Displayed Depression Symptoms on Facebook at Two Time Points: Content Analysis.

BACKGROUND: Depression is a prevalent and problematic mental disorder that often has an onset in adolescence. Previous studies have illustrated that depression disclosures on social media are common and may be linked to an individual's experiences of depression. However, most studies have examined depression displays on social media at a single time point. OBJECTIVE: This study aims to investigate displayed depression symptoms on Facebook at 2 developmental time points based on symptom type and gender. METHODS: Participants were recruited from an ongoing longitudinal cohort study. The content analysis of text-based Facebook data over 1 year was conducted at 2 time points: time 1 (adolescence; age 17-18 years) and time 2 (young adulthood; ages 20-22 years). Diagnostic criteria for depression were applied to each post to identify the displayed depression symptoms. Data were extracted verbatim. The analysis included nonparametric tests for comparisons. RESULTS: A total of 78 participants' Facebook profiles were examined, of which 40 (51%) were male. At time 1, 62% (48/78) of the adolescents had a Facebook profile, and 54% (26/78) displayed depression symptom references with an average of 9.4 (SD 3.1) references and 3.3 (SD 2.3) symptom types. Of the 78 participants, 15 (19%) females and 12 (15%) males displayed depression symptom references; these prevalence estimates were not significantly different by gender (P=.59). At time 2, 35 young adults displayed symptoms of depression with an average of 4.6 (SD 2.3) references and 2.4 (SD 1.3) symptom types. There were no differences in the prevalence of symptoms of depression displayed between males (n=19) and females (n=16; P=.63). CONCLUSIONS: This content analysis study within an ongoing cohort study illustrates the differences in depression displays on Facebook by developmental stage and symptom. This study contributes to a growing body of literature by showing that using social media to observe and understand depression during the emerging adult developmental period may be a valuable approach.

Knowledge, Attitudes, and Practices of Pediatric Long-term Care Facility Staff Regarding Infection Control for Acute Respiratory Infections and Influenza Vaccination.

We surveyed clinical staff and on-site teachers working at pediatric long-term care facilities regarding prevention and control of acute respiratory infections and influenza in staff and residents. We uncovered knowledge gaps, particularly among teachers and clinical staff working <5 years at sites, thereby elucidating areas for targeted staff education.

Ideas for addressing electronic harassment among adolescents attending a video blogging convention.

BACKGROUND: Electronic harassment affects 20-40% of adolescents and has been associated with significant negative outcomes including physical (ex. headache, abdominal pain), psychological (ex. depression, anxiety), and psychosocial (ex. school avoidance) problems. Evidence-based strategies to address electronic harassment are lacking, and few studies have incorporated adolescent input into intervention design. The purpose of this study was to use a novel data collection approach to determine perspectives on electronic harassment intervention and prevention from a targeted group of highly engaged adolescent technology users. METHODS: We conducted a qualitative survey of a purposeful sample of adolescents age 14 to 18 who were attending a video blogger convention in Seattle, Washington. Participants were approached by research staff and asked to read a vignette about an adolescent target of electronic harassment, then write down ideas for helping the target and/or preventing the scenario. Written responses were analyzed using a thematic analysis approach with an iterative comparative method to resolve any code discrepancies. We subsequently categorized codes into thematic code families to reach consensus about significant themes. RESULTS: 67 eligible adolescents completed the survey. 91% of participants were female with a mean age of 15.3 years (SD = 1.3). Code families emerged regarding people who could be involved in responses to electronic harassment: (1) Individuals targeted by electronic harassment, (2) Friends and bystanders, (3) Adults, and (4) Social media websites and policymakers. CONCLUSIONS: Findings demonstrate adolescent technology users' views on several creative strategies to prevent or intervene with electronic harassment. These strategies can be categorized using a socioecological framework, demonstrating potential to address electronic harassment on multiple levels. Many suggested responses involved the target of electronic harassment, rather than the perpetrator; future education efforts may require additional focus on perpetrators for more upstream prevention.

Secret Society 123: Understanding the Language of Self-Harm on Instagram.

PURPOSE: Nonsuicidal self-injury (NSSI) content is present on social media and may influence adolescents. Instagram is a popular site among adolescents in which NSSI-related terms are user-generated as hashtags (words preceded by a #). These hashtags may be ambiguous and thus challenging for those outside the NSSI community to understand. The purpose of this study was to evaluate the meaning, popularity, and content advisory warnings related to ambiguous NSSI hashtags on Instagram. METHODS: This study used the search term "#selfharmmm" to identify public Instagram posts. Hashtag terms co-listed with #selfharmmm on each post were evaluated for inclusion criteria; selected hashtags were then assessed using a structured evaluation for meaning and consistency. We also investigated the total number of Instagram search hits for each hashtag at two time points and determined whether the hashtag prompted a Content Advisory warning. RESULTS: Our sample of 201 Instagram posts led to identification of 10 ambiguous NSSI hashtags. NSSI terms included #blithe, #cat, and #selfinjuryy. We discovered a popular image that described the broader community of NSSI and mental illness, called "#MySecretFamily." The term #MySecretFamily had approximately 900,000 search results at Time 1 and >1.5 million at Time 2. Only one-third of the relevant hashtags generated Content Advisory warnings. CONCLUSIONS: NSSI content is popular on Instagram and often veiled by ambiguous hashtags. Content Advisory warnings were not reliable; thus, parents and providers remain the cornerstone of prompting discussions about NSSI content on social media and providing resources for teens.