection and development direction of waterfront space, thus demonstrating the feasibility of this approach.

Assessing the Usability, Appeal, and Impact of a Web-Based Training for Adults Responding to Concerning Posts on Social Media: Pilot Suicide Prevention Study

BACKGROUND

Suicide prevention remains challenging among youth, as many do not disclose suicidal ideation. Nearly one-third of American Indian and Alaska Native (AI and AN, tribal, or native) youth see concerning messages on social media at least weekly.

OBJECTIVE

To prepare adults to support AI and AN youth who post or view concerning messages, our team designed an hour-long training: Responding to Concerning Posts on Social Media. This study tested the usability, appeal, and impact of the training.

METHODS

A purposive sample of 70 adults was recruited to participate in the pilot, which included 2 study arms. Arm 1 participants completed a 30-min training video and reviewed accompanying handouts, including the Viewer Care Plan (VCP). The VCP provided a 3-step planning and response tool: (1) Start the Conversation, (2) Listen, Gather Information, and Assess Viewer Experience, and (3) Plan and Act. The intent of the VCP was to support and connect AI and AN youth who either view or post concerning messages on social media to life-saving resources. Those enrolled in arm 2 participated in an additional interactive role-play scenario with a coach that took place after the training, via text message. Participants provided qualitative and quantitative feedback on the training's relevance, appeal, and utility. Paired t tests were used to assess confidence in addressing concerning posts between pre- and postsurveys. Content analysis of the role-play transcripts was used to assess the quality and completion of the coached role-plays, in relation to the recommended VCP.

RESULTS

Altogether, 35 participants finished the training and completed pre- and postsurveys; 22 participants completed the 6-month follow-up survey. Pre-post analyses of differences in means found significant improvement across several efficacy measures, including confidence starting a conversation about social media (P=.003), confidence contacting the person who posted something concerning (P<.001), and confidence recommending support services to youth who view (P=.001) or youth who post concerning messages (P<.001). Similarly, pre- to 6-month analyses found significant positive improvement across multiple measures, including confidence contacting the youth who posted (P<.001), confidence starting a conversation about social media with youth (P=.003), and an increase in the number of experiences recommending resources for youth who viewed concerning social media posts (P=.02). Of the 3 steps of the VCP, the least followed step in coached role-plays was sharing tools and resources, which is a part of the third Plan and Act step.

CONCLUSIONS

Findings indicate that the Responding to Concerning Posts on Social Media training is a promising tool to prepare adults to intervene and complete the VCP. Additional evaluation with a larger cohort of participants is needed to determine the unique impact of the role-play scenario and changes in mental health referral rates, behaviors, and skills.

Adoption of Multi-screen Multitasking in Young Generation of China

Presently, people are increasingly becoming screen jugglers and frequently involving multitasking through multiple screens. The current study is focused on explaining multi-screen multitasking behavior of the younger generation in China. People like to self-regulate their routine behaviors to be productive and organized. Recent research in social psychology suggests that self-regulation occurs both deliberately and intuitively. This dual system approach of self-regulation promotes the idea that both reflective and impulsive forces are involved in determining human behavior. Owing to this conception, the present research opted for a dual system approach of self-regulation as the theoretical basis. Empirical data has been collected from university students in China and a total of 345 responses have been used for the analysis which has been performed through structural equation modeling in SmartPLS 3.0. The results indicate that the factors of both deliberative and automatic self-regulation are effective in determining multi-screen multitasking behavior.

A systematic review of online depression screening tools for use in the South African context

Background

According to the World Health Organization, the alarming increase in rates of depression globally has become a serious concern. In 2010, the prevalence rate of depression in South Africa was 4.6%. Given the context of South Africa where the majority of the population have limited access to healthcare facilities and 59.3% of the population have access to the Internet, an online depression screening tool would have much to offer.

Objective

To determine whether online depression screening tools would be suitable for use in South Africa.

Methods

This study presents a systematic review of online depression screening tools to determine whether one would be suitable for use in South Africa. Articles were accessed from seven electronic databases from 1970 to 2018. All articles included in the review were critically appraised.

Results

A total of 17 articles met the inclusion criteria. From the results, there was only one screening tool available on an open access platform for use by the general population. The most common depression online screening tools were the Beck Depression Inventory-II (BDI-II), the Center for Epidemiology Studies Depression Scale (CES-D) and the Patient Health Questionnaire (PHQ-9). It was also evident that there were negligible differences in the psychometric properties of online versus paper versions of the online screening tools. Furthermore, there were very few studies that considered the African or South African population and no online screening tools for major depressive disorder (MDD) developed in these contexts.

Conclusion

There appears to be a need for a depression screening tool to be adapted for online usage in South Africa. It is recommended that the online screening tool should be adapted from the three commonly used online depression screening tools: PHQ-9, CES-D and BDI-II.

Evaluation of Mental Health First Aid skills in an Australian university population

AIM

University students have high rates of mental health problems; however, most delay or fail to seek help altogether. Tertiary settings can offer educational and social programmes to increase mental health awareness and in turn increase the number of students seeking help for their problems. This study aimed to explore students' and staffs' knowledge of mental health issues, confidence to intervene and application of skills following Mental Health First Aid (MHFA) training.

METHODS

Students and staff at an Australian university who had completed MHFA training in the previous 24 months were invited to complete a validated online questionnaire.

RESULTS

Of the 566 eligible participants, 107 (19%) completed the questionnaire. The majority (65%) had applied their skills to someone in need, with the highest number applying it to students. Notably, of those who had applied their skills 23 participants (33%) had applied them in a crisis situation, the most common being panic attacks followed by suicidal thoughts. Although most (98%) applied their skills in a face-to-face capacity, 53% also reported assisting someone via electronic mediums and social media. The mean score for the literacy test was considered high, 12/16 (SD = 1.7) for students and 13/16 (SD = 2.5) for staff. The majority (94%) reported more confidence in providing support following training.

CONCLUSION

This study demonstrated that MHFA training on a university campus is associated with a high level of knowledge, confidence to intervene and apply MHFA skills to assist a student or friend in need, potentially impacting their long-term health outcomes and future professional careers.

Older Adolescents' Understanding of Participant Rights in the BlackBerry Project, a Longitudinal Ambulatory Assessment Study

For a long-term, longitudinal study that used BlackBerry smartphones for passive ambulatory assessment among older adolescents, this study focused on three areas of ethical concern: (1) adolescents' competence to give assent; (2) understanding of confidentiality, the protection of information, and project goals; and (3) awareness of procedures and benefits, and comfort with the research design. One hundred and seventy-eight participants were 17 and 18 years old (84 girls). Results suggested that participants freely gave consent and understood most, but not all of the informed consent information. Participants reported a high level of satisfaction. Participants showed less understanding of when their confidentiality would be broken and how data would be protected.

Using Text Messaging, Social Media, and Interviews to Understand What Pregnant Youth Think About Weight Gain During Pregnancy

BACKGROUND

The majority of pregnant youth gain more weight than recommended by the National Academy of Medicine guidelines. Excess weight gain during pregnancy increases the risk of dangerous complications during delivery, including operative delivery and stillbirth, and contributes to the risk of long-term obesity in both mother and child. Little is known regarding youth's perceptions of and knowledge about weight gain during pregnancy.

OBJECTIVE

The aim of this study was to describe the feasibility and acceptability of 3 novel data collection and analysis strategies for use with youth (social media posts, text message surveys, and semistructured interviews) to explore their experiences during pregnancy. The mixed-methods analysis included natural language processing and thematic analysis.

METHODS

To demonstrate the feasibility and acceptability of this novel approach, we used descriptive statistics and thematic qualitative analysis to characterize participation and engagement in the study.

RESULTS

Recruitment of 54 pregnant women aged between 16 and 24 years occurred from April 2016 to September 2016. All participants completed at least 1 phase of the study. Semistructured interviews had the highest rate of completion, yet all 3 strategies were feasible and acceptable to pregnant youth.

CONCLUSIONS

This study has described a novel youth-centered strategy of triangulating 3 sources of mixed-methods data to gain a deeper understanding of a health behavior phenomenon among an at-risk population of youth.

Depression symptoms and negative online disclosure among young adults in college: a mixed-methods approach

Background: Social media may be novel and promising avenues to identify youth at risk for depression. Missing from prior research on youth social media use in the service of mental health is our understanding of the kinds of negative experiences young people disclose online and their associations with depression symptoms.Aims: Using a mixed-methods approach, this study: (1) examined the association between depression symptoms and online disclosure of negative emotions; (2) explored the kinds of negative experiences young adults, in their own words, disclosed online; and (3) investigated the associations between depression symptoms and the online disclosure of negative experiences.Methods: Young adults in college (N = 261; 66 males, 195 females M_age 22) completed quantitative as well as qualitative questionnaires about their Facebook content and use and about their mental health (e.g. depression symptoms). Responses were analyzed using a thematic analysis, and a series of binary logistic regression analyses, controlling for age, gender, Facebook use and self-esteem.Results: An inductive thematic analysis of 121 qualitative responses reflecting negative emotional states revealed fours themes of negative experiences: life hassles, relationships, academics and work. Binary logistic regression analyses revealed that youth who reported higher depression symptoms were two times more likely to disclose negative emotions online and were three times more likely to disclose various hassles online than their peers who reported lower symptoms. Active Facebook users were almost two times more likely than less active users to disclose negative academic experiences.Conclusions: Online disclosure of negative emotions and experiences are linked with depression symptoms. Further, online disclosure of negative experiences may also reflect normative, age-related instabilities. In sum, social media may be promising avenues to detect mental health concerns (e.g., depression) in early adulthood.

Evaluating alcohol and marijuana use among emerging adult males via analysis of text messages

Background: Advances in social technologies offer new tools for large scale data collection and analysis of peer influence and social networks on substance use attitudes and behaviors. Objective: The objective of this study was to determine if text message content can predict alcohol and marijuana use attitudes and behaviors. Methods: Text messages from 91 males ages 18-25 were monitored over a period of 6 months and examined for content related to alcohol and marijuana. Self-report data indicating alcohol and marijuana use attitudes and behaviors were used to determine relationships between text message content, social network structure, and substance use attitudes and behaviors. Results: In total, 23,173 text messages were analyzed with 166 text messages including alcohol related terms and 195 text messages including drug related terms. Individuals who sent text messages related to alcohol use were more likely to have problem alcohol use and positive attitudes toward alcohol use, and individuals who sent text messages related to marijuana use reported higher frequency of marijuana use and more positive attitudes toward marijuana use. Individuals with multiple daily marijuana use were in positions that had less control over network structure. Conclusions: The results of this study indicate that monitoring text message content and social network structure among emerging adult males can potentially predict alcohol and marijuana use attitudes and behaviors. Text message content analysis is a novel technique increasing our understanding of the role of peer influence and social network on substance use attitudes and behaviors.

An exploration of the link between adult attachment and problematic Facebook use

BACKGROUND

Previous studies have reported on positive and negative psychological outcomes associated with the use of social networking sites (SNSs). Research efforts linking Facebook use with depression and low self-esteem have indicated that it might be the manner in which people engage with the site that makes its use problematic for some people. The aim of the current study was to test a theoretical model of problematic Facebook use, using adult attachment style as the predictor variable of interest.

METHOD

A cross-sectional design was employed wherein adult Facebook users (n = 717) completed measures of psychological distress, self-esteem, and adult attachment, in addition to measures of problematic Facebook use (i.e. social comparison, self-disclosures, impression management, & intrusive Facebook use). Data were analysed using hierarchical multiple regression and mediation analyses.

RESULTS

The results of this study indicated that attachment anxiety was predictive of all facets of problematic Facebook use, and that attachment avoidance was predictive of impression management, and social consequences of intrusive Facebook use. Further analyses confirmed the mediating influences of psychological distress and self-esteem on these relationships.

CONCLUSIONS

Users of Facebook with higher levels of attachment insecurity may be gravitating towards the site in order to fulfil their attachment needs. This tendency is likely to be particularly prevalent for those individuals with low self-esteem who are experiencing psychological distress.

Predicting Depression From Language-Based Emotion Dynamics: Longitudinal Analysis of Facebook and Twitter Status Updates

BACKGROUND

Frequent expression of negative emotion words on social media has been linked to depression. However, metrics have relied on average values, not dynamic measures of emotional volatility.

OBJECTIVE

The aim of this study was to report on the associations between depression severity and the variability (time-unstructured) and instability (time-structured) in emotion word expression on Facebook and Twitter across status updates.

METHODS

Status updates and depression severity ratings of 29 Facebook users and 49 Twitter users were collected through the app MoodPrism. The average proportion of positive and negative emotion words used, within-person variability, and instability were computed.

RESULTS

(49)=-.34, P=.01, 95% CI -0.58 to 0.09). Differences between Facebook and Twitter users in their emotion word patterns and psychological characteristics were also explored.

CONCLUSIONS

The findings suggest that negative emotion word instability may be a simple yet sensitive measure of time-structured variability, useful when screening for depression through social media, though its usefulness may depend on the social media platform.

Characterizing Depression Issues on Sina Weibo

The prevalence of depression has increased significantly over the past few years both in developed and developing countries. However, many people with symptoms of depression still remain untreated or undiagnosed. Social media may be a tool to help researchers and clinicians to identify and support individuals who experience depression. More than 394,000,000 postings were collected from China’s most popular social media website, Sina Weibo. 1000 randomly selected depression-related postings was coded and analyzed to learn the themes of these postings, and a text classifier was built to identify the postings indicating depression. The identified depressed users were compared with the general population on demographic characteristics, diurnal patterns, and patterns of emoticon usage. We found that disclosure of depression was the most popular theme; depression displayers were more engaged with social media compared to non-depression displayers, the depression postings showed geographical variations, depression displayers tended to be active during periods of leisure and sleep, and depression displayers used negative emoticons more frequently than non-depression displayers. This study offers a broad picture of depression references on China’s social media, which may be cost effectively developed to detect and help individuals who may suffer from depression disorders.

Recruitment of Participants and Delivery of Online Mental Health Resources for Depressed Individuals Using Tumblr: Pilot Randomized Control Trial

Background

Adolescents and young adults frequently post depression symptom references on social media; previous studies show positive associations between depression posts and self-reported depression symptoms. Depression is common among young people and this population often experiences many barriers to mental health care. Thus, social media may be a new resource to identify, recruit, and intervene with young people at risk for depression.

Objective

The purpose of this pilot study was to test a social media intervention on Tumblr. We used social media to identify and recruit participants and to deliver the intervention of online depression resources.

Methods

This randomized pilot intervention identified Tumblr users age 15-23 who posted about depression using the search term “#depress”. Eligible participants were recruited via Tumblr messages; consented participants completed depression surveys and were then randomized to an intervention of online mental health resources delivered via a Tumblr message, while control participants did not receive resources. Postintervention online surveys assessed resource access and usefulness and control groups were asked whether they would have liked to receive resources. Analyses included t tests.

Results

A total of 25 participants met eligibility criteria. The mean age of the participants was 17.5 (SD 1.9) and 65% were female with average score on the Patient Health Questionnaire-9 of 17.5 (SD 5.9). Among the 11 intervention participants, 36% (4/11) reported accessing intervention resources and 64% (7/11) felt the intervention was acceptable. Among the 14 control participants, only 29% (4/14) of reported that receiving resources online would be acceptable (P=.02). Participants suggested anonymity and ease of use as important characteristics in an online depression resource.

Conclusions

The intervention was appropriately targeted to young people at risk for depression, and recruitment via Tumblr was feasible. Most participants in the intervention group felt the social media approach was acceptable, and about a third utilized the online resources. Participants who had not experienced the intervention were less likely to find it acceptable. Future studies should explore this approach in larger samples. Social media may be an appropriate platform for online depression interventions for young people.

Help-Seeking on Facebook Versus More Traditional Sources of Help: Cross-Sectional Survey of Military Veterans

BACKGROUND

The media has devoted significant attention to anecdotes of individuals who post messages on Facebook prior to suicide. However, it is unclear to what extent social media is perceived as a source of help or how it compares to other sources of potential support for mental health problems.

OBJECTIVE

This study aimed to evaluate the degree to which military veterans with depression use social media for help-seeking in comparison to other more traditional sources of help.

METHODS

Cross-sectional self-report survey of 270 adult military veterans with probable major depression. Help-seeking intentions were measured with a modified General Help-Seeking Questionnaire. Facebook users and nonusers were compared via t tests, Chi-square, and mixed effects regression models. Associations between types of help-seeking were examined using mixed effects models.

RESULTS

The majority of participants were users of social media, primarily Facebook (n=162). Mean overall help-seeking intentions were similar between Facebook users and nonusers, even after adjustment for potential confounders. Facebook users were very unlikely to turn to Facebook as a venue for support when experiencing either emotional problems or suicidal thoughts. Compared to help-seeking intentions for Facebook, help-seeking intentions for formal (eg, psychologists), informal (eg, friends), or phone helpline sources of support were significantly higher. Results did not substantially change when examining users of other social media, women, or younger adults.

CONCLUSIONS

In its current form, the social media platform Facebook is not seen as a venue to seek help for emotional problems or suicidality among veterans with major depression in the United States.

An Analysis of Anxiety-Related Postings on Sina Weibo

This study examines anxiety-related postings on Sina Weibo to gain insight into social networking about mental health. The themes of a random sample of anxiety-related postings (n = 1000) were assessed. The disclosure of anxiety was the most common theme. The prevalence of anxiety was higher in certain areas where the economy is stronger than others, and the people living there suffered from more stress. Users who talked about feeling anxious tended to be more active on social media during leisure hours and less active during work hours. Our findings may be developed to detect and help individuals who may suffer from anxiety disorders at a low cost.

Adolescent and Young Adult Use of Social Media for Health and Its Implications

PURPOSE

To determine how adolescents and young adults (AYAs) use social media to share health information and to assess attitudes toward using social media to obtain health information and communicate with medical providers.

METHODS

A cross-sectional study of AYAs, 12 years or older, attending a primary care adolescent and young adult clinic. Participants completed an anonymous survey about health-related social media use, personal health, and communication with their health care team.

RESULTS

Of the 244 patients approached, 204 enrolled (83.6% participation rate). Almost all (98%) had used social media within the prior month, but only 51.5% had shared health information in these networks. These participants shared about mood (76.2%), wellness (57.1%), and acute medical conditions (41.9%). Those with self-reported poor health were more likely to share health information than other groups. Privacy was the most important factor determining which platform to use. Only 25% thought that social media could provide them with useful health information. Few AYAs connected with their health care team on social media and most did not want to use this method; texting was preferred.

CONCLUSIONS

AYAs maintain their privacy on social media regarding their health. Those with self-perceived poor health are more likely to share health information, potentially biasing online content and impairing the generalizability of social media research. AYAs do not view social media as a useful source of health information, which may limit the utility of public health messages through these platforms, and it may not be adequate for communication between patients and their health care team.

Estimation of the prevalence of adverse drug reactions from social media

This work aims to estimate the degree of adverse drug reactions (ADR) for psychiatric medications from social media, including Twitter, Reddit, and LiveJournal. Advances in lightning-fast cluster computing was employed to process large scale data, consisting of 6.4 terabytes of data containing 3.8 billion records from all the media. Rates of ADR were quantified using the SIDER database of drugs and side-effects, and an estimated ADR rate was based on the prevalence of discussion in the social media corpora. Agreement between these measures for a sample of ten popular psychiatric drugs was evaluated using the Pearson correlation coefficient, r, with values between 0.08 and 0.50. Word2vec, a novel neural learning framework, was utilized to improve the coverage of variants of ADR terms in the unstructured text by identifying syntactically or semantically similar terms. Improved correlation coefficients, between 0.29 and 0.59, demonstrates the capability of advanced techniques in machine learning to aid in the discovery of meaningful patterns from medical data, and social media data, at scale.

Adolescents' Depressive Symptoms and Subsequent Technology-Based Interpersonal Behaviors: A Multi-Wave Study

This study examined the longitudinal effects of adolescents' depressive symptoms on engagement in technology-based social comparison and feedback seeking (SCFS) behaviors. A total of 816 adolescents (54.7% girls; M_age =14.1 at Time 1) participated at three times points, each one year apart. Adolescents reported technology-based SCFS, depressive symptoms, and frequencies of technology use (cell phones, Facebook, and Instagram). Multiple group (by gender) latent growth curve models examined concurrent and lagged effects of depressive symptoms on SCFS, controlling for adolescent's underlying trajectories of SCFS and overall frequencies of technology use. Results indicated that higher levels of depressive symptoms were concurrently associated with greater SCFS after accounting for adolescents' typical patterns of SCFS. For boys only, higher depressive symptoms were prospectively associated with later increases in SCFS. Results highlight the importance of social media as a unique context in which depressed adolescents may be at risk for maladaptive interpersonal behavior.

Adolescents' Internalizing Symptoms as Predictors of the Content of Their Facebook Communication and Responses Received from Peers

This research examined how adolescents' internalizing symptoms, such as depression, anxiety, and loneliness, relate to the content of their Facebook communication and the responses they receive from peers on Facebook. Participants (n = 125, 56 female, age 18) reported on their internalizing symptoms in the summer following 12^th grade, and downloaded an application to their Facebook account that stored the content of all of their Facebook communication to secure, online archive. Two months of participants' status updates and comments and peers' comments were coded for content. Relations between internalizing symptoms and Facebook communication differed for girls and boys. For girls, internalizing symptoms predicted several types of Facebook content: negative affect, somatic complaints and eliciting support. In contrast, internalizing symptoms were not related to boys' Facebook posts. Relations between internalizing symptoms and peers' responses on Facebook also differed by gender. For girls, internalizing symptoms positively predicted receiving more peer comments expressing negative affect, and peer responses offering support. For boys, internalizing symptoms did not predict any of the measured peer responses. These findings suggest that girls prone to internalizing symptoms use Facebook in ways that appear similar to co-rumination, by expressing problems to friends and receive possibly reinforcing feedback in return.

An Analysis of Depression, Self-Harm, and Suicidal Ideation Content on Tumblr

BACKGROUND

Social networking about depression can be indicative of self-reported depression and/or can normalize risk behaviors such as self-harm and suicidal ideation.

AIM

To gain a better understanding of the depression, self-harm, and suicidal content that is being shared on Tumblr.

METHOD

From April 16 to May 10, 2014, 17 popular depression-related Tumblr accounts were monitored for new posts and engagement with other Tumblr users. A total of 3,360 posts were randomly selected from all historical posts from these accounts and coded based on themes ascertained by the research team.

RESULTS

The 17 Tumblr accounts posted a median number of 185 posts (range = 0-2,954). Content was engaged with (i.e., re-blogged or liked) a median number of 1,677,362 times (range = 0-122,186,504). Of the 3,360 randomly selected posts, 2,739 (82%) were related to depression, suicide, or self-harm. Common themes were self-loathing (412, 15%), loneliness/feeling unloved (405, 15%), self-harm (407, 15%), and suicide (372, 14%).

CONCLUSION

This study takes an important first step at better understanding the displayed depression-related references on Tumblr. The findings signal a need for suicide prevention efforts to intervene on Tumblr and use this platform in a strategic way, given the depression and suicidal content that was readily observed on Tumblr.

Mining the social mediome

The experiences and behaviors revealed in our everyday lives provide as much insight into health and disease as any analysis of our genome could ever produce. These characteristics are not found in the genome, but may be revealed in our online activities, which make up our social mediome.

Prevalence of Depression in Medical Students at the Lebanese University and Exploring its Correlation With Facebook Relevance: A Questionnaire Study

Background

The prevalence of major depression is particularly high in medical students, affecting around one-third of this population. Moreover, online social media, in particular Facebook, is becoming an intrinsic part in the life of a growing proportion of individuals worldwide.

Objective

Our primary objective is to identify the prevalence of depression in medical students at the Lebanese University Faculty of Medicine, a unique state university in Lebanon, its correlation with the utilization of the interactive features of Facebook, and the way students may resort to these features.

Methods

Students of the Lebanese University Faculty of Medicine were assessed for (1) depression and (2) Facebook activity. To screen for major depression, we used the Patient Health Questionnaire-9 (PHQ-9) scale. To test for Facebook activity, we developed the Facebook Resorting Questionnaire (FbRQ), which measures the degree to which students resort to Facebook.

Results

A total of 365 out of 480 students (76.0%) participated in the survey. A total of 25 students were excluded, hence 340 students were included in the final analysis. Current depression was reported in 117 students out of 340 (34.4%) and t tests showed female predominance. Moreover, PHQ-9 score multiple regression analysis showed that feeling depressed is explained 63.5% of the time by specific independent variables studied from the PHQ-9 and the FbRQ. Depression varied significantly among the different academic years (P<.001) and it peaked in the third-year students. One-way analysis of variance (ANOVA) showed that depression and resorting to Facebook had a positive and significant relationship (P=.003) and the different FbRQ categories had significant differences in resorting-to-Facebook power. The like, add friend, and check-in features students used when resorting to Facebook were significantly associated with depression.

Conclusions

This study showed that depression was highly prevalent among students of the Faculty of Medicine at the Lebanese University. Moreover, Facebook may be a promising, helpful, psychological tool for optimizing the management of depression. Our study brought to bear further questions that now prompt further observation and scrutiny to know more about the high rates of depression in this student population, more so in the part of the world studied, and to the growing role of social media.

Online and Social Media Suicide Prevention Interventions for Young People: A Focus on Implementation and Moderation

OBJECTIVE

Suicide remains a major global public health issue for young people. The reach and accessibility of online and social media-based interventions herald a unique opportunity for suicide prevention. To date, the large body of research into suicide prevention has been undertaken atheoretically. This paper provides a rationale and theoretical framework (based on the interpersonal theory of suicide), and draws on our experiences of developing and testing online and social media-based interventions.

METHOD

The implementation of three distinct online and social media-based intervention studies, undertaken with young people at risk of suicide, are discussed. We highlight the ways that these interventions can serve to bolster social connectedness in young people, and outline key aspects of intervention implementation and moderation.

RESULTS

Insights regarding the implementation of these studies include careful protocol development mindful of risk and ethical issues, establishment of suitably qualified teams to oversee development and delivery of the intervention, and utilisation of key aspects of human support (i.e., moderation) to encourage longer-term intervention engagement.

CONCLUSIONS

Online and social media-based interventions provide an opportunity to enhance feelings of connectedness in young people, a key component of the interpersonal theory of suicide. Our experience has shown that such interventions can be feasibly and safely conducted with young people at risk of suicide. Further studies, with controlled designs, are required to demonstrate intervention efficacy.

A content analysis of depression-related Tweets

This study examines depression-related chatter on Twitter to glean insight into social networking about mental health. We assessed themes of a random sample (n=2,000) of depression-related tweets (sent 4-11 to 5-4-14). Tweets were coded for expression of DSM-5 symptoms for Major Depressive Disorder (MDD). Supportive or helpful tweets about depression was the most common theme (n=787, 40%), closely followed by disclosing feelings of depression (n=625; 32%). Two-thirds of tweets revealed one or more symptoms for the diagnosis of MDD and/or communicated thoughts or ideas that were consistent with struggles with depression after accounting for tweets that mentioned depression trivially. Health professionals can use our findings to tailor and target prevention and awareness messages to those Twitter users in need.

Social Media Use in Chronic Disease: A Systematic Review and Novel Taxonomy

PURPOSE

The purpose of this study is to evaluate clinical outcomes from applications of contemporary social media in chronic disease; to develop a conceptual taxonomy to categorize, summarize, and then analyze the current evidence base; and to suggest a framework for future studies on this topic.

METHODS

We performed a systematic review of MEDLINE via PubMed (January 2000 to January 2015) of studies reporting clinical outcomes on leading contemporary social media (ie, Facebook, Twitter, Wikipedia, YouTube) use in 10 chronic diseases. Two reviewers independently performed data extraction and quality assessment; characterization of study outcomes as positive, negative, neutral, or undefined impact; and inductive, thematic analysis to develop our taxonomy.

RESULTS

Of 378 citations identified, 42 studies examining the use of Facebook (n = 16), blogs (n = 13), Twitter (n = 8), wikis (n = 5), and YouTube (n = 4) on outcomes in cancer (n = 14), depression (n = 13), obesity (n = 9), diabetes (n = 4), heart disease (n = 3), stroke (n = 2), and chronic lower respiratory tract infection (n = 1) were included. Studies were classified as support (n = 16), patient education (n = 10), disease modification (n = 6), disease management (n = 5), and diagnosis (n = 5) within our taxonomy. The overall impact of social media on chronic disease was variable, with 48% of studies indicating benefit, 45% neutral or undefined, and 7% suggesting harm. Among studies that showed benefit, 85% used either Facebook or blogs, and 40% were based within the domain of support.

CONCLUSIONS

Using social media to provide social, emotional, or experiential support in chronic disease, especially with Facebook and blogs, appears most likely to improve patient care.

Linking social media and medical record data: a study of adults presenting to an academic, urban emergency department

BACKGROUND

Social media may offer insight into the relationship between an individual's health and their everyday life, as well as attitudes towards health and the perceived quality of healthcare services.

OBJECTIVE

To determine the acceptability to patients and potential utility to researchers of a database linking patients' social media content with their electronic medical record (EMR) data.

METHODS

Adult Facebook/Twitter users who presented to an emergency department were queried about their willingness to share their social media data and EMR data with health researchers for the purpose of building a databank for research purposes. Shared posts were searched for select terms about health and healthcare.

RESULTS

Of the 5256 patients approached, 2717 (52%) were Facebook and/or Twitter users. 1432 (53%) of those patients agreed to participate in the study. Of these participants, 1008 (71%) consented to share their social media data for the purposes of comparing it with their EMR. Social media data consisted of 1 395 720 posts/tweets to Facebook and Twitter. Participants sharing social media data were slightly younger (29.1±9.8 vs 31.9±10.4 years old; p<0.001), more likely to post at least once a day (42% vs 29%; p=0.003) and more likely to present to the emergency room via self-arrival mode and have private insurance. Of Facebook posts, 7.5% (95% CI 4.8% to 10.2%) were related to health. Individuals with a given diagnosis in their EMR were significantly more likely to use terms related to that diagnosis on Facebook than patients without that diagnosis in their EMR (p<0.0008).

CONCLUSIONS

Many patients are willing to share and link their social media data with EMR data. Sharing patients have several demographic and clinical differences compared with non-sharers. A database that merges social media with EMR data has the potential to provide insights about individuals' health and health outcomes.

Marfan syndrome patient experiences as ascertained through postings on social media sites

Marfan syndrome (MS) is a connective tissue disorder that affects thousands of adolescents [Population Reference Bureau, 2013]. Some adolescent patients with MS may use social media to express their experiences and emotions, but little is known about what patients choose to share online. To investigate social media content related to Marfan syndrome we used search terms "Marfan syndrome" and "Marfans" on six different social media sites. The top five recent and popular posts for each site were collected and coded weekly for five weeks. Posts were excluded if they were reshared content or not in English. A codebook was developed using an iterative process to categorize posts and comments. Out of 300 posts collected 147 posts (49.0%) were included for evaluation. Categories of displayed content included personal pictures, memes and pictures featuring symptoms of MS (41.5%) and personal MS experiences (27.1% of posts). One quarter of the posts specifically mentioned a positive experience or how thankful the profile owner was for their life. A unique category of posts (13.7%) referenced Austin Carlile, a celebrity singer with MS, as a role model. Physicians and healthcare providers may consider using social media to understand common MS concerns and to place future health education materials.

"Friending" teens: systematic review of social media in adolescent and young adult health care

Background

Social media has emerged as a potentially powerful medium for communication with adolescents and young adults around their health choices.

Objective

The goal of this systematic review is to identify research on the use of social media for interacting with adolescents and young adults in order to achieve positive health outcomes.

Methods

A MEDLINE/PubMed electronic database search was performed between January 1, 2002 and October 1, 2013, using terms to identify peer-reviewed research in which social media and other Web 2.0 technologies were an important feature. We used a systematic approach to retrieve papers and extract relevant data.

Results

We identified 288 studies involving social media, of which 87 met criteria for inclusion; 75 studies were purely observational and 12 were interventional. The ways in which social media was leveraged by these studies included (1) observing adolescent and young adult behavior (n=77), (2) providing health information (n=13), (3) engaging the adolescent and young adult community (n=17), and (4) recruiting research participants (n=23). Common health topics addressed included high-risk sexual behaviors (n=23), alcohol, tobacco, and other drug use (n=19), Internet safety (n=8), mental health issues (n=18), medical conditions (n=11), or other specified issues (n=12). Several studies used more than one social media platform and addressed more than one health-related topic.

Conclusions

Social media technologies offer an exciting new means for engaging and communicating with adolescents and young adults; it has been successfully used to engage this age group, identify behaviors, and provide appropriate intervention and education. Nevertheless, the majority of studies to date have been preliminary and limited in their methodologies, and mostly center around evaluating how adolescents and young adults use social media and the resulting implications on their health. Although these explorations are essential, further exploration and development of these strategies into building effective interventions is necessary.

Online and social networking interventions for the treatment of depression in young people: a systematic review

BACKGROUND

Major depression accounts for the greatest burden of all diseases globally. The peak onset of depression occurs between adolescence and young adulthood, and for many individuals, depression displays a relapse-remitting and increasingly severe course. Given this, the development of cost-effective, acceptable, and population-focused interventions for depression is critical. A number of online interventions (both prevention and acute phase) have been tested in young people with promising results. As these interventions differ in content, clinician input, and modality, it is important to identify key features (or unhelpful functions) associated with treatment outcomes.

OBJECTIVE

A systematic review of the research literature was undertaken. The review was designed to focus on two aspects of online intervention: (1) standard approaches evaluating online intervention content in randomized controlled designs (Section 1), and (2) second-generation online interventions and services using social networking (eg, social networking sites and online support groups) in any type of research design (Section 2).

METHODS

Two specific literature searches were undertaken. There was no date range specified. The Section 1 search, which focused on randomized controlled trials, included only young people (12-25 years) and yielded 101 study abstracts, of which 15 met the review inclusion criteria. The Section 2 search, which included all study design types and was not restricted in terms of age, yielded 358 abstracts, of which 22 studies met the inclusion criteria. Information about the studies and their findings were extracted and tabulated for review.

RESULTS

The 15 studies identified in Section 1 described 10 trials testing eight different online interventions, all of which were based on a cognitive behavioral framework. All but one of the eight identified studies reported positive results; however, only five of the 15 studies used blinded interviewer administered outcomes with most trials using self-report data. Studies varied significantly in presentation of intervention content, treatment dose, and dropout. Only two studies included moderator or clinician input. Results for Section 2 were less consistent. None of the Section 2 studies reported controlled or randomized designs. With the exception of four studies, all included participants were younger than 25 years of age. Eight of the 16 social networking studies reported positive results for depression-related outcomes. The remaining studies were either mixed or negative. Findings for online support groups tended to be more positive; however, noteworthy risks were identified.

CONCLUSIONS

Online interventions with a broad cognitive behavioral focus appear to be promising in reducing depression symptomology in young people. Further research is required into the effectiveness of online interventions delivering cognitive behavioral subcomponents, such as problem-solving therapy. Evidence for the use of social networking is less compelling, although limited by a lack of well-designed studies and social networking interventions. A range of future social networking therapeutic opportunities are highlighted.

A mixed-methods observational study of human milk sharing communities on Facebook

OBJECTIVES

The Food and Drug Administration discourages the casual sharing of human milk because of the risk of pathogen transmission. No information is currently available on the prevalence of this practice. The purpose of this mixed-methods observational study is to describe the size and activity of online milk sharing communities.

MATERIALS AND METHODS

Data for 3 months were extracted from nine public Facebook pages that facilitate the exchange of human milk. The numbers of participants, interactions, and comments were analyzed.

RESULTS

We observed 954 individuals participating in milk sharing. The number of interactions per individual ranged from none to 16 (mean, 1.74 ± 1.65). Top reasons that participants requested milk included "lactation problems" (69.4%) and "child health problems" (48.5%). Nearly half of donors were offering 100 ounces or more, which is the minimum to be eligible to donate to nonprofit milk banks.

CONCLUSIONS

Milk sharing networks in the United States are active, with thousands of individuals participating in the direct exchange of raw human milk. Public health issues include increasing the supply of pasteurized donor milk for fragile infants, increasing breastfeeding support, and helping milk sharing families appropriately manage risks.

Did you hear the one about the doctor? An examination of doctor jokes posted on Facebook

BACKGROUND

Social networking sites such as Facebook have become immensely popular in recent years and present a unique opportunity for researchers to eavesdrop on the collective conversation of current societal issues.

OBJECTIVE

We sought to explore doctor-related humor by examining doctor jokes posted on Facebook.

METHODS

We performed a cross-sectional study of 33,326 monitored Facebook users, 263 (0.79%) of whom posted a joke that referenced doctors on their Facebook wall during a 6-month observation period (December 15, 2010 to June 16, 2011). We compared characteristics of so-called jokers to nonjokers and identified the characteristics of jokes that predicted joke success measured by having elicited at least one electronic laugh (eg, an LOL or "laughing out loud") as well as the total number of Facebook "likes" the joke received.

RESULTS

Jokers told 156 unique doctor jokes and were the same age as nonjokers but had larger social networks (median Facebook friends 227 vs 132, P<.001) and were more likely to be divorced, separated, or widowed (P<.01). In 39.7% (62/156) of unique jokes, the joke was at the expense of doctors. Jokes at the expense of doctors compared to jokes not at the expense of doctors tended to be more successful in eliciting an electronic laugh (46.5% vs 37.3%), although the association was statistically insignificant. In our adjusted models, jokes that were based on current events received considerably more Facebook likes (rate ratio [RR] 2.36, 95% CI 0.97-5.74).

CONCLUSIONS

This study provides insight into the use of social networking sites for research pertaining to health and medicine, including the world of doctor-related humor.

Facebook enhances antidepressant pharmacotherapy effects

Treatment-resistant major depressive disorder (TR-MDD) is a complex condition, with very low remission rates. In recent years some studies have been conducted on the implementation of cognitive behavioral therapy and psychodynamic psychotherapy interventions via the Internet to MDD patients, and results have been promising. However, there have been no studies in patients with TR-MDD nor with the use of Facebook with the psychiatrist as “friend.” 60 TR-MDD patients were randomized to one of three groups: Facebook group with psychiatrist as “friend,” Facebook group without psychiatrist as “friend,” and control group (no Facebook use). Both Facebook groups spent at least 1 hour/day on Facebook, 7 days/week, during the 3 months. All patients maintained their usual pharmacotherapy. All participants were evaluated at baseline and at 1, 2, and 3 months for depressive symptoms using HAD17 and BDI-II. Results show that both Facebook groups had a decrease on HADM17 and BDI-II scores as well as higher remission and response rates than the control group, with better results if the psychiatrist was a “friend” on Facebook. Therefore, in TR-MDD, Facebook can be used as an effective enhancement therapy, adjuvant to pharmacological therapy with regular consultations, especially if the psychiatrist is the patient's online “friend.”

Thin-slice judgments in the clinical context

Clinicians make a variety of assessments about their clients, from judging personality traits to making diagnoses, and a variety of methods are available to do so, ranging from observations to structured interviews. A large body of work demonstrates that from a brief glimpse of another's nonverbal behavior, a variety of traits and inner states can be accurately perceived. Additionally, from these "thin slices" of behavior, even future outcomes can be predicted with some accuracy. Certain clinical disorders such as Parkinson's disease and facial paralysis disrupt nonverbal behavior and may impair clinicians' ability to make accurate judgments. In certain contexts, personality disorders, anxiety, depression, and suicide attempts and outcomes can be detected from others' nonverbal behavior. Additionally, thin slices can predict psychological adjustment to divorce, bereavement, sexual abuse, and well-being throughout life. Thus, for certain traits and disorders, judgments from a thin slice could provide a complementary tool for the clinician's toolbox.

Effect of Facebook on the life of Medical University students

Background

Facebook is a social networking service launched in February 2004, owned and operated by Facebook, Inc. As of June 2012, Facebook reports more than 1 billion active users. Objective of study was to evaluate the effect of Facebook on the social life, health and behavior of medical students.

Methodology

It was a cross sectional, observational and questionnaire based study conducted in Dow University OF Health Sciences during the period of January 2012 to November 2012. We attempted to interview all the participants who could be approached during the period of the study. Participants were MBBS students, while all students of other courses and programs were taken as exclusion criteria. Approximately 1050 questionnaires were distributed to participants. Fifty questionnaires were rejected due to incomplete answers, yielding 1000 usable responses for an approximate 95% response rate. Informed verbal consent was taken from each participant. Study was ethically approved by Institutional Review Board of Dow University of Health Sciences. All the data was entered and analyzed through SPSS 19.

Result

Out of total 1000 participants, males were 400 (40%) and females were 600 (60%). Participants were in the age group of 18–25 years with a mean age of 20.08 years. Most of the participants were using Facebook daily (N = 640, 64%) for around 3–4 hours (N = 401, 40.1%). Majority of them (N = 359, 35.9%) believed that they were equally active on Facebook and in real life while few believed their social life became worse after start using Facebook (N = 372, 37.2%). Most of the participants admitted that they were considered as shy in real world (N = 390, 39.0%) while in the world of Facebook they were considered as fun loving by their friends (N = 603, 60.3%). A large number of participants (N = 715, 75%) complained of mood swings.

Conclusion

Youngsters are willing to compromise their health, social life, studies for the sake of fun and entertainment or whatever satisfaction they get after using Facebook. What we observed in our study was that although majority of our subjects showed multiple signs of Facebook addiction, they don’t realize it and if even they realize it they don’t want to quit Facebook and even if they want to quit, they can’t. Our observance concluded that majority of the users are highly addicted.