The survey study conducted by Woods and Scott8 concluded that overall social media use, emotional investment, and nighttime-specific social media use were associated with higher levels of anxiety and depression, lower self-esteem, and poorer sleep quality. Strengths of the study include a large sample size, well-defined target population, and up-to-date information that was gathered in 2016. In addition, the study used evidence-based tools to measure data, including the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale, the Rosenberg Self-esteem Scale, and the Social Integration and Emotional Connection subscale of the Social Media Use Integration Scale. The researchers did not mention any biases in the study. One limitation was the potential language barrier and the level of literacy. Many participants did not speak English as their primary language, and some had poor literacy. Poor understanding of questions from certain participants may have resulted in less accurate data.8 There was a risk for social desirability bias in the study, especially on reporting measures of mood and self-esteem, due to the language support that was given to some participants.8 

The findings from this literature review have practical value for healthcare providers, parents, and teachers who care for the adolescent population. An important role for primary care providers, parents, and teachers includes becoming familiar with the different types of social media outlets and the use of these sites, as well as the length of time spent using social media by the adolescent population they care for. Some of the most popular social media websites for adolescents include Facebook, Snapchat, Twitter, and Instagram. These sites are outlets for adolescents to send and receive different information about themselves to friends as well as strangers. Providers, parents, and teachers should be aware that profiles on these sites are open for the public to see unless there is a privacy setting that is manually chosen. Another important role for providers is to include routine screenings to assess the risk of depression associated with social media use. Tools could be developed to help providers engage in conversations that inquire about online contacts, incidence of being cyberbullied, and assessing the time that adolescents spend on social media.

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The use of social media can have negative consequences on the adolescent population. It is important for healthcare providers, parents, teachers, and the adolescent population to be aware of these effects and to take precautions to prevent depression, decreased self-esteem, and acts of cyberbullying. When precautions and screening are in place, there is a better chance of combating the negative effects of social media. 

Further research is needed to identify adolescents who have a higher risk for negative consequences of social media and to provide strategies that will allow them to avoid or manage those risks. Additional research could also focus on the amount of time that adolescents are invested in their social networking and focus less on how they are using their social networking sites. In addition, further guidance is needed for healthcare providers and parents on the appropriate social media use with adolescents. 

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Jessica Durbin, DNP, FNP-BC, Cristina R. DeNapoles, MSN, FNP, and Hayley Lundeen, MSN, FNP, are affiliated with the Department of Advanced Practice Nursing, College of Health and Human Services, Indiana State University, in Terre Haute.


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