Harmful compared to what? The problem of gaming and ambiguous causal questions.

BACKGROUND AND AIMS: There has been much concern regarding potential harmful effects of video game-play in the past 40 years, but limited progress in understanding its causal role. This paper discusses the basic requirements for identifying causal effects of video game-play and argues that most research to date has focused upon ambiguous causal questions. METHODS: Video games and mental health are discussed from the perspective of causal inference with compound exposures; that is, exposures with multiple relevant variants that affect outcomes in different ways. RESULTS: Not only does exposure to video games encompass multiple different factors, but also not playing video games is equally ambiguous. Estimating causal effects of a compound exposure introduces the additional challenge of exposure-version confounding. CONCLUSIONS: Without a comparison of well-defined interventions, research investigating the effects of video game-play will be difficult to translate into actionable health interventions. Interventions that target games should be compared with other interventions aimed at improving the same outcomes.

Impact of digital screen media activity on functional brain organization in late childhood: Evidence from the ABCD study.

The idea that the increased ubiquity of digital devices negatively impacts neurodevelopment is as compelling as it is disturbing. This study investigated this concern by systematically evaluating how different profiles of screen-based engagement related to functional brain organization in late childhood. We studied participants from a large and representative sample of young people participating in the first two years of the ABCD study (ages 9-12 years) to investigate the relations between self-reported use of various digital screen media activity (SMA) and functional brain organization. A series of generalized additive mixed models evaluated how these relationships related to functional outcomes associated with health and cognition. Of principal interest were two hypotheses: First, that functional brain organization (assessed through resting state functional connectivity MRI; rs-fcMRI) is related to digital screen engagement; and second, that children with higher rates of engagement will have functional brain organization profiles related to maladaptive functioning. Results did not support either of these predictions for SMA. Further, exploratory analyses predicting how screen media activity impacted neural trajectories showed no significant impact of SMA on neural maturation over a two-year period.

An intensive longitudinal dataset of in-game player behaviour and well-being in PowerWash Simulator.

The potential impacts that video games might have on players' well-being are under increased scrutiny but poorly understood empirically. Although extensively studied, a level of understanding required to address concerns and advise policy is lacking, at least partly because much of this science has relied on artificial settings and limited self-report data. We describe a large and detailed dataset that addresses these issues by pairing video game play behaviors and events with in-game well-being and motivation reports. 11,080 players (from 39 countries) of the first person PC game PowerWash Simulator volunteered for a research version of the game that logged their play across 10 in-game behaviors and events (e.g. task completion) and 21 variables (e.g. current position), and responses to 6 psychological survey instruments via in-game pop-ups. The data consists of 15,772,514 gameplay events, 726,316 survey item responses, and 21,202,667 additional gameplay status records, and spans 222 days. The data and codebook are publicly available with a permissive CC0 license.

Estimating the association between Facebook adoption and well-being in 72 countries.

Social media's potential effects on well-being have received considerable research interest, but much of past work is hampered by an exclusive focus on demographics in the Global North and inaccurate self-reports of social media engagement. We describe associations linking 72 countries' Facebook adoption to the well-being of 946 798 individuals from 2008 to 2019. We found no evidence suggesting that the global penetration of social media is associated with widespread psychological harm: Facebook adoption predicted life satisfaction and positive experiences positively, and negative experiences negatively, both between countries and within countries over time. Nevertheless, the observed associations were small and did not reach a conventional 97.5% one-sided credibility threshold in all cases. Facebook adoption predicted aspects of well-being more positively for younger individuals, but country-specific results were mixed. To move beyond studying aggregates and to better understand social media's roles in people's lives, and their potential causal effects, we need more transparent collaborative research between independent scientists and the technology industry.

A co-produced online cultural experience compared to a typical museum website for mental health in people aged 16-24: A proof-of-principle randomised controlled trial.

OBJECTIVE: We aimed to compare a co-produced online intervention encompassing the diverse human stories behind art and artefacts, named Ways of Being (WoB), with a typical museum website, the Ashmolean (Ash) on negative affect (NA), positive affect (PA) and psychological distress (K10). METHODS: In this parallel group RCT, 463 YP aged 16-24 were randomly assigned, 231 to WoB and 232 to Ash. RESULTS: Over the intervention phase (an aggregate score including all post-allocation timepoints to day-five) a group difference was apparent in favour of WoB for NA (WoB-Ash n=448, NA -0.158, p=0.010) but no differences were detected for PA or K10 and differences were not detected at week six. Group differences in NA in favour of WoB were detected in specific subgroups, e.g. ethnic minorities and males. Across participants (from both groups) mean K10 and NA improved between baseline and six weeks despite increased COVID-19 restrictions. Trial recruitment was rapid, retention high and feedback positive with broad geographical, occupational and ethnic diversity. CONCLUSIONS: Online engagement with arts and culture has the potential to impact on mental health in a measurable way in YP with high unmet mental health needs.

Not All Effects Are Indispensable: Psychological Science Requires Verifiable Lines of Reasoning for Whether an Effect Matters.

To help move researchers away from heuristically dismissing "small" effects as unimportant, recent articles have revisited arguments to defend why seemingly small effect sizes in psychological science matter. One argument is based on the idea that an observed effect size may increase in impact when generalized to a new context because of processes of accumulation over time or application to large populations. However, the field is now in danger of heuristically accepting all effects as potentially important. We aim to encourage researchers to think thoroughly about the various mechanisms that may both amplify and counteract the importance of an observed effect size. Researchers should draw on the multiple amplifying and counteracting mechanisms that are likely to simultaneously apply to the effect when that effect is being generalized to a new and likely more dynamic context. In this way, researchers should aim to transparently provide verifiable lines of reasoning to justify their claims about an effect's importance or unimportance. This transparency can help move psychological science toward a more rigorous assessment of when psychological findings matter for the contexts that researchers want to generalize to.

Time spent playing video games is unlikely to impact well-being.

Video games are a massively popular form of entertainment, socializing, cooperation and competition. Games' ubiquity fuels fears that they cause poor mental health, and major health bodies and national governments have made far-reaching policy decisions to address games' potential risks, despite lacking adequate supporting data. The concern-evidence mismatch underscores that we know too little about games' impacts on well-being. We addressed this disconnect by linking six weeks of 38 935 players' objective game-behaviour data, provided by seven global game publishers, with three waves of their self-reported well-being that we collected. We found little to no evidence for a causal connection between game play and well-being. However, results suggested that motivations play a role in players' well-being. For good or ill, the average effects of time spent playing video games on players' well-being are probably very small, and further industry data are required to determine potential risks and supportive factors to health.

Windows of developmental sensitivity to social media.

The relationship between social media use and life satisfaction changes across adolescent development. Our analyses of two UK datasets comprising 84,011 participants (10-80 years old) find that the cross-sectional relationship between self-reported estimates of social media use and life satisfaction ratings is most negative in younger adolescents. Furthermore, sex differences in this relationship are only present during this time. Longitudinal analyses of 17,409 participants (10-21 years old) suggest distinct developmental windows of sensitivity to social media in adolescence, when higher estimated social media use predicts a decrease in life satisfaction ratings one year later (and vice-versa: lower estimated social media use predicts an increase in life satisfaction ratings). These windows occur at different ages for males (14-15 and 19 years old) and females (11-13 and 19 years old). Decreases in life satisfaction ratings also predicted subsequent increases in estimated social media use, however, these were not associated with age or sex.

No effect of different types of media on well-being.

It is often assumed that traditional forms of media such as books enhance well-being, whereas new media do not. However, we lack evidence for such claims and media research is mainly focused on how much time people spend with a medium, but not whether someone used a medium or not. We explored the effect of media use during one week on well-being at the end of the week, differentiating time spent with a medium and use versus nonuse, over a wide range of different media types: music, TV, films, video games, (e-)books, (digital) magazines, and audiobooks. Results from a six-week longitudinal study representative of the UK population 16 years and older (N = 2159) showed that effects were generally small; between-person relations but rarely within-person effects; mostly for use versus nonuse and not time spent with a medium; and on affective well-being, not life satisfaction.

Use of online cultural content for mental health and well-being during COVID-19 restrictions: cross-sectional survey.

AIMS AND METHOD: To gain a deeper understanding of the use of online culture and its potential benefits to mental health and well-being, sociodemographic characteristics and self-reported data on usage, perceived mental health benefits and health status were collected in an online cross-sectional survey during COVID-19 restrictions in the UK in June-July 2020. RESULTS: In total, 1056 people completed the survey. A high proportion of participants reported finding online culture helpful for mental health; all but one of the benefits were associated with regular use and some with age. Reported benefits were wide-ranging and interconnected. Those aged under 25 years were less likely to be regular users of online culture or to have increased their use during lockdown. CLINICAL IMPLICATIONS: There may be benefits in targeting cultural resources for mental health to vulnerable groups such as young adults.

A cultural experience to support mental health in people aged 16-24 during the COVID-19 pandemic compared to a typical museum website: study protocol of an online randomised controlled trial.

BACKGROUND: Despite the high prevalence of common mental disorders in adolescents and young adults, and their association with poor health and socio-economic outcomes throughout the lifespan, many young people do not seek or receive help for such disorders. There is growing interest in the community sector in supporting mental health in young people; however, there is little by way of experimental research in this area. During the COVID-19 pandemic and lockdown, we designed an online cultural experience to reduce anxiety and depression and support mental health in people aged 16-24. METHODS/DESIGN: The O-ACE POP (Online Active Community Engagement Proof of Principle) study is a UK-based online randomised controlled trial of an online cultural experience named Ways of Being, involving human centred narratives and viewpoints, compared with a typical museum website (the Ashmolean Museum). We aim to compare efficacy on  affect,  symptoms of epression and anxiety, flourishing and loneliness as well as investigating potential mechanisms of action. DISCUSSION: The COVID-19 pandemic has provided a unique opportunity to design an innovative approach to supporting mental health in young adults. Findings derived from this study will allow us to evaluate the efficacy of this intervention and will inform the design of studies to further refine the resource and test it further. TRIAL REGISTRATION: ClinicalTrials.gov NCT04663594. Registered on 11 December 2020 (submitted in same form 27 November 2020). Protocol v1.0: 27 November 2020. Date recruitment began: 4 December 2020. Recruitment complete (estimate): February 2021.

Video game play is positively correlated with well-being.

People have never played more video games, and many stakeholders are worried that this activity might be bad for players. So far, research has not had adequate data to test whether these worries are justified and if policymakers should act to regulate video game play time. We attempt to provide much-needed evidence with adequate data. Whereas previous research had to rely on self-reported play behaviour, we collaborated with two games companies, Electronic Arts and Nintendo of America, to obtain players' actual play behaviour. We surveyed players of Plants vs. Zombies: Battle for Neighborville and Animal Crossing: New Horizons for their well-being, motivations and need satisfaction during play, and merged their responses with telemetry data (i.e. logged game play). Contrary to many fears that excessive play time will lead to addiction and poor mental health, we found a small positive relation between game play and affective well-being. Need satisfaction and motivations during play did not interact with play time but were instead independently related to well-being. Our results advance the field in two important ways. First, we show that collaborations with industry partners can be done to high academic standards in an ethical and transparent fashion. Second, we deliver much-needed evidence to policymakers on the link between play and mental health.

There is no evidence that associations between adolescents' digital technology engagement and mental health problems have increased.

Digital technology is ubiquitous in modern adolescence, and researchers are concerned that it has negative impacts on mental health that, furthermore, increase over time. To investigate if technology is becoming more harmful, we examined changes in associations between technology engagement and mental health in three nationally representative samples. Results were mixed across types of technology and mental health outcomes: Technology engagement had become less strongly associated with depression in the past decade, but social media use more strongly associated with emotional problems. We detected no changes in five other associations, or differential associations by gender. There is therefore little evidence for increases in the associations between adolescents' technology engagement and mental health. Information about new digital media has been collected for a relatively short time; drawing firm conclusions about changes in their associations with mental health may be premature. We urge transparent and credible collaborations between scientists and technology companies.

Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science.

The coronavirus disease 2019 (COVID-19) pandemic is having a profound effect on all aspects of society, including mental health and physical health. We explore the psychological, social, and neuroscientific effects of COVID-19 and set out the immediate priorities and longer-term strategies for mental health science research. These priorities were informed by surveys of the public and an expert panel convened by the UK Academy of Medical Sciences and the mental health research charity, MQ: Transforming Mental Health, in the first weeks of the pandemic in the UK in March, 2020. We urge UK research funding agencies to work with researchers, people with lived experience, and others to establish a high level coordination group to ensure that these research priorities are addressed, and to allow new ones to be identified over time. The need to maintain high-quality research standards is imperative. International collaboration and a global perspective will be beneficial. An immediate priority is collecting high-quality data on the mental health effects of the COVID-19 pandemic across the whole population and vulnerable groups, and on brain function, cognition, and mental health of patients with COVID-19. There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19. Discovery, evaluation, and refinement of mechanistically driven interventions to address the psychological, social, and neuroscientific aspects of the pandemic are required. Rising to this challenge will require integration across disciplines and sectors, and should be done together with people with lived experience. New funding will be required to meet these priorities, and it can be efficiently leveraged by the UK's world-leading infrastructure. This Position Paper provides a strategy that may be both adapted for, and integrated with, research efforts in other countries.

Teenage sleep and technology engagement across the week.

BACKGROUND: Throughout the developed world, adolescents are growing up with increased access to and engagement with a range of screen-based technologies, allowing them to encounter ideas and people on a global scale from the intimacy of their bedroom. The concerns about digital technologies negatively influencing sleep are therefore especially noteworthy, as sleep has been proven to greatly affect both cognitive and emotional well-being. The associations between digital engagement and adolescent sleep should therefore be carefully investigated in research adhering to the highest methodological standards. This understood, studies published to date have not often done so and have instead focused mainly on data derived from general retrospective self-report questionnaires. The value of this work has been called into question by recent research showing that retrospective questionnaires might fail to accurately measure these variables of interest. Novel and diverse approaches to measurement are therefore necessary for academic study to progress. METHODS: This study analyses data from 11,884 adolescents included in the UK Millennium Cohort Study to examine the association between digital engagement and adolescent sleep, comparing the relative effects of retrospective self-report vs. time-use diary measures of technology use. By doing so, it provides an empirical lens to understand the effects of digital engagement both throughout the day and before bedtime and adds nuance to a research area primarily relying on retrospective self-report. RESULTS: The study finds that there is a small negative association relating digital engagement to adolescent sleep both on weekdays and weekend days (median standardized association ßweekday = -0.06 and ßweekend = -0.03). There is a more negative association between digital engagement and total sleep time on weekdays compared to weekend days (median standardized ßweekday = -0.08, median standardized ßweekend = -0.02), while there is no such difference when examining adolescents' bedtime. Surprisingly, and contrary to our expectations, digital technology use before bedtime is not substantively associated with the amount of sleep and the tardiness of bedtime in adolescents. CONCLUSIONS: Results derived from the use of transparent Specification Curve Analysis methods show that the negative associations in evidence are mainly driven by retrospective technology use measures and measures of total time spent on digital devices during the day. The effects are overall very small: for example, an additional hour of digital screen time per day was only related to a 9 min decrease in total time spent sleeping on weekdays and a 3 min decrease on weekends. Using digital screens 30 min before bed led to a 1 min decrease in total time spent sleeping on weekdays and weekends. The study shows that more work should be done examining how to measure digital screen time before interventions are designed.

How Much Is Too Much? Examining the Relationship Between Digital Screen Engagement and Psychosocial Functioning in a Confirmatory Cohort Study.

OBJECTIVE: Previous studies have offered mixed results regarding the link between digital screen engagement and the psychosocial functioning of young people. In this study, we aimed to determine the magnitude of this relation, to inform the discussion regarding whether amount of digital screen time has a subjectively significant impact on the psychosocial functioning of children and adolescents. METHOD: We analyzed data from primary caregivers participating in the National Survey of Children's Health (NSCH), an annual nationally representative survey fielded by the US Census Bureau between June 2016 and February 2017. NSCH uses an address-based sampling frame and both Web- and paper-based data collection instruments to measure psychosocial functioning and digital engagement, including a modified version of the Strengths and Difficulties questionnaire and caregiver estimates of daily television- and device-based engagement, respectively. RESULTS: The expected parabolic inverted-U-shaped relationship linking digital screen engagement to psychosocial functioning was found. These results replicated past findings suggesting that moderate levels of screen time (1-2 hours a day) were associated with slightly higher levels of psychosocial functioning compared to lower or higher levels of engagement. Furthermore, it indicated that children and adolescents would require 4 hours 40 minutes of television-based engagement and 5 hours 8 minutes of daily device-based engagement before caregivers would be able to notice subjectively significant variations in psychosocial functioning. CONCLUSION: The possible influence of digital screen engagement is likely smaller and more nuanced than we might expect. These findings do not rule out the possibility that parents might only notice very high levels of screen time when their child manifests pronounced psychosocial difficulties. Future work should be guided by transparent and confirmatory programs of research.

Social media's enduring effect on adolescent life satisfaction.

In this study, we used large-scale representative panel data to disentangle the between-person and within-person relations linking adolescent social media use and well-being. We found that social media use is not, in and of itself, a strong predictor of life satisfaction across the adolescent population. Instead, social media effects are nuanced, small at best, reciprocal over time, gender specific, and contingent on analytic methods.