Gender differences in associations between digital media use and psychological well-being: Evidence from three large datasets

The association between screen time trajectories and the comorbidity of depression and anxiety

Depression and anxiety are often comorbid among adolescents. Adolescent screen time changes over time. This study investigates the association between screen time trajectories and the comorbidity of depression and anxiety from a longitudinal perspective. The data were collected from an ongoing prospective puberty cohort which was established in 2014 from Chongqing, China. 838 participants (52.03 % female; wave 1 mean age = 8.62, SD = 1.15) were followed up from 2014 to 2020. Questions about screen time were administered every six months. Trajectories of screen time were identified using latent class growth analysis. Children's Depression Inventory (CDI) and Screen for Child Anxiety Related Disorders (SCARED) were used to measure depression and anxiety. Latent profile analysis was used to identify the subtypes of comorbidity of depression and anxiety. Logistic regression was used to explore the association between screen time trajectory and the comorbidity of depression and anxiety. Three distinct trajectories of screen time were identified: Group Low (68.26 %) had consistently low screen time, Group High (26.37 %) had high screen time and Group Increasing (5.37 %) was characterized by an increasing screen time. Four subtypes of the comorbidity of depression and anxiety were fitted ("High comorbidity", "Low comorbidity", "Low depression symptoms" and "No symptoms"). Group Increasing and Group High were associated with "Low comorbidity" and "Low depression symptoms". Group Increasing was more likely to be the "high comorbidity" both boys and girls. However, Group High was associated with "high comorbidity" only in girls. The results of this study may inform future research and provide possible intervention targets.

Adolescents' Risky Online Behaviors and Social Desirability Bias in Vietnam: Privacy Disclosure and Pornography Use

This study quantified the prevalence of two risky online behaviors among adolescents in Vietnam: online privacy disclosure and online pornography use. We conducted a field experiment with 1,313 junior high school students aged 13-15 years in Hoa Binh city. In addition to conventional direct questions, we employed list experiments to address social desirability bias in the students' responses. The results indicated that 49.9% of the adolescents engaged in online privacy disclosure and that 58.5% were involved in online pornography use. This study revealed significant underreporting among adolescents (35.6 and 43.3 percentage points for privacy disclosure and pornography use, respectively). The heterogeneous analyses revealed that recent smartphone ownership and active smartphone and Facebook use were associated with a greater prevalence of these behaviors. Notably, urban adolescents showed greater engagement in pornography use than did their rural counterparts. This study represents a pioneering effort to empirically investigate sensitive online behaviors among adolescents utilizing an experimental approach to address measurement bias. Our findings suggest that list experiments are a robust method for assessing sensitive issues and emphasize the critical need for educational interventions to mitigate online risks faced by young people.

Gender dysphoria in adolescence: examining the rapid-onset hypothesis

The sharp rise in the number of predominantly natal female adolescents experiencing gender dysphoria and seeking treatment in specialized clinics has sparked a contentious and polarized debate among both the scientific community and the public sphere. Few explanations have been offered for these recent developments. One proposal that has generated considerable attention is the notion of "rapid-onset" gender dysphoria, which is assumed to apply to a subset of adolescents and young adults. First introduced by Lisa Littman in a 2018 study of parental reports, it describes a subset of youth, primarily natal females, with no childhood indicators of gender dysphoria but with a sudden emergence of gender dysphoria symptoms during puberty or after its completion. For them, identifying as transgender is assumed to serve as a maladaptive coping mechanism for underlying mental health issues and is linked to social influences from peer groups and through social media. The purpose of this article is to analyze this theory and its associated hypotheses against the existing evidence base and to discuss its potential implications for future research and the advancement of treatment paradigms.

The relationship between online communication and mental health and cardiorespiratory fitness from ages 15 to 17: a longitudinal cohort study

BACKGROUND

Adolescence is a critical developmental period marked by significant mental and physical health changes. This longitudinal study examines the relationship between online communication and health from age 15 to 17, focusing on mental health indicators (depression, anxiety, self-esteem, and body image) and cardiorespiratory fitness (CRF). We aimed to assess whether increased time spent in online communication is associated with poorer mental health and lower CRF among adolescents, with consideration of potential moderating effects of sex and socioeconomic status (SES).

METHODS

Data were collected from 315 Icelandic adolescents at age 15 (2015) and age 17 (2017; N = 236). Linear mixed-effects models were used to examine the association between online communication and health outcomes, including depression, anxiety, body image, self-esteem, and CRF. Models accounted for year, sex, and SES, with random intercepts for individual variability.

RESULTS

More online communication was significantly associated with poorer mental health outcomes, including more symptoms of depression (p < 0.001, marginal R² = 0.14), anxiety (p = 0.032, marginal R² = 0.13), lower self-esteem (p = 0.006, marginal R² = 0.07), more negative body image (p = 0.010, marginal R² = 0.13), and lower CRF; p = 0.003, marginal R² = 0.35). These associations did not change between years and were consistent across sex and SES groups. CRF declined from age 15 to 17. Females reported generally worse mental health and lower CRF than males, while higher SES was linked to lower depression scores and higher self-esteem. However, no significant interactions were found between online communication, sex, or SES, suggesting that the impacts of online communication on health were broadly applicable across demographic groups.

CONCLUSIONS

This study underscores the potential negative effects of online communication on mental and physical health among adolescents, regardless of sex or SES. The findings highlight the importance of balancing time spent online communicating with physical activity to support overall adolescent well-being. These insights could inform public health initiatives and preventive strategies to foster healthier digital habits in an increasingly online world, especially during this sensitive developmental period.

The Public Perception of Zoophilic Acts in Hungary

This study aimed to assess public perceptions and knowledge of, and attitudes towards, zoophilia in Hungary. Conducted between October and December 2021 with 1753 respondents, the survey revealed significant interest and concern regarding zoophilia. The majority (98.3%) of respondents deemed zoophilia to be unacceptable from both health and animal welfare perspectives. Of those surveyed, 98.9% believed that animals possess dignity, and 84.7% felt that zoophilia negatively impacts this dignity. However, awareness of Hungarian legislation on zoophilia was limited, with 38.9% of respondents unaware that such acts are legally prohibited. The survey also highlighted a strong consensus (98.2%) favoring strict penalties for zoophilia. Additionally, the survey uncovered that 14% of respondents had encountered or heard of zoophilic incidents, involving various animals, predominantly dogs. Gender and settlement type significantly influence attitudes toward zoophilic acts, with women and people in capital and major cities being more aware of the legal prohibition and more supportive of strict sanctions. The results underscore a crucial need for enhanced public education on legal standards and ethical considerations regarding zoophilia and suggest a significant gap in understanding and managing the issue, necessitating further research and legislative reforms.

Longitudinal relations among online social activities, peer relationship problems, and well-being in children: The moderating effect of extraversion

Prior research has predominantly examined the relations between online social activities (OSA) and mental health among adolescents and adults, with comparatively less emphasis placed on children, particularly concerning positive indicators of subjective health, such as well-being. The relations between OSA and well-being are likely intricate and necessitate meticulously designed methodologies to investigate the associations and their underlying mechanisms. This longitudinal study employed the random intercept cross-lagged panel models to explore the dynamic relations between OSA and well-being, considering peer relationship problems as a potential mediator and extraversion as a moderator of the associations, while distinguishing between- and within-person effects. A total of 2,300 Chinese children (56.1% boys, Mage = 9.49, SD = 0.56) completed four measurements over a two-year period. The results indicated that: (a) OSA negatively predicted well-being, but not vice versa; (b) peer relationship problems mediated the relations from OSA to well-being; and (c) extraversion served as a moderator of the associations, with notable differences between extraverted and introverted children. These findings provide valuable insights for developing targeted guidance for children's Internet use to enhance their general well-being.

Problematic Media Use and Anxiety Symptoms in Adolescents: The Role of Age and Gender

BACKGROUND

Adolescence is a critical biopsychosocial adjustment period, with increased susceptibility to problematic media use (PMU) and associated risk-taking behaviors. The aim of the present study consisted of identifying the relationship between PMU (i.e., videogames, mobile phones, internet, and television) and anxiety in adolescents, considering the moderating effect of gender and age.

METHODS

A descriptive study using a national survey was conducted on a sample of 4034 participants.

RESULTS

Significant gender mean differences were found in PMU and anxiety, with large and moderate effect sizes for PMU (videogames) in males (d = 0.86) and anxiety in females (d = 0.67). Additionally, a direct positive relationship between age and anxiety was observed. Furthermore, PMU significantly predicted anxiety after controlling for age and gender in all cases. Gender had a significant and stronger moderating effect on PMU (television) and anxiety for the male subgroup. The moderating effect of age on PMU and anxiety was statistically significant and more pronounced at younger ages.

CONCLUSIONS

This research demonstrates the association between PMU and anxiety in adolescents, highlighting the need to further explore other moderating factors influencing mental health symptoms beyond age and gender. It is important to emphasize that mental health is a shared responsibility and not solely the domain of mental health professionals. Therefore, initiatives should be promoted to engage educators, parents, and policymakers in addressing this collective challenge.

Sleep problems were unrelated to social media use in the late COVID-19 pandemic phase: A cross-national study

Sleep problems are commonly related to stress and mental health problems. However, social media use has become widespread in the general population during recent years, and their addictive potential may influence people's sleep routine. In addition, the COVID-19 pandemic gave rise to substantial mental health problems in the population, and restrictions in social life gave social media a unique position as means for both entertainment and interpersonal contact. The aim of the study was to examine sleep problems in relationship to social media use in a cross-national sample two years after the COVID-19 outbreak. Participants were 1405 adults from four countries who completed a cross-sectional online survey. The data were analyzed with independent samples t-tests, Chi Squared tests of independence, and single and multivariable logistic regression analyses. Of the 858 (61.1%) participants who reported sleep problems during the past weeks, a substantial proportion (n = 353, 41.1%) related their sleep problems to their experience with COVID-19. With adjustments for age, gender, employment, and psychological distress, more hours of daily social media use was not significantly associated with sleep problems. However, higher age (OR: 1.13, p = 0.01), female gender (OR: 1.69, p<0.001), having employment (OR: 1.34, p = 0.04), and higher levels of psychological distress (OR: 1.20, p<0.001) were independently associated with sleep problems. While the debate about the pros and cons of social media use continue, this study suggests that higher levels of social media use was not of great concern for people's sleep quality in the late COVID-19 pandemic phase. However, other aspects of social media use (eg, time of the day, content of interactions, associated stress experience) may be more relevant for understanding sleep problems and may be taken into consideration for people who experience such problems.

Prospective Associations Between Preschool Exposure to Violent Televiewing and Externalizing Behavior in Middle Adolescent Boys and Girls

OBJECTIVE

Early childhood exposure to violent media content represents an actionable target for preventive intervention. The associated risks for later aggressive behavior have been established in childhood, but few studies have explored widespread long-term associations with antisocial behavior. We investigate prospective associations between exposure to violent television content in early childhood and subsequent antisocial behavior in mid-adolescence.

METHOD

Participants are 963 girls and 982 boys from the Quebec Longitudinal Study of Child Development (QLSCD) birth cohort. Parents reported the frequency of their child's exposure to violent television content at ages 3.5 and 4.5 years. Four indicators of antisocial behavior were self-reported by participants at age 15 years. These indicators were linearly regressed on exposure to violent television content at ages 3.5 and 4.5 years. All analyses, stratified by sex, controlled for pre-existing and concurrent potential individual and family confounding variables.

RESULTS

For boys, preschool violent televiewing was associated with increases in proactive aggression (β = 0.065; 95% CI, 0.001 to 0.089), physical aggression (β = 0.074; 95% CI, 0.040 to 0.487), and antisocial behavior (β = 0.076; 95% CI, 0.013 to 0.140) by mid-adolescence. No prospective associations were found for girls.

CONCLUSIONS

This study of typically developing children demonstrates long-term perils associated with early exposure to violent content in childhood. We observed risks for aggressive and delinquent behavior in boys, more than a decade later. Preventive intervention campaigns that target knowledge transfer to parents and communities regarding the potential insidious consequences of preschool exposure promise more optimal development in youth.

Social inequalities in youth mental health in Canada, 2007-2022: a population-based repeated cross-sectional study

PURPOSE

Rising concern surrounds youth mental health in Canada, with growing disparities between females and males. However, less is known about recent trends by other sociodemographic factors, including sexual orientation, ethnocultural background, and socioeconomic status.

METHODS

This study analyzed data from 96 683 youths aged 15-24 who participated in the nationally representative Canadian Community Health Survey (CCHS) between 2007 and 2022. Trends in absolute and relative inequalities in poor/fair self-rated mental health (SRMH) by sex, sexual orientation, racialized and Indigenous identity, and socioeconomic conditions were assessed.

RESULTS

The percent of youths reporting poor/fair SRMH quadrupled from 4.3% in 2007-08 to 20.1% in 2021-22. During the same period, absolute inequalities in SRMH increased by 9.9% points (95% CI: 6.6, 12.9) for females compared to males, 11.4% points (95% CI: 4.6, 18.2) for Indigenous versus non-racialized youth, and 15.4% points (95% CI: 5.7, 25.1) for youth (aged 18-24) identifying as lesbian, gay, or bisexual (LGB) compared to heterosexual.

CONCLUSION

The sustained deterioration in youth SRMH over the past decade and a half has been accompanied by widening inequalities across several dimensions important for health equity in Canada. Action is needed to identify and implement effective programs and policies to support youth mental health and address disparities.

From Stigma to Strength? The Interrelations Between Sexual Identity Stigma, Well-Being, and Accepting Communities on Instagram Amongst Sexual Minority Youth

INTRODUCTION

Initial evidence suggests that engaging with accepting communities on social media such as Instagram may inform sexual minority youths' sense of stigma and well-being. However, as existing research has predominately drawn upon cross-sectional or qualitative designs, it is currently unclear whether the positive experiences identified in previous research accumulate, endure, or evolve over time. We also know relatively little about whether engagement with accepting online communities is primarily a compensatory or enhancing behavior. Thus, drawing upon minority stress theory and broaden-and-build theory, this study explores the longitudinal reciprocal relationships between perceived stigma, well-being, and engagement with accepting Instagram communities.

METHOD

Three-wave panel data were collected from 460 sexual minority youth in the United States and Poland (M age = 18.58, SD = 1.64), and data were analyzed using a random intercept cross-lagged panel model.

RESULTS

At the between-person level, engagement with accepting Instagram communities was positively associated with perceived stigma and negatively associated with well-being. No significant within-person associations emerged between perceived stigma and engagement with accepting Instagram networks. However, a positive reciprocal relationship was found between well-being and engagement with accepting Instagram communities. Cultural context had no moderating effect on the hypothesized model.

CONCLUSIONS

Results suggest that whilst the interrelations between perceived stigma and engaging with accepting online networks may be short-lived, engaging with supportive Instagram communities may contribute to an upward spiral of positive emotions. Findings therefore extend the existing literature regarding the potential benefits of social media use amongst sexual minority youth.

Prevalence and Patterns of Social Media Use in Early Adolescents

OBJECTIVE

To describe patterns of social media use, including underage (under 13 years) use and sex differences, in a diverse, national sample of early adolescents in the U.S.

METHODS

We analyzed the social media use data in the Adolescent Brain Cognitive Development Study (2019-2021, Year 3), which includes a national sample of early adolescents in the U.S. Specifically, using chi-squared and t-tests, we compared social media use patterns across demographic characteristics stratified by age and sex.

RESULTS

In the sample of 10,092 11-to-15-year-old adolescents, 69.5% had at least one social media account; among social media users, the most common platforms were TikTok (67.1%), YouTube (64.7%), and Instagram (66.0%). A majority (63.8%) of participants under 13 years (minimum age requirement) reported social media use. Under-13 social media users had an average of 3.38 social media accounts, with 68.2% having TikTok accounts and 39.0% saying TikTok was the social media site they used the most. Females reported higher use of TikTok, Snapchat, Instagram, and Pinterest, while males reported higher use of YouTube and Reddit. Additionally, 6.3% of participants with social media accounts reported having a secret social media account hidden from their parents' knowledge.

CONCLUSION

Our findings reveal a high prevalence rate of underage social media use in early adolescence. These findings can inform current policies and legislation aimed at more robust age verification measures, minimum age requirements, and the enhancement of parental controls on social media. Clinicians can counsel about the potential risks of early adolescent social media use.

WHAT'S NEW

In a sample of 10,092 U.S. early adolescents, a majority (63.8%) of participants under 13 years old (minimum age requirement) reported social media use. Under-13 social media users had an average of 3.38 social media accounts.

Social Media Addiction and Cognitive Behavioral Physical Activity Among Adolescent Girls: A Cross-Sectional Study

OBJECTIVE

To measure a multivariate analysis of social media addiction and cognitive-behavioral physical activity associated with several sociodemographic characteristics in adolescent girls.

DESIGN AND METHODS

A cross-sectional study. The sample consisted of adolescent girls studying in a vocational high-school in the Middle-Black-Sea region in Türkiye (n = 333). A questionnaire, Social Media Addiction Scale-for-Adolescents (SMAS-A), and Cognitive-Behavioral Physical Activity Questionnaire (CBPAQ) were used to collect the data.

RESULTS

The mean age was 15.35 (SD = 1.15), and 29.4% were the ninth-class students. Of the adolescent girls, 85.9% were social-media users, 59.8% used the internet 2-hours-or-more/daily, 67.9% declared themselves as moderately-active. The mean scores of the SMAS-A and the CBPAQ were 3.40 (SD = 1.61) and 21.03 (SD = 7.64), respectively. There was a significantly-negative correlation between cognitive-behavioral physical activity and social-media addiction levels. The One-Way MANOVA results showed significant differences in the academic level, family income, mother education, and physical activity measurement application usage affected to cognitive-behavioral physical activity. Social media usage habit affected to the social media addiction level.

CONCLUSIONS

Daily internet usage time and self-declared physical activity level were the mutually affected factors. School nurses should act to improve healthy social media usage habits to promote well-being and encourage the positive attitudes towards regular physical activity in this population.

Game Faces: How Digital Play Affects the Psychological Landscape of Youth

The use of video games in children and adolescents has been growing since the invention of home interactive entertainment. With that growth, many parents and mental health professionals alike have questioned the impact on the mental well-being of their children and patients. Using current literature, we shall investigate the impact of video gaming on children's and teenagers' mental health in this systemic review. We will investigate time spent playing video games and the development of behavioral disorders, obsessive-compulsive disorder (OCD), depression, anxiety, and general psychological well-being. A search of PubMed and EBSCO discovery host was done, looking for primary peer-reviewed articles on the mental health outcomes of video gaming in the pediatric population (2-18 years old) of North America with no prior mental health diagnosis. The search returned 713 articles. After screening and selection, nine articles on six distinct studies were included. Overall, increased time spent playing video games was linked to increased depression and OCD symptoms, behavioral disorders, and suicidal ideation. This is a multifactorial issue that lacks substantial research in the current literature, leaving an opportunity for expansion on this topic in the future.

Moderating effect of cultural differences on the association between social media use and mental health outcomes in adolescents: A cross-cultural comparison study

The influence of social media on the mental health of adolescents has been controversial and the findings in the literature are inconclusive. Although prior studies have identified several factors that may cause or trigger the proposed relationship, little is known about the culture-related factors as an underlying mechanism that could explain the complexity of this association. This study addressed this gap by examining the associations between the two domains of social media (i.e., time spent on weekdays and weekends) and two mental health outcomes (anxiety and depression) in adolescents via the moderating effect of horizontal-vertical individualism and collectivism. 299 secondary school students (Mage = 15.21 years; 61% girls) from Türkiye (N = 176), Ireland (N = 70), and England (N = 53) completed self-report surveys. Spending more than four hours on weekdays and weekends was positively associated with anxiety and depression whereas spending more than two hours on social media during weekends was positively associated with anxiety in the entire sample. Horizontal and vertical individualism moderated the association between time spent on social media and depression in the entire sample. The study's strengths and limitations, along with the implications of the findings for future research, are thoroughly discussed.

Online social activity time predicts ADHD problems in youth from late childhood to early adolescence in the ABCD study

Online social interactions increase into adolescence. Although cross-sectional studies have positively associated online social activity (OSA) time and attention-deficit/hyperactivity disorder (ADHD) problems, the directionality remains unclear. Therefore, we examined longitudinal associations between OSA time and ADHD problems using data from the Adolescent Brain Cognitive Development (ABCD) study. Four waves of ABCD data from 11,819 youth participants (52.1% boys; Baseline: Mage = 9.92 years, SDage = 0.62) were utilized. Random-intercepts cross-lagged panel models (RI-CLPMs) adjusting for potential confounds were employed to estimate longitudinal bidirectional associations. Multiple-group RI-CLPM analyses examined potential moderation effects of OSA content type and child's sex. The results revealed that greater OSA time was associated with more ADHD problems in early adolescence, while more ADHD problems did not predict greater OSA time. In moderation analyses, the cross-lagged effects of OSA time on ADHD problems were only significant for girls, and boys showed an inverse relation between ADHD problems and subsequent OSA time. No moderation effect of OSA content type was observed. These findings highlight the potential detrimental effect of OSA time on the development of attentional processes, especially for girls, thereby offering insights that could guide the development and targeting of interventions to mitigate future risks for ADHD problems during adolescence.

Associations between internet addiction and suicidal ideation in depressed adolescents: the mediating effect of insomnia as well as sex differences

BACKGROUND

Insomnia may mediate the association between internet addiction (IA) and suicidal ideation (SI). However, such association has not been thoroughly investigated in adolescents with major depressive disorder (MDD). Thus, our study aimed to explore whether insomnia significantly affects the association between IA and SI in adolescents with MDD, as well as any sex differences.

METHODS

From January 2021 to September 2023, this cross-sectional study included 502 adolescents with MDD and 123 healthy controls (HCs). The Clinical Global Impression-Severity (CGI-S), the Internet Addiction Test (IAT), the Insomnia Severity Index Scale (ISI) and the Positive and Negative Suicidal Ideation Scale (PANSI) were used to assess subjects' severity of depression, IA, insomnia and SI. And we employed the PROCESS macro program to examine the mediating role of insomnia between IA and SI.

RESULTS

Compared to HCs, adolescents with MDD had significantly higher levels of SI and their prevalence of IA and insomnia were 50.0% and 35.7%. In patients, PANSI scores correlated negatively with age and age of onset, and positively with disease duration as well as the scores of the CGI-S, IAT, and ISI (all p < 0.01). Moreover, above-mentioned correlations were more significant in girls. Mediation analyses showed that insomnia mediated the effect of IA on SI, and the total, direct, and indirect effects were 0.197 (95% CI: 0.132-0.262), 0.157 (95% CI: 0.096-0.218) and 0.040 (95% CI: 0.014-0.068), respectively. In female patients, the total, direct, and indirect effects were 0.224 (95% CI: 0.151-0.296), 0.191 (95% CI: 0.124-0.257) and 0.033 (95% CI: 0.002-0.068), respectively. In male patients, insomnia acted as a fully mediated effect between IA and SI, with an effect value of 0.045 (95% CI: 0.008-0.093).

CONCLUSION

Depressed adolescents have higher suicide risk, and SI is significantly associated with IA and insomnia, especially in girls. Moreover, insomnia may mediate the association between IA and SI. However, given the small sample size of this study and the limitations of assessment tools used, the results need to be viewed with caution. Regardless, clinical interventions should be strengthened for IA and insomnia in adolescents with MDD to reduce suicide risk.

Recruitment of Adolescents to Virtual Clinical Trials: Recruitment Results From the Health4Me Randomized Controlled Trial

Background

Preventive interventions are needed to provide targeted health support to adolescents to improve health behaviors. Engaging adolescents in preventive interventions remains a challenge, highlighting the need for innovative recruitment strategies. Given adolescents' lives are intertwined with digital technologies, attention should be focused on these avenues for recruitment. The evolving nature of clinical trials, including the emergence of virtual clinical trials, requires new recruitment approaches, which must be evaluated.

Objective

This study aimed to examine the effectiveness and cost of various digital recruitment strategies for recruiting adolescents to a virtual clinical trial, evaluate the progression of participants from screening to enrollment, and explore factors associated with nonparticipation. This was conducted using data from the Health4Me Study, a preventive digital health intervention to improve physical activity and nutrition behaviors among adolescents aged 12 to 18 years.

Methods

Participants were recruited into the Health4Me Study via social media advertisements on various contemporary platforms, emails to schools, emails to contacts within known networks, and emails to relevant youth organizations. Data were collected from social media advertisements, screening, and recruitment logs. Data analysis included summary and descriptive statistics, as well as chi-square tests to explore factors associated with nonparticipation.

Results

From 2369 expressions of interest, 390 (16.4%) participants were enrolled. A total of 19 advertisements were placed on social media, and 385 promotional emails were sent to schools, contacts within known networks, and relevant youth organizations. Social media advertisements reached 408,077 unique accounts. Advertisements mostly reached those living in populous states in Australia (306,489/408,077, 75.11% of unique accounts) and those identifying as female (177,698/408,077, 43.55% of unique accounts). A total of 24.97% (101,907/408,077) of advertisements were delivered to accounts with uncategorized genders. The total cost per participant enrolled was Aus $3.89 (approximately US $2.58). Most participants (1980/2305, 85.90%) found out about this study through Instagram. Differences in screening characteristics between eligible participants who did and did not enroll were found to be statistically significant for gender (P=.02), with fewer males and more individuals reporting their gender as "other" enrolling than expected by chance alone. The recruitment method also differed (P<.001), with fewer participants enrolling through Instagram and more enrolling through other methods (eg, known networks or word of mouth) than expected by chance alone.

Conclusions

This study found that virtual clinical trial recruitment was found to be low-cost, with the potential to increase trial participation. Social media was the most effective recruitment method, reaching all states and territories, including hard-to-reach populations. Future action is needed to explore recruitment methods that are more effective for males and to build trust among adolescents regarding clinical trial recruitment via social media.

Analysing Digital Engagement Patterns: A Machine Learning Investigation into Social Anxiety Among Adolescents with ADHD

Background: The relationship between screen time and mental health among adolescents, particularly those identified as "digital natives", has become increasingly pertinent, especially in the context of heightened digital engagement during the COVID-19 pandemic. This study aims to examine the associations between digital engagement patterns, ADHD severity, and anxiety symptoms in adolescents aged 11-18. Methods: A cross-sectional observational study was conducted with a sample of 97 adolescents diagnosed with ADHD. Participants completed validated questionnaires assessing daily digital activities and anxiety symptoms while caregivers provided additional contextual information. Data were analyzed using Random Forest regression to identify relationships between screen time, ADHD severity, and anxiety symptoms. Results: The findings indicate an average screen time of 6.6 h on weekdays and 8.1 h on weekends, with social media emerging as the primary activity, particularly among female participants. Notable gender differences were identified, with family dynamics influencing digital engagement; family disputes had a more significant impact on girls than boys. Furthermore, specific anxiety traits, i.e., physical symptoms and harm avoidance, significantly predicted time spent on social media across all genders considered in the study, while others, namely social anxiety and separation anxiety, were less valuable. Conclusions: This study highlights the complex interplay between screen time, ADHD, and anxiety symptoms in adolescents. These findings underscore the importance of tailored interventions that address the nuanced relationships between digital engagement and mental health in this population, warranting further research to develop effective management strategies.

Exploring digital use, happiness, and loneliness in Japan with the experience sampling method

Smartphones have become an integral part of modern life, raising concerns about their impact on mental health, especially among young people. However, previous studies yielded inconsistent results, possibly due to neglecting the possibility of interactions between offline and online communications. To explore potential interactions among different communication modes (online vs. offline) and communication types (private vs. public), we adopted the experience sampling method to track 418 Japanese individuals over 21 days and analyzed the data using multilevel models and psychometric network models. The findings revealed that digital use has only small direct effects on happiness and loneliness, especially through public (one-to-many) online communication. The increased digital use reduced offline communication time, indirectly influencing loneliness to a large degree. Overall, this study highlights the indirect effects of decreased face-to-face communication and the significant role of one-to-many online communication, which may explain a part of the diverse findings on this issue.

Sex differences in clinically diagnosed psychiatric disorders over the lifespan: a nationwide register-based study in Sweden

Background

Limited studies exist on sex differences in incidence rates of psychiatric disorders across the lifespan. This study aims to analyze sex differences in the incidence rates of clinically diagnosed psychiatric disorders over the lifespan.

Methods

We conducted a nationwide register-based cohort study, including all individuals who were born in Sweden and lived in Sweden between 2003 and 2019, including 4,818,071 females and 4,837,829 males. We calculated sex- and age-specific standardized incidence rates for any and 10 major types of psychiatric disorders. Multivariable-adjusted incidence rate differences (IRDs) for diagnosed psychiatric disorders between females and males were estimated.

Findings

During a follow-up of 119,420,908 person-years, males showed a higher incidence rate of any diagnosed psychiatric disorder than females at age 5-9 (IRD = -8.93; 95% CI: -9.08 to -8.79; per 1000 person-years), whereas females showed a higher rate than males at age 15-19 (IRD = 9.33; 95% CI: 9.12-9.54) and onwards (except age 60-69). Specifically, among females, excess rates were apparent for depressive, anxiety, eating, stress-related and bipolar disorders at age 10-54, whereas among males, excess rates were pronounced for autism and attention deficit hyperactivity disorders before age 14, drug use disorders at age 15-54, and alcohol use disorders in adulthood. For schizophrenia, the male excess at age 15-49 shifted to female excess at age 60-79. The magnitude of IRDs were greater in recent years and individuals with lower socioeconomic status.

Interpretation

Knowledge about the lifespan and socioeconomic variations in the sex differences in rates of diagnosed psychiatric disorders may inform targeted screening/intervention strategies.

Funding

Vetenskapsrådet, FORTE, Karolinska Institutet Strategic Research Area in Epidemiology and Biostatistics, and Icelandic Research Fund.

Overthinking over Screens: Girls Ruminate More After Negative Social Media Interactions with Peers Compared to In-Person Interactions

With the rise and ubiquity of social media (SM), the context for peer interactions has changed drastically for adolescents, yet, little is known about how digital peer interactions compare to in-person interactions in their impact on adolescents' emotional experiences. Adolescents employ various emotion regulation (ER) strategies to navigate the complexities of peer interactions, with varying strategy adaptiveness and efficacy. This study delves into the prevalence of ER strategies following daily negative peer interactions on SM, exploring to what extent context (SM or in-person) influences the selection of ER strategies. Over 16 days, 106 U.S. adolescent girls, aged 11-13 (half at high risk for developing an affective disorder), participated in ecological momentary assessments, detailing their worst recent peer interactions, the context (SM or in-person), and the subsequent ER strategies employed. Multilevel models revealed that teens were more prone to rumination after negative peer interactions on SM than in-person (OR = 2.08, p = .031), after adjusting for the overall prevalence of SM and in-person interactions. No other significant differences emerged in ER strategy selection based on the context of the interaction. Findings highlight that although adolescents may adapt their ER strategy selection to suit the demands of specific interpersonal situations across contexts, negative peer interactions on SM may lead to more rumination, potentially contributing to the link between SM use and depression. We discuss how unique features of SM might elicit rumination, such as SM's lack of physical social cues and its permanent, public, and asynchronous nature.

Excessive internet use among Finnish young people between 2017 and 2021 and the effect of COVID-19

PURPOSE

An increase in excessive Internet use (EIU) among adolescents during the COVID-19 pandemic was suggested in many studies. However, these studies were mostly based on cross-sectional and/or unrepresentative samples.

METHODS

Using data from a nationwide Finnish school survey in the years 2017, 2019 and 2021 (N = 450,864; aged 13-20 years), changes in the prevalence of EIU (EIUS, 5-item) were assessed. The effects of COVID-19 (year 2021 vs. 2017/2019 combined) and linear trend were analyzed in logistic regression models. Models were adjusted for loneliness, depression, anxiety, and sociodemographic factors.

RESULTS

Among males, EIU prevalence varied minimally (7.8-8.1%) from 2017 to 2021. Among females, the prevalence increased from 6.8 to 11.7% and the effect of COVID-19 was significant (OR = 1.53; p < 0.001). Including the linear trend in the model turned the COVID-19 effect on EIU among females non-significant (p = 0.625), whereas the trend was significant (OR = 1.17; p < 0.001). Adjusting the models with mental health-related factors attenuated the effect of COVID-19 to some extent, but not the effect of linear trend.

CONCLUSIONS

There is a sex difference in the way the prevalence of EIU developed from 2017 to 2021 among Finnish adolescents. In males, there was no indication of increased prevalence of EIU and among females, while the effect of COVID-19 was first found, it was also suggested to be a product of a trend already started before the COVID-19 pandemic. These results are in contrast with some earlier studies suggesting an effect of COVID-19 on EIU.

Are social media use and popularity in the peer group linked during adolescence? A meta-analytic review

BACKGROUND

Popularity in adolescence has been the subject of considerable empirical inquiry over the last two decades. As research on this dimension of social experience evolved, fundamental shifts occurred in the modalities through which adolescents communicate. Social networking platforms, instant messaging applications, and other forms of social media emerged as organizing features of adolescent peer groups.

OBJECTIVE

In the current paper, we present a systematic review and meta-analysis examining evidence that social media activity is associated with both popularity and goals for becoming popular.

METHODS

Syntheses were conducted based on 34 effect sizes from 12 studies (N = 7776; 4037 girls and 3739 boys) using three-level Meta-analytic techniques.

RESULTS

Average effect sizes across studies were of small to medium magnitude and were not influenced by Meta-analytic moderators. Although the findings provide support for expected positive associations between social media activity and popularity, unresolved questions remain.

The impact of social media use on psychiatric symptoms and well-being of children and adolescents in the Post-COVID-19 era: a four-year longitudinal study

This longitudinal study examined the long-term effects of the COVID-19 pandemic on social media use and its impact on psychiatric symptoms and well-being of 3,697 Israeli children and adolescents aged 8 to 14. Data were collected from October 2019 to June 2023, covering four school years and five measurement points prior to, throughout and post- COVID-19. Social media usage, psychiatric symptoms (depression, anxiety, somatization, and general distress), as well as subjective well-being (positive and negative emotions, and life satisfaction) were assessed. The analysis also probed the extent to which social support and extracurricular activities moderated the associations between social media use and mental health outcomes. The results of the growth mixed-effects models indicated a significant increase in social media use and psychiatric symptoms, and a significant decrease in subjective well-being over time. Greater social media use was related to more psychiatric symptoms and negative emotions, but also to more positive emotions and life satisfaction. Social support buffered the negative effects of excessive social media use on mental health, whereas extracurricular activities increased positive emotions, but also psychiatric symptoms related to social media use. These findings highlight the need for targeted interventions to regulate social media usage, given its lasting consequences on the mental health of children and adolescents in the wake of the COVID-19 pandemic.

Youths' sensitivity to social media feedback: A computational account

While it is often argued that continuous exposure to social feedback is specifically challenging for the hypersensitive developing brain, empirical evidence is lacking. Across three studies, we reveal the developmental differences and computational mechanisms that underlie the social media engagement and feedback processing of adolescents and adults. First, using a reinforcement learning model on a large Instagram trace dataset (N = 16,613, 1.6+ million posts), we show that adolescents are more sensitive to social feedback than adults. Second, in an experimental study (N = 194), we show that adolescents' mood is affected more strongly by a reduction in likes than adults. Last, in a neuroimaging study (N = 96), we show that social media feedback sensitivity is related to individual differences in subcortical-limbic brain volumes of emerging adults. Together, these findings highlight the need for digital competence programs to help youth manage the constant feedback they encounter on social media platforms.

An Investigation of the Longitudinal Bidirectional Associations Between Interactive Versus Passive Social Media Behaviors and Youth Internalizing Difficulties. A Within-Person Approach

Ongoing concerns about the mental health of young people have intensified interest in the role of social media, with research suggesting that the nature of social media behaviors-whether interactive or passive-may differentially impact mental health. However, the bidirectional relationships between specific types of social media use and internalizing difficulties (anxiety and depression) remain underexplored, particularly at the within-person level over time. Data were extracted from the Dutch population-based Longitudinal Internet Studies for the Social Sciences (LISS) panel. Four yearly studies assessing time spent on interactive (communication) and passive use of social media in October (2019-2022) and four annual studies evaluating internalizing difficulties (anxiety and depression) in November (2019-2022) were used. Respondents who were 16- 25 years old in October 2019 (N = 321; M = 20.49; SD = 2.94; 61.7% female). Random Intercept Cross Lagged Path Models were used to analyze the data. There were no significant associations between passive social media use and internalizing difficulties at the within-person level over time. Within-person interactive use was associated with decreases in internalizing difficulties at one time point (2021 to 2022). The results provide marginal evidence that distinct social media behaviors are prospective factors associated with internalizing difficulties in young people.

'I'm still su!c!dal when you're done with the paperwork': an inductive framework thematic analysis of #camhs on TikTok

BACKGROUND

Young people are sharing their experiences of Child and Adolescent Mental Health Services (CAMHS) in the United Kingdom on TikTok. Little is known about the content of these videos and their influence on young people's attitudes towards seeking professional mental health support.

METHODS

This study explored how CAMHS is represented in a sample of 100 #camhs TikTok videos using participatory inductive framework thematic analysis.

RESULTS

Four themes were developed alongside young people as co-researchers: (a) CAMHS can be frustrating and unhelpful, but sometimes life-saving, (b) Young people can feel their distress is invalidated by CAMHS, (c) CAMHS makes young people feel responsible for their distress, and (d) Young people may not feel CAMHS professionals are trustworthy. Video content described dismissive responses to expressions of suicidal ideation, professional knowledge being privileged over lived experience, and breaches of confidentiality. Some shared positive experiences of CAMHS helping to keep them safe.

CONCLUSIONS

Together, the themes reflect a representation of CAMHS as a service where adults are powerful and young people occupy a subjugated position. This may influence young people's professional help-seeking behaviour. Recommendations for clinical practice and future research are presented.

Pixels and perception: Mapping the association between digital media and psychotic-like experiences in adolescents

INTRODUCTION

Psychotic-like experiences (PLEs) during adolescence can lead to psychotic disorders. Digital media usage has been suggested to link to PLEs, but research is limited on how different types of screen exposure may differentially relate to PLEs over time. This study aimed to examine longitudinal associations between screen usage patterns and PLEs in adolescents.

METHODS

Participants comprised 11,876 adolescents assessed annually from ages 9-12 years as part of the Adolescent Brain Cognitive Development study (ABCD). Screen usage (TV, video games, online video, social media, texting, video chat) and PLEs were assessed via self-report. Longitudinal network analysis models were estimated to examine connections between screen usage types and PLEs across three time points.

RESULTS

Two clusters were formed, including digital media for socializing (e.g., social media/texting/video chat) and digital media for entertainment (e.g., online video/video games/TV). Texting and online video(s) had the highest centrality at each time point, suggesting importance in the network. PLE symptoms of hallucinations and concentration difficulties exhibited higher centrality than other symptoms. Online video and TV were influential bridges between screen usage and PLEs. Network structure significantly differed between ages 9-10 and 10-12 years, but global strength was unchanged over time.

DISCUSSION

Results highlight the importance of understanding the associations between specific screen usage types and PLE symptoms. Texting and online video usage appear most influential in the development of adolescent PLEs over time. Findings can inform targeted interventions to promote healthy screen habits and reduce PLEs in at-risk youth.

Inconsistency in psychological resilience and social support with mental health in early adolescents: A multilevel response surface analysis approach

BACKGROUND

Given the high prevalence of adolescent mental health problems, promoting understanding and implementation of protective factors is crucial for prevention and intervention efforts addressing adolescent mental health problems. This study aims to investigate whether consistency and inconsistency in protective factors are associated with adolescent mental health problems and to inform adolescent mental health interventions that target the unique needs of adolescents and promote adolescent mental health.

METHODS

We used multistage cluster sampling to conduct psychological resilience, social support, and mental health questionnaires from April to June 2023 among 10,653 Chinese adolescents (52.3 % were boys). Data were analyzed using polynomial regressions with response surface analysis.

RESULTS

The higher levels of psychological resilience and social support in adolescents were associated with fewer mental health problems (anxiety: a1 = -1.83, P < 0.001; depression: a1 = -2.44, P < 0.001; and perceived stress: a1 = -1.20, P < 0.001). When the level of psychological resilience was greater than social support, the greater the discrepancy the higher the perceived stress among adolescents (a3 = 1.19, P < 0.001). Moreover, the consistency of psychological resilience and social support had a greater impact on girls' mental health (anxiety: a1 = -1.97, P < 0.001; depression: a1 = -2.71, P < 0.001; perceived stress: a1 = -1.23, P < 0.001).

LIMITATIONS

The cross-sectional study design limited the inference of causal relationships between variables.

CONCLUSIONS

These results emphasize that adolescents need a balanced development of protective factors and targeted intervention programs for different mental health problems.

Prevalence of online sexual harassment and online bullying: a nationwide survey among high school students in Denmark

Background

Using data from a nationwide survey among high school students in Denmark, the aim of the current study is to measure the prevalence of online bullying and online sexual harassment and assess gender and age differences in exposure.

Methods

We used data from the Danish National Youth Study 2019, which is a nationwide web survey among high school students, including general, commercial, preparatory and technical high schools. Data were collected from January to April 2019 through a self-administered questionnaire in the classroom. A total of 29,086 students participated (response rate: 66%). The survey included questions about online sexual harassment (victimization and perpetration) and online bullying.

Results

Approximately 11% of students reported receiving sexually offensive inquiries online, and about 10% received a sexual image/video of others without the subjects' consent. Additionally, 4% experienced that other people shared a sexual image/video of them without their consent within the last 12 months. The most common type of online bullying was feeling ignored by others online (25%), followed by someone spreading rumors or writing nasty things about them (13%), and receiving threats/unpleasant messages (12%). Gender results were mixed.

Screen Time and Mental Health in Canadian Youth: An Examination of Nationally Representative Data

As screens have become ubiquitous in modern-day society, investigating the effects of high screen time on mental health is highly warranted. In the past decade, many studies have determined that higher levels of screen time engagement are associated with adverse mental health outcomes like anxiety and depression. However, the nature of the relationship between screen time and mental health requires further investigation to gain a better understanding of its mechanisms and properties. The purpose of this study is to utilize a nationally representative data set to (1) examine how factors like sex, age, and socioeconomic status moderate the relationship between screen time and mental health in Canadian youth and (2) determine whether this relationship supports the Goldilocks hypothesis or an exposure-response curve. It was hypothesized that (1) young, female, lower socioeconomic status individuals will be more strongly associated with poor mental health, and that (2) mental health will peak at low screen time usage, therefore, supporting an exposure-response curve. A series of moderation analyses concluded that young, male, lower socioeconomic status individuals strongly moderated the relationship between screen time and poor mental health compared to their counterparts. Furthermore, three out of the four mental health (presence of mood disorder, presence of anxiety disorder, and depression severity) measures peaked at an average of 12 hours and 19 minutes of screen time per week, hence, supporting the exposure-response curve.

Phubbing and its impact on the individual's psychological well-being

Increasingly, smartphones have become a part of people's everyday lives, and are now considered by many to be an indispensable social accessory. Since attachment to a smartphone could have negative psychological consequences, a burgeoning new area of research has emerged which examines the effects of smartphones on individuals' well-being. Hence, this study focuses on phubbing - one's engagement with the smartphone during a face-to-face conversation with another person or group of people - and its association with psychological well-being. For this investigation, a quantitative descriptive approach has been adopted involving a sample of 370 women and men from Spain between 25 and 60 years old. The survey was distributed during late 2019 and the first quarter of 2020. The Phubbing Behaviors Survey was conducted, comprising five dimensions (cultural, technological, social, communicational, and psychological), and a total of 33 items requiring responses on a 5-point Likert scale. This survey was used in conjunction with the General Health Questionnaire (GHQ-28), consisting of four categories (somatic symptoms, social dysfunction, anxiety and insomnia, and severe depression), and 7 items per category. The findings reveal a positive correlation between phubbing and severe depression and, young women under 25 years old show higher levels of somatic symptoms than men in the same age group. This study demonstrates the need to raise awareness via health education and to promote healthy use of the Internet to prevent psychological distress resulting from phubbing.

Societal Perception of Animal Videos on Social Media-Funny Content or Animal Suffering? A Survey

On social media, numerous animal videos are uploaded and viewed every day. However, these videos, which are apparently funny for humans, are often associated with animal suffering. In this study, 3246 participants of an online survey were asked about their personal perception of animal videos on social media, about recognising animal suffering in these videos, and about their respective reactions. A total of 98.5% of participants who used social media already saw animal videos. Participants most frequently viewed informative videos (52.9%), followed by funny/entertaining animal videos (41.8%). For 45.8% of participants, animal suffering was often recognisable in animal videos. Female participants were more likely to recognise animal suffering than male participants (p < 0.001), and participants living in a rural residence were more likely to recognise it than those from an urban residence (p = 0.017). Furthermore, 62.5% of participants had left a critical comment or disliked a video with animal suffering. Animal videos seem to be highly popular on social media, but animal suffering may go unnoticed in funny videos. The fact that 91.8% of participants want a warning label for animal suffering in videos shows that social media users would like to see animal welfare be given more prominence on social media.

Synthesizing perspectives: Crafting an Interdisciplinary view of social media's impact on young people's mental health

This study explores the intricate relationship between social media usage and the mental health of young individuals by leveraging the insights of 492 UK school headteachers. It adopts a novel multidisciplinary approach, integrating perspectives from psychology, sociology, education studies, political science, philosophy, media studies, linguistics, social work, anthropology, and health sciences. The application of thematic analysis, powered by ChatGPT-4, identifies a predominantly negative perspective on the impact of social media on young people, focusing on key themes across various disciplines, including mental health, identity formation, social interaction and comparison, bullying, digital literacy, and governance policies. These findings culminated in the development of the five-factor Comprehensive Digital Influence Model, suggesting five key themes (Self-Identity and Perception Formation, Social Interaction Skills and Peer Communication, Mental and Emotional Well-Being, Digital Literacy, Critical Thinking, and Information Perception, and Governance, Policy, and Cultural Influence in Digital Spaces) to focus the impacts of social media on young peoples' mental health across primary and secondary educational stages. This study not only advances academic discourse across multiple disciplines but also provides practical insights for educators, policymakers, and mental health professionals, seeking to navigate the challenges and opportunities presented by social media in the digital era.

Body Perceptions and Psychological Well-Being: A Review of the Impact of Social Media and Physical Measurements on Self-Esteem and Mental Health with a Focus on Body Image Satisfaction and Its Relationship with Cultural and Gender Factors

This narrative review examines the interplay among body image perceptions, social media influence, physical measurements, and their impact on psychological well-being, focusing on the roles of cultural and gender differences and the need to understand the research methodologies employed in this field. In the age of digital proliferation, platforms like Instagram and Facebook have reshaped body image concerns, often leading to increased dissatisfaction and psychological distress due to constant exposure to idealized images and a culture of social comparison. Physical attributes such as weight, height, and BMI are scrutinized under societal standards of health and attractiveness, contributing to a spectrum of mental health issues including low self-esteem, depression, and eating disorders. This examination reveals how cultural norms and gender expectations further complicate body image perceptions, affecting individuals differently based on societal and personal ideals. It synthesizes current research and types of methods to illuminate how these factors together influence mental health and self-esteem, advocating for comprehensive interventions and policy measures aimed at mitigating body dissatisfaction and promoting a healthier, more inclusive understanding of body image. By delving into the complexities of body image satisfaction and its psychological implications, this review highlights the necessity of addressing these concerns within public health and social policy frameworks, underscoring the importance of a multifaceted approach to enhance individual and societal well-being.

Associations between media use at bedtime and sleep: a cross-sectional analysis on differences between girls and boys

Objectives

This study investigated associations between the use of electronic media and sleep in children and young adolescents, with a specific focus on the moderation of associations by sex and age.

Methods

Between 2021 and 2022, 453 10- to 14-year-old children participating in the LIFE Child cohort study (Germany) reported on their use of electronic media (daily screen time, use at bedtime, device ownership) and on their sleep difficulties (Sleep Self Report). Associations between media use and sleep as well as interactions with age and sex were assessed using linear regression analyses.

Results

The analyses revealed significant associations between the use of media at bedtime and bedtime problems (in girls only), sleep behavior problems (in girls only), and daytime sleepiness (in girls and boys). Daily screen time, in contrast, was associated with none of the sleep difficulties. The number of media devices owned by the child was only associated with bedtime problems in girls, and this association lost statistical significance once media use at bedtime was included as further predictor.

Conclusion

The findings underline the potentially sleep-disturbing role of electronic media at bedtime. Furthermore, they suggest that this effect is more pronounced in girls than in boys.

European Portuguese Version of the Game Addiction Scale-7: Factor Structure and Psychometric Properties

INTRODUCTION

Game addiction (GA) can be described as a compulsive and excessive usage of computers or video games that causes emotional and or social problems. The current study tested the factor structure and psychometric properties of the European Portuguese Game Addiction Scale (GAS-7-PT) short version.

METHODS

The sample encompassed 375 participants, 233 women (62.1%) and 142 men (37.9%), with a mean age of 21.71 (standard deviation = 5.82) years old. Participants completed a set of self-report measures online: the GAS-7-PT, the Scale of Involvement in Video Games and the Patient Health Questionnaire-4.

RESULTS

Confirmatory factor analyses confirmed a biological sex invariant single-factor structure with a very good fit to the data. The GAS-7-PT showed good reliability and test-retest reliability. Correlations with related and unrelated measures suggested convergent validity, and partial correlation results pointed to incremental validity. Men showed significantly higher scores than women.

CONCLUSION

The GAS-7-PT is a self-report instrument with suitable psychometric properties for clinical and research contexts. The availability of a European Portuguese version confirms the GAS-7 robust consistency and allows further cross-cultural clinical research.

Intense and problematic social media use and sleep difficulties of adolescents in 40 countries

INTRODUCTION

Social media has become a ubiquitous part of everyday life; however, evidence suggests patterns of social media use can affect sleep health in children and adolescents. This study aimed to examine the associations of intense and problematic social media use (SMU) with sleep-onset difficulties in adolescence.

METHODS

We analysed data from 212,613 adolescents aged 11-15 years (51.1% girls) from 40 European and North American countries that participated in the 2017/2018 Health Behaviour in School-aged Children survey. Intense SMU assessed how often respondents had online contact through social media, and problematic SMU was assessed by symptoms of addiction to social media. Sleep-onset difficulties were assessed using a self-reported item. Multilevel mixed-effects logistic regression was used to obtain the estimates.

RESULTS

Sleep-onset difficulties were more common among girls than boys (27.1% vs 20.8%). Intense SMU was significantly associated with sleep-onset difficulties in boys in 17 countries and in girls in 25 countries, while problematic SMU was significantly associated in most of the participating countries. Overall, exposure to problematic SMU alone was highly associated with sleep-onset difficulties both in girls (OR 2.20, 2.04-2.38) and boys (OR 1.88, 1.73-2.04), while the association estimates for intense SMU were smaller and comparable across gender (Girls: OR 1.27, 1.23-1.31; Boys: OR 1.22, 1.18-1.27). Sensitivity analyses supported the above findings.

CONCLUSIONS

Intense and/or problematic SMU were associated with sleep-onset difficulties across gender with associations being higher for problematic compared to intense SMU. Prospective research with objective measures is needed to understand the causal mechanisms underlying these relationships.

Adolescent Female Users' Avatar Creation in Social Virtual Worlds: Opportunities and Challenges

Many adolescent females are active online, finding creative ways to express themselves through evolving social media technologies. Social virtual worlds (SVWs), distinguished by extensive avatar customization features, provide them with unique opportunities to craft virtual identities and explore diverse facets of self-presentation. This study investigates adolescent females' construction of avatars in Zepeto, a South Korea-based global SVW platform. Employing social representation theory (SRT) as a theoretical framework, this study conducted in-depth interviews with adolescent female Zepeto users to uncover their perceptions of and motivations behind avatar creation in SVWs, as well as to explore how the interplay of virtual and real worlds presents them with various opportunities and challenges. While the prospects of SVWs remain uncertain, examining how these young users interpret and experience SVWs contributes to identifying potential strategies to enhance the sustainability of these platforms.

A Digital Math Game and Multiple-Try Use with Primary Students: A Sex Analysis on Motivation and Learning

Sex differences have been a rarely addressed aspect in digital game-based learning (DGBL). Likewise, mixed results have been presented regarding the effects according to sex and the conditions that generate these effects. The present work studied the effects of a drill-and-practice mathematical game on primary students. The study focused on an analysis by sex, measuring motivation and learning in the practice activity. Also, two instructional mechanics were considered regarding the question answering to search for possible differences: a multiple-try feedback (MTF) condition and a single-try feedback (STF) condition. A total of 81 students from four courses and two schools participated in the intervention. The study's main findings were as follows: (a) the girls outperformed the boys in terms of the students' learning gains; (b) the girls presented lower levels of competence and autonomy than the boys; (c) under MTF, the girls presented lower levels of autonomy but no differences in competence contrasted with the boys; (d) under STF, the girls presented lower levels of competence but no differences in autonomy contrasted with the boys; (e) no sex differences existed in interest, effort, and value, in general, as per the instructional condition. This study enhances the knowledge of sex differences under diverse instructional settings, in particular providing insights into the possible differences by sex when varying the number of attempts provided to students.

Sex Differences in Temporal Sleep Patterns, Social Jetlag, and Attention in High School Adolescents

Insufficient sleep and irregular sleep hours are common in adolescents, who experience a delayed sleep phase due to biopsychosocial changes associated with puberty, resulting in later sleep times. However, early morning class hours shorten sleep duration on weekdays. This condition is harmful to cognitive performance, which may be accentuated in girls due to a greater sleep need and less resistance to sleep deprivation. In this study, we evaluated sex differences concerning temporal sleep patterns, social jetlag, and attention in high school adolescents attending morning classes. Students ( n  = 146 - F: 73-16.1 ± 0.8 years; M: 73-16.2 ± 0.9 years) completed a Health and Sleep questionnaire, kept a sleep diary for 10 days, which incorporated a Maldonado Sleepiness Scale, and performed a Continuous Performance Task. Girls went to bed earlier and woke up on weekends, and spent more time in bed at night and in 24 h on weekdays and weekends, while they also had a greater irregularity in wake-up times ( p  < 0.05). There were no differences between sexes in terms of social jetlag, sleep debt, and sleepiness upon awakening ( p  > 0.05). Regarding attention, the girls had a longer reaction time in phasic alertness ( p  < 0.01) and a tendency to have fewer errors in selective attention ( p  = 0.06). These results persisted when controlled for sleep parameters. Therefore, we suggest that girls have a greater sleep need and less resistance to sleep deprivation, while the differences in attention performance could be due to different strategies, the girls could be making a trade, increasing reaction time in favor of better accuracy, while the boys could be prioritizing a faster response time.

Explanatory and modifying factors of the association between sex and depression onset during adolescence: An exploratory study

BACKGROUND

The prevalence of Major Depressive Disorder (MDD) is twice as high in women as in men and this difference already emerges during adolescence. Because the mechanisms underlying this sex-difference remain poorly understood, we took a bottom-up approach to identify factors explaining the sex-MDD relationship.

METHODS

Data came from the TRacking Adolescents' Individual Lives Survey (TRAILS), a population study investigating youths' development from age 11 into adulthood. We assessed multiple baseline covariates (e.g., demographic, social and psychological) at ages 11-13 years and MDD onset at ages 19 and 25 years. In regression analyses, each covariate's role in the sex-MDD association as an effect modifier or confounder/explanatory variable was investigated. Replicability was evaluated in an independent sample.

RESULTS

The analyses identified no effect-modifiers. Baseline internalizing problems, behavioral inhibition, dizziness, comfort in classroom, physical complaints, attention problems, cooperation, self/effortful control, interpersonal life events and computer use partially explained the association between sex and MDD at age 19. The association between sex and MDD at age 25 was explained by largely the same variables, but also by shyness, acne, antisocial behavior, aggression, affection from peers and time spent shopping. The explanatory roles of internalizing problems, behavioral inhibition, negative events involving gossip/rumors and leisure-time spending (computer-use/shopping) were replicated.

LIMITATIONS

Potentially important baseline variables were not included or had low response rates. Gender roles or identification were not considered. Baseline MDD was not adjusted for.

CONCLUSION

The sex-MDD association is partially explained by sex differences in symptoms and vulnerability factors already present in early adolescence.

The relationship between online communication and adolescents' mental health: Long-term evaluation between genders

AIMS

In a relatively short time, online communication has become an important part of adolescents' lives, and concerns have been raised about its potential effects on mental health. The first aim was to compare mental health status and online communication in 15-year-old Icelanders born in 1988 and in 1994. The second aim was to assess whether the relationship between online communication and mental health has changed among 15-year-old Icelanders from 2003 to 2015 across genders.

METHODS

Analysis used data from self-reports from 2003 (N=385, 51% males) and 2015 (N=302, 42% males). Mental health was assessed with subscales of Symptom Checklist 90 and online communications with self-reports. To evaluate the difference in anxiety and depression, a factorial analysis of variance was conducted between gender and years. Multigroup structural equation modelling was used to assess the change in the relationship between years.

RESULTS

Symptoms of anxiety and depression remained unchanged for males. Symptoms of depression increased for females, while anxiety was stable between 2003 and 2015. In 2003, there was no relationship between online communication and mental health. However, in 2015, an association was found for females.

CONCLUSIONS

Depression is getting worse for adolescent females, and an association between time spent online communicating and mental health emerged for them in 2015, which did not exist in 2003. These findings add to the possibility that online communication is harmful for mental health, but more detailed studies are still needed.

Self-Selected Versus Assigned Target to Reduce Smartphone Use and Improve Mental Health: Protocol for a Randomized Controlled Trial

BACKGROUND

Smartphones have become integral to people's lives, with a noticeable increase in the average screen time, both on a global scale and, notably, in India. Existing research links mobile consumption to sleep problems, poor physical and mental health, and lower subjective well-being. The comparative effectiveness of monetary incentives given for self-selected versus assigned targets on reducing screen time and thereby improving mental health remains unanswered.

OBJECTIVE

This study aims to assess the impact of monetary incentives and target selection on mobile screen time reduction and mental health.

METHODS

We designed a 3-armed randomized controlled trial conducted with employees and students at an educational institution in India. The study is conducted digitally over 12 weeks, including baseline (2 weeks), randomization (1 week), intervention (5 weeks), and postintervention (4 week) periods. We emailed the employees and students to inquire about their interest in participation. Those who expressed interest received detailed study information and consent forms. After securing consent, participants were asked to complete the initial survey and provide their mobile screen time during the baseline period. At the beginning of the intervention period, the participants were randomly allocated into 1 of 3 study groups in a 2:2:1 ratio (self-selected vs assigned vs control). Participants in the self-selected group were presented with 3 target options: 10%, 20%, and 30%, and they were asked to self-select a target to reduce their mobile screen time from their baseline average mobile screen time. Participants in the assigned group were given a target to reduce their mobile screen time from their baseline average mobile screen time. The assigned target was set as the average of the targets selected by participants in the self-selected group. During the intervention period, participants in the self-selected and assigned group were eligible to receive a monetary incentive of INR (Indian Rupee) 50 (US $0.61) per day for successfully attaining their target. Participants in the control group neither received nor selected a target for reducing their mobile screen time and did not receive any monetary incentives during the intervention period. All participants received information regarding the advantages of reducing mobile screen time. As an incentive, all participants would receive INR 500 (US $6.06) upon completion of the study and a chance to win 1 of 2 lotteries valued at INR 5000 (US $60.55) for consistently sharing their mobile screen time data.

RESULTS

Currently, the study intervention is being rolled out. Enrollment occurred between August 21, 2023, and September 2, 2023; data collection concluded in November 2023. We expect that results will be available by early 2024.

CONCLUSIONS

The monetary incentives and self-selected versus assigned targets might be effective interventions in reducing mobile screen time among working professionals and students.

TRIAL REGISTRATION

AsPredicted 142497; https://aspredicted.org/hr3nn.pdf.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/53756.

Artificial intelligence and social media on academic performance and mental well-being: Student perceptions of positive impact in the age of smart learning

The advancement of artificial intelligence (AI) and the ubiquity of social media have become transformative agents in contemporary educational ecosystems. The spotlight of this inquiry focuses on the nexus between AI and social media usage in relation to academic performance and mental well-being, and the role of smart learning in facilitating these relationships. Using partial least squares-structural equation modeling (PLS-SEM) on a sample of 401 Chinese university students. The study results reveal that both AI and social media have a positive impact on academic performance and mental well-being among university students. Furthermore, smart learning serves as a positive mediating variable, amplifying the beneficial effects of AI and social media on both academic performance and mental well-being. These revelations contribute to the discourse on technology-enhanced education, showing that embracing AI and social media can have a positive impact on student performance and well-being.

Effects of Gender and Social Network Use on High School Students’ Emotional Well-Being during COVID-19

Various studies conducted during the COVID-19 pandemic have confirmed changes in online behaviour, with young people increasingly using social networks. This trend appears to correlate with a heightened risk of various psychological and emotional problems. The main aim of this study is to explore the patterns of social network use among high school students amidst the pandemic, particularly focusing on the presence of specific emotional problems and potential gender differences. In addition, this study aims to contribute to the existing body of knowledge on the influence of lockdown measures on adolescents. A probabilistic sample of N = 825 students from 20 high schools in Zagreb participated in this study. Alongside basic sociodemographic variables, this study assessed social network habits and emotional problems using the Depression Anxiety Stress Scales 21 (DASS-21). The findings indicate intensive social media engagement during the pandemic. The results of the MANOVA analysis (gender x daily time on social media) show significant effects of both the time spent on social networks and gender on mental health, while no interaction effect was observed. Female students and those who spend more time on social media have higher levels of depression, anxiety, and stress symptoms. These findings underscore the need for addressing emotional problems and habits in the virtual environment of high school students and implementing appropriate preventive and treatment interventions.

Social media does not elicit a physiological stress response as measured by heart rate and salivary cortisol over 20-minute sessions of cell phone use

The pervasive use of social media has raised concerns about its potential detrimental effects on physical and mental health. Others have demonstrated a relationship between social media use and anxiety, depression, and psychosocial stress. In light of these studies, we examined physiological indicators of stress (heart rate to measure autonomic nervous system activation and cortisol to assess activity of the hypothalamic-pituitary-adrenal axis) associated with social media use and investigated possible moderating influences of sex, age, and psychological parameters. We collected physiological data from 59 subjects ranging in age from 13 to 55 across two cell phone treatments: social media use and a pre-selected YouTube playlist. Heart rate was measured using arm-band heart rate monitors before and during cell phone treatments, and saliva was collected for later cortisol analysis (by enzyme immunoassay) before and after each of the two cell phone treatments. To disentangle the effects of cell phone treatment from order of treatment, we used a crossover design in which participants were randomized to treatment order. Our study uncovered a significant period effect suggesting that both heart rate and cortisol decreased over the duration of our experiment, irrespective of the type of cell phone activity or the order of treatments. There was no indication that age, sex, habits of social media use, or psychometric parameters moderated the physiological response to cell phone activities. Our data suggest that 20-minute bouts of social media use or YouTube viewing do not elicit a physiological stress response.

Instagram Stories Unveiled: Exploring Links with Psychological Distress, Personality, and Gender

Instagram is one of the most used platforms, and ephemeral stories are proving to be the most used medium for users to share content on the platform. However, there have been few studies examining this type of content in relation to emotional well-being. This study examined the association between the number of published Instagram stories, psychological well-being, personality traits, and gender in a sample of 734 Instagram users from Italy, including 281 men and 453 women, with a mean age of 25.19 years (SD = 7.08). Participants were recruited online and asked to complete an online questionnaire. Differences were found between genders in terms of time spent on Instagram, but not in terms of the number of stories posted in the past week. In the overall sample, a small positive correlation was found between the number of Instagram stories posted and extraversion. When considering gender differences, small effect sizes were observed for emotional dysregulation, agreeableness, and neuroticism, indicating a stronger association with Instagram stories in the female group, and for openness, indicating a stronger association in the male group. Results of multiple regression analyses suggest that among females, psychological variables, including personality and emotional distress, may have a stronger association with Instagram stories. To our knowledge, this is the first study to report these differences. The findings help to clarify how certain characteristics of social media platforms relate to psychological well-being and personality differently in men and women in their journey to using social media.

Hierarchy of demographic and social determinants of mental health: analysis of cross-sectional survey data from the Global Mind Project

OBJECTIVES

To understand the extent to which various demographic and social determinants predict mental health status and their relative hierarchy of predictive power in order to prioritise and develop population-based preventative approaches.

DESIGN

Cross-sectional analysis of survey data.

SETTING

Internet-based survey from 32 countries across North America, Europe, Latin America, Middle East and North Africa, Sub-Saharan Africa, South Asia and Australia, collected between April 2020 and December 2021.

PARTICIPANTS

270 000 adults aged 18-85+ years who participated in the Global Mind Project.

OUTCOME MEASURES

We used 120+ demographic and social determinants to predict aggregate mental health status and scores of individuals (mental health quotient (MHQ)) and determine their relative predictive influence using various machine learning models including gradient boosting and random forest classification for various demographic stratifications by age, gender, geographical region and language. Outcomes reported include model performance metrics of accuracy, precision, recall, F1 scores and importance of individual factors determined by reduction in the squared error attributable to that factor.

RESULTS

Across all demographic classification models, 80% of those with negative MHQs were correctly identified, while regression models predicted specific MHQ scores within ±15% of the position on the scale. Predictions were higher for older ages (0.9+ accuracy, 0.9+ F1 Score; 65+ years) and poorer for younger ages (0.68 accuracy, 0.68 F1 Score; 18-24 years). Across all age groups, genders, regions and language groups, lack of social interaction and sufficient sleep were several times more important than all other factors. For younger ages (18-24 years), other highly predictive factors included cyberbullying and sexual abuse while not being able to work was high for ages 45-54 years.

CONCLUSION

Social determinants of traumas, adversities and lifestyle can account for 60%-90% of mental health challenges. However, additional factors are at play, particularly for younger ages, that are not included in these data and need further investigation.