Navigating social media risks, benefits with the teenage patient

In a 2011 survey from the AAP Council on Communications and Media, researchers found that nearly one-fourth of all teenagers access social media sites more than 10 times daily — far more frequently than surveyed parents believed.

The increasing availability of digital technology among teenagers has only compounded this trend: 75% of surveyed teenagers owned smartphones, 25% of whom use them for social media. While social media sites represent crucial components in teenage social and emotional development, clinicians and parents are also concerned about the risks associated with these unsupervised digital communities, including cyberbullying, sexting, online solicitation, and media-related depression.

To address these more concerning aspects of the digital age, Infectious Diseases in Children spoke with Rachel Dawson, DO, MPH, FAAP, an adolescent medicine physician in the department of pediatrics at Baylor Scott & White Health about the ramifications and benefits of social media use in this demographic, as well as what parents can do to prevent negative communication.

How prevalent is social media use among children and teenagers?

Dawson: Social media is now very prevalent with this age group. It’s something that teenagers and even younger kids are getting into, and it becomes their way of communicating with one another. It may be easier for them than face-to-face communication. This has become a way in which they share their lives.

What makes social media so enticing to children of this age?

Dawson: I think the biggest draw is that it is just easier than coming up to someone and actually talking to them. It is much easier to send a message because they are not face to face with someone.

If teenagers are using social media, what are some of the specific psychosocial implications that these children might face?

Dawson: There are many positives to social media use. If they use social media, they can communicate with a larger group of people around their state, their country and the world. They might have a larger group of friends and groups of individuals that they would not necessarily communicate with that they can now communicate with. They may see the world in a different light because they are exposed to new things that they may not be exposed to if they didn’t have access to social media.

In terms of negative aspects, we touched upon face-to-face communication concerns. They may have difficulties picking up the phone and talking to someone or expressing themselves verbally. Sometimes, these kids may not live in a world that is real. They may post things on social media that they wish were real. When they look at it, they may think that this person lives in a world in which they do not. It is a made-up ideal. It can lead to ‘Facebook depression’ or ‘social media depression,’ where users want to do all these things that other people are doing on social media.

In a review you wrote, you mention the dangers of sex trafficking in this age group. Could you tell me about how social media may play a role in this process, and what are some warning signs to look for?

Dawson: Sometimes, sex trafficking can begin with the internet or social media. Because the internet is so accessible, kids may meet people online that they do not know. People can communicate anything online, including fake ages and dishonest intents. Adolescents can be concrete thinkers, meaning that they think of the here and now and not abstractly about the future and what could happen. They might meet someone online and think that the person is who they say they are. They may meet in an unsafe environment or invite people to their home when their parents are not home. The people kids contact could be older individuals that are sex traffickers, and the teenagers don’t know that.

These individuals may seem nice at first. They could start a relationship that seems very naive and not a big deal, but it could eventually lead to situations where they offer them things like shoes and clothes or just a relationship. Some kids like the attention.

I’ve had a couple of patients in my own clinic who started meeting an individual that they met online and they became simple dating relationships. The individual then started asking the teenager to do things for them to prove their love. This is not limited to romantic relationships, though. It could be their friends in school or people they know.

Speaking of negative relationships, can you speak a little on their prevalence, and what are some signs that a child may be a victim of cyberbullying?

Dawson: Cyberbullying is going to be more prevalent now just because of the access we have with the internet. It is much easier to do because they are not going up to somebody’s face and saying these comments directly to them. It can be done anonymously and distributed quickly among a very large group of people. It is a really difficult source to control.

The signs of cyberbullying are similar to the signs of traditional bullying. The child may have stopped excelling in school or started avoiding certain people. Kids who have been cyberbullied are more likely to engage in risky behavior, be involved in drugs or alcohol, skip school, and have low grades and self-esteem. They may even complain of medical problems like headaches or stomachaches because they do not want to go to school. They are two- to 10-times more likely to commit suicide and have mental health issues because they are being bullied.

Parents should encourage their children to actually talk about these things and let them know that if they are having issues with cyberbullying that they are not going to be punished by having their cell phone or computer taken away.

What can parents do if they are concerned about their teen’s social media use?

Dawson: I suggest that parents should be involved in what their children are doing. They should know what social media apps and websites their kids are on and befriend them on these sites. This way, they can monitor what their kids are posting. As much as parents want to trust their children, they are still children and should be protected. If they are not comfortable with that, parents can ask friends or trusted individuals be friends with them on social media.

Talk to your children about what is safe and what is not. Even if you think it should be obvious advice, like not to add someone they do not know on social media, you still want to say that. They should never post anything on social media that might be hurtful to others, post nude photos, post anything that they know they can never take back. You want to make it clear to them that there are expectations on social media and on the internet.

Disclosure: Dawson reports no relevant financial disclosures.