Scrutinizing the effects of digital technology on mental health

Gender disparity in prevalence of mental health issues in Kerala: a systematic review and meta-analysis

BACKGROUND

Kerala is a state in south India, appreciated for its education, better health indicators and quality of life. However, there is a proportionately high prevalence of mental health illnesses and suicides reported in the state. It is unclear if there is any disparity in the gender categories in this. With this systematic review, we aim to systematically study the gender disparity in the prevalence of mental health (MH) issues among adolescents, younger and older adults in Kerala.

METHODS

A search strategy was built and several databases like Pubmed, Cochrane, Scopus, EMBASE, EBSCOhost, Web of Science, and ProQuest were used alongside grey literature to identify relevant articles. The study was conducted according to the PRISMA guidelines following a prespecified protocol. After relevant data extraction, the estimates were pooled using random effects model due to the high heterogeneity assessed by tau-squared, Cochran Q, and prediction interval. Subgroup analyses, and meta-regression were used to reduce heterogeneity. We also identified the influence and heterogeneity contributed by individual studies using influence plots, Baujat plot, clustering, and performed several sensitivity analyses.

RESULTS

Twenty articles were included in the review and meta-analysis. The pooled odds ratio of mental health illnesses amongst females compared to males in Kerala was 1.31 (95% CI: 1.0 - 1.73) and falls within a prediction interval of 0.38 to 4.53. The individual studies showed high heterogeneity (I2 = 92%, p = p < 0.01) and hence, subgroup analysis was done for several prespecified subgroups based on etiology, geography, demography, study settings, and age groups. Heterogeneity was significantly reduced by subgrouping based on etiology, study setting and age (p, 0.001, p < 0.001, p = 0.001). In etiologic subgrouping the highest pooled odds was in comorbidities associated MH issues (2.54) and least in non-specific (0.97). In age subgrouping, the highest pooled odds was in elderly (2.53) and least in adolescents (0.63). The odds was highest in health care facility (2.21) and least in educational institution (0.78) based studies. Meta-regression based on the size of the study failed to reduce heterogeneity.

INTERPRETATIONS

A gender disparity was evident in the prevalence of mental health issues, with a higher Odds in females especially among the elderly and adults. A Gender transformative approach in legislative, health systems and policy frameworks will be the answer to this.

Depression fully mediates the effects of problematic internet use on nonsuicidal self-injury among adolescents during the COVID-19 outbreak

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic threatened adolescents' mental health and livelihoods, which can worsen their non-suicidal self-injury (NSSI) behaviors. With the significant increase of total online time use, adolescents become more prone to problematic internet use (PIU). This study examined whether depression mediated the relationship between PIU and NSSI among adolescence during the COVID-19 outbreak. Constructed with a cross-sectional design during the COVID-19 outbreak in Taiwan, 1060 participants were drawn from junior high schools through stratified and cluster sampling, and completed a set of comprehensive surveys. The mediation model demonstrated a good fit to the data, GFI = .96, CFI = .97, NFI = .97, NNFI = .95, IFI = .97, and SRMR = .02. The overall fit of the mediational model was adequate. The path from PIU to depression, β = .41, p < .001, and the path from depression to NSSI, β = .40, p < .001, were both significant. Moreover, the effect of PIU to NSSI decreased from .23 (p < .001) to .05 (p = .099) when depression was incorporated into the analysis. Moreover, results in bootstrapping analysis displayed that the indirect effect (PIU on NSSI via depression) was statistically significant (p < .001) and the direct effect (PIU on NSSI) was statistically non-significant (p = .134). The full mediation model was confirmed. The findings of the structure equation modeling and bootstrap analysis showed that PIU significantly and positively predicted NSSI, and that depression fully mediated this relationship.

Screen Media Use and Mental Health of Children and Adolescents: A Secondary Analysis of a Randomized Clinical Trial

Importance

Excessive screen media use has been associated with poorer mental health among children and adolescents in several observational studies. However, experimental evidence supporting this hypothesis is lacking.

Objective

To investigate the effects of a 2-week screen media reduction intervention on children's and adolescents' mental health.

Design, Setting, and Participants

This prespecified secondary analysis of a cluster randomized clinical trial with a 2-week follow-up included 89 families (with 181 children and adolescents) from 10 Danish municipalities in the region of Southern Denmark. All study procedures were carried out in the home of the participants. Enrollment began on June 6, 2019, and ended on March 30, 2021. This analysis was conducted between January 1 and November 30, 2023.

Intervention

Families were randomly allocated to a screen media reduction group or a control group. The 2-week screen media reduction intervention was designed to ensure a high level of compliance to the reduction in leisure-time screen media use. Participants allocated to the intervention group had to reduce their leisure-time screen media use to 3 hours per week or less per person and hand over smartphones and tablets.

Main Outcomes and Measures

The main outcome was the between-group mean difference in change in total behavioral difficulties, measured by the Strengths and Difficulties Questionnaire at 2-week follow-up. Results were estimated using mixed-effects tobit regression models. Analyses were carried out as both intention to treat and complete case.

Results

In the sample of 89 families including 181 children and adolescents (intervention group [45 families]: 86 children; mean [SD] age, 8.6 [2.7] years; 42 girls [49%]; control group [44 families]: 95 children; mean [SD] age, 9.5 [2.5] years; 57 girls [60%]), there was a statistically significant between-group mean difference in the total difficulties score, favoring the screen media reduction intervention (-1.67; 95% CI, -2.68 to -0.67; Cohen d, 0.53). The greatest improvements were observed for internalizing symptoms (emotional symptoms and peer problems; between-group mean difference, -1.03; 95% CI, -1.76 to -0.29) and prosocial behavior (between-group mean difference, 0.84; 95% CI, 0.39-1.30).

Conclusions and Relevance

This secondary analysis of a randomized clinical trial found that a short-term reduction in leisure-time screen media use within families positively affected psychological symptoms of children and adolescents, particularly by mitigating internalizing behavioral issues and enhancing prosocial behavior. More research is needed to confirm whether these effects are sustainable in the long term.

Trial Registration

ClinicalTrials.gov Identifier: NCT04098913.

The Google Health Digital Well-Being Study: Protocol for a Digital Device Use and Well-Being Study

BACKGROUND

The impact of digital device use on health and well-being is a pressing question. However, the scientific literature on this topic, to date, is marred by small and unrepresentative samples, poor measurement of core constructs, and a limited ability to address the psychological and behavioral mechanisms that may underlie the relationships between device use and well-being. Recent authoritative reviews have made urgent calls for future research projects to address these limitations. The critical role of research is to identify which patterns of use are associated with benefits versus risks and who is more vulnerable to harmful versus beneficial outcomes, so that we can pursue evidence-based product design, education, and regulation aimed at maximizing benefits and minimizing the risks of smartphones and other digital devices.

OBJECTIVE

The objective of this study is to provide normative data on objective patterns of smartphone use. We aim to (1) identify how patterns of smartphone use impact well-being and identify groups of individuals who show similar patterns of covariation between smartphone use and well-being measures across time; (2) examine sociodemographic and personality or mental health predictors and which patterns of smartphone use and well-being are associated with pre-post changes in mental health and functioning; (3) discover which nondevice behavior patterns mediate the association between device use and well-being; (4) identify and explore recruitment strategies to increase and improve the representation of traditionally underrepresented populations; and (5) provide a real-world baseline of observed stress, mood, insomnia, physical activity, and sleep across a representative population.

METHODS

This is a prospective, nonrandomized study to investigate the patterns and relationships among digital device use, sensor-based measures (including both behavioral and physiological signals), and self-reported measures of mental health and well-being. The study duration is 4 weeks per participant and includes passive sensing based on smartphone sensors, and optionally a wearable (Fitbit), for the complete study period. The smartphone device will provide activity, location, phone unlocks and app usage, and battery status information.

RESULTS

At the time of submission, the study infrastructure and app have been designed and built, the institutional review board of the University of Oregon has approved the study protocol, and data collection is underway. Data from 4182 enrolled and consented participants have been collected as of March 27, 2023. We have made many efforts to sample a study population that matches the general population, and the demographic breakdown we have been able to achieve, to date, is not a perfect match.

CONCLUSIONS

The impact of digital devices on mental health and well-being raises important questions. The Digital Well-Being Study is designed to help answer questions about the association between patterns of smartphone use and well-being.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/49189.

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences

Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.

Association between digital engagement and urban-rural disparities in Chinese women's depressive symptoms: A national-level cross-sectional study

Objectives

This study aims to investigate the impact of digital engagement on urban-rural disparities in depressive symptoms among Chinese women.

Methods

Using a dataset from the China Family Panel Studies (CFPS) wave 2020, this study analyzes the impact of digital engagement on the urban-rural disparity in women's depressive symptoms using multiple linear regression and recentered influence function (RIF) models. Furthermore, the extent to which digital engagement affects the urban-rural disparity in women's depressive symptoms was calculated using the RIF decomposition method.

Results

Analysis showed that rural women had significantly higher levels of depressive symptoms compared to urban women; digital engagement significantly reduced women's depressive symptoms levels and mitigated the urban-rural disparity for women with moderate to high levels of depressive symptoms, and the mitigating effect was stronger for the highly depressed sample, but still widened the urban-rural disparity in women's depressive symptoms overall. In addition, the results of the RIF decomposition showed that digital engagement explained 28.28% of the urban-rural disparity in women's depressive symptoms.

Conclusion

There is a significant disparity in depressive symptoms levels between urban and rural women in China. Digital engagement reduces women's depressive symptoms, but it also widens the depressive symptoms disparity between urban and rural women overall. Digital engagement is potentially positive for reducing women's depressive symptoms.

Temporal Location of Changes in the US Suicide Rate by Age, Ethnicity, and Race: A Joinpoint Analysis 1999-2020

ABSTRACT

Suicide rates differ over time. Our objective was to determine when significant changes occurred by age, race, and ethnicity in the United States between 1999 and 2020. National Center for Health Statistics WONDER data were used in joinpoint regression. The annual percent change in suicide rate increased for all race, ethnic, and age groups, except for those 65 years and older. For American Indian/Alaska Natives, the largest increase occurred between 2010 and 2020 for those with ages 25 to 34 years. For Asian/Pacific Islander, the largest increase occurred among those 15 to 24 years old between 2011 and 2016. For Black/African-Americans, the largest increases occurred between 2010 and 2020 among 15- to 34-year-olds. For Whites, the largest increase occurred between 2014 and 2017 among 15- to 24-year-olds. Between 2018 and 2020, suicide rates significantly declined among Whites 45 to 64 years of age. Among Hispanics, significant increases in suicide rate occurred between 2012 and 2020 among those with ages 15 to 44 years. Between 1999 and 2020, the contour of suicide burden varied by age groups, race, and ethnicity.

Epidemiology of mental health disorders in the citizens of Tehran: a report from Tehran Cohort Study

BACKGROUND

Mental health disorders (MHD) impose a considerable burden on public health systems. With an increasing worldwide trend in urbanization, urban mental health stressors are affecting a larger population. In this study, we evaluated the epidemiology of mental health disorders in the citizens of Tehran using the Tehran Cohort Study (TeCS) data.

METHODS

We utilized data from the TeCS recruitment phase. A total of 10,247 permanent residents of Tehran metropolitan (aged 15 years and older) were enrolled in the study from March 2016 to 2019 via systematic random sampling from all 22 districts of Tehran. The participant's demographic, socioeconomic, and medical characteristics were evaluated by conducting comprehensive interviews. The standardized Persian version of the General Health Questionnaire version 28 was utilized to assess the mental status of the patients according to four central mental health disorders.

RESULTS

Almost 37.1% of Tehran residents suffered mental health problems (45.0% of women and 28.0% of men). The greatest incidence of MHDs was seen in the 25-34 and over 75 age groups. The most common mental health disorders were depression (43%) and anxiety (40%), followed by somatization (30%) and social dysfunction (8.1%). Mental health disorders were more frequent in the southeast regions of the city.

CONCLUSIONS

Tehran residents have a significantly higher rate of mental health disorders compared to nationwide studies, with an estimated 2.7 million citizens requiring mental health care services. Awareness of mental health disorders and identifying vulnerable groups are crucial in developing mental health care programs by public health authorities.

Problematic internet use and suicidality and self-injurious behaviors in adolescents: Effects of negative affectivity and social support

BACKGROUND

Problematic internet use (PIU) has been shown to be closely associated with suicidality and self-injurious behavior (SSIB), but the mechanism to help explain this association is understudied. The aim of the present study is to test mediating effects of negative affectivity between PIU and SSIB and whether social support moderates this mediating effect.

METHODS

A sample of 2173 middle and high school students (M_age = 14.66, SD_age = 1.87) in central China were recruited. All participants completed a self-report questionnaire assessing PIU, SSIB, negative affectivity, and social support. Simple mediation analysis and moderated mediation analysis were conducted to examine the roles of negative affectivity and social support in the association between PIU and SSIB.

RESULTS

PIU was positively associated with SSIB, and negative affectivity mediated this association (β = 0.255, Boot 95 % CI: 0.219 to 0.296). The indirect effect of negative affectivity was moderated by social support, with a stronger association between PIU and SSIB for adolescents with lower social support (β = 0.228, Boot 95 % CI: 0.178 to 0.282) than their counterparts (β = 0.098, Boot 95 % CI: 0.068 to 0.133).

LIMITATION

Cross-sectional design with self-report measures.

CONCLUSIONS

PIU is a detrimental risk factor for SSIB, as it is associated with high negative affectivity and increased SSIB, which was more robust for adolescents with lower social support. These results highlight the importance of helping adolescents regulate negative affectivity and improving social support-based preventative interventions to reduce SSIB.

The impact of income inequity on energy consumption: The moderating role of digitalization

Income inequity and energy consumption have become important issues for sustainable development, and digitalization offers unlimited potential for bridging the income gap and decreasing energy consumption. Based on an international perspective, we confirm the impact of income inequality on energy consumption in 108 countries from 2000 to 2019 and then explore the moderating and threshold effects of digitalization on the impact of income inequality on energy consumption. The empirical results indicate that income inequality causes a surge in energy consumption, and the dynamic SYS-GMM results suggest that for every 1 unit increase in income inequality, energy consumption increases by 0.003 unit. The moderating effect suggests that digitalization helps mitigate the impact of a 3.654% surge in energy consumption caused by income inequality. In comparison, digitalization has a significant moderating effect on energy consumption in middle- and high-income countries (Europe, the Americas, and the Asia-Pacific region), and the moderating effect of digitalization is effective in both free and non-free economies. The dynamic SYS-GMM threshold panel models reveal a non-linear relationship between income inequality and energy consumption affected by digitalization. This provides international evidence that reveals the underlying mechanisms of digitalization, income inequality, and energy consumption. It will better guide countries in harnessing digital dividends to overcome the twin dilemmas of the income gap and energy poverty.

Work-From-Home in the New Normal: A Phenomenological Inquiry into Employees' Mental Health

The COVID-19 pandemic has forced employees to adapt and adjust to the new normal in an unprecedented way. While some employees have been able to move to work-from-home (WFH) relatively easily, many find it challenging. Notwithstanding the magnitude of change, little is known about the determinants of WFH employees' mental health during COVID-19. This study therefore aims to explore (1) the salient factors that contribute to the mental health issues of WFH employees and (2) strategies to overcome WFH challenges. A qualitative approach using phenomenological inquiry was adopted. Forty-one employees who worked from home in Pakistan were sampled using the purposive and snowball sampling techniques. Data was collected via semi-structured interviews and analyzed using thematic analysis. Overall, employees believe that organizations offer inadequate support in both work-related and non-work-related matters. Five themes were elicited and coded as factors that contribute to mental health issues among WFH employees. Technical issues and system complexities, the absence of flexible working arrangements, distractions, a lack of communication, and inadequate social support were found to obstruct WFH and cause mental distress. Behavioral and cognitive coping strategies were also determined to tackle these mental issues. This study complements the human resource literature by exploring the factors that obstruct WFH and cause mental health issues in the context of the pandemic crisis. As mental well-being is more intricate than administrative arrangements, the study is useful for organizations to develop a feasible mechanism that facilitates the smooth execution of WFH for employees while ensuring their mental health is preserved. Using a phenomenological inquiry, the present study is one of the few to explore the factors that contribute to the mental health of WFH employees in the context of the pandemic crisis. Apart from its contribution to knowledge on human resource management and organizational behavior, it provides useful implications for managers, policymakers, and practitioners to manage WFH employees more effectively.

The worst mistake 2.0? The digital revolution and the consequences of innovation

The invention of agriculture 12,000 years ago has been called the worst mistake in human history. Alongside the social, political, and technological innovations that stemmed from it, there came a litany of drawbacks ranging from social inequality, a decline in human health, to the concentration of power in the hands of a few. Millennia after the invention of agriculture, another revolution-the digital revolution-is having a similar impact on humanity, albeit at a scale and speed measured in decades. Despite the tremendous advances brought about by this revolution, there is today a rapidly expanding gulf within and between societies along technological lines; alarming effects on sociality and cognition due to a persistent online presence; and a concentration of power in the form of wealth and data within a handful of tech companies, the likes of which has never been seen before. While the effects of agriculture can now be discerned with thousands of years of hindsight, those of the digital revolution can be witnessed in real time. Is the digital revolution paving the way for a more equitable and stable world, or is it leading humanity down a road that will prove to be more detrimental the more ensconced in technology we become?

Social Network Analysis as a Cybernetic Modelling Facility for Participatory Design in Technology-Supported College Curricula

Despite iterative learning design being increasingly implemented, such approaches are often delineated by well-defined periods of design/implementation. However, second-order cybernetics, which suggests a participatory approach to learning design, involves responsively adapting learning environments to meet students' needs, treating them as agentic participants in the classroom. In our mixed methods study, we investigate whether such a process can facilitate egalitarian participation and collaborative interactions in a technology-assisted classroom. We use the example of a graduate psychology class of 17 students and suggest that adaptation of live-chat activities by a participant observer on the Reddit social media platform that supplemented the in-person lecture dynamically, using a network analysis and qualitative ethnography as a modelling facility mimicked the ongoing feedback loops of social media platforms, enabling students to use social media with a critical eye, and engage in productive collaboration. Our quantitative results present network graphs for weekly eigen centrality to understand the egalitarian nature of the network, and transitivity to understand the likelihood for collaboration between more than two agents. Our qualitative results elaborate selected Reddit posts, and weekly field notes to explain how redesigning the chat weekly helped augment lecture-based discussion with the instructor and critique of student presentations, spurring egalitarian participation through a space-place dialectic. Students also provided end-semester feedback that was analyzed using inductive coding, to design future courseware.

Severity of loneliness, depression and perceived social support in adults in the empty nest stage of the family life cycle and the influence of using digital technology

PURPOSE

Study aimed to identify association between loneliness, depression and perceived social support in adults living in the empty nest stage of family life cycle and to assess impact of digital technology use on the same.

METHODS

In this hospital based cross-sectional study, we recruited 281 adults aged 50 years and above. Assessment of loneliness and depression was done using University of California Los Angeles Loneliness scale and Patient Health Questionnaire. Social support was assessed using Multidimensional scale of perceived social support. Digital technology use was assessed based on their self -reported use of mobile, or computer.

RESULTS

Among the participants (age 50-75 years), women accounted for 57.7%. 71% of the adults were staying with the spouse, 85% of the participants reported lowincome status. Mean score (SD) of loneliness was 61.7(10.23). Only 17.8% were classified as having no to mild depression, while 52.7% reported low social support. Loneliness severity correlated significantly with depression severity (σ = 0.59, p = 0.000), and perceived social support (σ = -0.78, p = 0.000). Use of digital technology (72.9%) was associated with significantly lower loneliness score (U=4120.00, p = 0.000, lower depression score (U=5106.00, p = 0.000) and higher perceived social support (U=4366.00, p = 0.000).

CONCLUSION

Loneliness is present in adults in the empty nest stage of life cycle. Its severity positively correlated with depressive symptoms and negatively with perceived social support. Digital technology users seem to have lower loneliness, lower depression severity and higher social support compared to non-digital technology users.

Gordon Pask’s second-order cybernetics and Lev Vygotsky’s cultural historical theory: Understanding the role of the internet in developing human thinking

This three-part article reinforces crosscurrents between cybernetician Gordon Pask’s work towards creating responsive machines applied to theater and education, and Vygotsky’s theory, to advance sociohistorical approaches into the internet age. We first outline Pask’s discovery of possibilities of a neoclassical cybernetic framework for human–human, human–machine, and machine–machine conversations. Second, we outline conversation theory as an elaboration of the reconstruction of mental models/concepts by observers through reliance on sociocultural psychological approaches, and apply concepts like the zone of proximal development and perezhivanie to Paskian aesthetic technologies. Third, we interpret Pask’s teaching/learning devices as zones of proximal development, and outline how Paskian algorithms in digital devices like THOUGHTSTICKER have been generalized on today’s internet, supplemented by corporate interests. We conclude that Paskian theory may offer understandings of the roles of internet technologies in transforming human thinking, and suggest (re)designing tools incorporating algorithms that contextually advance conceptual understanding that deviates from current indexing approaches.

Does Objectively Measured Social-Media or Smartphone Use Predict Depression, Anxiety, or Social Isolation Among Young Adults?

Despite a plethora of research, the link between digital technology use and psychological distress among young adults remains inconclusive. Findings in this area are typically undermined by methodological limitations related to measurement, study design, and statistical analysis. Addressing these limitations, we examined the prospective, within-person associations between three aspects of objectively-measured digital technology use (smartphone use duration and frequency; social media use duration) and three aspects of psychological distress (depression, anxiety, and social isolation) among a sample of young adults (N = 384). Across 81 different model specifications, we found that most within-person prospective effects between digital technology use and psychological distress were statistically non-significant and all were very small-even the largest effects were unlikely to register a meaningful impact on a person's psychological distress. In post hoc subgroup analyses, we found scant evidence for the claim that digital technology use is more harmful for women and/or younger people.

Social Networking Service, Patient-Generated Health Data, and Population Health Informatics: National Cross-sectional Study of Patterns and Implications of Leveraging Digital Technologies to Support Mental Health and Well-being

BACKGROUND

The emerging health technologies and digital services provide effective ways of collecting health information and gathering patient-generated health data (PGHD), which provide a more holistic view of a patient's health and quality of life over time, increase visibility into a patient's adherence to a treatment plan or study protocol, and enable timely intervention before a costly care episode.

OBJECTIVE

Through a national cross-sectional survey in the United States, we aimed to describe and compare the characteristics of populations with and without mental health issues (depression or anxiety disorders), including physical health, sleep, and alcohol use. We also examined the patterns of social networking service use, PGHD, and attitudes toward health information sharing and activities among the participants, which provided nationally representative estimates.

METHODS

We drew data from the 2019 Health Information National Trends Survey of the National Cancer Institute. The participants were divided into 2 groups according to mental health status. Then, we described and compared the characteristics of the social determinants of health, health status, sleeping and drinking behaviors, and patterns of social networking service use and health information data sharing between the 2 groups. Multivariable logistic regression models were applied to assess the predictors of mental health. All the analyses were weighted to provide nationally representative estimates.

RESULTS

Participants with mental health issues were significantly more likely to be younger, White, female, and lower-income; have a history of chronic diseases; and be less capable of taking care of their own health. Regarding behavioral health, they slept <6 hours on average, had worse sleep quality, and consumed more alcohol. In addition, they were more likely to visit and share health information on social networking sites, write online diary blogs, participate in online forums or support groups, and watch health-related videos.

CONCLUSIONS

This study illustrates that individuals with mental health issues have inequitable social determinants of health, poor physical health, and poor behavioral health. However, they are more likely to use social networking platforms and services, share their health information, and actively engage with PGHD. Leveraging these digital technologies and services could be beneficial for developing tailored and effective strategies for self-monitoring and self-management.

Time Spent on Social Media and Risk of Depression in Adolescents: A Dose-Response Meta-Analysis

Adolescent depression is a worldwide public health concern and has contributed to significant socioeconomic burden. Investigating the association between time spent on social media (TSSM) and depression may provide guidance toward the prevention and intervention of adolescent depression. However, related literature reported mixed findings in terms of the relationship between TSSM and depression in adolescents. Hence, we conducted a comprehensive dose−response meta-analysis to clarify this issue. We conducted a systematic title/abstract and topic search of the relative terms in Web of Science, PubMed, PsycINFO databases through 9 January 2022. Odd ratios (ORs) were used to examine the pooled effect size of the association between TSSM and risk of depression. Dose−response analysis was evaluated by a generalized least squares trend estimation. Twenty-one cross-sectional studies and five longitudinal studies including a total of 55,340 participants were included. Overall, more TSSM was significantly associated with a higher risk of depression symptoms (OR = 1.60, 95%CI: 1.45 to 1.75) with high heterogeneity (Q(29) = 105.9, p < 0.001; I2 = 72.6%). The association was stronger for adolescent girls (OR = 1.72, 95%CI: 1.41 to 2.09) than boys (OR = 1.20, 95%CI: 1.05 to 1.37). Five studies with seven reports were included in dose−response analysis. There was a linear dose−response association of TSSM and risk of depression. The risk of depression increased by 13% (OR = 1.13, 95%CI: 1.09 to 1.17, p < 0.001) for each hour increase in social media use in adolescents. TSSM is associated with depression in a linear dose−response and gender-specific manner, which suggests the need for better monitoring of adolescent social media use. However, motivation, content, and engagement on and exposure to social media use may also be important contributing factors, making it necessary to interpret the current findings with caution. Therefore, further research is required to clarify not only the causal link between TSSM and depression by randomized control studies but also the influence of other factors, such as active vs. passive social media use or different types of engagement or environments in which social media is used.

Examining the Associations between COVID-19-Related Psychological Distress, Social Media Addiction, COVID-19-Related Burnout, and Depression among School Principals and Teachers through Structural Equation Modeling

This study aims to investigate the relationships between COVID-19-related psychological distress, social media addiction, COVID-19-related burnout, and depression. The research, which was designed according to the relational survey model, was conducted with the participation of 332 school principals and teachers who received graduate education in the field of educational administration. Research data were collected through online surveys and then structural equation modeling (SEM) was used to test and analyze the proposed hypotheses. The study’s findings revealed that COVID-19-related psychological distress strongly predicted COVID-19-related burnout. In this context, as the psychological distress associated with COVID-19 increased, the sense of burnout associated with COVID-19 also increased. However, it was found that burnout associated with COVID-19 significantly and positively predicted depression. SEM results revealed that COVID-19-related psychological distress directly affected COVID-19-related burnout, depression, and social media addiction. In addition, it was determined that an indirect effect of COVID-19-related burnout and social media addiction exists in the relationship between COVID-19-related psychological distress and depression.

Impact of COVID-19 on the digital divide: a rapid review

OBJECTIVE

The increased reliance on digital technologies to deliver healthcare as a result of the COVID-19 pandemic has meant pre-existing disparities in digital access and utilisation of healthcare might be exacerbated in disadvantaged patient populations. The aim of this rapid review was to identify how this 'digital divide' was manifest during the first wave of the pandemic and highlight any areas which might be usefully addressed for the remainder of the pandemic and beyond.

DESIGN

Rapid review and narrative synthesis.

DATA SOURCES

The major medical databases including PubMed and Embase and Google Scholar were searched alongside a hand search of bibliographies.

ELIGIBILITY CRITERIA

Original research papers available in English which described studies conducted during wave 1 of the COVID pandemic and reported between 1 March 2020 and 31 July 2021.

RESULTS

The search was described using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and identified nine studies. The results are presented within a refined framework describing the three key domains of the digital divide: (1) digital access, within which one study described continuing issues with internet connectivity among vulnerable patients in the UK; (2) digital literacy, where seven studies described how ethnic minorities and the elderly were less likely to use digital technologies in accessing care; (3) digital assimilation, where one study described how video technologies can reduce feelings of isolation and another how elderly black males were the most likely group to share information about COVID-19 on social media platforms.

CONCLUSIONS

During the early phase of the pandemic in the developed world, familiar difficulties in utilisation of digital healthcare among the elderly and ethnic minorities continued to be observed. This is a further reminder that the digital divide is a persistent challenge that needs to be urgently addressed when considering the likelihood that in many instances these digital technologies are likely to remain at the centre of healthcare delivery.

Visioning the future of health promotion

COVID-19 has shown us clearly that the world must commit to a transformative approach that promotes health and wellbeing. Living in the Anthropocene - an epoch defined by human impact on our ecosystems - moves us into unknown territory. The challenge is to find a way of living that aims to meet the needs of all people within the means of the living planet. We will require foresight, agility and resilience to be well prepared. The global risks we face are enormous and they are interconnected - yet the opportunity to accelerate change for the better is extraordinary as well. We have models, knowledge and technologies at our disposal that could significantly improve health and wellbeing and create fairer and more sustainable societies - yet they have not been used widely to serve the public purpose and to address inequities.

Quality of life among undergraduate university students during COVID-19 movement control order in Sarawak

BACKGROUND AND AIMS

This study aimed to examine the quality of life (QoL) and health satisfaction of undergraduate university students in Sarawak during MCO and its association with socio-demographic profiles.

METHODS

In this cross-sectional study, QoL and satisfaction of health of 503 undergraduate university students (63.4% females) from a public university was assessed online using the World Health Organization QoL (WHOQOL)-BREF instrument.

RESULTS

The overall QoL and satisfaction with health were 3.7 ± 0.87 and 3.9 ± 0.82, respectively. Male students showed significantly lower mean scores for the environmental domains than female students (63.37 ± 16.21 vs 68.10 ± 14.00, P < .01). Students who lived inside the campus (vs outside campus) showed significantly lower mean score for the physical health (61.49 ± 13.94 vs 67.23 ± 13.93, P < .01), environmental health (58.35 ± 15.07 vs 70.49 ± 13.21, P < .01), overall QoL (3.39 ± 0.90 vs 3.84 ± 0.83, P < .01), and satisfaction with health (3.71 ± 0.90 vs 3.97 ± 0.77, P < .01). Students with parent's income below RM5000 (vs parent's income more than RM5000) had significantly lower mean score for the environmental domain (65.06 ± 14.35 vs 68.20 ± 15.74, P < .05). Others ethnicity scored significantly lower than Bumiputera Sarawak and Malay while Bumiputera Sarawak scored significantly lower than Chinese in physical health domain (Malay = 65.73 ± 13.40, Chinese = 63.24 ± 15.35, Bumiputra Sarawak = 67.35 ± 13.30, Others = 60.84 ± 15.88, P < .05). Malay (69.99 ± 15.20) scored significantly higher than other ethnicities (Chinese = 63.58 ± 15.80; Bumiputera Malaysia = 65.23 ± 13.66; others = 63.98 ± 15.59) in environmental domain (P < .01). When comparing between religions, the results also showed there were significant differences between different religion groups in overall QoL (Islam = 3.75 ± 0.93, Christianity = 3.77 ± 0.79, Others = 3.34 ± 1.14, P < .05), physical health (Islam = 65.00 ± 13.86, Buddhism = 68.40 ± 11.99, Christianity = 64.77 ± 14.94, Others = 61.00 ± 16.03, P < .05), and environmental health (Islam = 69.66 ± 15.48, Buddhism = 64.99 ± 11.36, Christianity = 64.87 ± 15.61, Others = 62.13 ± 16.28, P < .05).

CONCLUSION

By understanding university students' QoL in this global disaster, relevant authorities would provide a better rehabilitation and assistance to those affected ones.

Adolescent development and growing divides in the digital age

Adolescents are constantly connected to their devices, and concerns have been raised that this connectivity is damaging their development more generally, and their mental health in particular. Recent narrative reviews and meta-analyses do not support a strong linkage between the quantity of adolescents' digital technology engagement and mental health problems. Instead, it appears that offline vulnerabilities tend to mirror and shape online risks in ways that may further amplify mental health inequalities among youth. New approaches for supporting youth mental health, especially for vulnerable youth and those typically excluded from traditional services, are now both possible and required.
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Quantity, Content, and Context Matter: Associations Among Social Technology Use and Sleep Habits in Early Adolescents

PURPOSE

This study aimed to investigate the associations of social technology access and content, bedtime behaviors, parental phone restrictions, and timing and duration of sleep on school nights in early adolescents.

METHODS

Adolescents (aged 11-15 years, n = 772) in the Northeast U.S. completed an online survey during or after school in spring 2019.

RESULTS

Quantity of social technology use (e.g., checking social media, problematic internet behaviors, mobile use), content viewed (e.g., emotional or violent videos, risky behaviors), and social context (e.g., bedtime behaviors, starting social media at an early age) were significantly related to later bedtimes and fewer hours of sleep on school nights. Parental rules restricting mobile phone and online use before bed and obtaining a smartphone at a later age were associated with increased sleep time and earlier bedtime.

CONCLUSIONS

Quantity, content, and context of social technology use may affect sleep timing and duration in early adolescents.

Social networking and symptoms of depression and anxiety in early adolescence

BACKGROUND

Use of social networking in later childhood and adolescence has risen quickly. The consequences of these changes for mental health are debated but require further empirical evaluation.

METHODS

Using data from the Childhood to Adolescence Transition Study (n = 1,156), duration of social networking use was measured annually at four time points from 11.9 to 14.8 years of age (≥1 h/day indicating high use). Cross-sectional and prospective relationships between social networking use and depressive and anxiety symptoms were examined.

RESULTS

In adjusted (age, socioeconomic status, prior mental health history) cross-sectional analyses, females with high social networking use had greater odds of depressive (odds ratio [OR]: 2.15; 95% confidence interval [CI]: 1.58-2.91) and anxiety symptoms (OR: 1.99; 95% CI: 1.32-3.00) than those that used a few minutes at most, while males with high social networking use had 1.60 greater odds of reporting depressive symptoms (95% CI: 1.09-2.35). For females, an increased odds of depressive symptoms at age 14.8 was observed for high social networking use at one previous wave and at two or three previous waves, even after adjustment (OR: 1.76; 95% CI: 1.11-2.78; OR: 2.06, 95% CI: 1.27-3.37, respectively) compared to no wave of high use.

CONCLUSIONS

Our results suggest weak to moderate increased odds of depression and anxiety in girls and boys with high social networking use versus low/normal use. These findings indicate that prevention programs for early mental health problems might benefit from targeting social networking use in early adolescence.

Psychosocial issues in isolated and confined extreme environments

PALINKAS, L.A., and P. SUEDFELD. Psychosocial Issues in Isolated and Confined Extreme Environments. NEUROSCI BIOBEHAV REV (1) XXX-XXX, 2020. Psychosocial elements of behavior and performance will significantly impact the outcomes of long duration missions in space, ranging from individual and team decrements to positive benefits associated with successful adaptation. This paper reviews our current understanding of the individual, interpersonal and organizational issues related to living and working in isolated and confined extreme (ICE) environments. Individual issues include changes in emotions and cognitive performance; seasonal syndromes linked to changes in the physical environment; and positive effects of adapting to ICE environments. Interpersonal issues include processes of crew cohesion, tension and conflict; interpersonal relations and social support; the impact of group diversity and leadership styles on small group dynamics; and crew-mission control interactions. Organizational issues include the influence of organizational culture and mission duration on individual and group performance, crew autonomy, and managerial requirements for long duration missions. Improved screening and selection, leadership, coping and interpersonal skills training, and organizational change are key elements to optimizing adjustment to the environment and preventing decrements during and after long duration missions.

Problematic Social Media Use and Health among Adolescents

(1) Background: The use of social media has become an integral part of adolescents' daily lives. However, the intensive use of social media can develop into a health-threatening addiction, but unfavourable health consequences can occur even with less use. Social media user groups categorized as no-risk, moderate risk (of developing problematic behaviour), and problematic use were examined with reference to their prevalence, their associations with individual determinants and health, and the increased health risk between groups. (2) Methods: The Finnish nationally representative HBSC data (persons aged 11, 13, and 15, n = 3408) and descriptive and binary logistic regression analysis were applied. (3) Results: Problematic social media use (9.4%) was most common among older age groups, and among persons with moderate/low school achievement, low health literacy, and low parental monitoring. Belonging to a moderate risk group (33.5%) was most frequent among girls, and among adolescents with low/moderate parental monitoring and health literacy. All the negative health indicators systematically increased if the respondent belonged to a moderate risk or problematic use group. (4) Conclusions: The study confirmed the association between problematic social media use and negative health outcomes and highlighted the need to pay close attention to adolescents at moderate risk who exhibited negative health outcomes.

Puberty Initiates Cascading Relationships Between Neurodevelopmental, Social, and Internalizing Processes Across Adolescence

Adolescence is a period of dramatic developmental transitions-from puberty-related changes in hormones, bodies, and brains to an increasingly complex social world. The concurrent increase in the onset of many mental disorders has prompted the search for key developmental processes that drive changes in risk for psychopathology during this period of life. Hormonal surges and consequent physical maturation linked to pubertal development in adolescence are thought to affect multiple aspects of brain development, social cognition, and peer relations, each of which have also demonstrated associations with risk for mood and anxiety disorders. These puberty-related effects may combine with other nonpubertal influences on brain maturation to transform adolescents' social perception and experiences, which in turn continue to shape both mental health and brain development through transactional processes. In this review, we focus on pubertal, neural, and social changes across the duration of adolescence that are known or thought to be related to adolescent-emergent disorders, specifically depression, anxiety, and deliberate self-harm (nonsuicidal self-injury). We propose a theoretical model in which social processes (both social cognition and peer relations) are critical to understanding the way in which pubertal development drives neural and psychological changes that produce potential mental health vulnerabilities, particularly (but not exclusively) in adolescent girls.

Participant Engagement in a Transmedia Storytelling Web-Based App Intervention for Mental Health of Latina Women: Qualitative Analysis

BACKGROUND

Stigma, fear, and lack of knowledge regarding treatment options or where to get help create delays for Latina women in accessing needed mental health help. Story-based media interventions hold appeal for Latina women. Thus, we drew upon the Social Cognitive Theory by Bandura to create an evidence-based, transmedia storytelling web-based app for mental health called Catalina: Confronting My Emotions to connect Latina women to a curated set of mental health resources. Understanding how Latina women perceive various aspects of the web-based app will help design future expansions.

OBJECTIVE

A previously published analysis led to the development of a category on how participants related to the lead character (Catalina) in the story line of the web-based app as a real person. However, the purpose of this analysis was to gain an understanding of participants' experiences with the extension of the dramatic story line of the web-based app beyond Catalina to a Latina nurse-therapist character named Veronica, who was featured prominently in the app's interactive content and bonus videos.

METHODS

Qualitative analyses were conducted with interview data from a community-based sample of 28 English-speaking Latina women aged between 21 and 50 years who scored above the threshold for anxiety (Generalized Anxiety Disorder-7) and/or depression (Patient Health Questionnaire-9) but were not suicidal at screening. Data were collected 72 hours after participants engaged with our transmedia storytelling web-based app for mental health. Grounded theory methodology guided the analysis and interpretation of data that had been collected telephonically, recorded, and transcribed with identifiers removed. Analyses included initial and focused coding using process codes (gerund form of verbs in codes focused on action), informed by symbolic interactionism, and the development of categories with properties through constant comparison, memo writing, and the use of charts and diagrams.

RESULTS

Our participants experienced a multiphase process that was most heavily related to Veronica, the Latina nurse-therapist character in our web-based app, who led them through a process to a place of action. We conceptualized this process as moving from passive viewer to active participant of a transmedia storytelling web-based app intervention. Overall, 3 new conceptual categories provided insight into women's experiences, including encountering a trustworthy nurse-therapist character, taking in messages that dispel old beliefs, and preparing when and how to take action. Each category has nuanced properties that reflect participants' experiences.

CONCLUSIONS

Active engagement with our web-based app led our sample to successfully transition from the viewpoint of the observer to the viewpoint of the experiencer, moving from a passive position of watching to active engagement that involved imagining, thinking, reflecting, and acting. Careful development of dramatic material for health-related web-based apps using transmedia story extension and bonus videos needs to be based on input from the target group from the start of development through evaluation and testing.

Screen Time, Social Media Use, and Adolescent Development

Adolescents spend much of their daily lives online, and fears abound that digital technology use, and social media in particular, is harming their social and emotional development. Findings to date do not support causal or robust associations between social media use and adolescents’ development. Instead, prior studies have produced a mix of small positive, negative, and often null associations. The narrative around social media and adolescent development has been negative, but empirical support for the story of increasing deficits, disease, and disconnection is limited. This article reviews what is known about the association between social media use and adolescent social and emotional well-being, identifies key limitations in current research, and recommends ways to improve science while also minimizing risk and creating opportunities for positive development in an increasingly digital and uncertain age.

A meta-analysis of the association between adolescent social media use and depressive symptoms

BACKGROUND

The association of adolescent social media use with mental health symptoms, especially depression, has recently attracted a great deal of interest in public media as well as the scientific community. Some studies have cited statistically significant associations between adolescent social media use and depression and have proposed that parents must regulate their adolescents' social media use in order to protect their mental health.

METHOD

In order to rigorously assess the size of the effect that has been reported in the current scientific literature, we conducted a meta-analysis of studies that measured the association between social media use specifically and depressive symptoms amongst early- to mid- adolescents (11-18 years-old). We searched Psychnet, PubMed, and Web of Science with the following terms: online social networks, social media, internet usage, facebook, twitter, instagram, myspace, snapchat, and depression.

RESULTS

We found a small but significant positive correlation (k=12 studies, r=.11, p<.01) between adolescent social media use and depressive symptoms. There was also high heterogeneity (I²=95.22%) indicating substantial variation among studies.

CONCLUSIONS

High heterogeneity along with the small overall effect size observed in the relationship between self-reported social media use and depressive symptoms suggests that other factors are likely to act as significant moderators of the relationship. We suggest that future research should be focused on understanding which types of use may be harmful (or helpful) to mental health, rather than focusing on overall use measures that likely reflect highly heterogeneous exposures.