Online information, extreme communities and internet therapy: Is the internet good for our mental health?

Too much information! When job resources become job demands, producing a curvilinear relationship between informational social support and creativity

OBJECTIVE

Informational social support can have both positive and negative effects on employees. This research aims to examine the curvilinear relationship between informational social support and employees' cognitive processes, specifically cognitive depletion and creativity. Additionally, we investigate the moderating role of emotional stability on this curvilinear relationship, particularly regarding cognitive depletion.

METHODS

A total of 108 male employees in South Korea participated in the study, completing 864 two-wave, time-lagged daily diary questionnaires. The surveys measured informational social support, cognitive depletion, creativity, and emotional stability.

RESULTS

The findings reveal that informational social support enhances employees' cognitive processes up to a certain threshold, after which its effects become detrimental, demonstrating a curvilinear pattern. Furthermore, emotional stability moderates this relationship: emotionally stable employees show a linear relationship between informational social support and cognitive depletion, while emotionally unstable employees exhibit a curvilinear relationship.

CONCLUSION

Our results suggest that excessive informational social support may harm employees' cognitive processes, indicating that there is an optimal level of support, beyond which the effects become counterproductive.

Navigating the digital landscape: Relationship between type of internet use and well-being among students-A mediation and moderation analysis

Background

The amount and frequency of internet use are often used to forecast its pros and cons, with mixed findings. After COVID-19, technological advances and sociological upheavals have shown the internet's ability to support numerous activities, necessitating a change in internet use. Beyond internet use frequency, it has been advised to examine why people use it and how it affects their well-being. Hence, we aimed to investigate the various mediators and moderators in the relationship between the quality of internet use (type of activity) and well-being. Further, we investigated whether user attributes such as initial age and frequency of internet use moderate the influence of internet use quality on problematic internet use, loneliness, and well-being.

Methods

131 students in Manipur who were 18 years old were included in this cross-sectional study. Self-rated measures of the Adult Internet Usage questionnaire, Internet Addiction Test, and Mental Health Continuum-Short Form assessed internet use, dependence, and well-being.

Results

Loneliness mediates the association between well-being and internet behaviors related to personal use-self-actualization (BootSE = .53, BootLLCI = .10, BootULCI = 2.18), cultural use-belonging (BootSE =.57, BootLLCI = -2.23, BootULCI = -.02). Average online hours moderate economic use-education, loneliness, and well-being (BootSE =.13, BootLLCI = -.55, BootULCI = -.04).

Conclusion

To conclude, the effectiveness of internet use affects well-being differently depending on the type of activity. After a certain point, even seemingly good internet activities may have diminishing returns.

The Relationship between Orthorexia Nervosa and Obsessive Compulsive Disorder

Orthorexia nervosa (ON) is characterized by an intense avoidance of foods considered unhealthy, obsession with healthy eating behaviors, and pathological fixation on healthy foods. Although there are still debates in the literature about the psychological factors and symptoms of ON, it should be noted that many of the symptoms share common features with obsessive compulsive disorder (OCD). The aim of the present study was to investigate the relationship between ON and OCD with its subtypes. In this framework, the cross-sectional study was conducted with an opportunistic sample of 587 participants (86% women and 14% men), with an average age of 29.32 (s.d. = 11.29; age range = 15-74). Our work showed that almost all OCD subtypes were largely correlated with ON. The lowest correlation was for "Checking" and the highest for "Obsession". Overall, the OCD subtypes (i.e., Indecisiveness, Just Right, Obsession, and Hoarding) were more strongly associated with ON measures, while subtypes Checking and Contamination, although positively associated, had lower correlation coefficients.

Examining the Pro-Eating Disorders Community on Twitter Via the Hashtag #proana: Statistical Modeling Approach

BACKGROUND

There is increasing concern around communities that promote eating disorders (Pro-ED) on social media sites through messages and images that encourage dangerous weight control behaviors. These communities share group identity formed through interactions between members and can involve the exchange of "tips," restrictive dieting plans, extreme exercise plans, and motivating imagery of thin bodies. Unlike Instagram, Facebook, or Tumblr, the absence of adequate policy to moderate Pro-ED content on Twitter presents a unique space for the Pro-ED community to freely communicate. While recent research has identified terms, themes, and common lexicon used within the Pro-ED online community, very few have been longitudinal. It is important to focus upon the engagement of Pro-ED online communities over time to further understand how members interact and stay connected, which is currently lacking.

OBJECTIVE

The purpose of this study was to explore beyond the common messages of Pro-ED on Twitter to understand how Pro-ED communities get traction over time by using the hashtag considered to symbolize the Pro-ED movement, #proana. Our focus was to collect longitudinal data to gain a further understanding of the engagement of Pro-ED communities on Twitter.

METHODS

Descriptive statistics were used to identify the preferred tweeting style of Twitter users (either as mentioning another user in a tweet or without) as well as their most frequently used hashtag, in addition to #proana. A series of Mann Whitney U tests were then conducted to compare preferred posting style across number of followed, followers, tweets, and favorites. This was followed by linear models using a forward step-wise approach that were applied for Pro-ED Twitter users to examine the factors associated with their number of followers.

RESULTS

This study reviewed 11,620 Pro-ED Twitter accounts that posted using the hashtag #proana between September 2015 and July 2018. These profiles then underwent a 2-step screening of inclusion and exclusion criteria to reach the final sample of 967 profiles. Over 90% (10,484/11,620) of the profiles were found to have less than 6 tweets within the 34-month period. Most of the users were identified as preferring a mentioning style of tweeting (718/967, 74.3%) over not mentioning (248/967, 25.7%). Further, #proana and #thinspo were used interchangeably to propagate shared themes, and there was a reciprocal effect between followers and the followed.

CONCLUSIONS

Our analysis showed that the number of accounts followed and number of Pro-ED tweets posted were significant predictors for the number of followers a user has, compared to likes. Our results could potentially be useful to social media platforms to understand which features could help or otherwise curtail the spread of ED messages and activity. Our findings also show that Pro-ED communities are transient in nature, engaging in superficial discussion threads but resilient, emulating cybersectarian behavior.

Predicting the Intention to Use Cybercounseling Among Chinese Adolescents: An Extended Theory of Planned Behavior

With the rapid development of Information Communication Technology, cybercounseling has become a more feasible modality to receive psychological support. However, very limited research has explored the intention to use cybercounseling. This study aimed to use an extended theory of planned behavior (E-TPB) model to predict the intention to use cybercounseling among Chinese adolescents. The moderation effect of gender in the constructs of the E-TPB model was also investigated. A total of 1,216 Chinese adolescents (602 males, mean age = 14.21, standard deviation = 1.28) completed the self-report questionnaire. Structural equation modeling and multigroup analyses were performed using AMOS 20.0. The overall E-TPB model explained 29.8 percent of the variance in the intention to use cybercounseling. Subjective norm (SN) was the strongest predictor of the intention to use cybercounseling, followed by perceived behavioral control (PBC) and attitude (ATT). Moreover, two additional variables (i.e., attitude toward Internet and computer self-efficacy) significantly predicted the ATT and PBC, respectively. Furthermore, gender was found to significantly moderate the E-TPB model. Unexpectedly, social stigma toward seeking psychological help did not show a significant effect on SN. This study showed that the E-TPB is an efficient model to explain the intention to use cybercounseling and suggested the influence of social factor (i.e., SN) on the intention to use cybercounseling among Chinese adolescents. These results would be beneficial for understanding and promoting the cybercounseling application.

How Smoking Advocates are Connected Online: An Examination of Online Social Relationships Supporting Smoking Behaviors

Social media platforms can facilitate online relationship formation among people who engage in risky health behavior such as smoking or unprotected sex. The purpose of this study is to gain a better understanding of how individuals who promote risky health behavior are connected with similar others on social media. Focusing on smoking behavior, this study investigates the theoretical mechanisms that drive social connections among pro-smoking users, and examines an empirical instance of one such network structure on Twitter. Consistent with the social identity framework, the study finds that pro-smoking networks manifest higher stance homophily (pro-smoking vs. anti-smoking) and higher network cohesion than anti-smoking networks. Different from the hypothesis, however, the result shows lower network exclusivity than anti-smoking networks. Most pro-smoking users who had social ties with anti-smoking users were found to be individuals rather than pressure groups or organizations. Bridging users on both sides tended to be linked to pressure groups. This paper concluded with discussion of implications of the current findings.

Attachment and behavioral addictions in adolescents: The mediating and moderating role of coping strategies

Gambling, video gaming, and Internet use are typically included as everyday activities that could potentially become behavioral addictions. There is growing evidence that views non-substance related addictions as coping mechanisms, and considers that attachment styles are likely to play a pivotal role on the development of such addictions, especially on young people. Therefore, the present study aimed to: (1) explore the association between attachment, coping, and behavioral addictions (i.e., gambling disorder, video game addiction, and problematic Internet use); and (2) to analyze the mediating/moderating effect that coping has in the relationship of attachment and these behavioral addictions. A sample consisting of 472 students from secondary education (Mean age = 15.6; SD = 1.33; 51.6% females) was recruited. The findings showed a negative association between attachment and behavioral addictions. Most coping strategies were found to be associated with attachment styles, except for self-critique and emotional avoidance. In particular, problem avoidance was significantly correlated to all behavioral addictions. In addition, self-blame and problem solving were significantly correlated to video game addiction and problematic Internet use. Finally, coping was found to act as a mediator and moderator between attachment and video game addiction and problematic Internet use.

Transformation of Adolescent Peer Relations in the Social Media Context: Part 2-Application to Peer Group Processes and Future Directions for Research

As social media use becomes increasingly widespread among adolescents, research in this area has accumulated rapidly. Researchers have shown a growing interest in the impact of social media on adolescents' peer experiences, including the ways that the social media context shapes a variety of peer relations constructs. This paper represents Part 2 of a two-part theoretical review. In this review, we offer a new model for understanding the transformative role of social media in adolescents' peer experiences, with the goal of stimulating future empirical work that is grounded in theory. The transformation framework suggests that the features of the social media context transform adolescents' peer experiences by changing their frequency or immediacy, amplifying demands, altering their qualitative nature, and/or offering new opportunities for compensatory or novel behaviors. In the current paper, we consider the ways that social media may transform peer relations constructs that often occur at the group level. Our review focuses on three key constructs: peer victimization, peer status, and peer influence. We selectively review and highlight existing evidence for the transformation of these domains through social media. In addition, we discuss methodological considerations and key conceptual principles for future work. The current framework offers a new theoretical perspective through which peer relations researchers may consider adolescent social media use.

Public attitudes and literacy about posttraumatic stress disorder in U.S. adults

There has been little study of public literacy regarding posttraumatic stress disorder (PTSD). Public knowledge and attitudes about PTSD are important for encouraging treatment, prevention, and informing policies. Using a national online survey of 541 adults across 47 U.S. states in November 2016, we assessed attitudes and knowledge about PTSD. Most notably with respect to attitudes, 76-94% of the sample endorsed more federal funding for research, training, and practice for PTSD; and 76% of the sample also believed people with PTSD should have restricted access to firearms. With respect to knowledge, participants demonstrated good general knowledge about PTSD, but tended to overestimate the rate of PTSD and trauma exposure, and demonstrated little knowledge about effective treatments. Sociodemographic characteristics and political affiliation were associated with PTSD knowledge and attitudes, but clinical characteristics did not explain much additional variance. Together, these findings suggest that there is strong public support for research and practice related to PTSD, but little public knowledge about evidence-based treatments for this disorder.

Online Information Searches and Help Seeking for Mental Health Problems in Urban China

In recent years, the Internet has emerged as an alternative information source on mental health problems. Yet, the profile of the typical Internet help seeker is to be determined. Based on data from a household survey of 2558 Beijing residents, the study investigates online information searches and help seeking for mental health problems. Multinomial logistic regressions are estimated for respondents' access to the Internet, and mental-health-related information searches and help seeking on the Internet for the whole community sample and the most psychologically distressed subsample. The study identifies a digital divide in online help seeking for mental health issues based on age, migration and hukou status, and socio-economic factors. Youth and high socio-economic status are significant predictors of Internet access and use. Among the whole community sample, rural-to-urban migrants are less likely to have access to the Internet and search information or seek help online. Among the most psychologically distressed subsample, urban-to-urban migrants are significantly more likely to have access to the Internet and search information or seek help online. Given the shortage of mental health professionals in China, online information dissemination and guided self-help, if properly designed, could offer a means to reach large numbers of individuals in a cost-effective manner.

Young people, self-harm and internet forums

A generation of digital natives are living their lives in fundamentally different ways from previous generations. The rapid advance of the internet and mobile telephones, and the adoption of online social media, mean that substantial parts of the social lives of young people are played out in online settings. This has implications for how young people discuss and seek help for mental health problems. This commentary discusses the role of online forums for young people who self-harm. Practitioners need to understand the potential harms and benefits, and explore how benefits can be harnessed and harms minimised.

An Empirical Analysis of Internet Message Boards for Self-Harming Behavior

Much debate surrounds the potential effects of self-harm forum use. Arguments in favor highlight factors such as providing access to a supportive community. However critical voice highlighting potential dangers such as forums serving as a platform to promote self-harm, clearly dominate the debate. Using an online questionnaire, the goal of the current study was to examine sociodemographic characteristics, the psychopathology of forum users, motives for participating, and subjective effects of self-harm forum use. A total of 309 self-harm forum users participated in this study. 3 heterogeneous user types with differing motives for visiting the forum and different usage effects were identified. The results question the assumptions that self-harm forums are a source of harm and point to their predominantly constructive and preventive functions.

Suicidality, psychopathology, and the internet: Online time vs. online behaviors

This study investigated whether several psychopathology variables, including suicidality, could predict the time people spend using the internet (hours online). Next, we examined a specific at-risk population (suicidal individuals) by their online behaviors, comparing suicidal individuals who went online for suicide-related purposes with suicidal individuals who did not go online for suicide-related purposes. An anonymous online sample of 713 (aged 18-71) reported hours online, psychiatric histories, and completed several standardized scales. After accounting for age and education, hierarchical regression modeling showed that the assessed psychopathology variables, including suicidality, did not explain significant variance in hours online. Hours online were better predicted by younger age, greater willingness to develop online relationships, higher perceived social support, higher curiosity, and lower extraversion. Suicidal participants, who did or did not go online for suicide-related purposes, did not differ on hours online. Multiple regression modeling showed that those who went online for suicide-related purposes were likely to be younger, more suicidal, and more willing to seek help from online mental health professionals. These findings revealed that hours online are not a valid indicator of psychopathology. However, studying online behaviors of specific at-risk groups could be informative and useful, including for suicide prevention efforts.

International multi-site survey on the use of online support groups in bipolar disorder

BACKGROUND

Peer support is an established component of recovery from bipolar disorder, and online support groups may offer opportunities to expand the use of peer support at the patient's convenience. Prior research in bipolar disorder has reported value from online support groups.

AIMS

To understand the use of online support groups by patients with bipolar disorder as part of a larger project about information seeking.

METHODS

The results are based on a one-time, paper-based anonymous survey about information seeking by patients with bipolar disorder, which was translated into 12 languages. The survey was completed between March 2014 and January 2016 and included questions on the use of online support groups. All patients were diagnosed by a psychiatrist. Analysis included descriptive statistics and general estimating equations to account for correlated data.

RESULTS AND CONCLUSIONS

The survey was completed by 1222 patients in 17 countries. The patients used the Internet at a percentage similar to the general public. Of the Internet users who looked online for information about bipolar disorder, only 21.0% read or participated in support groups, chats, or forums for bipolar disorder (12.8% of the total sample). Given the benefits reported in prior research, clarification of the role of online support groups in bipolar disorder is needed. With only a minority of patients using online support groups, there are analytical challenges for future studies.

Challenges in Internet Addiction Disorder: Is a Diagnosis Feasible or Not?

An important international discussion began because of some pioneer studies carried out by Young (a) on the internet addiction disorder (IAD). In the fifth and most recent version of the Diagnostic, and Statistical Manual of Mental Disorders (DSM) there is no mention of this disorder and among researchers there are basically two opposite positions. Those who are in favor of a specific diagnosis and those who are claiming the importance of specific criteria characterizing this behavior and the precise role it has in the patient’s life. The aim of the present paper is to answer the question whether it is possible or not to formulate diagnoses of internet-related disorders. We revised literature on the history of diagnostic criteria, on neurocognitive evidence, on the topic debate and on IAD instrumental measures. We found that the disorder was not univocally defined and that the construct was somehow too broad and generic to be explicative for a diagnosis. Indeed, the models are borrowed from other addiction pathologies and they are often formulated before the development of internet as intended in current society. In conclusion, we think we need a more innovative, integrated and comprehensive model for an IAD diagnosis.

Virtual Environments, Online Racial Discrimination, and Adjustment among a Diverse, School-Based Sample of Adolescents

Given the recent rise in online hate activity and the increased amount of time adolescents spend with media, more research is needed on their experiences with racial discrimination in virtual environments. This cross-sectional study examines the association between amount of time spent online, traditional and online racial discrimination and adolescent adjustment, including depressive symptoms, anxiety and externalizing behaviors. The study also explores the role that social identities, including race and gender, play in these associations. Online surveys were administered to 627 sixth through twelfth graders in K-8, middle and high schools. Multiple regression results revealed that discrimination online was associated with all three outcome variables. Additionally, a significant interaction between online discrimination by time online was found for externalizing behaviors indicating that increased time online and higher levels of online discrimination are associated with more problem behavior. This study highlights the need for clinicians, educational professionals and researchers to attend to race-related experiences online as well as in traditional environments.

Who Goes Online for Suicide-Related Reasons?

BACKGROUND

Although people who use the Internet for suicide-related reasons have been found to report significantly higher levels of suicidal ideation, little is known about the characteristics of these users.

AIMS

To examine the differences between suicidal people who use the Internet for suicide-related reasons and those who do not.

METHOD

Participants were 205 Australian citizens and permanent residents aged 18-24 years who had felt suicidal within the past year. Participants were recruited online through non-mental health-related websites and asked to complete an anonymous online survey.

RESULTS

In univariate analyses, suicide-related users reported significantly higher levels of social anxiety and lifetime and past year suicidal ideation than non-suicide-related users, as well as a higher likelihood of future suicide and overall higher risk for suicide. There were no differences on depressive symptoms and perceived social support. Both groups were unlikely to anticipate seeking help from any source and generally perceived similar barriers to offline help-seeking. Multivariate analyses showed that past year suicidal ideation and likelihood of future suicide significantly predicted suicide-related Internet use.

CONCLUSIONS

Individuals may choose to go online for alternative methods of coping when their suicidal feelings become more severe, demonstrating the need for more online suicide prevention efforts.

Addiction in the Making

This review traces the literatures in cultural anthropology and neighboring disciplines that are focused on addiction as an object of knowledge and intervention, and as grounds for self-identification, sociality, and action. Highlighting the production of disease categories, the staging of therapeutic interventions, and the ongoing work of governance, this work examines addiction as a key site for the analysis of contemporary life. It likewise showcases a general movement toward accounts of addiction that foreground complexity, contingency, and multiplicity.

Online social support networks

Peer support groups have a long history and have been shown to improve health outcomes. With the increasing familiarity with online social networks like Facebook and ubiquitous access to the Internet, online social support networks are becoming popular. While studies have shown the benefit of these networks in providing emotional support or meeting informational needs, robust data on improving outcomes such as a decrease in health services utilization or reduction in adverse outcomes is lacking. These networks also pose unique challenges in the areas of patient privacy, funding models, quality of content, and research agendas. Addressing these concerns while creating patient-centred, patient-powered online support networks will help leverage these platforms to complement traditional healthcare delivery models in the current environment of value-based care.

Suicidal and online: how do online behaviors inform us of this high-risk population?

To assist suicide prevention we need a better understanding of how suicidal individuals act in their environment, and the online world offers an ideal opportunity to examine daily behaviors. This anonymous survey (N = 1,016) provides first-of-its-kind empirical evidence demonstrating suicide-risk people (n = 290) are unique in their online behaviors. Suicidal users reported more time online, greater likelihood of developing online personal relationships, and greater use of online forums. In addition, suicide-risk women reported more time browsing/surfing and social networking. The authors conclude that suicide prevention efforts should respond to suicide-risk users' greater demands for online interpersonal communications.

How many bytes does it take? A content analysis of cyber issues in couple and family therapy journals

In the fifteen years since the explosion of the Internet, using cyber technology for work and social functions has exponentially increased. Yet, questions around how to manage such changes remain elusive in family therapy literature. In this investigation, we conducted a content analysis to determine to what extent marriage/couple and family therapy (M/CFT) journals have responded to the integration of the Internet in couple and family life. We found 79 of 13,274 articles across seventeen journals focused on the Internet in some capacity. Implications for clinical practice, training, and future research are discussed.

The quality of mental health information commonly searched for on the Internet

Previous research has reviewed the quality of online information related to specific mental disorders. Yet, no comprehensive study has been conducted on the overall quality of mental health information searched for online. This study examined the first 20 search results of two popular search engines-Google and Bing-for 11 common mental health terms. They were analyzed using the DISCERN instrument, an adaptation of the Depression Website Content Checklist (ADWCC), Flesch Reading Ease and Flesch-Kincaid Grade Level readability measures, HONCode badge display, and commercial status, resulting in an analysis of 440 web pages. Quality of Web site results varied based on type of disorder examined, with higher quality Web sites found for schizophrenia, bipolar disorder, and dysthymia, and lower quality ratings for phobia, anxiety, and panic disorder Web sites. Of the total Web sites analyzed, 67.5% had good or better quality content. Nearly one-third of the search results produced Web sites from three entities: WebMD, Wikipedia, and the Mayo Clinic. The mean Flesch Reading Ease score was 41.21, and the mean Flesch-Kincaid Grade Level score was 11.68. The presence of the HONCode badge and noncommercial status was found to have a small correlation with Web site quality, and Web sites displaying the HONCode badge and commercial sites had lower readability scores. Popular search engines appear to offer generally reliable results pointing to mostly good or better quality mental health Web sites. However, additional work is needed to make these sites more readable.

Internet suicide: communities of affirmation and the lethality of communication

As a tool of instant information dissemination and social networking, the Internet has made possible the formation and affirmation of public identities based on personality traits that are usually characterized by clinicians as pathological. The wide variety of online communities of affirmation reveals new conditions for permissiveness and inclusiveness in expressions of these socially marginal and clinically pathologized identities. Much the same kind of discourse common to these online communities is evident in some suicide forums. Web sites with suicide as their central raison d'être, taken together, encompass a wide range of ideas and commitments, including many that provide collective affirmation outside of (and often with hostility toward) professional intervention. The paradox of a potentially life-affirming effect of such forums runs counter to a stark dualism between online therapy versus "prochoice" forums and, by extension, to simple models of the influence of ideas on the lethality of suicide. Different forums either intensify or mitigate self-destructive tendencies in ways that are significant for understanding the place of communication in the occurrence of suicide and for therapeutic practice.

Development and initial evaluation of a smartphone application based on acceptance and commitment therapy

Background

An intervention, consisting of an ACT-based smartphone-application and a web-based psychoeducation, has been developed. The smartphone-application, together with the psychoeducation, aims to function as a self-help intervention for living consistently with one's values. The study is an exploratory investigation of this new smartphone-based tool.

Case description

Primarily, the study aims at investigating a new field, providing a basis for generating hypotheses for further research. The first aim of this initial, exploratory study was to examine if this intervention had an effect on the variables of: valued actions, psychological flexibility, and life satisfaction as well as the states of depression, anxiety and stress, for a non-clinical sample of 11 Swedish Iphone users. This was made with a quasi-experimental pretest-posttest design without control group. The second aim was to investigate how the participants experienced the intervention, as measured by a qualitative questionnaire.

Discussion and evaluation

The group analyses showed that the participants increased their valued action and psychological flexibility significantly during the intervention. Furthermore, value-based actions and psychological flexibility showed small effect sizes when comparing pretest and posttest score. However, the design of the study makes it impossible to draw any certain conclusions. The qualitative questionnaire showed a general positive experience of the intervention.

Conclusions

The results from the present study indicated that the intervention should be studied further. The findings also generated a number of hypotheses that could be investigated in further research.

Electronic supplementary material

The online version of this article (doi:10.1186/2193-1801-1-11) contains supplementary material, which is available to authorized users.

Social media and suicide: a public health perspective

There is increasing evidence that the Internet and social media can influence suicide-related behavior. Important questions are whether this influence poses a significant risk to the public and how public health approaches might be used to address the issue. To address these questions, we provide an overview of ways that social media can influence suicidal behavior, both negatively and positively, and we evaluate the evidence of the risk. We also discuss the legal complexities of this important topic and propose future directions for research and prevention programs based on a public health perspective.

Self- and other-diagnosis in user-led mental health online communities

This article consists of a qualitative analysis of discussion forums in online mental health communities whose members routinely write about diagnosis. The analysis concerns the function of diagnosis from the perspective of personal identity, with particular focus on the status of official diagnosis, as well as community members' discussions of symptoms and psychiatric syndromes that amount to informal diagnosis or consultation. Self-diagnosis sometimes takes the form of recommended "quizzes" and other online quasi-diagnostic tools. Other-diagnosis, in which a third party is discussed by community members, is also considered. We discuss the implications of such online discourse for Internet users themselves as well the challenges for the health and medical professions.

Quand le poker cesse d’être un jeu

Cet article fait état d’une enquête portant sur une communauté électronique de joueurs de poker, qui échangent ensemble en ligne au sujet de leurs pratiques et habitudes de jeu. L’analyse du contenu des échanges qui prennent place dans le forum vise à éclairer le rapport particulier qu’entretiennent ces aspirants joueurs professionnels de poker avec le jeu ainsi que le rôle que joue la fréquentation d’un espace électronique de joueurs en regard du rapport qu’ils entretiennent avec le jeu. L’article montre que la pratique de ces joueurs est pensée comme un parcours, dans lequel on joue maintenant dans le but de s’améliorer pour devenir un jour un joueur gagnant. L’article trace les contours du cadre disciplinaire dans lequel les joueurs envisagent le jeu et se penche sur les principes qui fondent les règles auxquelles ceux-ci disent vouloir s’astreindre en vue de devenir des « joueurs gagnants ». L’analyse révèle en outre la caractère structurant de l’opposition entre « poissons » et « bons joueurs » dans les représentations et discours des joueurs qui fréquentent le forum et montre enfin que la participation à ces échanges permet aux joueurs de se retrouver entre eux, autour d’une même conception marginale du jeu, alors même que leur entourage semble plutôt susceptible de s’inquiéter de leurs habitudes de jeu et du rapport qu’ils entretiennent avec le poker.

Perceived connections between information and communication technology use and mental symptoms among young adults - a qualitative study

Background

Prospective associations have been found between high use of information and communication technology (ICT) and reported mental symptoms among young adult university students, but the causal mechanisms are unclear. Our aim was to explore possible explanations for associations between high ICT use and symptoms of depression, sleep disorders, and stress among young adults in order to propose a model of possible pathways to mental health effects that can be tested epidemiologically.

Methods

We conducted a qualitative interview study with 16 women and 16 men (21-28 years), recruited from a cohort of university students on the basis of reporting high computer (n = 28) or mobile phone (n = 20) use at baseline and reporting mental symptoms at the one-year follow-up. Semi-structured interviews were performed, with open-ended questions about possible connections between the use of computers and mobile phones, and stress, depression, and sleep disturbances. The interview data were analyzed with qualitative content analysis and summarized in a model.

Results

Central factors appearing to explain high quantitative ICT use were personal dependency, and demands for achievement and availability originating from the domains of work, study, social life, and individual aspirations. Consequences included mental overload, neglect of other activities and personal needs, time pressure, role conflicts, guilt feelings, social isolation, physical symptoms, worry about electromagnetic radiation, and economic problems. Qualitative aspects (destructive communication and information) were also reported, with consequences including vulnerability, misunderstandings, altered values, and feelings of inadequacy. User problems were a source of frustration. Altered ICT use as an effect of mental symptoms was reported, as well as possible positive effects of ICT on mental health.

Conclusions

The concepts and ideas of the young adults with high ICT use and mental symptoms generated a model of possible paths for associations between ICT exposure and mental symptoms. Demands for achievement and availability as well as personal dependency were major causes of high ICT exposure but also direct sources of stress and mental symptoms. The proposed model shows that factors in different domains may have an impact and should be considered in epidemiological and intervention studies.

The use of the Internet for counseling the suicidal individual: possibilities and drawbacks

The role of the Internet in facilitating and preventing suicide is reviewed. Two online suicide prevention programs are described: SAHAR in Israel and Befrienders worldwide. Examples are provided of crisis intervention by e-mail. Finally, some caveats are presented based on experiences with crisis intervention by telephone.

Searching for health information online: characteristics of online health seekers

OBJECTIVE

To investigate the use of, and willingness to use, the internet for health information purposes in Ireland, with a particular focus on the demographic and mental health of users and non-users.

METHODS

Data from the Health Research Board National Psychological Wellbeing and Distress Survey were analyzed. This telephone survey included 2711 adults aged 18 years and over living in private households in Ireland. Internet use was measured using three items: past use, use specifically for health information, and willingness to use the internet in the future. Current psychological wellbeing was measured using the 12-item General Health Questionnaire. In addition, mental health problems in the previous year were measured. Sociodemographic variables examined included age, gender, employment status, and education.

RESULTS

Online health-seeking differed significantly by gender, age, employment status, and educational level. A substantial proportion of internet users with poor mental health were found to have searched for health information online. A high willingness to use the internet for health information in the future by non-users was reported.

CONCLUSION

This study has shown that those with mental health problems use the internet to search for health information more often than those who have not experienced such problems. It has also shown that there is still a digital divide in terms of online health seeking, which is influenced by age, gender, education, and employment status. These findings highlight the need to address access, technological, psychological, and perceptual issues that may present barriers to the use of online health seeking.