“This association is strong enough that clinicians could consider
asking their patients with depression and anxiety about multiple
platform use and counseling them that this use may be related to their
symptoms,” said lead author and physician Brian A. Primack, M.D., Ph.D., director of CRMTH and assistant vice chancellor for health and society in Pitt’s Schools of the Health Sciences.
“While we can’t tell from this study whether depressed and anxious
people seek out multiple platforms or whether something about using
multiple platforms can lead to depression and anxiety, in either case
the results are potentially valuable.”
In 2014, Primack and his colleagues sampled 1,787 U.S. adults ages
19 through 32, using an established depression assessment tool and
questionnaires to determine social media use.
The questionnaires asked about the 11 most popular social media
platforms at the time: Facebook, YouTube, Twitter, Google Plus,
Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine and LinkedIn.
Participants who used seven to 11 platforms had 3.1 times the odds
of reporting higher levels of depressive symptoms than their
counterparts who used zero to two platforms. Those who used the most
platforms had 3.3 times the odds of high levels of anxiety symptoms than
their peers who used the least number of platforms. The researchers
controlled for other factors that may contribute to depression and
anxiety, including race, gender, relationship status, household income,
education and total time spent on social media.
Primack, who also is a professor of medicine at Pitt, emphasized that the directionality of the association is unclear.
“It may be that people who suffer from symptoms of depression or
anxiety, or both, tend to subsequently use a broader range of social
media outlets. For example, they may be searching out multiple avenues
for a setting that feels comfortable and accepting,” said Primack.
“However, it could also be that trying to maintain a presence on
multiple platforms may actually lead to depression and anxiety. More
research will be needed to tease that apart.”
Primack and his team propose several hypotheses as to why multi-platform social media use may drive depression and anxiety:
• Multitasking, as would happen when switching between platforms,
is known to be related to poor cognitive and mental health outcomes.
• The distinct set of unwritten rules, cultural assumptions and
idiosyncrasies of each platform are increasingly difficult to navigate
when the number of platforms used rises, which could lead to negative
mood and emotions.
• There is more opportunity to commit a social media faux pas when
using multiple platforms, which can lead to repeated embarrassments.
“Understanding the way people are using multiple social media
platforms and their experiences within those platforms—as well as the
specific type of depression and anxiety that social media users
experience—are critical next steps,” said co-author and psychiatrist
César G. Escobar-Viera, M.D., Ph.D., a postdoctoral research associate
at Pitt’s Health Policy Institute
and at CRMTH. “Ultimately, we want this research to help in designing
and implementing educational public health interventions that are as
personalized as possible.”
A. Everette James, J.D., M.B.A.,
director of Pitt’s Health Policy Institute, is senior author of the
research publication. Additional authors are Ariel Shensa, M.A., Erica
Barrett, Jaime E. Sidani, Ph.D., M.P.H., and Jason Colditz, M.Ed., all
of Pitt.
This research was supported by the National Institutes of Health grant number R01-CA140150.