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Centers for Disease Control and Prevention. (2019). Youth risk behavior surveillance system (YRBSS) . Centers for Disease Control and Prevention. https://www.cdc.gov/healthyyouth/data/yrbs/index.htm Key Takeaway The Youth Risk Behavior Surveillance System (YRBSS) measures health-related behaviors and experiences that can lead to death and disability among youth and adults. Results help monitor health trends, identify emerging issues, and plan and evaluate programs that can help improve adolescent health. What is the Youth Risk Behavior Surveillance System? The Youth Risk Behavior Surveillance System (YRBSS) is a set of surveys that track behaviors that can lead to poor health in students grades 9 through 12. The surveys are administered every other year. Some of the health-related behaviors and experiences monitored are: Student demographics: sex, sexual identity, race and ethnicity, and grade Youth health behaviors and conditions: sexual, injury and violence, bullying, diet and physical activity, obesity, and mental health, including suicide Substance use behaviors: electronic vapor product and tobacco product use, alcohol use, and other drug use Student experiences: parental monitoring, school connectedness, unstable housing, and exposure to community violence a group of teens Data are also collected on sex and sexual orientation. The survey is anonymous, and no identifying data are collected.

What is the purpose of YRBSS? The YRBSS was designed to: Determine how often unhealthy behaviors occur Assess whether unhealthy behaviors increase, decrease, or stay the same over time Provide data at the national, state, territorial and freely associated state, tribal, and local levels Provide data comparing different groups of adolescents Monitor progress toward achieving the Healthy People Objectives and other program goals Why is YRBSS important? YRBS results help monitor adolescent health behavior changes over time, identify emerging issues, and plan and evaluate programs to support the health of youth. YRBS data are used by health departments, educators, lawmakers, doctors, and community organizations to inform school and community programs, communications campaigns, and other efforts. For more information on why these data are so important, check out Why YRBS? What are the components of the YRBSS?

The YRBSS is a system of surveys. It includes: A national survey, called the Youth Risk Behavior Survey (YRBS), conducted by CDC that includes high school students from both private and public schools within the U.S. Surveys conducted by departments of health and education at the state, tribal, territorial, or local levels of their respective public high school students From 1991 through 2021, the YRBSS has collected data from more than 5 million high school students in more than 2,200 separate surveys. Gordon, M. S., & Christine McCauley Ohannessian. (2023). Social Media Use and Early Adolescents’ Academic Achievement: Variations by Parent-Adolescent Communication and Gender. Youth & Society . https://doi.org/10.1177/0044118x231180317 Abstract Research investigating social media use typically focus on late adolescents and young adults, despite a growing number of early adolescents, 93% to 97%—having at least one social media platform. Also, early adolescents are more likely to engage with newer sites, such as Snapchat and Instagram, than older platforms such as Facebook and Twitter. Given the evolving landscape of social media, the present study examines the impact of the use of various social media platforms, along with its moderating effects, on adolescents’ academic achievement, using a sample of N = 1,459 early adolescents. Results were such that, as frequency of use on each platform: Facebook, Twitter, Instagram, and Snapchat increased, academic achievement decreased. Specific to interaction effects, frequent use of Facebook and Instagram and early adolescents’ academic achievement were moderated by motheradolescent communication; while gender moderated the association between

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frequent use of Twitter and Snapchat and early adolescents’ academic achievement. Implications are discussed. Knispel, S. (2020, September 24). Getting fewer “likes” on social media can make teens anxious and depressed . NewsCenter. https://www.rochester.edu/newscenter/getting-fewer-likes- on-social-media-can-make-teens-anxious-and-depressed-453482/ Lack of positive feedback can decrease adolescents’ feelings of self-worth, multi-institutional study finds. Simply not getting enough validation on social media can increase depression and anxiety, especially in the most vulnerable populations for whom these platforms may contribute to a cycle of rejection. That’s according to a new paper published in Child Development that explores the psychological effects of receiving insufficient positive feedback online. Led by researchers at the University of Texas at Austin, a multi-institutional team, including two University of Rochester psychologists, employed an experimental social media task over three studies. The team found that teenagers who received few “likes” during a standardized social media interaction felt more strongly rejected, and reported more negative thoughts about themselves. Study participants were told they were helping test drive a new social media program that allowed them to create a profile and interact with same-age peers by viewing and liking other people’s profiles. The “likes” received were tallied, and a ranking of the various

profiles displayed them in order of most to least liked. In reality, these “likes” were assigned by computer scripts. “Up to now, many people thought that social rejection was just a fact of life for adolescents, but that it didn’t really matter. This research demonstrates otherwise”—coauthor Harry Reis, a professor of psychology and the Dean’s Professor in Arts, Sciences & Engineering Participants were randomly assigned to receive either few “likes” or many “likes” relative to the other displayed profiles. In a post-task questionnaire, students in the fewer-“likes” group reported more feelings of rejections and other negative emotions than those who received more “likes.” “So much of the research on social media and mental health uses survey methods, but we know that correlation does not guarantee causation,” says study coauthor David Yeager, an associate professor of psychology at UT Austin. “This study is an important scientific advance because it uses an experiment, and it shows that not getting enough ‘likes’ actually causes adolescents to reduce their feelings of self- worth.” Study participants were notified after the study that the “likes” they had received were random. “Up to now, many people thought that social rejection was just a fact of life for adolescents, but that it didn’t really matter. This research demonstrates otherwise,” says coauthor Harry Reis, a professor of psychology and the Dean’s Professor in Arts, Sciences & Engineering

at Rochester. Rochester associate professor of psychology Jeremy Jamieson was also part of the team. A second study using the same experimental task found that adolescents with the strongest negative reaction to receiving insufficient “likes” were also more likely to experience symptoms of depression and had higher sensitivity to daily stressors. According to coauthor Chris Beevers, a professor of psychology at UT Austin who leads the Institute for Mental Health Research, adolescents who feel less self-worth are at higher risk for depression. “Feedback from peers is an important source of information that shapes how adolescents view themselves.” A third study showed that students who had been victimized by their peers at school had the most negative reactions to receiving fewer “likes” and also had the greatest propensity to attribute this lack of “likes” to flaws in their own character. Developmental psychologists know that social status comes into sharp focus during the teenage years of human development, and adolescents are acutely aware of their relative popularity even in the absence of explicitly negative feedback. “This study helps us understand the power of peer approval and social status during adolescence,” says the study’s lead author Hae Yeon Lee, who is now a postdoctoral researcher at Stanford University.

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The authors note that social media has the potential to exacerbate feelings of rejection and inadequacy in adolescents, because those who rank lowest on the popularity hierarchy may come to social media hoping to receive the validation denied to them in their daily lives—only to experience the same disappointment of not measuring up to their peers. “These results are striking, in part, because the adolescents aren’t getting bullied or harassed; they’re just not getting ‘liked’ as much as they want to be,” Yeager says. “And that’s leading them to show symptoms of depression.” Mahon, C., & Hevey, D. (2021). Processing Body Image on Social Media: Gender Differences in Adolescent Boys’ and Girls’ Agency and Active Coping. Frontiers in Psychology , 12 (12). https://doi.org/10.3389/fpsyg.2021.626763 Discussion Some participants, particularly girls, reported that they felt social media negatively influenced their body image perceptions. Aligning with the literature, adolescents reported that appearance-focused activities like photo sharing/editing practices and appearance comparisons with celebrities, social media influencers, and peers led to feelings of body dissatisfaction (Edcoms and Credos, 2016; Rodgers and Melioli, 2016; Burnette et al., 2017). Limiting their social media use and avoiding, unfollowing, or ignoring problematic body related content were the strategies most used by adolescents to protect their body image on social media. However, as found by Burnette et al. (2017), these strategies were considered

limited in their effectiveness because of the difficulty in avoiding ubiquitous body-related content on social media. Adolescents were aware of targeted advertising and the fact that their newsfeeds were often propagated with content that they did not necessarily want or chose to see; this limited their perceived control over social media use, especially among girls. Aligning with these control beliefs, girls tended to report more passive responses to social media such as “putting up” with problematic content. Some boys, on the other hand, reported that they actively sought out and selected positive content that inspired them to exercise or helped them improve in some way. It should be noted that the number of boys in the present study was relatively small. Adolescent girls did not appear to engage in such active selection strategies as they felt that any content related to body image exerted negative effects on them, including content designed to promote positive body image. Adolescent girls’ reservations about body positive/acceptance content is notable as it contrasts with the endorsement of the protective effects of this content for body image in the literature (e.g., Convertino et al., 2019; Rodgers et al., 2019); given the recency of its emergence, the limitations of body positive content may not have been extensively documented in the literature or it may be the case that this kind of content resonates with adult women but not adolescents. Although the influence of body positive content on adolescent body image perceptions requires further research, these findings indicate that adolescent girls experienced social media as a largely negative and disempowering space for body image.

However, VSCO was a photo-sharing platform that was preferred by some girls to Instagram because it did not contain feedback indices such as likes, comments, followers and subsequently did not put as much appearance-related pressure on girls. VSCO has not previously featured in body image research and is worthy of further research attention because it represents a platform that may contain protective features for body image, namely the lack of hierarchical popularity structures or feedback indices. Some girls distanced themselves from body ideals by reminding themselves that body ideals were not attainable – a strategy also noted by Burnette et al. (2017). However, most girls reported that their knowledge of unrealistic body ideals did little to protect their body image perceptions and they continued to compare despite this awareness. Girls also achieved psychological distance from body ideals by reasoning that while they admired certain body features on others, they did not desire them themselves because these features would be incompatible with their own appearance. Adolescent boys in this sample reported deprioritizing the importance of the muscular ideal and distancing themselves from comparison targets as a way of protecting body image perceptions. This low investment in body-related content was also identified by Holmqvist and Frisén (2012) as a feature that supported adolescent boys’ body image. Adolescents exhibited a repertoire of strategies to protect and promote body image. The use of these strategies by adolescents and their perceived effectiveness varied. Passive and avoidance strategies were most commonly used but were limited in terms of perceived effectiveness, while active and acceptance strategies were considered effective but were

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least commonly employed, especially by girls. As these active and acceptance-focused strategies are considered components of positive body image (Holmqvist and Frisén, 2012), enabling adolescents to employ more active cognitive processing and reframing strategies may enhance their resilience to social media content. Adolescents in this sample did exhibit aspects of protective filtering (as observed by Burnette et al., 2017), in that they were critical of the extreme natures of body ideals and attempted to psychologically distance from and reduce comparisons with these ideals. They also expressed an appreciation of body diversity on social media. However, protective filtering involves both the rejection of negative body-related messages and the endorsement of positive messages (Andrew et al., 2015). Contrasting with the findings of Burnette et al. (2017), high social media literacy levels did not always serve protective effects for body image and adolescent girls in this sample were largely unable to internalize positive body-related messages and struggled to accept/appreciate their own bodies. Boys appeared to hold more positive perceptions of social media’s influence on body image, processed body-related content in “protective ways” and exhibited higher levels of body- acceptance than girls. Mirroring the findings of the national study of adolescent boys in the United Kingdom of Edcoms and Credos (2016), boys in this sample were less aware of photo-editing and manipulation of images of male bodies on social media and viewed body ideals as attainable with sufficient hard work and effort. It may be the case that social media is experienced as a less pressurizing and more motivating space for boys,

encouraging them to hold these more positive evaluations of social media. Alternatively, boys may have deemed it acceptable to report beliefs that body ideals were attainable and that they were not negatively affected by social media in order to adhere to masculine gender roles of self-reliance and dominance (Gattario and Frisén, 2019). Boys may also be less aware of manipulation/editing strategies or less critical in perceptions of body ideal attainability and this might protect them from feelings of disempowerment and dissatisfaction when exposed to body-related content. Nonetheless, some boys and girls reported self-criticism, self-blame, and body-dissatisfaction from social media comparisons and for perceived failures to adhere to desired body standards. Knowledge/information about body ideals did not always appear to change how individuals felt about their body image. This suggests that enhancing social media literacy and knowledge is not alone sufficient to mitigate tendencies to engage in appearance comparison and body ideal internalization behaviors and help individuals to internalize positive body-related messages. Furthermore, relying on body positive/body acceptance content to promote positive body image is also not sufficient given adolescent girls’ skepticism of this content and its ability to improve their body image perceptions. Self-compassion approaches are purported to target and change how individuals feel about their bodies by addressing self-criticism and shame at the root of body dissatisfaction (Gilbert and Irons, 2005; Gilbert, 2010). Instead of trying to inhibit appearance comparisons like media literacy approaches, compassion focused approaches (e.g., Neff, 2003; Gilbert, 2009, 2014) try to reduce the self-criticism arising from comparisons – an approach,

which may be particularly beneficial in light if the highly self-critical attitudes held particularly by adolescent girls about their bodies. Compassion focused approaches have been found to be effective in reducing body dissatisfaction and disordered eating, in addition to promoting body appreciation and positive body image in adults (Braun et al., 2016; Rahimi-Ardabili et al., 2018). However, the ability of compassion-focused approaches to improve body image outcomes has not been investigated in adolescents (Rahimi-Ardabili et al., 2018). Compassion-focused approaches may be particularly useful for improving adolescent body image on social media, as they can provide individuals with the skills to reframe self- critical thoughts and enhance their resilience to negative body-related messages on social media. Self-compassion may also enable adolescents, especially girls, to internalize positive body-related messages and foster greater levels of body appreciation (Andrew et al., 2016). They therefore represent a new and potentially promising alternative for tackling body image concerns in adolescents. Conclusion Some adolescents, especially girls, indicated that social media led them to feel dissatisfied with their bodies. Boys and girls appeared to employ different strategies to manage to address the gender-specific challenges they encountered online. Boys appeared to exhibit more agency and active coping strategies, which contrasted with girls who were less optimistic about their ability to control social media outcomes and who struggled to interpret body-

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related information in a positive, self-protective way. Future research should examine these gender differences in larger samples across diverse contexts. Martinez , J. L. V. (2018). #StatusofMind: Social Media and Young People’s Mental Health and Wellbeing . Www.issup.net. https://www.issup.net/knowledge-share/resources/2018- 05/statusofmind-social-media-and-young-peoples-mental-health-and KEY POINTS 91% of 16-24 year olds use the internet for social networking Social media has been described as more addictive than cigarettes and alcohol Rates of anxiety and depression in young people have risen 70% in the past 25 years Social media use is linked with increased rates of anxiety, depression and poor sleep Cyber bullying is a growing problem with 7 in 10 young people saying they have experienced it Social media can improve young people’s access to other people’s experiences of health and expert health information Those who use social media report being more emotionally supported through their contacts CALLS TO ACTION Introduction of a pop-up heavy usage warning on social media Social media platforms to highlight when photos of people have been digitally manipulated NHS England to apply the Information Standard Principles to health information published via social media Safe social media use to be taught during PSHE education in schools

Social media platforms to identify users who could be suffering from mental health problems by their posts, and discreetly signpost to support Youth-workers and other professionals who engage with young people to have a digital (including social) media component in their training More research to be carried out into the effects of social media on young people’s mental health Moreno, M. A., & Uhls, Y. T. (2019). Applying an affordances approach and a developmental lens to approach adolescent social media use. DIGITAL HEALTH , 5 (1-6), 205520761982667. https://doi.org/10.1177/2055207619826678 O’Reilly, M. (2020). Social media and adolescent mental health: The good, the bad and the ugly. Journal of Mental Health , 29 (2), 200–206. https://www.tandfonline.com/doi/full/10.1080/09638237.2020.1714007 Abstract Background: Social media are integral in the lives of adolescents. Practitioners need to be able to assess risk, and social media are potentially a new dimension to consider. Adolescent voices and practitioner perspectives are central to understanding the relationship between social media and mental health, yet there is limited work that highlights their views. Method: Eight focus groups, six with adolescents aged 11–18 years and two with mental health practitioners, were conducted. Ethical approval was provided. Discussions allowed for expression of experiences, views and opinions of the relationship between social media and mental health. Results: Participants discussed what might be thought of as the “good”, the “bad” and the “ugly” side of social media, navigating the benefits of social media to well-being against possible negative impacts on adolescents. They differentiated personal use from third

party attributions whereby they extolled the risk to adolescents outside of their personal group. Much of the negative rhetoric of social media was repeated by mental health practitioners, although there was some acknowledgement of potential benefit. Conclusions: Practitioners need to consider social media and its role in practice. When risk- assessing adolescents, it is arguably useful to include a social media dimension, without presuming the relationship will be negative. Pedalino, F., & Camerini, A.-L. (2022). Instagram Use and Body Dissatisfaction: The Mediating Role of Upward Social Comparison with Peers and Influencers among Young Females. International Journal of Environmental Research and Public Health , 19 (3), 1543. https://doi.org/10.3390/ijerph19031543 The present study found that the relationship between browsing through the looks of others on Instagram and body dissatisfaction, measured by the lack of body appreciation, is fully mediated by upward appearance comparison with social media influencers. Thus, the exposure to idealized pictures and stories of this comparison target is associated with detrimental outcomes in female adolescents and young women. The findings of our study highlight the need for public health interventions to raise awareness about the posting practices of social media influencers and to strengthen a positive body image, with special attention to particularly vulnerable girls. Prior interventions to promote a positive body image among women proved to be effective [54]. However, interventions aimed at female adolescents and young women, such as the Boost Body Confidence and Social Media Savvy intervention [55], should specifically consider the social media context and highlight the nature and detrimental consequences of the exposure to manipulated photos

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and stories. Interventions supported by social media influencers can be particularly useful. In fact, body positivity movements already initiated by some celebrities on social media [56] can help females to focus less on the external beauty ideals conveyed through social media and to foster self-esteem and create emotional support, thus preventing and addressing health issues such as body image concerns. In addition to that, media literacy interventions providing factual information and debunking false beliefs [57] as well as strengthening the ability to access, analyze, and evaluate body-image-related content [58], can be another successful strategy to counteract unrealistic images of female beauty and to help females to think critically about the idealized body images and messages they find on social media. Primack, B. A., Shensa, A., Sidani, J. E., Escobar-Viera, C. G., & Fine, M. J. (2020). Temporal Associations Between Social Media Use and Depression. American Journal of Preventive Medicine , 60 (2). https://doi.org/10.1016/j.amepre.2020.09.014 Primack, B. A., Shensa, A., Sidani, J. E., Whaite, E. O., Lin, L. yi, Rosen, D., Colditz, J. B., Radovic, A., & Miller, E. (2017). Social Media Use and Perceived Social Isolation among Young Adults in the U.S. American Journal of Preventive Medicine , 53 (1), 1–8. https://doi.org/10.1016/j.amepre.2017.01.010 Shafer, L. (2017, December 15). Social Media and Teen Anxiety | Harvard Graduate School of Education . Www.gse.harvard.edu. https://www.gse.harvard.edu/ideas/usable- knowledge/17/12/social-media-and-teen-anxiety As adults witness the rising tides of teenaged anxiety, it’s tough not to notice a common thread that runs through the epidemic — something that past generations never dealt with.

Clutched in the hand of nearly every teen is a smartphone, buzzing and beeping and blinking with social media notifications. Parents, all too often, just want to grab their teen’s phone and stuff it in a drawer. But is social media and the omnipresence of digital interactions really the cause of all this anxiety? Recent studies have noted a significant uptick in depression and suicidal thoughts over the past several years for teens, especially those who spend multiple hours a day using screens, and especially girls. But many of the pressures teenagers feel from social media are actually consistent with developmentally normal concerns around social standing and self-expression. Social media can certainly exacerbate these anxieties, but for parents to truly help their children cope, they should avoid making a blanket condemnation. Instead, parents should tailor their approach to the individual, learning where a particular child's stressors lie and how that child can best gain control of this alluring, powerful way to connect with peers. A Link Between Social Media and Mental Health Concerns Many experts have described a rise in sleeplessness, loneliness, worry, and dependence among teenagers — a rise that coincides with the release of the first iPhone 10 years ago. One study found that 48 percent of teens who spend five hours per day on an electronic device have at least one suicide risk factor, compared to 33 percent of teens who spend two hours a day on an electronic device. We’ve all heard anecdotes, too, of teens being reduced to tears from the constant communication and comparisons that social media invites.

Through likes and follows, teens are "getting actual data on how much people like them and their appearance," says Lindsey Giller, a clinical psychologist at the Child Mind Institute who specializes in youth and young adults with mood disorders. "And you're not having any break from that technology." She's seen teens with anxiety, poor self-esteem, insecurity, and sadness attributed, at least in part, to constant social media use. Teenage Challenges and Stressors, Exacerbated But the connection between anxiety and social media might not be simple, or purely negative. Correlation does not equal causation; it may be that depression and anxiety lead to more social media use, for example, rather than the other way around. There could also be an unknown third variable — for instance, academic pressures or economic concerns — connecting them, or teens could simply be more likely to admit to mental health concerns now than they were in previous generations. “So many of the behaviors we’re talking about have pre-digital corollaries,” says Weinstein, a postdoctoral fellow at the Harvard Graduate School of Education. “They’re the same sort of developmental challenges that adolescents have grappled with for decades, though now they’re taking place in different spaces that can certainly amplify them and shift their quality, quantity, and scale. “But the idea of wanting to fit in, the critical importance of peer relationships, and the process of figuring out which version of yourself you want to be and how you want to express that identity to others — those features of adolescence are not new.” What’s Triggering about Social Media?

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Youth and technology expert Amanda Lenhart’s 2015 Pew study of teens, technology, and friendships reveals a range of social media-induced stressors: Seeing people posting about events to which you haven’t been invited Feeling pressure to post positive and attractive content about yourself Feeling pressure to get comments and likes on your posts Having someone post things about you that you cannot change or control In analyses of thousands of adolescents’ reactions to digital stressors, Weinstein and her colleagues have found even more challenges: Feeling replaceable: If you don’t respond to a best friend’s picture quickly or effusively enough, will she find a better friend? Too much communication: A boyfriend or girlfriend wants you to be texting far more often than you’re comfortable with. Digital “FOMO”: If you’re not up-to-date on the latest social media posts, will it prevent you from feeling like you can participate in real-life conversations at school the next day? Attachment to actual devices: If your phone is out of reach, will your privacy be invaded? Will you miss a message from a friend when he needs you? For Parents, Strategies on Mitigating Anxiety — Without Overreacting With so many different stressors, a key piece of advice for parents is to individualize your approach. In the same way that different teenagers need different types of social support from their parents, they need different types of digital support, as well. Weinstein suggests that if your teen seems irritable or overwhelmed by social media, pay attention to what specifically is causing those feelings.

Giller agrees. "Really check in with your teen about what's going on," she says. Parents can and should help support and problem-solve with their teen, but they should also offer validation about how difficult these situations can be. However, as a family, you can also set screen-free times — whether it’s every evening after 9 p.m., on the car ride to school, an occasional screen-free weekend, or longer stretches over vacations and camps. “Many teens say they appreciate” these chances, says education writer Anya Kamenetz, whose upcoming book The Art of Screen Time: How Your Family Can Balance Digital Media and Real Life explores these issues in-depth. A significant part of your teen’s phone habits may be related to her parents, too. “Be good role models in your own use of tech,” advises Kamenetz. That means being mindful of your own distracted habit of reaching for your cell, but it also means rejecting the isolation that screen time can generate. Make digital media an opportunity for real-life social opportunities, she says. Share some media activities with your teenager — playing games, watching YouTube clips, or reading up on mutual interests together. And in most situations, it’s best to work with your teen to set social media expectations. “You want to build consensus and get their buy-in,” says Kamenetz. Constant surveillance or control won’t build trust. Make it an open, mutual discussion. You want to get teens to put their devices down on their own, says Weinstein, “so that you’re helping them build their ability to manage their interactions with and through technology.” And that’s increasingly looking like a key life skill that we’ll all need to develop, now and into the future.

Twenge, J. M. (2017, August 3). Have Smartphones Destroyed a Generation? The Atlantic; The Atlantic. https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone- destroyed-a-generation/534198/ Using the above sources the topic, ‘Social Media and Adolescent Mental Health’ write a literature review given the following prompt; 1a. social media and Adolescent Anxiety (700 words) : an analysis of the research presented by comparing, contrasting, and connecting the published research articles you selected to elaborate on. 1b. social media and its impact on Body Image) (700 words) : an analysis of the research presented by comparing, contrasting, and connecting the published research articles you selected to elaborate on. Minimum of 1500 words. Separate the sources for each subheading.

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