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Developing Healthy Social Media Practices: An Outpatient Caregiver-Adolescent Group Intervention

DOI:10.1007/s10879-022-09559-2
Authors:
Aubrey Borgen at Central Michigan University
Aubrey Borgen
Sarah E Domoff at Central Michigan University
Sarah E Domoff
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Abstract

Adolescents frequently use social media to connect with peers, develop friendships, and explore their identity. However, some adolescents, particularly those with co-occurring mental health concerns or other vulnerabilities, may experience problems or dysfunction related to their social media use. Navigating online social interactions, regulating one’s own use of social media, and being aware of how content of social media may impact users are important skills that youth need to build in today’s digital age. The purpose of this paper is to describe the rationale for, and components of, a group therapy intervention (Developing Healthy Social Media Practices) for caregivers and their adolescents that seeks to (a) provide psychoeducation about the risks and benefits of social media use; (b) teach youth and their caregivers online social problem solving skills; (c) facilitate caregiver-adolescent communication about online social interactions and other online risks; and (d) promote motivation to change social media practices that youth and their caregivers identify as impacting functioning.
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Journal of Contemporary Psychotherapy
https://doi.org/10.1007/s10879-022-09559-2
example, viewing idealized images, pro-anorexia or pro-
bulimia content, and experiencing negative feedback from
peers about appearance on social media can contribute to
lower self-esteem (Woods & Scott, 2016), greater body dis-
satisfaction (Stronge et al., 2015), and higher self-objecti-
cation (Hanna et al., 2017). Similarly, social media content
that discusses or depicts self-injury may be triggering to
high-risk youth, given its association with suicidal ideation
and history of non-suicidal self-injury (Nesi et al., 2021).
Thus, social media content may dierentially impact youth
depending on their pre-existing mental health concerns or
risk factors.When adolescents use social media (e.g., at or
after bedtime, during mealtime, while completing school-
work) also appears to drive whether outcomes are positive
or negative. For example, recent research suggests that the
link between social media use and depression, poorer well-
being, and other internalizing symptoms could be explained
by disrupted sleep and shorter sleep duration for adolescents
who view social media in the evening (Vernon et al., 2015,
2017). Finally, how adolescents use media (i.e., their moti-
vations for using social media and how they engage with
content) also aects its impact on youth. Adolescents and
young adults who engage in social comparison on social
media (instead of using the platforms to connect with friends
Social media, including social networking sites and applica-
tions, are widely popular among adolescents. The COVID-
19 pandemic has accelerated the use of social media given
that adolescents experienced a marked decrease in face-to-
face social interactions due to school closures and public
health social distancing guidelines. Given the popularity
of social media, research has considered both the positive
and negative aspects of social media engagement. Social
media has been linked to positive outcomes for adolescents,
including relationship formation or maintenance (Lenhart
et al., 2015) and exploration of identity (Uhls et al., 2017).
These positive, or potentially negative, eects depend on
what adolescents view on social media, when they are using
it, and how they are using it .
Determining what adolescents are viewing on social
media is crucial to determining how it will aect them. For
Sarah E. Domo
domof1se@cmich.edu
Aubrey L. Borgen
borge1al@cmich.edu
1 Department of Psychology, Central Michigan University, 101
Sloan Hall Mt. Pleasant, 48859 Michigan, MI, USA
Abstract
Adolescents frequently use social media to connect with peers, develop friendships, and explore their identity. However,
some adolescents, particularly those with co-occurring mental health concerns or other vulnerabilities, may experience
problems or dysfunction related to their social media use. Navigating online social interactions, regulating one’s own use
of social media, and being aware of how content of social media may impact users are important skills that youth need
to build in today’s digital age. The purpose of this paper is to describe the rationale for, and components of, a group
therapy intervention (Developing Healthy Social Media Practices) for caregivers and their adolescents that seeks to (a)
provide psychoeducation about the risks and benets of social media use; (b) teach youth and their caregivers online social
problem solving skills; (c) facilitate caregiver-adolescent communication about online social interactions and other online
risks; and (d) promote motivation to change social media practices that youth and their caregivers identify as impacting
functioning.
Keywords Social media · Body image · Screen time · Smartphone · Problematic media
Accepted: 16 August 2022
© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022
Developing Healthy Social Media Practices: An Outpatient Caregiver-
Adolescent Group Intervention
Aubrey L.Borgen1· Sarah E.Domo1
1 3
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Youth with a history of adverse childhood experiences (ACEs) are more likely to develop risky health behaviors. With the increase of media use in the general population, it is likely that these high-risk youth are developing maladaptive behaviors associated with media use (i.e., problematic media use). The goals of this article are (1) to describe symptoms of problematic media use in high-risk youth and (2) to determine whether ACEs are related to problematic media use in this population. Data were collected through online questionnaires from 348 parents or legal guardians of children ages 5 to 18 years, the majority of whom had been adopted. Parents and guardians reported on the child’s history of ACEs and completed the Problematic Media Use Measure-Short Form (PMUM-SF). Almost half of the participants reported that their child had a history of four or more ACEs (48.9%). Caregivers of foster or adopted children reported more symptoms of problematic media use than those reporting on their biological children. After adjusting for covariates, the number of ACEs predicted problematic media use above and beyond variance explained by demographic factors or screen time amount. Children with a history of ACEs had higher problematic media use compared to children without ACEs.
Online Self-Injury Activities among Psychiatrically Hospitalized Adolescents: Prevalence, Functions, and Perceived Consequences
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The majority of adolescents with psychiatric disorders use social media, engaging in a range of online activities that may confer both risks and benefits. Very little work, however, has examined engagement in online activities related to self-injury among these youth, such as posting about self-injury, viewing self-injury related content, or messaging about self-injury with online or offline friends. This study examined the frequency and types of online self-injury activities in which adolescents engage, perceived functions that these activities serve, and associated risk for self-injurious thoughts and behaviors (SITBs). Participants were 589 psychiatrically-hospitalized adolescents (Mage = 14.88), who completed self-report measures assessing online self-injury activities, perceived functions and consequences of these activities, and SITBs. Results indicated that 43.3% of the sample had engaged in online self-injury activities, that the majority (74.8%) used social networking sites (e.g., Snapchat, Instagram) to do so, and that these activities were significantly more common among sexual and gender minority youth. Adolescents who talked about self-injury with friends met online were more likely to report a history of suicide attempt(s). A latent profile analysis revealed three distinct subgroups of youth based on their perceived functions of engaging in online self-injury activities. Subgroups reporting higher levels of engagement for purposes of identity exploration, self-expression, and aiding recovery were at heightened risk for negative perceived consequences of these activities and reported greater suicidal ideation severity. Findings offer new insights for identifying youth who may be at heightened risk for SITBs in the context of social media use.
Social media use and depression in adolescents: a scoping review
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  • Feb 2020
There have been increases in adolescent depression and suicidal behaviour over the last two decades that coincide with the advent of social media (SM) (platforms that allow communication via digital media), which is widely used among adolescents. This scoping review examined the bi-directional association between the use of SM, specifically social networking sites (SNS), and depression and suicidality among adolescents. The studies reviewed yielded four main themes in SM use through thematic analysis: quantity of SM use, quality of SM use, social aspects associated with SM use, and disclosure of mental health symptoms. Research in this field would benefit from use of longitudinal designs, objective and timely measures of SM use, research on the mechanisms of the association between SM use and depression and suicidality, and research in clinical populations to inform clinical practice.
Addictive phone use and academic performance in adolescents
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  • Sep 2019
Adolescents are among the highest utilizers of Smartphones and social media applications (apps) in the United States. There has been increased concern that youth may become dependent on (“addicted to”) Smartphones, yet limited research has considered excessive use (beyond that of hours of phone use) in adolescents. To address this gap, we measured addictive phone use and its association with academic performance in a sample of 641 adolescents. We found that our measure of addictive phone use (Addictive Patterns of Use scale [APU]) had strong psychometric properties and associated with hours of social media use and media multitasking. Additionally, APU associated with poorer academic performance, over and above hours of school day social media use and social media multitasking during homework. Thus, dependence on Smartphones may be a distinct risk factor for poor academic performance. Longitudinal research should be utilized to confirm our findings and provide evidence for directionality.
The effects of active social media engagement with peers on body image in young women
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This experimental study examined the effects of engaging on social media with attractive female peers on young adult women's body image. Participants were 118 female undergraduate students randomly assigned to one of two experimental conditions. Participants first completed a visual analogue scale measure of state body image and then either browsed and left a comment on the social media site of an attractive female peer (n = 56) or did the same with a family member (n = 62) and then completed a post-manipulation visual analogue scale measure of state body image. A 2 × 2 mixed analysis of variance showed a significant interaction between condition and time. Follow-up t-tests revealed that young adult women who engaged with an attractive peer on social media subsequently experienced an increase in negative body image (dependence-corrected d = 0.13), whereas those who engaged with a family member did not (dependence-corrected d = 0.02). The findings suggest that upward appearance comparisons on social media may promote increased body image concerns in young adult women.
Adolescent Digital Stress: Frequencies, Correlates, and Longitudinal Association With Depressive Symptoms
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Purpose Adolescents are among the most frequent users of social media and are highly attuned to social feedback. However, digital stress, or subjective distress related to social media demands, expectations, and others’ approval and judgment, is understudied in adolescents. Methods We conducted a preliminary investigation of self-reported digital stress and its hypothesized correlates (social media, peer status, and mental health variables) among 680 students (Mage = 14.27, SD = .62; 49.2% female). Results Nearly half of participants reported experiencing digital stress at least “sometimes,” regardless of race or ethnicity; sex differences were small. Digital stress was associated with greater social media use and importance, peer importance, popularity, and all mental health variables. Digital stress was also associated longitudinally with increases in depressive symptoms. Conclusions These preliminary findings suggest the importance of further investigation of digital stress and its effects on adolescent health.
Problematic Media Use and Symptoms of Anxiety and Depression During the Pandemic: An Investigation among Peruvian Adolescents in low- and middle-income Settings
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  • Jul 2021
Problematic media use (PMU), or the excessive use of digital media that hinders an adolescent’s functioning, has gained concerns, especially during the COVID-19 lockdowns. Using a large sample of low-and middle-income youth living in Perú, we examined rates of PMU during early stages of the COVID-19 pandemic including the effects of gender and school grade level. In a subset of the sample with pre-COVID-19 data, we examined whether PMU increased during the pandemic and if anxiety and depression symptoms (pre-COVID-19) predicted an increase in PMU during the pandemic. Results showed that 7.8% of adolescents endorsed higher PMU scores in the “Problematic use” category with older adolescents endorsing higher PMU scores, with similar levels for boys and girls. In the sample with pre-COVID-19 data, main effect models revealed that PMU did not increase overall; however, depression and anxiety symptoms at time 1 significantly predicted higher PMU at time 2 (when controlling for time 1 PMU).
Investigating the association between bullying victimization and suicidal ideation among adolescents: Evidence from the 2017 Youth Risk Behavior Survey
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Background Suicide among adolescents in the United States is the second leading cause of death. Bullying victimization has also been identified as a growing public health concern. Although studies have examined the association between bullying victimization and mental health outcomes, there is a dearth of research investigating the association between bullying victimization and suicidal ideation among adolescents. Objective The objective of this study is to investigate the association between bullying victimization and suicidal ideation among adolescents. Participants and Setting Data for this study came from the 2017 National Youth Risk Behavior Survey. Methods An analytic sample of 14,603 adolescents aged 14–18 years (52 % female) was analyzed using binary logistic regression. Results About 18 % of adolescents experienced suicidal ideation during the past 12 months. About one in ten adolescents (9.1 %) were victims of both school bullying and cyberbullying. Bullying victimization was associated with suicidal ideation whereby, adolescents who experienced both school bullying and cyberbullying victimization had 3.26 times higher odds of experiencing suicidal ideation (AOR = 3.26, p < .001, 95 % CI=3.10-3.43), adolescents who experienced school bullying victimization had 2.15 times higher odds of experiencing suicidal ideation (AOR = 2.15, p < .001, 95 % CI=2.04–2.27), and adolescents who experienced cyberbullying victimization had twice the odds of experiencing suicidal ideation (AOR = 2.00, p < .001, 95 % CI=1.87–2.14). Other factors significantly associated with suicidal ideation include forced sexual intercourse, depressive symptoms, cigarette smoking, alcohol use, cannabis use, and illicit drug use. Conclusion Understanding the association between bullying victimization and suicidal ideation could contribute to early identification of adolescents who may be at risk for suicide.
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