Displayed Health Risk Behaviors

Many of the major causes of morbidity and mortality in US adolescents are related to risky health behaviors, such as violence, sexual activity, and substance use. Because SNSs, such as Facebook, give adolescents the opportunity to post information about their personal lives, such as likes, dislikes, and activities, they also present an opportunity for adolescents to display information about risky behaviors, both in text and picture format. These displays are not uncommon; previous research has shown that approximately half of all adolescent SNS profiles contain references to risky health behaviors. A study of older adolescents on Myspace found that 41% of SNS profiles referenced substance use, 24% referenced sex, and 14% referenced violent behavior. There are two ways in which these public displays referencing risk behaviors may present risks to adolescents.

First, many adolescents do not realize that even with privacy settings available on SNSs, once information is posted online, it is often permanent and available for others to view. A previous study found that 75% of adolescents were unaware that online content that has been uploaded cannot be permanently deleted. Future employers, school admissions panels, and other adult role models may be able to view and make judgments based on displayed online information.

A second risk to the public display of health risk behaviors on SNSs is the potential influence these displays could have on other, particularly younger, adolescents. Studies have shown that adolescents often believe SNS references to be accurate, which may influence their own perceptions and actions. It has been postulated that SNSs act as a “superpeer,” combining the influence of traditional media with the power of interpersonal persuasion. It is possible that when adolescents view comments about sexual activity or substance use on another user’s profile that did not result in any negative consequences, this could be a powerful tool of persuasion that results in engagement of those same activities by other adolescents. In addition to influencing the behavior of others, posting information about risky health behaviors may influence others’ opinions about the person displaying the information. For example, using focus groups, Moreno and colleagues found that displayed sexual references on female college students SNS profiles increased the sexual expectations of college men.

Cyberbullying

Cyberbullying is defined as the deliberate use of social media to communicate false, embarrassing, or hostile information about another individual. It can include name calling, spreading rumors, pretending to be someone else, sending unwanted pictures or texts, distributing pictures without consent, making threats, or asking someone to do something sexual. Although cyberbullying can have similar consequences as traditional offline bullying, such as depression and anxiety, there are some unique aspects of cyberbullying that may increase the potential severity of these consequences. For instance, because it occurs online, cyberbullying can occur at any time, not just when face to face. Additionally, given the wide use of SNSs, cyberbullying has the potential to reach a large audience, which can increase the embarrassment factor.

Estimates of the prevalence of cyberbullying range from 6% to 42% in the United States. This large range is likely due to the lack of a standardized definition of cyberbullying; studies that used narrow definitions of behaviors found more narrow ranges of estimates of the behavior. For example, a study of middle school students found that 29.5% of boys and 27.8% of girls have posted a “rude or nasty” comment on an SNS page. Although there are concerns that cyberbullying is a more anonymous form of bullying, one study found that 73% of youth knew the identity of the cyberbully.

It is unclear if the prevalence of cyberbullying varies by gender. One study found that boys were more likely than girls to be perpetrators and girls more likely than boys to be victims of cyberbullying. Another study, however, demonstrated no differences between genders in regards to perpetrators of cyberbullying, although it did find that older female adolescents (10th and 11th graders) were more likely to be victims of cyberbullying than male adolescents of the same age. Despite these unknowns, cyberbullying can have significant psychosocial effects on the victims, including depression, anxiety, social isolation, and even suicide attempts. Several headline cases of suicide in the media have raised awareness and concern about these consequences.

Sexting

The term, sexting , refers to sending, receiving, or forwarding sexually explicit messages or pictures over cell phones, computers, or other digital devices. A recent survey found that 20% of teens have sent or posted nude or seminude photos or videos of themselves. In most cases these photos were intended to be viewed only by a boyfriend or girlfriend. A survey in 2008 revealed, however, that 40% of teens and young adults had been shown a message of a sexual nature that had been intended for someone else. In recent years, there have been news reports about adolescents who have been charged with felony child pornography or juvenile law misdemeanors as a result of sexting messages that reached beyond the intended audience. Other consequences of sexting include emotional distress and school suspensions.

Online Solicitation

Given the anonymity of the Internet and the ease with which identity can be disguised, concerns have been raised about child predators using SNSs to solicit adolescents. A study assessing the online patterns of sexual offenders (both Internet and non-Internet offenders) performed from 2008 to 2009 found that 74.5% of past offenders were unwilling to answer questions about their use of SNSs, even though “none used” was an option. In this same study, those past offenders who did admit to using SNSs named Myspace as the most commonly visited site. Additionally, more than half of the Internet offenders admitted to disguising their identity while online, and 63.3% reported that they initiated conversations about sexual activity during their first contact with a stranger online.

Although a study done in 2008 demonstrated that youth were less likely to be solicited on an SNS compared with in a chat room, the danger is present and measurable. A national survey of 10 to 15 year olds who had used the Internet within the preceding 6 months found that 15% had experienced an unwanted sexual solicitation while online within the past year. Despite concerns about adults soliciting adolescents for sexual activities, however, most recent studies found that sexual solicitation most often occurs between two teenagers instead of between teenagers and adults.

Mental Health and Development

Ask just about any parent of a teenager: adolescence can be a time of high drama, insecurities, and frequent mood swings. The mental health of adolescents is a heavily researched concept; it is unsurprising, then, that the effect of SNSs on adolescent mental health has attracted the attention of researchers.

In 2006, Dutch researchers found that adolescents who had experienced a greater number of positive reactions to their SNS profile also experienced higher self-esteem and satisfaction with their life. Comparably, in 2009, a study of college students in Texas demonstrated that Facebook usage was positively correlated with life satisfaction, social trust, and civic engagement. Epidemiologic studies over the years have repeatedly demonstrated that as the size of users’ social networks increase, so does their overall health. There may be a limit in social network size for this benefit, because research suggests that those with extremely large social networks may have a decrease in the quality of their interactions with others, with superficial engagement substituting for meaningful relationships.

Along with surviving the drama of adolescence, one of the most important milestones in adolescence is the development of an identity, a sense of self with experiences, morals, and beliefs that help guide future decisions. SNSs give adolescents opportunities to explore and shape their identity by choosing what information about themselves to display to the public and how the information they display changes in response to new experiences as well as how it relates to feedback from peers. Additionally, for those adolescents with interests outside the mainstream culture, SNSs provide an outlet for meeting new people with shared interests. These online peer groups may provide adolescents with the support they need to develop an identity that they may not have been able to do offline.

Education and Civic Engagement

At first glance, it may seem strange that Facebook and other SNSs could have any positive effect on education, considering that time spent with social media is time spent not doing homework. Initial studies suggested a correlation between increased usage of Facebook and lower grade point average, contributing to many schools blocking SNSs from being accessible on the schools’ Internet networks. Recent studies have not found any relationship (either positive or negative) between SNS usage and grade point average, however. Additionally, there are many reports of teachers and schools using SNSs as teaching tools to improve interest and adolescent engagement in academic activities. John Chase, a teacher in New York, has created online and multimedia assignments for students that often address topics that are challenging to teach in traditional formats. Examples include assignments designed to improve understanding of dyslexia and those contemplating bullying and suicide ( http://www.classroom20.com/profile/JohnathanChase ). A common use of SNSs in schools is blogging to help increase skills in creative writing.

In addition to directly using SNSs in classroom assignments, these sites can be used as a means of communication between students as well as between students and teachers to discuss homework assignments and projects. These online tools allow for easy collaboration while eliminating the hassle of arranging and organizing meeting times outside of school.

Because of the ease of communicating quickly with large groups of people, SNSs are tools not only for finding help on homework assignments but also for organizing large group events. One feature of SNSs, such as Facebook, is the ability to create groups and events, which can be private or publicly available to others on the site. Many of the existing groups on Facebook are dedicated to political, religious, or community purposes, allowing adolescents to meet people and discuss ideas with others. A national survey of 1000 adolescents and young adults ages 14 to 22 found that those who used the Internet more often were more politically aware and civically engaged compared with those who used the Internet less often. In recent years, there have been anecdotal reports of adolescents using SNSs to organize beneficial activities, ranging from church outings to political campaigns.

Social Capital

The term, social capital , is used in many different ways, with a wide range of definitions. All of these definitions are based on the idea that social networks have value and that individuals can derive benefit from their interactions and relationships with others. Given that SNSs allow individuals to create larger social networks than they could offline, it seems logical that using an SNS could help adolescents build social capital. A study in 2007 found that increased Facebook use was positively correlated with bridging and bonding social capital in college students.

There are several hypothesized ways in which online social networks could bring benefit to adolescents. For instance, SNSs allow adolescents to access health information that they may be too uncomfortable to ask a pediatrician about, and they also allow adolescents with a chronic disease to join online support groups to help them deal with new diagnoses or share stories with others who understand their situation in life. Additionally, SNSs give adolescents the benefit of being able to start and maintain relationships despite physical distance.