Social media use may play important role in youth suicide, expert says

Editor’s note: This article, originally posted on Oct. 5, 2020, has been republished to include website enhancements.

Digital experiences among adolescents may significantly impact their mental health and well-being, according to a presenter at the American Psychiatric Nurses Association Annual Conference.

Jamie Zelazny, PhD, RN, assistant professor at the University of Pittsburgh School of Medicine, noted that suicide is the second-leading cause of death among individuals aged 10 to 24 years. Further, suicide rates have tripled among youth aged 10 to 14 years, as well as among girls, and suicide rates are significantly higher among African American children younger than 13 years.

Rising suicide rates in these demographic groups have coincided with rising rates of social media use.

“A study published in 2015 found that the threshold for where kids start to have more mental health problems is the 2-hour mark,” Zelazny said during the presentation. “Teens who reported using social media sites more than 2 hours a day were much more likely to report poor mental health outcomes like distress and suicidal ideation. A study done the following year found that problematic internet use resulted in poor mental health outcomes longitudinally, and these were mediated by poor sleep.”

Other study results suggested that social media use among teens is linked to low self-esteem, poor body image and risk-taking behaviors. Moreover, social comparison and cyberbullying have been associated with depression, anxiety and suicidal ideation among adolescents.

In an ongoing pilot study that is part of a larger project to assess the potential of a social media monitoring intervention, Zelazny and colleagues analyzed data of 15 suicidal teens recruited from an intensive outpatient program at Western Psychiatric Hospital in Pennsylvania. The teens participated in three focus groups and completed questionnaires in which they provided feedback on positive and negative consequences of social media use.

Results showed 67% of participants reported feeling worse about their own lives because of social media. Further, 73% felt pressured to post content that boosted their appearance to others, 60% felt pressured to tailor content for popularity and likes and 80% reported being affected by social media drama. However, 73% reported feeling supported on social media through challenges or tough times, 53% felt more connected to their friends’ feelings and 93% felt more connected to their friends’ lives.

Social media risks identified via qualitative interviews included heavy and problematic use; interference with sleep; cyberbullying; exposure to self-harm/suicidal content; inauthenticity/being untrue to oneself; negative upward social comparison; and thwarted belonginess/unmet need to connect to others. Protective factors identified via qualitative interviews included getting support and encouragement from social media; feeling connected to friends; social engagement or encouragement to participate in social interaction; and personal expression or ability to speak freely.

Zelazny noted limitations of the study, including its small sample size and that it consisted of severely ill teens who were receiving treatment in an intensive outpatient program.

“We really have to routinely assess the impact of social media use, and when I say that, I don’t mean we need a special assessment or questionnaire, but to actually think about it when we’re assessing any symptoms that kids are presenting with,” Zelazny said.