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Suicidality and self-injurious behavior among adolescent social media users at psychiatric hospitalization

Published online by Cambridge University Press:  27 April 2020

Reem M.A. Shafi*
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Rochester, Minnesota, USA
Paul A. Nakonezny
Affiliation:
Department of Psychiatry and Department of Population and Data Sciences, Division of Biostatistics, University of Texas Southwestern Medical Center Dallas, Texas, USA
Magdalena Romanowicz
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Rochester, Minnesota, USA
Aiswarya L. Nandakumar
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Rochester, Minnesota, USA
Laura Suarez
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Rochester, Minnesota, USA
Paul E. Croarkin
Affiliation:
Department of Psychiatry and Psychology, Mayo Clinic Depression Center, Rochester, Minnesota, USA
*
Author for correspondence: Reem M.A. Shafi, MBBS Email: [email protected]

Abstract

Background

The current study sought to examine the relationship between documented social media use and suicidality and self-injurious behaviors in adolescents at the time of psychiatric hospitalization.

Methods

We retrospectively identified adolescents (aged 12-17 years) hospitalized on an inpatient psychiatric unit during 1 year. Abstracted information included documented social media use, demographic variables, documented self-injurious behaviors, the Patient Health Questionnaire-9, and the Suicide Status Form-II. Logistic regression was implemented to examine the effect of social media use on the risk of self-injurious behaviors and suicidality.

Results

Fifty-six adolescents who used social media were identified and matched with 56 non-social media users. Those with reported social media use had significantly greater odds of self-injurious behaviors at admission (odds ratio, 2.55; 95% confidence intervals, 1.17-5.71; P = .02) vs youth without reported social media use. Adolescents with reported social media use also had greater odds of increased suicidal ideation and suicide risk than those with no reported use, but these relationships were not statistically significant.

Conclusions

Social media use in adolescents with a psychiatric admission may be associated with the risk of self-injurious behaviors and could be a marker of impulsivity. Further work should guide the assessment of social media use as part of a routine adolescent psychiatric history.

Type
Original Research
Copyright
© Cambridge University Press 2020

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References

Belfort, EL, Miller, L. Relationship between adolescent suicidality, self-injury, and media habits. Child Adolesc Psychiatr Clin N Am. 2018;27(2):159169.CrossRefGoogle ScholarPubMed
Carson, NJ, Gansner, M, Khang, J. Assessment of digital media use in the adolescent psychiatric evaluation. Child Adolesc Psychiatr Clin N Am. 2018;27(2):133143.CrossRefGoogle ScholarPubMed
Shafi, RMA, Romanowicz, M, Croarkin, PE. #SwitchedOn: a call for assessing social media use of adolescents. Lancet Psychiatry. 2018;5(11):e27.CrossRefGoogle Scholar
Reid Chassiakos, YL, Radesky, J, Christakis, D, Moreno, MA, Cross, C. Children and adolescents and digital media. Pediatrics. 2016;138(5): e20162593; doi: https://doi.org/10.1542/peds.2016-2593.CrossRefGoogle ScholarPubMed
Roser, K, Schoeni, A, Roosli, M. Mobile phone use, behavioural problems and concentration capacity in adolescents: a prospective study. Int J Hyg Environ Health. 2016;219(8):759769.CrossRefGoogle ScholarPubMed
Chiu, CT, Chang, YH, Chen, CC, Ko, MC, Li, CY. Mobile phone use and health symptoms in children. J Formos Med Assoc. 2015;114(7):598604.CrossRefGoogle ScholarPubMed
Yang, SY, Chen, MD, Huang, YC, Lin, CY, Chang, JH. Association between smartphone use and musculoskeletal discomfort in adolescent students. J Community Health. 2017;42(3):423430.CrossRefGoogle ScholarPubMed
Nathan, N, Zeitzer, J. A survey study of the association between mobile phone use and daytime sleepiness in California high school students. BMC Public Health. 2013;13:840.CrossRefGoogle ScholarPubMed
Oberst, U, Wegmann, E, Stodt, B, Brand, M, Chamarro, A. Negative consequences from heavy social networking in adolescents: the mediating role of fear of missing out. J Adolesc. 2017;55:5160.CrossRefGoogle ScholarPubMed
O’Keeffe, GS. Social media: challenges and concerns for families. Pediatr Clin North Am. 2016;63(5):841849.CrossRefGoogle ScholarPubMed
Rafla, M, Carson, NJ, DeJong, SM. Adolescents and the internet: what mental health clinicians need to know. Curr Psychiatry Rep. 2014;16(9):472.CrossRefGoogle ScholarPubMed
Odgers, C. Smartphones are bad for some teens, not all. Nature. 2018;554(7693):432434.CrossRefGoogle ScholarPubMed
Robinson, J, Cox, G, Bailey, E, et al. Social media and suicide prevention: a systematic review. Early Interv Psychiatry. 2016;10(2):103121.CrossRefGoogle ScholarPubMed
Brown, RC, Fischer, T, Goldwich, AD, Keller, F, Young, R, Plener, PL. #cutting: non-suicidal self-injury (NSSI) on Instagram. Psychol Med. 2018;48(2):337346.CrossRefGoogle ScholarPubMed
Sueki, H. The association of suicide-related Twitter use with suicidal behaviour: a cross-sectional study of young internet users in Japan. J Affect Disord. 2015;170:155160.CrossRefGoogle ScholarPubMed
Marchant, A, Hawton, K, Stewart, A, et al. A systematic review of the relationship between internet use, self-harm and suicidal behaviour in young people: the good, the bad and the unknown. PLoS ONE. 2017;12(8):e0181722.CrossRefGoogle ScholarPubMed
Zdanow, C, Wright, B. The representation of self injury and suicide on emo social networking. Afr Sociol Rev. 2012;16:81101.Google Scholar
Cash, SJ, Thelwall, M, Peck, SN, Ferrell, JZ, Bridge, JA. Adolescent suicide statements on MySpace. Cyberpsychol Behav Soc Netw. 2013;16(3):166174.CrossRefGoogle ScholarPubMed
Belfort, EL, Mezzacappa, E, Ginnis, K. Similarities and differences among adolescents who communicate suicidality to others via electronic versus other means: a pilot study. 2012;2:258262.Google Scholar
Moreno, MA, Ton, A, Selkie, E, Evans, Y. Secret Society 123: understanding the language of self-harm on Instagram. J Adolesc Health. 2016;58(1):7884.CrossRefGoogle ScholarPubMed
McDougall, MA, Walsh, M, Wattier, K, et al. The effect of social networking sites on the relationship between perceived social support and depression. Psychiatry Res. 2016;246:223229.CrossRefGoogle ScholarPubMed
Saffran, K, Fitzsimmons-Craft, EE, Kass, AE, Wilfley, DE, Taylor, CB, Trockel, M. Facebook usage among those who have received treatment for an eating disorder in a group setting. Int J Eat Disord. 2016;49(8):764777.CrossRefGoogle Scholar
Stanton, J, Drake af Hagelsrum, E, Stasiak, K. Access to the internet in an acute child and adolescent mental health inpatient unit. Aust N Z J Psychiatry. 2015;49(5):487488.CrossRefGoogle Scholar
Richardson, LP, Ludman, E, McCauley, E, et al. Collaborative care for adolescents with depression in primary care: a randomized clinical trial. JAMA. 2014;312(8):809816.CrossRefGoogle ScholarPubMed
Romanowicz, M, O’Connor, SS, Schak, KM, Swintak, CC, Lineberry, TW. Use of the Suicide Status Form-II to investigate correlates of suicide risk factors in psychiatrically hospitalized children and adolescents. J Affect Disord. 2013;151(2):467473.CrossRefGoogle ScholarPubMed
Vandenbroucke, JP, von Elm, E, Altman, DG, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology. 2007;18(6):805835.CrossRefGoogle ScholarPubMed
Madley-Dowd, P, Hughes, R, Tilling, K, Heron, J. The proportion of missing data should not be used to guide decisions on multiple imputation. J Clin Epidemiol. 2019;110:6373.CrossRefGoogle Scholar
van Buuren, S. Multiple imputation of discrete and continuous data by fully conditional specification. Stat Methods Med Res. 2007;16(3):219242.CrossRefGoogle ScholarPubMed
Benjamini, Y, Hochberg, Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc Series B Stat Methodol. 1995;57:289300.Google Scholar
Nesi, J, Wolff, JC, Hunt, J. Patterns of social media use among adolescents who are psychiatrically hospitalized. J Am Acad Child Adolesc Psychiatry. 2019;58(6):635.e1639.e1.CrossRefGoogle ScholarPubMed
Meshi, D, Tamir, DI, Heekeren, HR. The emerging neuroscience of social media. Trends Cogn Sci. 2015;19(12):771782.CrossRefGoogle ScholarPubMed
Dunbar, RI. Social cognition on the Internet: testing constraints on social network size. Philos Trans R Soc Lond B Biol Sci. 2012;367(1599):21922201.CrossRefGoogle ScholarPubMed
Schurz, M, Radua, J, Aichhorn, M, Richlan, F, Perner, J. Fractionating theory of mind: a meta-analysis of functional brain imaging studies. Neurosci Biobehav Rev. 2014;42:934.CrossRefGoogle ScholarPubMed
Tamir, DI, Mitchell, JP. Disclosing information about the self is intrinsically rewarding. Proc Natl Acad Sci U S A. 2012;109(21):80388043.CrossRefGoogle ScholarPubMed
Fareri, DS, Chang, LJ, Delgado, MR. Computational substrates of social value in interpersonal collaboration. J Neurosci. 2015;35(21):81708180.CrossRefGoogle ScholarPubMed
Fareri, DS, Delgado, MR. Social rewards and social networks in the human brain. Neuroscientist. 2014;20(4):387402.CrossRefGoogle ScholarPubMed
Ruff, CC, Fehr, E. The neurobiology of rewards and values in social decision making. Nat Rev Neurosci. 2014;15(8):549562.CrossRefGoogle ScholarPubMed
Casey, BJ, Oliveri, ME, Insel, T. A neurodevelopmental perspective on the research domain criteria (RDoC) framework. Biol Psychiatry. 2014;76(5):350353.CrossRefGoogle ScholarPubMed
Westlund Schreiner, M, Klimes-Dougan, B, Begnel, ED, Cullen, KR. Conceptualizing the neurobiology of non-suicidal self-injury from the perspective of the Research Domain Criteria Project. Neurosci Biobehav Rev. 2015;57:381391.CrossRefGoogle ScholarPubMed
Na, PJ, Yaramala, SR, Kim, JA, et al. The PHQ-9 Item 9 based screening for suicide risk: a validation study of the Patient Health Questionnaire (PHQ)-9 Item 9 with the Columbia Suicide Severity Rating Scale (C-SSRS). J Affect Disord. 2018;232:3440.CrossRefGoogle Scholar
Nandakumar, AL, Vande Voort, JL, Nakonezny, PA, et al. Psychometric properties of the Patient Health Questionnaire-9 modified for major depressive disorder in adolescents. J Child Adolesc Psychopharmacol. 2019;29(1):3440.CrossRefGoogle ScholarPubMed