Objectively measured digital technology use during the COVID-19 pandemic: Impact on depression, anxiety, and suicidal ideation among young adults

2021 ◽  
Author(s):  
Craig Sewall

IntroductionResearch indicates that stressors introduced by the COVID-19 pandemic have negatively impacted mental health, particularly among young people.1 Time spent on digital technology (e.g., social media, smartphones) has also increased2 as schools, workplaces, and social gathering sites have closed, thus intensifying pre-pandemic concerns regarding the putative effects of digital technology use (DTU) on mental health. Indeed, recent academic and newspaper articles have both directly and indirectly asserted that increased DTU is a source of the heightened psychological distress observed during the pandemic.3–5 However, these claims are dubious for two primary reasons. First, these articles rely on self-report measures of DTU, which are inaccurate6 and prone to systematic bias.7 Second, since the pandemic has impacted both mental health and DTU for many, the observed association between the two may be attributable to a shared common cause, rather than causality. Thus, we investigated the longitudinal associations between objectively measured DTU and mental health while accounting for important COVID-19-related effects.MethodsThis study was approved by the University of Pittsburgh and followed Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guidelines. In this four-wave panel study, participants were recruited from Prolific (https://www.prolific.co/), an online participant-recruitment platform. Waves of data collection were launched on August 14, September 12, October 14, and November 9 of 2020. Eligible participants were U.S. residents, 18-35 years old, iPhone users, and had ≥ 10 previous submissions on Prolific with approval rating ≥95%. At each wave, participants uploaded screenshots of their “Screen Time” application (which passively tracks device usage) and completed self-reports of mental health (depression, anxiety, suicidal ideation [SI]), COVID-19-related stressors, and perceived COVID-19-related impact on well-being and DTU (Table 1). We extracted three elements from the “Screen Time” screenshots: (1) total screen time, (2) total time spent on social media, and (3) total number of pickups. We estimated separate random-intercept multilevel models for each mental health outcome using Mplus. Predictors were entered hierarchically in blocks (see eTable 3 in Supplement) to assess ΔR2 at the within- and between-person levels. See Supplement for methodological details. ResultsA total of 384 young adults participated in this study (Mage = 24.5, SDage = 5.1; 57% female; 54% white; 48% Bachelor’s degree education or above). Overall, participants averaged 47.5 hours of Screen Time, 677 pickups, and 15.5 hours of social media over the past week. On average, participants reported experiencing between 4 and 5 pandemic-related stressors per wave. Mean depression and anxiety t-scores were 54.6 and 56.7, respectively, and nearly 29% of participants reported past-week SI at least once. See eTable 1 for summary statistics of sample demographics and primary variables.Results of the multilevel analyses revealed that objectively-measured total screen time and social media use were unrelated to within- or between-person differences in mental health, while between-person difference in pickups was negatively associated with depression (see Figure 1). Together, the objective DTU variables explained, at most, 2.8% of the within- or between-person variance in any of the mental health outcomes (eTable 3 in Supplement). COVID-related impacts on well-being had the largest effects across models—accounting for about 45% and 10%, respectively, of the between- and within-person variance in depression and anxiety, and 21%/28% of the between/within variance in SI. DiscussionAmong a sample of young adults, a population with particularly high rates of DTU8 and COVID-19-related distress,1 we found that objectively-measured DTU did not contribute to increases in depression, anxiety, or SI—refuting the popular notion that increases in DTU may be contributing to young peoples’ psychological distress during the pandemic. Rather, depression, anxiety, and SI were driven mostly by young peoples’ reports of the pandemic’s impact on their well-being. The convenience-based sample, retrospective (past week) assessments of mental health outcomes, and single-item measures of COVID-19-related impacts are limitations of the study. Nevertheless, results indicate that current speculations about the direct harms of DTU on mental health may be unfounded and risk diverting attention from a more likely cause: pandemic-related stressors.

2021 ◽  
Author(s):  
Craig Jeffrey Robb Sewall ◽  
Aidan G.C. Wright

Despite a plethora of research, the link between digital technology use (i.e., smartphones and social media) and psychological distress among young adults remains inconclusive. The relia-bility and validity of findings in this area are typically undermined by common 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, smartphone use frequency, and social media use duration) and three aspects of psychological distress (depression, anxiety, and social isolation) among a sample of young adults (N = 384). We found that the digital technology use -> psychological distress within-person lagged effects, as well as vice versa, were very small (Bs ≤ .10) and non-significant. This study is the first to examine the pro-spective association between objectively-measured digital technology use and psychological distress—providing much-needed clarification into this highly relevant area of research.


2020 ◽  
Vol 8 (3) ◽  
pp. 379-399 ◽  
Author(s):  
Craig J. R. Sewall ◽  
Todd M. Bear ◽  
John Merranko ◽  
Daniel Rosen

Using Apple’s Screen Time application to obtain reported actual iPhone and social media (SM) use, we examined the accuracy of retrospective estimates of usage, how inaccuracies bias associations between use and psychosocial well-being (depression, loneliness, and life satisfaction), and the degree to which inaccuracies were predicted by levels of well-being. Among a sample of 325 iPhone users, we found that (a) participants misestimated their weekly overall iPhone and SM use by 19.1 and 12.2 hours, respectively; (b) correlations between estimated use and well-being variables were consistently stronger than the correlations between reported actual use and well-being variables; and (c) the degree of inaccuracy in estimated use was associated with levels of participant well-being and amount of use. These findings suggest that retrospective estimates of digital technology use may be systematically biased by factors that are fundamental to the associations under investigation. We propose that retrospective estimates of digital technology use may be capturing the construct of perceived use rather than actual use, and discuss how the antecedents, correlates, and consequences of perceived use may be distinct from those of actual use. Implications of these findings are discussed in view of the ongoing debate surrounding the effects of digital technology use on well-being.


2017 ◽  
Vol 8 (5) ◽  
pp. 541-549 ◽  
Author(s):  
B. Davison ◽  
T. Nagel ◽  
G. R. Singh

Mental health is fundamental to an individual’s health and well-being. Mental health disorders affect a substantial portion of the Australian population, with the most vulnerable time in adolescence and young adulthood. Indigenous Australians fare worse than other Australians on almost every measure of physical and mental health. Cross-sectional data from young adults (21–27 years) participating in the Life Course Program, Northern Territory, Australia, is presented. Rates of psychological distress were high in remote and urban residing Indigenous and urban non-Indigenous young adults. This rate was more pronounced in young women, particularly in Indigenous remote and urban residing women. Young adults with high psychological distress also had lower levels of positive well-being, higher perceived stress levels, experienced a higher number of major life events and were at an increased risk of suicidal ideation and/or self-harm. This study supports the need for a continued focus on early screening and treatment at this vulnerable age. The significant association seen between psychological distress and other markers of emotional well-being, particularly risk of suicidal ideation and/or self-harm, highlights the need for a holistic approach to mental health assessment and treatment. A concerted focus on improving the environs of young adults by lowering levels of stress, improving access to adequate housing, educational and employment opportunity, will assist in improving the emotional health of young adults.


2021 ◽  
Author(s):  
Lizzy Winstone ◽  
Becky Mars ◽  
CMA Haworth ◽  
Jon Heron ◽  
Judi Kidger

Background There is mixed evidence as to the effects of different types of social media use on mental health, but previous research has been platform-specific and has focused on an oversimplified distinction between active and passive use. This study aimed to identify different underlying subgroups of adolescent social media user based on their pattern of social media activities and test associations between user type and future mental health. Methods Students from nineteen schools (N=2,456) in south-west England completed an online survey measuring thirteen social media activities and four psychosocial outcomes (past year self-harm, depression, anxiety and poor well-being) at age 13 years (October 2019) and repeated a year later (October 2020; aged 14 years). Latent class analysis using Mplus identified distinct classes of social media user. A bias-adjusted three-step model was used to test associations between class membership at baseline and mental health at follow-up. Analyses were adjusted for gender, ethnicity, sexual orientation, socio-economic status, disability, social media screen-time and baseline mental health.Results A four-class model of social media user at baseline was selected based on fit statistics and interpretability. User types were labelled High Communicators; Moderate Communicators; Broadcasters; and Minimal users. Broadcasters at age 13 had the poorest mental health outcomes at age 14, with mental health and well-being generally better in the two Communicator groups. Conclusions Findings suggest that adolescents with high levels of content sharing – in addition to socialising and browsing online – are most likely to be experiencing poor mental health a year later. Recommendations regarding social media use should move beyond screen-time to consider different user types, and mental health implications of their engagement with different online activities.


2020 ◽  
Author(s):  
David Zendle

Background and AimsThe case for the existence of pathological video game and social media use is often supported by two arguments. First, that excessive usage of these technologies is particularly associated with psychopathological conditions such as depression and anxiety. Second, that specific features of these technologies make them particularly likely to be used to excess. However, it is presently unclear whether this is the case.DesignTwo large scale online surveys were conducted on representative samples of UK adults. The first (n=1430) investigated correlations between psychopathology and excessive engagement in a variety of common leisure pursuits including video gaming and social media use. The second (n=1184) examined whether video games and social media were more likely to be engaged in to excess than other common pursuits.Sample StudiedTwo nationally representative samples of UK adults aged 18+ were recruited via prolific.co, an online panel provider.MeasurementsExcessive engagement in a variety of activities were measured via adaptations of the Internet Gaming Disorder Scale. Depression and anxiety were measured via administration of the PHQ-9 and GAD-7 respectively.FindingsExcessive engagement in all measured activities was linked to both depression and anxiety. All relationships were of a clinically important magnitude. Using IGD criteria, excessive gaming was more prevalent than excessive engagement in other leisure pursuits. It is unclear whether this reflects actual differences in excessive use or limitations of the IGD symptoms. Relationships remained significant when self-criticism was accounted for, but were reduced in magnitude to potentially sub-clinical levels. ConclusionsLinks to psychopathology were similar across a wide variety of activities, suggesting that excessive technology use is not uniquely harmful to mental health. Additionally, the negative effects of excessive technology use on psychopathology are partly explained by self-criticism, highlighting the importance of this factor in the future measurement of behavioural overuse conditions. Using IGD criteria, excessive gaming is more prevalent than excessive engagement in other activities, which may reflect either the special nature of games, or problems with the IGD criteria.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Edge ◽  
Alexandra Newbold ◽  
Thomas Ehring ◽  
Tabea Rosenkranz ◽  
Mads Frost ◽  
...  

Abstract Background Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety. Method/design The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16–24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored. Discussion This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people. Trial registration ClinicalTrials.gov, NCT04950257. Registered 6 July 2021 – Retrospectively registered.


2020 ◽  
Author(s):  
Brittany Joyce Allen ◽  
Zoe Ellen Stratman ◽  
Bradley R. Kerr ◽  
Qianqian Zhao ◽  
Megan A. Moreno

BACKGROUND Transgender, nonbinary, and gender diverse (TNG) youth encounter barriers to psychosocial wellness and also describe exploring identities and communities online. Studies of cisgender youth connect increased digital technology use with loneliness and decreased body image. However, little is known about psychosocial factors associated with digital technology use among TNG compared to cisgender youth. OBJECTIVE Our goal in this study was to examine associations between psychosocial measures and digital technology use for cisgender and TNG youth. METHODS We surveyed a nationally representative sample of adolescents (ages 13-18) about psychosocial wellness and digital technology use. Psychosocial measures included assessment of body image, parental support, loneliness, well-being, and fear of missing out (FOMO). Digital media use assessments included the short Problematic and Risky Internet Use Screening Scale (PRIUSS-3) and the Adolescent Digital Technology Interactions and Importance (ADTI) scale and subscales. The psychosocial outcomes were compared between gender groups while adjusting for age and parent social media use using PROC GLM. Stratified correlations were compared between gender identity groups for parent support, body image, loneliness, well-being, and FOMO compared with ADTI and PRIUSS-3 scores using PROC NLMIXED to compare the regression coefficients of standardized values between gender groups. All comparisons were adjusted for age and parent social media use. RESULTS Among 4575 adolescents, 53 (1.16%) self-identified as TNG youth. TNG youth had lower well-being (23.52 versus 26.78, P<.001), lower parent support (19.57 versus 23.44, P<.001), lower body image (13.72 versus 17.09, P<.001), and higher loneliness scores (9.01 versus 6.59, P<.001) compared to cisgender peers. In a pattern different from cisgender peers, problematic internet use scores for TNG youth correlated positively with body image (0.26 vs. -0.17, P=.003) and well-being (0.33 vs. -0.08, P=.002). Parental support also correlated positively with ADTI 2 scores for TNG youth (0.05), though correlated negatively with ADTI 2 scores for cisgender youth (-0.22, P=.04). CONCLUSIONS Overall, this study supports previous findings that show that TNG youth experience barriers to psychosocial wellness, and adds that this includes loneliness. This study also suggests that the correlation of PIU with both well-being and improved body image shows that PIU may not be unilaterally problematic amongst TNG youth, which may be because of specific digital media affordances that TNG youth engage. Whether this more complicated picture of PIU applies to other minority populations besides TNG youth will be an important area for future research.


This book provides an academically oriented and scientifically based description of how technological advances may have contributed to a wide range of mental health outcomes, covering the spectrum from problems and maladies to improved and expanded healthcare services. Digital technologies covered include internet use (including social networking, shopping, gambling, viewing of pornography, etc.), digital gaming, smartphones, mobile applications, virtual reality, and computer-based therapeutic interventions. Both the positive and negative aspects of these various types of digital technologies are discussed. Further, some chapters include a discussion of future developments in the field. The book has been written by international experts in the applications of digital technology across many countries and quality universities. This book consists of eight sections. The first focuses on digital technology in the general population. The second covers problematic conceptual issues in the impact of technology use. The third discusses potential positive impacts of digital technology. The fourth covers potential negative impacts of digital technologies. The fifth evaluates utilizing digital technologies for assessment and legal considerations. The sixth explores using digital technologies to improve overall well-being. The seventh discusses the use of digital technologies to treat specific disorders, and the eighth presents a discussion on treatments of problematic technology use. The book concludes with a brief summary as well as a discussion of future directions for digital technologies.


Author(s):  
Sophie H. Li ◽  
Joanne R. Beames ◽  
Jill M. Newby ◽  
Kate Maston ◽  
Helen Christensen ◽  
...  

AbstractThere has been significant disruption to the lives and mental health of adolescents during the COVID-19 pandemic. The purpose of this study was to assess the psychological and lifestyle impact of the pandemic on Australian adolescents, using an online survey, administered during the outbreak. Self-report surveys were administered online to a sample of 760 Australian adolescents aged 12–18 years assessing impact on a range of domains including behaviour, education, relationships, lifestyle factors (exercise, technology use, and sleep), and mental health outcomes (psychological distress, loneliness, health anxiety and well-being). Results showed that three quarters of the sample experienced a worsening in mental health, since the pandemic began, with negative impacts reported on learning, friendships and family relationships. There were also high higher levels of sleep disturbance, psychological distress and health anxiety, relative to normative samples. Effects on mental health were worse among those who reported a previous diagnosis of depression and/or anxiety relative to those without no such history. Adolescents are already vulnerable to the onset of mental illness at this developmental stage, and the current research underscores the need to find rapid and accessible ways to support adolescent mental health during times of crisis.


2021 ◽  
Vol 9 ◽  
Author(s):  
Mark A. Bellis ◽  
Catherine A. Sharp ◽  
Karen Hughes ◽  
Alisha R. Davies

Introduction: Population health concerns have been raised about negative impacts from overuse of digital technologies. We examine patterns of online activity predictive of Digital Overuse and Addictive Traits (DOAT). We explore associations between DOAT and mental well-being and analyse how both relate to self-reported changes in self-esteem, perceived isolation, and anxiety about health when individuals use the internet for health purposes.Methods: A cross-sectional nationally representative household survey of adults using stratified random sampling (compliance 75.4%, n = 1,252). DOAT was measured using self-reported questions adapted from a social media addiction scale (failure to cut down use, restlessness when not using, and impact on job/studies and home/social life in the last year), combined into a single DOAT score. Higher DOAT score was defined as &gt;1 standard deviation above population mean. The Short Warwick-Edinburgh Mental Well-being Scale was used to measure mental well-being. Analyses were limited to those with internet access (n = 1,003).Results: Negative impacts of digital technology use on work and home/social lives were reported by 7.4% of respondents. 21.2% had tried but failed to cut down use in the past year. Higher DOAT was associated with higher social media and internet use but also independently associated with greater risks of low mental well-being. Higher DOAT was associated with both improvement and worsening of self-esteem, perceived isolation and anxiety about health when using the internet for health reasons, with no change in these outcomes most likely in those with lower DOAT. Lower mental well-being was associated with a similar bi-directional impact on perceived isolation and was also associated with worsening self-esteem.Conclusions: Substantial proportions of individuals report negative impacts on home, social and working lives from digital technology use, with many trying but failing to cut down use. Individuals with higher DOAT may experience improvements or worsening in self-esteem and other measures of mental well-being when using the internet for health purposes. From a public health perspective, a greater understanding of risk factors for digital overuse, its impacts on well-being and how to reasonably limit use of technology are critical for a successful digital revolution.


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