Social Media and Adolescents: What Are the Health Risks?
Primary care providers should screen for depression and other health-related risks associated with the use of social media by adolescents.
A search of the literature shows that studies have highlighted the points that social media use is correlated with decreased self-esteem and depression, with a positive correlation as time spent on social media increases.9 The findings from Pantic et al10 are in agreement, as they found that depression in adolescents increases as the amount of time spent on social media increases. The survey findings from Blomfield Neira and Barber7 also indicated that adolescents invested in social media are more likely to have lower self-esteem and a higher depressed mood. Nighttime-specific social media use and emotional investment in social media have been found to be associated with lower self-esteem, poorer sleep quality, and higher levels of anxiety and depression.8 Social media can have a negative health impact on the self-esteem and body image of youth.4 Additionally, social media can have an impact on adolescents through cyberbullying, which can have a detrimental effect on youth.11
Limitations and strengths
The study conducted by Kiracaburn9 was well done and provides valuable information about social media use. The study had a well-defined target population, as well as a large sample size. These features are important because they yield results specific to the target population, prevent error, and control bias.12 The 2016 study was up-to-date and did not note any biases. In addition, the study used evidenced-based tools to collect data, including the Children's Depression Inventory, the Social Media Addiction Scale, and the Rosenberg Self-Esteem Scale. Limitations included that it was a foreign study and included participants from a single city in the Aegean region. It may have been more beneficial to use samples from various cities and even more beneficial to have participants from the United States to get a better representation of US adolescents. Also, as the study used self-reports and quantitative scales, it may have been beneficial to use more detailed, qualitative instruments to provide further evidence.9
The study conducted by Pantic et al10 yielded statistically significant results that concluded that depression could be correlated to the time spent on social media sites in the adolescent population. Statistically significant results strengthen a study's findings because they mean that the results have a low probability that they occur due to chance.12 Confounding factors were taken into account to test the causal relationship between depression and time spent on social media. The study used a valid instrument, the BDI-II-II for depression screening. In addition, the study was up-to-date, conducted in 2012, and did not mention any biases that were encountered. Limitations included a small sample size. The smaller the sample size, the lower the chance of having an accurate representation of the population of interest.12 The study also used foreign participants from Central Serbia. Although, the study did take into account confounding factors, factors of socioeconomic status and physical activity were not considered.10
The strengths of the study conducted by Chapin11 include a large sample size that represented the adolescent population. The study also used a valid instrument, PAPM. This instrument was applied to the adolescent population and used to test cyberbullying. The study was up-to-date and conducted in 2016, and it did not mention any biases that were encountered during the study's conduction. Limitations included a sample that was limited to Pennsylvania adolescents who participated in particular antiviolence programs. In addition, the participants were aware of the topic of the study, which could have skewed the results.11
Richards and colleagues identified a negative impact on self-esteem, well-being, and body image in adolescents with the use of social media.4 The strengths of their systematic review included the use of relevant studies on the impact of social media and the targeted youth population. There was no evidence of bias in the review. A limitation of the review was the range of social media tools included in the studies. Many studies included the social media sites Facebook and MySpace. However, the social media sites popular to adolescents such as Instagram, Pinterest, Twitter, Snapchat, Linkedin, and Google+ were not popular or even developed at the time that the studies were conducted.4
The strengths of the systematic review conducted by Pantic include a concise review on recent research, suggesting a relationship between social networking use and psychiatric disorders.6 The review of studies indicates that prolonged social networking use may be associated with depression and low self-esteem.6 There was no evidence of bias in the conducted review. One limitation of the review is that not all social networking sites are the same. Most of the studies focused on Facebook as the most widely used social networking site. Facebook is based on creating profiles and uploading comments, photos, and videos. Twitter is based on user posting and reading short “tweets.”6
The survey study conducted by Blomfield Neira and Barber7 yielded statistically significant results on the use of social media associated with a lower self-esteem and a higher depressed mood in adolescents. Strengths include a large sample size of high school students and the use of statistical methods and tools to test reliability, relationship, and significance. To measure reliability of the Likert scale, the Cronbach's alpha was used. Pearson's correlation was conducted to measure the strength of the relationship between having a social network profile, social network frequency, and social network adjustment and the indicators of adjustment, which include self-esteem, self-concept, and depressed mood. Analysis of variance (ANOVAs) was conducted to examine the relationship between having a social networking profile and the effect on self-esteem, self-concept, and depressed mood. To test if frequency and investment in social networking is linked to self-esteem, self-concept, and depressed mood, the hierarchical regression was conducted.7 The researchers did not mention any biases that were encountered during the study. One limitation was that the researchers did not establish causality; youth with lower self-esteem and depression could be more prone to invest in social networking than their peers. Another limitation was that the study only included adolescents from Western Australia.7