Social media: the root cause of rising youth self-harm or a convenient scapegoat?

IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Medical Journal of Australia Pub Date : 2024-10-28 DOI:10.5694/mja2.52503
Helen Christensen, Aimy Slade, Alexis E Whitton
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Increased social media use may be a correlate, exacerbating factor, or a consequence of rising trends in youth self-harm, which may have entirely separate causes. Despite its potential negative impacts, social media is also a source of information and support for young people experiencing mental health problems.<span><sup>1</sup></span> Restricting young people's access to social media could impede pathways for help-seeking. This complexity highlights the need for a considered approach.</p><p>Rising self-harm over recent decades coincides with the advent of smartphones. Research shows an 8–11% increase in self-harm among young people,<span><sup>2</sup></span> along with increases in depression and anxiety. This increase became apparent around 2010–12,<span><sup>3</sup></span> affecting those born after 1995 who entered adolescence during the ascendence of social media and smartphones. In his book <i>The anxious generation</i>,<span><sup>3</sup></span> Jonathan Haidt argues that widespread adoption of social media, coupled with overly restrictive parenting practices, is the cause of increasing self-harm, brought about via “a new way of growing up”. Others suggest that sharing of content depicting suicide methods or romanticising self-harm might contribute to an increase in self-harm behaviours through a process of social contagion.<span><sup>4</sup></span> These trends have raised concerns among parents and politicians, leading to calls for restricting access to digital platforms.<span><sup>5</sup></span></p><p>Technological innovations have historically influenced social norms and societal structures, so it is crucial to take these concerns seriously. However, the argument that social media is the cause of rising trends in youth self-harm is relatively weak.</p><p>First, the effect is not universal. Although some studies indicate that rates of anxiety, depression and self-harm have indeed increased among young people, these trends have been disputed by some and may not be universal.<span><sup>6</sup></span> Second, associations are weak in longitudinal studies and meta-analyses. The Black Dog Institute's Future Proofing Study, which followed over 6000 Australian adolescents, revealed only small associations between social media use and future depression,<span><sup>7</sup></span> consistent with other studies.<span><sup>8-11</sup></span> Meta-analyses also report small associations,<span><sup>12, 13</sup></span> suggesting that even if a link exists, it may be too weak to explain population-level youth self-harm trends.</p><p>Third, any explanation for the causal role of social media on self-harm must account for the disproportionate rise in self-harm in young women compared with young men. Some researchers propose that girls use social media more frequently than boys and are more negatively affected by it, but studies suggest that the impact of social media on depression in girls appears too small to be clinically meaningful.<span><sup>14</sup></span> Evidence shows that problematic social media use does not significantly differ in its impact on depression between girls and boys.<span><sup>15</sup></span> Therefore, differences in social media use may not fully explain the greater rise in self-harm among young women.</p><p>Restricting social media may have harmful effects. Although limiting its use may be reasonable for some, complete bans could harm others. Young people facing mental health challenges often turn to online resources to understand their symptoms,<span><sup>16</sup></span> with those experiencing more severe suicidal ideation more likely to seek help online.<span><sup>17</sup></span> Research shows that young people who access self-harm content online are often already engaging in self-harm<span><sup>18</sup></span> and turn to social media seeking support and understanding.<span><sup>19</sup></span> Gender minority youth — individuals whose gender identity differs from their sex assigned at birth — who face high rates of depression, self-harm and suicide, and who face health care discrimination,<span><sup>20</sup></span> rely on social media for mental health resources.<span><sup>21</sup></span> Complete bans could hinder health literacy development and help-seeking behaviours, especially among those at greater risk. Age-restrictions might push young people into using less regulated platforms, while also undermining the responsibility of existing platforms to create safe online communities.</p><p>Focusing solely on social media as the cause of youth mental health issues may obscure critical societal factors. Global challenges, such as violence against women, highlighted by conflicts worldwide and recent attacks in Australia, play a crucial role. Young adults today face significant socio-economic hurdles,<span><sup>22</sup></span> including stagnant income growth, reduced home ownership, and job insecurity. These economic trends can intensify gendered violence, hinder health care access, and increase mental health risks for those with pre-existing vulnerabilities. Climate change weighs heavily on youth, ranking among the top issues affecting their mental health.<span><sup>23</sup></span> Although social media might amplify exposure to these factors (eg, via cyberbullying, excessive negative or harmful content), current data do not definitively support a direct causal link between increased social media use and poorer mental health. In our efforts to understand the drivers of rising youth self-harm, social media cannot become a scapegoat for broader factors that drive mental health problems.</p><p>If there is a causal link between social media and youth self-harm, generative artificial intelligence (AI) could exacerbate the problem. Generative AI poses a substantial risk in the context of social media. Rather than merely sharing information, generative AI can fabricate it, enabling more sophisticated online attacks and creation of explicit content. This can exacerbate the disproportionately negative effects on adolescents, women, and minority groups.<span><sup>24</sup></span> Of particular concern is the ability of generative AI to deliver personalised content and misinformation about self-harm continuously to young users.</p><p>The Box presents our recommendations to better understand the problem. As Australia introduces policies that restrict young people's social media exposure, we must investigate the effect these policies have or do not have. Does government regulation of inappropriate content result in reductions in self-harm? Does restriction of smartphones in schools improve mental health? Does public education around self-harm and online self-harm content<span><sup>26</sup></span> make a difference? Addressing many of these questions is urgent, as a range of initiatives, such as those advocated by the United States Surgeon General's Advisory,<span><sup>27</sup></span> are now being introduced. This is a rare opportunity to identify the extent to which (and for whom) social media has adverse mental health effects.</p><p>Social media is unlikely to be the primary cause of rising mental health problems among young people. Social media amplifies prejudices and attitudes already present in our societies, but it does not create them. Discrimination and inequality increase self-harm risk, regardless of whether they are experienced online or in-person. Young women are subject to major policing of their voices, interests and opinions online, but this reflects broader societal attitudes towards young women, not something unique to social media. Simple solutions to restrict social media are not likely to fix the problem. This would be akin to stopping the flow of toxic chemicals into a river while failing to shut down the factory that causes the pollution. We need to deal with the broader ongoing societal issues of misogyny, violence, racism and discrimination.</p><p>No relevant disclosures.</p><p>Not commissioned; externally peer reviewed.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"221 10","pages":"524-526"},"PeriodicalIF":6.7000,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52503","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Australia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.5694/mja2.52503","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Recent events have reignited debate over whether social media is the root cause of increasing youth self-harm and suicide. Social media is a fertile ground for disseminating harmful content, including graphic imagery and messages depicting gendered violence and religious intolerance. This proliferation of harmful content makes social media an unwelcoming space, especially for women, minority groups, and young people, who are more likely to be targeted by such content, strengthening the narrative that social media is at the crux of a youth mental health crisis.

However, the parallel rise in social media use and youth mental health problems does not imply a causal relationship. Increased social media use may be a correlate, exacerbating factor, or a consequence of rising trends in youth self-harm, which may have entirely separate causes. Despite its potential negative impacts, social media is also a source of information and support for young people experiencing mental health problems.1 Restricting young people's access to social media could impede pathways for help-seeking. This complexity highlights the need for a considered approach.

Rising self-harm over recent decades coincides with the advent of smartphones. Research shows an 8–11% increase in self-harm among young people,2 along with increases in depression and anxiety. This increase became apparent around 2010–12,3 affecting those born after 1995 who entered adolescence during the ascendence of social media and smartphones. In his book The anxious generation,3 Jonathan Haidt argues that widespread adoption of social media, coupled with overly restrictive parenting practices, is the cause of increasing self-harm, brought about via “a new way of growing up”. Others suggest that sharing of content depicting suicide methods or romanticising self-harm might contribute to an increase in self-harm behaviours through a process of social contagion.4 These trends have raised concerns among parents and politicians, leading to calls for restricting access to digital platforms.5

Technological innovations have historically influenced social norms and societal structures, so it is crucial to take these concerns seriously. However, the argument that social media is the cause of rising trends in youth self-harm is relatively weak.

First, the effect is not universal. Although some studies indicate that rates of anxiety, depression and self-harm have indeed increased among young people, these trends have been disputed by some and may not be universal.6 Second, associations are weak in longitudinal studies and meta-analyses. The Black Dog Institute's Future Proofing Study, which followed over 6000 Australian adolescents, revealed only small associations between social media use and future depression,7 consistent with other studies.8-11 Meta-analyses also report small associations,12, 13 suggesting that even if a link exists, it may be too weak to explain population-level youth self-harm trends.

Third, any explanation for the causal role of social media on self-harm must account for the disproportionate rise in self-harm in young women compared with young men. Some researchers propose that girls use social media more frequently than boys and are more negatively affected by it, but studies suggest that the impact of social media on depression in girls appears too small to be clinically meaningful.14 Evidence shows that problematic social media use does not significantly differ in its impact on depression between girls and boys.15 Therefore, differences in social media use may not fully explain the greater rise in self-harm among young women.

Restricting social media may have harmful effects. Although limiting its use may be reasonable for some, complete bans could harm others. Young people facing mental health challenges often turn to online resources to understand their symptoms,16 with those experiencing more severe suicidal ideation more likely to seek help online.17 Research shows that young people who access self-harm content online are often already engaging in self-harm18 and turn to social media seeking support and understanding.19 Gender minority youth — individuals whose gender identity differs from their sex assigned at birth — who face high rates of depression, self-harm and suicide, and who face health care discrimination,20 rely on social media for mental health resources.21 Complete bans could hinder health literacy development and help-seeking behaviours, especially among those at greater risk. Age-restrictions might push young people into using less regulated platforms, while also undermining the responsibility of existing platforms to create safe online communities.

Focusing solely on social media as the cause of youth mental health issues may obscure critical societal factors. Global challenges, such as violence against women, highlighted by conflicts worldwide and recent attacks in Australia, play a crucial role. Young adults today face significant socio-economic hurdles,22 including stagnant income growth, reduced home ownership, and job insecurity. These economic trends can intensify gendered violence, hinder health care access, and increase mental health risks for those with pre-existing vulnerabilities. Climate change weighs heavily on youth, ranking among the top issues affecting their mental health.23 Although social media might amplify exposure to these factors (eg, via cyberbullying, excessive negative or harmful content), current data do not definitively support a direct causal link between increased social media use and poorer mental health. In our efforts to understand the drivers of rising youth self-harm, social media cannot become a scapegoat for broader factors that drive mental health problems.

If there is a causal link between social media and youth self-harm, generative artificial intelligence (AI) could exacerbate the problem. Generative AI poses a substantial risk in the context of social media. Rather than merely sharing information, generative AI can fabricate it, enabling more sophisticated online attacks and creation of explicit content. This can exacerbate the disproportionately negative effects on adolescents, women, and minority groups.24 Of particular concern is the ability of generative AI to deliver personalised content and misinformation about self-harm continuously to young users.

The Box presents our recommendations to better understand the problem. As Australia introduces policies that restrict young people's social media exposure, we must investigate the effect these policies have or do not have. Does government regulation of inappropriate content result in reductions in self-harm? Does restriction of smartphones in schools improve mental health? Does public education around self-harm and online self-harm content26 make a difference? Addressing many of these questions is urgent, as a range of initiatives, such as those advocated by the United States Surgeon General's Advisory,27 are now being introduced. This is a rare opportunity to identify the extent to which (and for whom) social media has adverse mental health effects.

Social media is unlikely to be the primary cause of rising mental health problems among young people. Social media amplifies prejudices and attitudes already present in our societies, but it does not create them. Discrimination and inequality increase self-harm risk, regardless of whether they are experienced online or in-person. Young women are subject to major policing of their voices, interests and opinions online, but this reflects broader societal attitudes towards young women, not something unique to social media. Simple solutions to restrict social media are not likely to fix the problem. This would be akin to stopping the flow of toxic chemicals into a river while failing to shut down the factory that causes the pollution. We need to deal with the broader ongoing societal issues of misogyny, violence, racism and discrimination.

No relevant disclosures.

Not commissioned; externally peer reviewed.

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社交媒体:青少年自残事件增多的根本原因,还是方便的替罪羊?
最近发生的事件再次引发了关于社交媒体是否是导致青少年自残和自杀现象日益增多的根本原因的争论。社交媒体是传播有害内容的沃土,包括描述性别暴力和宗教不容忍的图片和信息。有害内容的泛滥使社交媒体成为一个不受欢迎的空间,尤其是对于女性、少数群体和年轻人来说,他们更有可能成为这些内容的攻击目标,这也加强了社交媒体是青少年心理健康危机的关键所在这一说法。社交媒体使用的增加可能是青少年自残趋势上升的一个相关因素、加剧因素或后果,而这可能有完全不同的原因。1 限制青少年使用社交媒体可能会阻碍他们寻求帮助的途径。近几十年来,自残行为的增加与智能手机的出现不谋而合。研究表明,随着抑郁和焦虑的增加,年轻人自我伤害的比例也增加了 8-11%。这种增长在 2010-12 年间变得明显,3 影响到 1995 年后出生的人,他们在社交媒体和智能手机兴起时进入青春期。乔纳森-海特(Jonathan Haidt)在其著作《焦虑的一代》(The anxious generation)3 中指出,社交媒体的广泛应用,再加上父母过于严格的教育方式,是 "新的成长方式 "导致自残现象日益增多的原因。4 这些趋势引起了家长和政界人士的担忧,他们呼吁限制使用数字平台。5 技术创新历来影响着社会规范和社会结构,因此认真对待这些担忧至关重要。然而,认为社交媒体是导致青少年自残趋势上升的原因的论据相对薄弱。尽管一些研究表明,青少年的焦虑、抑郁和自残率确实有所上升,但这些趋势受到一些人的质疑,而且可能并不具有普遍性。黑狗研究所(Black Dog Institute)的 "面向未来研究"(Future Proofing Study)对 6000 多名澳大利亚青少年进行了跟踪调查,结果显示社交媒体的使用与未来抑郁之间的关联很小,7 这与其他研究结果一致。一些研究人员认为,女孩比男孩更频繁地使用社交媒体,受到的负面影响也更大,但研究表明,社交媒体对女孩抑郁的影响似乎太小,没有临床意义。尽管限制社交媒体的使用对某些人来说是合理的,但完全禁止社交媒体的使用可能会伤害到其他人。面临心理健康挑战的年轻人往往会求助于网络资源来了解自己的症状,16 而那些有更严重自杀倾向的人更有可能在网上寻求帮助。17 研究表明,在网上获取自残内容的年轻人往往已经在进行自残18 ,并转向社交媒体寻求支持和理解。性别少数群体青年--其性别认同与其出生时的性别不同--面临抑郁、自残和自杀的高发 率,并面临医疗歧视,20 他们依靠社交媒体获取心理健康资源。年龄限制可能会迫使年轻人使用监管较少的平台,同时也会削弱现有平台创建安全网络社区的责任。全球面临的挑战,如世界各地的冲突和最近在澳大利亚发生的袭击事件所凸显的暴力侵害妇女行为,都起到了至关重要的作用。
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来源期刊
Medical Journal of Australia
Medical Journal of Australia 医学-医学:内科
CiteScore
9.40
自引率
5.30%
发文量
410
审稿时长
3-8 weeks
期刊介绍: The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.
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