Debate: Should academics collaborate with digital companies to improve young people's mental health?

Should academics collaborate with social media and gaming companies to identify and reduce mental health impacts on children and young people? While opinions on this question sharply diverge within the academic community, in practice collaboration is already widespread. As digital platforms increasingly dominate the time and attention of many young people and are the source of both considerable concern as well as offering innovative opportunities for beneficial interventions, researchers are recognising the potential for collaboration to accelerate positive impact. However, concerns over the independence and transparency of collaborative research have received little institutional or collective response. Recognising both the promise and the pitfalls, this debate article calls for multidisciplinary deliberation within the academy to support the co-development of clear guidelines on the principles and processes by which collaboration is best undertaken, as well as the basis for ensuring that some research remains independent.

Review: Digital experiences and their impact on the lives of adolescents with pre-existing anxiety, depression, eating and nonsuicidal self-injury conditions - a systematic review.

BACKGROUND: Published systematic reviews provide evidence linking positive and negative digital experiences to adolescent mental health. However, these reviews focus on the general public rather than the digital experiences of adolescents with different pre-existing mental health conditions and so may be limited in their clinical relevance. We review publications relating to anxiety, depression, eating disorders and nonsuicidal self-injury to identify common and condition-specific digital experiences and how these may be implicated in the origins and maintenance of these mental health conditions. METHODS: A systematic literature search using a combination of mental health, digital experience (including social media use), and age of the target population terms was conducted on four databases. Detailed findings from the included studies were summarised using a combination of thematic and narrative methods. RESULTS: Five qualitative and 21 quantitative studies met the eligibility criteria for inclusion (n = 5021). Nine studies included adolescents with depression, one with eating problems, two with nonsuicidal self-injury and 14 with multiple emotional health conditions. The review identified six themes related to the target populations' digital experiences: (a) social connectivity and peer support; (b) escape and/or distraction; (c) social validation and social comparison; (d) accessing/creation of potentially harmful content; (e) cyberbullying; and (f) difficulties with self-regulation during engagement with digital media. CONCLUSIONS: Digital practices of adolescents with pre-existing clinical vulnerabilities are complex and encompass a range of positive and negative experiences, which appear to have common elements across different clinical populations. The literature is currently too limited to identify disorder-specific practices, with too few direct or indirect comparisons between conditions.

Editorial: The role of digital technology in children and young people's mental health - a triple-edged sword?

The rapid expansion of access to, and engagement with, the Internet and digital technology over the past 15 or so years has transformed the social, educational and therapeutic space occupied by children and young people in contemporary society in remarkable ways. First, it has created previously unimaginable opportunities for learning and development and personal exploration and growth. Second, it seems that the very same qualities and characteristics of the Internet that make these positive contributions possible, such as its immediacy, portability, intimacy, unconstrained reach and lack of supervision and regulation of content, has opened children and young people up to a range of serious social, intellectual and mental health risks. Finally, over and above these 'effects', the digital space is increasingly successfully being harnessed for the identification and treatment of mental health problems. Accordingly, the Internet is not so much a double-, as a triple-edged sword, with regard to children's mental health.

Contextualising the link between adolescents' use of digital technology and their mental health: a multi-country study of time spent online and life satisfaction.

BACKGROUND: Evidence on whether the amount of time children spend online affects their mental health is mixed. There may be both benefits and risks. Yet, almost all published research on this topic is from high-income countries. This paper presents new findings across four countries of varying wealth. METHODS: We analyse data gathered through the Global Kids Online project from nationally representative samples of Internet-using children aged 9 to 17 years in Bulgaria (n = 1,000), Chile (n = 1,000), Ghana (n = 2,060) and the Philippines (n = 1,873). Data was gathered on Internet usage on week and weekend days. Measures of absolute (comparable across countries) and relative (compared to other children within countries) time use were constructed. Mental health was measured by Cantril's ladder (life satisfaction). The analysis also considers the relative explanatory power on variations in mental health of children's relationships with family and friends. Analysis controlled for age, gender and family socioeconomic status. RESULTS: In Bulgaria and Chile, higher-frequency Internet use is weakly associated with lower life satisfaction. In Ghana and the Philippines, no such pattern was observed. There was no evidence that the relationship between frequency of Internet use and life satisfaction differed by gender. In all four countries, the quality of children's close relationships showed a much stronger relationship with their life satisfaction than did time spent on the Internet. CONCLUSIONS: Time spent on the Internet does not appear to be strongly linked to children's life satisfaction, and results from one country should not be assumed to transfer to another. Improving the quality of children's close relationships offers a more fruitful area for intervention than restricting their time online. Future research could consider a wider range of countries and links between the nature, rather than quantity, of Internet usage and mental health.

Annual research review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age.

AIMS AND SCOPE: The usage of mobile phones and the internet by young people has increased rapidly in the past decade, approaching saturation by middle childhood in developed countries. Besides many benefits, online content, contact or conduct can be associated with risk of harm; most research has examined whether aggressive or sexual harms result from this. We examine the nature and prevalence of such risks, and evaluate the evidence regarding the factors that increase or protect against harm resulting from such risks, so as to inform the academic and practitioner knowledge base. We also identify the conceptual and methodological challenges encountered in this relatively new body of research, and highlight the pressing research gaps. METHODS: Given the pace of change in the market for communication technologies, we review research published since 2008. Following a thorough bibliographic search of literature from the key disciplines (psychology, sociology, education, media studies and computing sciences), the review concentrates on recent, high quality empirical studies, contextualizing these within an overview of the field. FINDINGS: Risks of cyberbullying, contact with strangers, sexual messaging ('sexting') and pornography generally affect fewer than one in five adolescents. Prevalence estimates vary according to definition and measurement, but do not appear to be rising substantially with increasing access to mobile and online technologies, possibly because these technologies pose no additional risk to offline behaviour, or because any risks are offset by a commensurate growth in safety awareness and initiatives. While not all online risks result in self-reported harm, a range of adverse emotional and psychosocial consequences is revealed by longitudinal studies. Useful for identifying which children are more vulnerable than others, evidence reveals several risk factors: personality factors (sensation-seeking, low self-esteem, psychological difficulties), social factors (lack of parental support, peer norms) and digital factors (online practices, digital skills, specific online sites). CONCLUSIONS: Mobile and online risks are increasingly intertwined with pre-existing (offline) risks in children's lives. Research gaps, as well as implications for practitioners, are identified. The challenge is now to examine the relations among different risks, and to build on the risk and protective factors identified to design effective interventions.

Advancing the understanding of children's digital engagement: responsive methodologies and ethical considerations in psychological research.

Children's perspectives and experiences with digital media (digital engagement for short) are becoming difficult to observe and measure in today's highly multi-faceted, personalized and dynamic media ecosystem. In response, psychologists are developing a host of innovative methods. These may be broadly divided into those which prioritize children's active participation in research and those which develop techniques for passive observation. This article presents a state-of-the-art review of emerging methodologies to highlight the ethical issues that arise, by drawing on the Belmont principles for ethical research. We identify strengths and weaknesses of both participatory and non-participatory methods and recommend ways for future research to harness the potential of child-centered, responsive, and ethical methods.

Dynamic Interplay of Online Risk and Resilience in Adolescence (DIORA): a protocol for a 12-month prospective observational study testing the associations among digital activity, affective and cognitive reactions and depression symptoms in a community sample of UK adolescents.

INTRODUCTION: The impact of digital activity on adolescent mental health has been difficult to assess because of methodological limitations and a lack of strong theory. Dynamic Interplay of Online Risk and Resilience in Adolescence (DIORA) is a longitudinal study designed to address these core limitations and tease apart the reciprocal influences linking digital activity and depression symptoms (hereafter 'depression') over 12 months in middle adolescence. This study will examine whether negative affective and cognitive reactions evoked by risky digital activities increase depression. It will additionally examine whether protective characteristics (eg, self-efficacy) moderate the associations between digital activity and depression. DIORA will also explore the reverse pathways between digital activity and depression, namely whether depression exacerbates negative affective and cognitive reactions and, in turn, increase risky digital activities or, further, whether risks can be mitigated through active management of digital activity and/or reactions that it evokes. Finally, the study will examine whether the effects of digital activity observed for depression contrast with those observed for well-being. METHODS AND ANALYSIS: This is a prospective observational study with three assessment points: baseline (T1), 6 months (T2) and 12 months (T3). We aim to recruit a minimum of 276 adolescents aged between 13 and 14 years from secondary schools in the UK and 1 parent/caregiver/guardian (hereafter, 'parent') for each adolescent. Study questionnaires will be completed online.We will fit a range of models to examine the direct and indirect associations among digital activity, the reactions it evokes, depression and wellbeing, and individual and contextual mediators and moderators drawing on the structural equation modelling framework. ETHICS AND DISSEMINATION: The study was approved by the London School of Economics and Political Science Research Ethics Committee, reference number 249287. The results will be published in peer-reviewed scientific journals and disseminated through presentations, posters and blogs.

Social media and adolescent well-being in the Global South.

Despite the rapid proliferation of digital technologies in the Global South, most academic research on social media and adolescent well-being has primarily focused on the Global North. This review investigates how social media impacts adolescent well-being in the Global South. We first review five regions (Sub-Saharan Africa, Middle East & North Africa, Latin America, China and South & South-East Asia) to highlight the complex ways social media interacts with well-being around the world. We then outline research gaps in the current understanding of the impacts of social media use on adolescent populations in diverse cultural contexts. We finally highlight potential lines of inquiry that future researchers could explore to build a nuanced, contextual perspective of the risks and opportunities of social media use.

GRADE-ADOLOPMENT Process to Develop 24-Hour Movement Behavior Recommendations and Physical Activity Guidelines for the Under 5s in the United Kingdom, 2019.

BACKGROUND: This article summarizes the approach taken to develop UK Chief Medical Officers' physical activity guidelines for the Under 5s, 2019. METHODS: The Grading of Recommendations Assessment, Development and Evaluation (GRADE)-Adaptation, Adoption, De Novo Development (ADOLOPMENT) approach was used, based on the guidelines from Canada and Australia, with evidence updated to February 2018. Recommendations were based on the associations between (1) time spent in sleep, sedentary time, physical activity, and 10 health outcomes and (2) time spent in physical activity and sedentary behavior on sleep outcomes (duration and latency). RESULTS: For many outcomes, more time spent in physical activity and sleep (up to a point) was beneficial, as was less time spent in sedentary behavior. The authors present, for the first time, evidence in GRADE format on behavior type-outcome associations for infants, toddlers, and preschoolers. Stakeholders supported all recommendations, but recommendations on sleep and screen time were not accepted by the Chief Medical Officers; UK guidelines will refer only to physical activity. CONCLUSIONS: This is the first European use of GRADE-ADOLOPMENT to develop physical activity guidelines. The process is robust, rapid, and inexpensive, but the UK experience illustrates a number of challenges that should help development of physical activity guidelines in future.