Social Media Use and Self-Injurious Thoughts and Behavior: A Systematic Review and Meta-Analysis

• In Event: New Advances in the Study of Adolescents’ Social Media Use: Theoretical and Empirical Perspectives

Abstract

The role of social media in mental health concerns has been the source of considerable public and scholarly debate. Given that rising rates of self-injurious thoughts and behaviors (SITBs) have coincided with the widespread adoption of social media sites (e.g., Facebook, Instagram, Twitter), researchers have begun to investigate a potential link between these phenomena. Some studies suggest that social media use may be associated with greater risk of SITBs, due to potential displacement of in-person interactions, experiences of cybervictimization, or exposure to SITB-related content. On the other hand, some studies find small or no associations between social media use and SITBs, or suggest positive outcomes (i.e., increased social support) of use.

The number of studies examining social media use has increased exponentially in recent years. However, there has been no prior systematic review of studies of social media use and SITBs. Thus, the purpose of this meta-analysis was twofold: 1) to provide a comprehensive overview of the current landscape of research on social media use (i.e., any social media-related behavior or experience) and SITBs, i.e., suicidal ideation (SI), suicide plans, suicide attempts, and nonsuicidal self-injury (NSSI), and 2) to examine the association between social media use and SITBs, as well as potential moderators (e.g., age, gender) of this association.

A systematic search of the literature was conducted in PsycINFO, MEDLINE, and CINAHL on August 12, 2020, with search results limited to English-language and peer-reviewed publications. This was supplemented by a search of the references of prior reviews. Study authors were contacted for more information as needed. All procedures were pre-registered on PROSPERO (#CRD42020182002).

A final set of 65 articles was included in the review. Separate pooled effect sizes were estimated within random-effects models for the association between each SITB outcome and any social media-related construct for which two or more unique effects were identified: cybervictimization, cyberbullying, exposure to/generating SITB-related content, frequency of social media use, problematic/addictive social media use, social media importance, and sexting. The majority of identified studies examined cybervictimization, with significant associations between cybervictimization and SI (OR = 2.81, 95% CI = 2.34 – 3.38, p < .001), plans (OR = 3.07, 95% CI = 2.18 – 4.34, p < .001), attempts (OR = 3.22, 95% CI = 2.50 – 4.14, p < .001), and NSSI (OR = 4.36, 95% CI = 2.32 – 8.20, p < .001). In meta-regression analyses evaluating potential moderators, the associations of cybervictimization with SI and attempts, respectively, were stronger for adolescents than for adults. Fewer studies emerged in other social media use categories. However, in general, significant associations emerged between SITBs and cyberbullying perpetration, SITB-related social media use, and problematic/addictive use. Notably, associations were not significant between frequency of use and SITB outcomes. Overall, findings clarify the relations between social media use and SITBs and highlight the moderating role of age in the link between cybervictimization and SI and attempts. Future research that examines a broader range of social media behaviors and experiences is warranted.

Authors

• Jacqueline Nesi, Brown University
  Presenting Author

• Taylor Burke, Brown University
  Non-Presenting Author

• Alexandra H. Bettis, Vanderbilt University Medical Center
  Non-Presenting Author

• Anastacia Kudinova, Brown University
  Non-Presenting Author

• Heather MacPherson, Brown University
  Non-Presenting Author

• Elizabeth C. Thompson, Brown University
  Non-Presenting Author

• Kara Anne Fox, University of North Carolina at Chapel Hill
  Non-Presenting Author

• Hannah R. Lawrence, McLean Hospital
  Non-Presenting Author

• Sarah A. Thomas, Brown University
  Non-Presenting Author

• Jennifer Wolff, Brown University
  Non-Presenting Author

• Melanie Altemus, Brown University
  Non-Presenting Author

• Sheiry Soriano, Brown University
  Non-Presenting Author

• Richard Liu, Massachusetts General Hospital
  Non-Presenting Author