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BACKGROUND: Identifying proximal risk factors for suicidal ideation that are modifiable and relevant for adolescents and young adults is critical for suicide prevention. This study used an intensive monitoring approach to examine whether objectively- and subjectively- measured sleep characteristics predict next-day suicidal ideation occurrence and intensity through affective reactivity to interpersonal events in young people at high risk for suicide. METHODS: Participants included 59 (13-23 years; 76% White; 75% female) adolescents and young adults undergoing intensive outpatient program treatment for depression and suicidality. Participants completed daily ratings of suicidal ideation, sleep quality, and affective reactivity to positive and negative interpersonal events for up to 3 months (M = 56 days, SD = 24.13). Actigraphy captured behavioral sleep duration and timing. Multilevel modeling was used to evaluate within-person fluctuations in sleep and affective reactivity as predictors of suicidal ideation, and multilevel mediation tested the indirect effects of sleep on suicidal ideation via affective reactivity to interpersonal events. RESULTS: Results indicate significant indirect effects of objectively measured sleep duration and subjective sleep quality on next-day suicidal ideation via affective reactivity to negative and positive interpersonal events, respectively. Shorter-than-usual sleep predicted the presence and intensity of next-day suicidal ideation via heightened affective reactivity to negative interpersonal events. Worse sleep quality than usual predicted next-day suicidal ideation via reduced affective reactivity to positive interpersonal events. CONCLUSIONS: Affectivity reactivity is a proximal mechanism through which sleep indices may influence risk for suicidal thinking on a daily basis. Findings highlight the utility of targeting sleep and emotion regulation in suicide prevention among adolescents and young adults at high-risk for suicide.
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Distúrbios do Início e da Manutenção do Sono , Suicídio , Adulto Jovem , Adolescente , Feminino , Humanos , Masculino , Ideação Suicida , Suicídio/psicologia , Sono , Actigrafia , Fatores de RiscoRESUMO
BACKGROUND: Youth with bipolar disorder (BD) are at high risk for suicidal thoughts and behaviors and frequently experience interpersonal impairment, which is a risk factor for suicide. Yet, no study to date has examined the longitudinal associations between relationship quality in family/peer domains and suicidal thoughts and behaviors among youth with BD. Thus, we investigated how between-person differences - reflecting the average relationship quality across time - and within-person changes, reflecting recent fluctuations in relationship quality, act as distal and/or proximal risk factors for suicidal ideation (SI) and suicide attempts. METHODS: We used longitudinal data from the Course and Outcome of Bipolar Youth Study (N = 413). Relationship quality variables were decomposed into stable (i.e., average) and varying (i.e., recent) components and entered, along with major clinical covariates, into separate Bayesian multilevel models predicting SI and suicide attempt. We also examined how the relationship quality effects interacted with age and sex. RESULTS: Poorer average relationship quality with parents (ß = -.33, 95% Bayesian highest density interval (HDI) [-0.54, -0.11]) or friends (ß = -.33, 95% HDI [-0.55, -0.11]) was longitudinally associated with increased risk of SI but not suicide attempt. Worsening recent relationship quality with parents (ß = -.10, 95% HDI [-0.19, -0.03]) and, to a lesser extent, friends (ß = -.06, 95% HDI [-0.15, 0.03]) was longitudinally associated with increased risk of SI, but only worsening recent relationship quality with parents was also associated with increased risk of suicide attempt (ß = -.15, 95% HDI [-0.31, 0.01]). The effects of certain relationship quality variables were moderated by gender but not age. CONCLUSIONS: Among youth with BD, having poorer average relationship quality with peers and/or parents represents a distal risk factor for SI but not suicide attempts. Additionally, worsening recent relationship quality with parents may be a time-sensitive indicator of increased risk for SI or suicide attempt.
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Transtorno Bipolar , Ideação Suicida , Adolescente , Teorema de Bayes , Transtorno Bipolar/epidemiologia , Humanos , Análise Multinível , Fatores de Risco , Tentativa de SuicídioRESUMO
BACKGROUND: Suicide is now the 2nd leading cause of death among adolescents and young adults. Social media's influence on youth suicidal risk or attenuation of risk is a novel and rapidly expanding topic of research that requires attention from a broad range of mental health services professionals. We aimed to provide an updated review of social media-related risk and protective factors to youth deliberate-self harm (DSH) to guide mental health services professionals in offering care and support to youth vulnerable to suicide. METHODS: Studies on which primary research was conducted that evaluated young people's use of social media platforms related to DSH were systematically searched via Scopus and identified through expert recommendation and the Association for Computing Machinery's digital library of conference materials. The search focused on the timeframe June 2014 to September 2019, to offer an update since the time the most recent systematic reviews on this topic concluded their literatures searches. Quality was reviewed using the Mixed Methods Appraisal Tool (MMAT). RESULTS: A total of 38 articles were eligible, and 24 articles rated as high quality were included in a narrative review. Of the included articles, 19 explored DSH risk and 8 explored DSH protection. Most articles reported on cross-sectional quantitative or qualitative studies. Opportunities for both risks and benefits were explored, and potential influences of social media use were considered for subgroups of youth who may be especially vulnerable to suicide. CONCLUSIONS: In the relatively short period of review, the association between social media use and youth DSH was tested in population-based studies, offering preliminary evidence for suicide prevention and treatment efforts. Further research is needed to understand the contribution of social media use to youth DSH, particularly among youth most vulnerable to suicidal risk.
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Many academics and pundits contend that social media use is the primary cause of an international youth mental health crisis. However, these claims often rely on correlational evidence, ignoring the confounding effects of developmental, environmental, social, and psychological factors that influence mental health. This oversimplifies the complex etiology of mental health problems. We call for a more nuanced understanding of the role of social media in youth mental health that avoids oversimplification. Additionally, we urge researchers to move beyond vague, narrative-driven verbal theories and encode them into precise, testable causal models. Using simulation techniques and specification curve analyses, we show how misspecified models that ignore these confounding factors can lead to biased conclusions about social media's adverse effects. This simplistic focus on social media use diverts attention from the broader factors contributing to youth mental health problems, hindering the development of effective interventions and support. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Saúde Mental , Mídias Sociais , Humanos , Adolescente , Transtornos Mentais/psicologia , Transtornos Mentais/epidemiologia , NarraçãoRESUMO
There is growing recognition that many people feel the need to regulate their use of the internet and other digital technologies to support their wellbeing. In this study, we used Mozilla Firefox browser telemetry to investigate the role played by various usage factors in desires to regulate time spent online. In particular, we investigated how six metrics pertaining to time spent on the internet, and the diversity and intensity of use, predict participants' (n = 8,094) desires to spend more or less time online. Across all six metrics, we did not find evidence for a relationship between browser usage metrics and participants wanting to spend more or less time online. This finding was robust across various analytical pathways. The study highlights a number of considerations and concerns that need to be addressed in future industry-academia collaborations that draw on trace data or usage telemetry.
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Due to the methodological challenges inherent in studying social media use (SMU), as well as the methodological choices that have shaped research into the effects of SMU on well-being, clear conclusions regarding relationships between SMU and well-being remain elusive. We provide a review of five methodological developments poised to provide increased understanding in this domain: (a) increased use of longitudinal and experimental designs; (b) the adoption of behavioural (rather than self-report) measures of SMU; (c) focusing on more nuanced aspects of SMU; (d) embracing effect heterogeneity; and (e) the use of formal modelling and machine learning. We focus on how these advances stand to bring us closer to understanding relations between SMU and well-being, as well as the challenges associated with these developments.
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Mídias Sociais , HumanosRESUMO
Despite a plethora of research, the link between digital technology use and psychological distress among young adults remains inconclusive. Findings in this area are typically undermined by methodological limitations related to measurement, study design, and statistical analysis. Addressing these limitations, we examined the prospective, within-person associations between three aspects of objectively-measured digital technology use (smartphone use duration and frequency; social media use duration) and three aspects of psychological distress (depression, anxiety, and social isolation) among a sample of young adults (N = 384). Across 81 different model specifications, we found that most within-person prospective effects between digital technology use and psychological distress were statistically non-significant and all were very small-even the largest effects were unlikely to register a meaningful impact on a person's psychological distress. In post hoc subgroup analyses, we found scant evidence for the claim that digital technology use is more harmful for women and/or younger people.
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BACKGROUND: Research suggests that the disruptions introduced by the COVID-19 pandemic have led to increased psychological distress and time spent on digital technology among young people, thus intensifying pre-pandemic concerns regarding the putative effects of digital technology use on mental health. To robustly examine whether increases in digital technology use are associated with increases in psychological distress during the pandemic it is crucial to (1) collect objective data on digital technology use and (2) account for potential confounding caused by pandemic-related stressors. METHODS: We conducted a four-wave panel study of U.S. young adults (N=384; Mage = 24.5 ± 5.1; 57% female) from August-November of 2020. Participants provided screenshots of their iPhone "Screen Time" application and completed measures assessing current mental health status (depression, anxiety, and suicidal ideation) and pandemic-related impacts on well-being. We used random-intercept multilevel models to examine the within- and between-person associations between mental health, objective digital technology use, and pandemic-related stressors. RESULTS: Multilevel analyses revealed that none of the objectively-measured digital technology use variables were positively associated with depression, anxiety, or suicidal ideation at the within- or between-person levels. In contrast, pandemic-related impacts on mental health had by far the largest effects on depression, anxiety, and suicidal ideation. LIMITATIONS: The convenience-based sample and use of single-item measures of pandemic-related impacts are limitations of the study. CONCLUSIONS: Current speculations about the direct harms of digital technology use on mental health may be unfounded and risk diverting attention from a more likely cause: pandemic-related distress.
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COVID-19 , Pandemias , Adolescente , Adulto , Ansiedade/epidemiologia , Depressão/epidemiologia , Tecnologia Digital , Feminino , Humanos , Masculino , SARS-CoV-2 , Ideação Suicida , Adulto JovemRESUMO
There is widespread public and academic interest in understanding the uses and effects of digital media. Scholars primarily use self-report measures of the quantity or duration of media use as proxies for more objective measures, but the validity of these self-reports remains unclear. Advancements in data collection techniques have produced a collection of studies indexing both self-reported and log-based measures. To assess the alignment between these measures, we conducted a pre-registered meta-analysis of this research. Based on 106 effect sizes, we found that self-reported media use correlates only moderately with logged measurements, that self-reports were rarely an accurate reflection of logged media use and that measures of problematic media use show an even weaker association with usage logs. These findings raise concerns about the validity of findings relying solely on self-reported measures of media use.