Youth With Internalizing Conditions Spend More Time on Social Media, Feel Lack of Control Online

Youth with mental illness spend significantly more time on social media than those without, reports a study published today in Nature Human Behavior. However, only youth with internalizing conditions such as depression or anxiety disorders were more likely to feel a lack of control about their social media use or engage in other unhealthy online behaviors.

Luisa Fassi, M.Sc., of the University of Cambridge, and colleagues examined data from 3,340 English youth ages 11 to 19 (50% female) who participated in the 2017 Mental Health of Children and Young People study and identified themselves as using at least one social media site. In addition to completing online surveys, the youth had face-to-face clinical interviews to identify the presence and severity of mental health symptoms. In total, 529 youth in the sample (16%) had a mental illness.

Overall, youth who had a mental illness spent significantly more time on social media weekly than those without (average 2.8 hours versus 1.9 hours, respectively) and were also less satisfied on average with their number of online friends. When looking at subcategories of mental illness, the researchers uncovered additional differences. Youth with an internalizing condition not only spent more time online (around three hours weekly) and were less happy about their online friend count, but they also engaged more frequently in online social comparisons, were more likely to say that social media feedback (e.g., number of likes) impacted their mood, and were more likely to feel lack of control about their time spent online.

Contrary to the researchers’ hypothesis, a lack of control was not a problem among youth with an externalizing condition such as a conduct disorder or attention deficit/hyperactivity disorder. In fact, the only meaningful difference for youth with an externalizing condition relative to youth with no mental illness was that they spent more time online, the researchers wrote.

“The results have implications for clinical practice. Specifically, we find key aspects of social media engagement that could inform the creation of guidelines for patient consultations and early intervention strategies,” Fassi and colleagues continued. Examples would be psychoeducation and behavioral therapies focusing on social comparisons and social media feedback, especially in youth with internalizing symptoms.

For related information, see the Psychiatric News article “Ask Young Patients About Social Media Use.”

(Image: Getty Images/iStock/martin-dm)

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Excessive Crying, Irritability in Infancy Associated With Later Behavioral Problems

Infants who cry excessively (more than 3 hours at least 1 day/week) may be more likely to experience behavioral problems in childhood and adolescence than infants who cry less, suggests a report published yesterday in the Journal of the Academy of Child & Adolescent Psychiatry. Brain scans of these children at age 10 also revealed that the amygdala—a part of the brain involved with assessing threat and regulating emotional responses—was smaller in those who cried excessively and/or were irritable as infants.

“Most infants who cry excessively grow to be healthy, typically developing children, and it remains reasonable to remind parents of the good prognosis,” wrote Sara Sammallahti, Ph.D., of Erasmus MC Sophia Children’s Hospital in the Netherlands and colleagues. “Nonetheless, … our results suggest parent-reported excessive crying should not be simply shrugged off: it could reflect one of the earliest child markers of vulnerability to develop behavioral problems.”

The researchers analyzed data from the Generation R Study cohort, which included 4,751 children born in the Netherlands between 2002 and 2006. As part of the study, parents were asked to report if their three-month-old infants cried excessively by answering yes or no to the question “Has your child ever cried for more than 3 hours a day (24 hours) during the last week?” and/or if the baby was irritable, using the Mother and Baby Scales irritability scale. The parents were also asked to complete the Child Behavior Checklist (CBCL) when the children were 1.5, 3, 6, and 10 years. The CBCL measures internalizing problems (such as anxiety) and externalizing problems (such as aggression). At age 14, the youth completed the Youth Self-Report, which also measures internalizing and externalizing problems in adolescence. The children also underwent a structural brain MRI around the age of 10.

Children who cried excessively in infancy had higher parent-rated internalizing and externalizing problems throughout childhood compared with those who did not cry excessively in infancy; higher infant irritability was also associated with higher parent-rated internalizing and externalizing problems. Similarly, children who cried excessively and/or were more irritable as infants had smaller amygdala volume at 10 years.

“Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and be linked with neurobiological differences in the development of the amygdala,” Sammallahti and colleagues wrote.

They continued, “Neurobiological differences can manifest in crying behavior; however, behavior could also precede neurobiological differences: the experiences of irritable, excessively crying infants could impact structural amygdala development … [O]ur study suggests crying behavior and amygdala development are associated.”

For related information, see the Psychiatric News article “Irritability in Childhood May Point to Teens At High Risk for Suicide.”

(Image: iStock/Milan_Jovic)

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