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词条 Digital media use and mental health
释义

  1. Origins

  2. Childhood technology use

  3. Disciplinary Perspectives

     NGOs and educational sector   Technology    Digital anthropology    Digital sociology    Psychology   Psychiatry   Neuroscience 

  4. Treatment considerations

  5. Further reading

  6. References

{{Infobox tool
| name = Digital media use and mental health
| related = Digital sociology, Psychiatry, Digital anthropology, Psychology, Neuroscience, Social media, Technology
| types = social media addiction, gaming disorder, internet addiction disorder
| image = Diverse people using phones.jpeg
| caption = Smartphone usage may affect mental health
}}Digital media use has been complicated by digital media overuse, variously termed digital addictions or digital dependencies. These constructs are biopsychosocial and cultural phenomena, that behave differently in various societies and cultures.[1] They have been under study and analysis for some years,[2] predominantly by psychologists, sociologists, anthropologists and medical experts.[2] Some reviews have considered evidence of benefits of digital media use, stating that current evidence shows "moderate use of digital technology is not intrinsically harmful and may be advantageous in a connected world",[3] however a 2019 systematic review of reviews in the British Medical Journal found no evidence of net health benefits yet proven scientifically.[2]

From a medical perspective, 2019 editor of JAMA Pediatrics, amongst multiple other medical experts, considered that internet addiction may be "a 21st century epidemic",[4] and in 2018 he commented that childhood internet overuse may be a form of "uncontrolled experiment(s) on ... children."[5] Internet addiction has been considered as a diagnosis since the mid 1990s.[6]

A 2014 review of the proposed medical diagnosis of social media addiction considered the exclusion of this diagnosis from the Diagnostic and Statistical Manual of Mental Disorders, pointing to a growing body of evidence that suggested its necessity for consideration as a mental disorder.[7][8] The concept of social media and its relation to addiction has been examined since 2009.[9] However, the use of the English word "addiction" in relation to these phenomena and diagnoses has come under question.[12][10]

Social media has unintentionally altered the ways that children think, interact and develop; in some cases in a positive way, and sometimes in a very negative way.[11][12] While mental health problems have occurred throughout human history, scientists are unclear as to the direct links between social media and mental health outcomes. They appear to depend on the individual, and the social media platform used.[16]

Origins

Founded in current research on the adverse consequences of overusing technology,[13][14] "digital addiction", or "digital dependence" has been used as an overarching phrase to suggest an increasing trend of compulsive behaviour amongst users of technological devices.[1]

Unrestrained use of technological devices may affect developmental, social, mental and physical well-being and result in symptoms akin to other behavioural addictions.[15] Several clinics worldwide now offer treatment for internet addiction disorder,[16][17] and several studies have sought to establish a connection between the use of the internet and patterns of behaviour.[18][19]

A critical review published in the International Journal of Mental Health Addiction in 2018 specifically considered the term "addiction" in relation to overuse of the internet, questioning its suitability as a separate psychiatric entity, or whether it is a manifestation of other psychiatric disorders. They proposed that there is a lack of recognition and consensus on the concept, treatments and diagnoses are difficult, concluding "new media has been subject to such moral panic and thus this serves a historical tradition within societal conception."[20]

Childhood technology use

One review considered "continued concerns about health and developmental/behavioral risks of excessive media use for child cognitive, language, literacy, and social-emotional development, (and) applied (the evidence to) clinical care".[21] Due to the ready availability of multiple technologies to children worldwide, the problem is bi-directional, as taking away digital devices may also have a detrimental effect.[22][23][24]

In regard to childhood technology use, the American Academy of Pediatrics (AAP) developed a Family Media Plan. The intention of such a plan would be to help parents assess and structure their family's use of electronic devices and media more safely.[25] The Canadian Paediatric Society produced a similar guideline. However, a systematic review of reviews published in 2019 commented that these and other national guidelines have been criticised in lacking evidence. They reviewed previous reviews on the issue, concurring that the evidence was of mainly low to moderate quality. However they considered that overall, there is evidence associating sceentime with poorer psychological health including symptoms such as inattention, hyperactivity, low self esteem, and behavioural issues in childhood and adolescence. They did not find evidence for any positive health benefits of screen time. In regard to quality of life, they discussed that "Suchert[26] reported that there was a positive association between screentime and poorer psychological well-being or perceived quality of life in 11/15 studies. Costigan[27] reported a negative association between screentime and perceived health in 4/4 studies.[28]

Disciplinary Perspectives

As awareness of these issues increased, many disciplines continue to work on their mitigation, on improving understanding of the issues, and on potential innovative solutions. The Lancet commission on global mental health and sustainability 2018 report considered benefits and harms of technology, discussing its ethical risks and challenges for those with codified diagnoses and without. It considered the roles of various technologies in mental health, particularly in public education, patient screening, treatment, training/supervision and system improvement. It commented on the specific risks such as cyber-bullying, privacy and confidentiality, potential lawmaker discrimination, and future unintended consequences of the widening digital divide in mental health. It commented that digital media use in healthcare is unregulated in most countries, stating that "policies are needed to guide the safe and effective application of digital technologies in health care."[29]

NGOs and educational sector

The ADDitude magazine online page continues to support those with the known correlated digital dependencies, to those with or without codified diagnoses, as well as providing a United States directory of educational resources for children.[30][31] Similar resources are available from NGOs and other support or advocacy groups operating, including from the American Academy of Child and Adolescent Psychiatry.[32][33] A 2018 OECD report that considered developmental and educational risks of the internet, noting its inherent benefits. It considered that "greater social media use is associated with poorer sleep and mental health", whilst noting the benefits of structured, limited internet use in children and adolescents. It also noted an overall 40% increase in internet use in school age children between 2010 and 2015, and that different OECD nations had marked variations in childhood technology use.[34]

Technology

Various technology firms have implemented changes to mitigate the negative effects of excessive Internet use. In December 2017, Facebook admitted passive consumption of social media could be harmful to mental health, although they said active engagement can have a positive effect. In January 2018, the platform made major changes to increase user engagement.[35] In January 2019, in a far reaching BBC interview with Sir Nick Clegg about mental health and other criticisms of Facebook, the corporation asserted it would do "whatever it takes to make (social media) safer online especially for (young people)." It admitted "heavy responsibilities" to the global community, and invited regulation by governments.[36]

In 2018, Alphabet Inc released an update for Android smartphones, including a dashboard app enabling users to set timers on application overuse.[37] Apple Inc purchased a third party application and then incorporated it as "screen time", promoting it as an integral part of iOS 12.[38] Journalists have questioned the functionality and motivations of both of these interventions from these corporations for users and for parents.[37][39]

Two large investors in Apple Inc in 2018 "believe(d) both the content and the amount of time spent on phones need to be tailored to youths" and called upon Apple Inc to act, prior to regulators and consumers potentially forcing it to. They pointed to multidisciplinary research, especially in the education sector, of "unintentional negative side effects",[40] publishing an open letter in regard to this.[41] Apple Inc responded that they have "always looked out for kids, and (they) work hard to create powerful products that inspire, entertain, and educate children while also helping parents protect them online," planning new features to that they asserted may allow Apple to play a pioneering role in regards to young peoples health.[42] A German technology startup developed an Android phone specifically designed for efficiency and minimizing screen time.[43] News Corp reported multiple strategies for minimizing screen time.[44] Facebook and Instagram announced "new tools" that they consider may assist with dependence on their products.[45]

Digital anthropology

Anthropologists have been exploring "the borderland between anthropology, medicine and psychiatry" for some decades.[46] Professor Daniel Miller, a professor of anthropology at the University College London [47] noted the effects of social media are very specific to individual locations and cultures. He contended that "a layperson might dismiss these stories as superficial. But the anthropologist takes them seriously, empathetically exploring each use of digital technologies in terms of the wider social and cultural context." The University College London offers a free five week course in relation to this, entitled Anthropology of Social Media: Why we Post, as well as offering other free e-books in relation to the issue.[48]

Digital anthropology is a developing field which studies the relationship between humans and digital-era technology. It aims to consider arguments in terms of ethical and societal scopes, rather than simply observing technological changes.[49] Brian Solis, a digital analyst, anthropologist and keynote speaker working in the field, in 2018 stated "we’ve become digital addicts: it's time to take control of technology and not let tech control us."[50]

Digital sociology

Digital sociology, overlapping with digital anthropology and considering cultural geographies, explores "the ways in which people interact with and use digital media using both qualitative methodologies (such as interviews, focus groups and ethnographic research)." It also investigates the various contextualisations of longstanding concerns in relation to young peoples dependence on "these technologies, their access to online pornography, cyber bullying or online sexual predation."[51] A 2012 sociological study in Turkey "revealed that the level of religiosity has a significant effect on the patterns of Internet consumption."[52]

Three journalists from Guardian Media Group discussed the moral panic around screen time in 2018, considering it may be partially attributable to search algorithms, as "Google does not sort search output by quality; it ranks search input by popularity". They commented on the lack of good research into the issue, noting the diversity of technology use, arguing that oversimplifying the concepts "makes meaningful understandings or interventions impossible."[53]

Psychology

A 2015 psychological review concluded there was a link suggested between basic psychological needs and social media addiction. "Social network site users seek feedback, and they get it from hundreds of people—instantly. It could be argued that the platforms are designed to get users “hooked”."[54] Some working in the field of philosophy published that the "excessive use of the internet and its resulting dependence ... (has) negative effects on wellbeing" from a psychological perspective. They considered its possible amelioration by considering ancient Eastern and Western philosophies, suggesting they "may give us inspiration to confront the challenges of technological enslavement in general."[55] Other psychologists considered "arguments in favor of reconsidering the Internet as an environment rather than as a tool, ... (exploring) the Internet's role in cognitive ecology, as well as the inadequacy of treating the Internet as a tool and thus of the current Internet-addiction model."[56]

In the United Kingdom, a study of 1,479 14-24 year olds compared psychological benefits and challenges of the largest five social media platforms: Facebook, Instagram, Snapchat, Twitter and YouTube. It concluded that YouTube was the only platform with a net positive rating "based on the 14 health and wellbeing-related questions", followed by Twitter, Facebook, and Snapchat, with Instagram having the lowest rating. Instagram was considered by the report to have some positive effects such including self expression, self identity, and community, but these were outweighed by its negative effects including on sleep, body image, and "fear of missing out".[57]

Psychiatry

Psychiatric experts have called for further studies to explore psychiatric correlates with digital media use in childhood and adolescence. "Over the past 10 years, the introduction of mobile and interactive technologies has occurred at such a rapid pace that researchers have had difficulty publishing evidence within relevant time frames."[58] A 2019 systematic review confirmed that most prior reviews were of low or moderate quality, suggesting "higher levels of screentime is associated with a variety of health harms (in childhood and adolescence, including) adiposity, unhealthy diet, depressive symptoms and quality of life".[28] Symptoms of ADHD have been positively correlated with digital media use in a large prospective study.[59] The ADHD symptom of hyperfocus may cause affected people to overuse digital media items such as video games or online chatting. [60]

There is preliminary evidence that mental health problems can be effectively treated through interventions delivered digitally, be that online[61][62] or via a smartphone.[63][64]

Neuroscience

Dar Meshi and colleagues noted in 2015 that "Neuroscientists are beginning to capitalize on the ubiquity of social media use to gain novel insights about social cognitive processes."[65] A 2018 neuroscientific review published in Nature commented that this and other evidence "suggests an important interplay between actual social experiences, both offline and online, and brain development." It considered social media is good for "at least the following two important functions: 1. (social connection) with others (the need to belong) and (2.) manag(ing) the impression individuals make on others (reputation building, impression management, and online self-presentation)." It called for further study, considering "adolescence a tipping point in development for how social media can influence their self-concept and expectations of self and others."[66]

Treatment considerations

With the pervasiveness of various technologies across many societies, scientific study into treatments of digital media overuse has increased, however rigorous, evidence-based treatment models are yet to be comprehensively established. This is partially due to lack of consensus around the various definitions of technological overuse.[67] There is some limited evidence into cognitive behavioural therapy, and family based interventions. Medications have not been shown to be effective in randomised controlled trials, and many studies investigated patient cohorts with co-morbid psychiatric conditions.[67] Treatment centres have proliferated in some countries, and China and South Korea have treated it as a public health crisis, with 300 and 190 nationwide centres opened, respectively, in each country.[68]

Further reading

{{refbegin}}
  • {{Cite book|title=Are we all addicts now? : digital dependence|others=Beales, Katriona, MacDonald, Fiona|isbn=9781786940810|location=[Liverpool]|oclc=988053669|last1 = Bartlett|first1 = Vanessa|last2=Bowden-Jones|first2=Henrietta|year=2017}}
  • {{Cite book|title=Irresistible : the rise of addictive technology and the business of keeping us hooked|last=Alter|first=Adam|isbn=9780735222847|location=New York|oclc=990286417|date = 2018-03-06}}
  • {{Cite book|url=https://www.worldcat.org/oclc/988278461|title=Internet addiction in children and adolescents : risk factors, assessment, and treatment|last=Young|first=Kimberly|last2=de Abreu|first2=Cristiano Nabuco |isbn=9780826133731|location=New York, NY|oclc=988278461|year=2017}}
{{refend}}

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{{Digital media use and mental health}}

15 : Social media|Behavioral addiction|Cultural anthropology|Cyberspace|Digital media|Digital technology|Technology in society|Attention deficit hyperactivity disorder|Attention disorders|Childhood psychiatric disorders|Educational psychology|Emotional and behavioral disorders in childhood and adolescence|Learning disabilities|Psychiatric diagnosis|Ailments of unknown cause
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