Social Media

In our global digital world, social connections are embedded within the external environment we are physically engaged in and the life that we virtually share on social media. Social media is a class of mobile and Internet-based applications that allow people to receive information and to build and share user-generated content. Through the creation of a virtual profile, it is possible to interact with real-life friends, meet new people from all over the world, connect with one’s favorite celebrities, and to maintain both online and offiine relationships. Since 2004, the use of social media has been increasing rapidly, with the possibility to be connected to the Internet anytime and anywhere. According to the nature of the content, the user can choose, from a wide range of applications, the platform that best suits the purpose of the communication. For example, Facebook is more focused on real-life friends and relatives and encourage interactions through services such as sharing pictures, videos, status updates, and joining groups with specific interests.

Social platforms like Twitter, which are also known as “microblogs,” are characterized by brief communication. Other applications, like Instagram or Snapchat, provide photo- and video-sharing services, together with the possibility to like, comment, and re-post preferred content. Figure 1 shows the popularity of the leading social networks, ranked by the worldwide number of active users (source: ourworldindata.org).
Social media platforms are widely used across different age groups and cultures, but especially for children and teenagers, online communication represents “a window into the secret world of adolescent peer culture, even as it offers young people a new screen for the projection of adolescent developmental issues” (1). While social media offers tremendous potential in allowing self-expression of personality and maintaining contact with a network of friends, some studies have also highlighted the risk of negative consequences of excessive online social platforms usage (2, 3). Online social interaction, the blurring of lines between offiine and virtual life (4, 5), and the concept of digital identity (6) have become topics of great interest in psychology and mental health fields (7). Researchers in the field are attempting to find a consensual definition of the concept of “problematic social media use,” as it is often confused with a description of addictive behavior related to general Internet services, which has been included in the 5th edition of the Diagnostic and Statistical Manual of mental disorders (8). In accordance with a biopsychosocial framework, problematic use of social media involves a set of alterations affecting biological functions (i.e., neurotransmitters regulation and circadian rhythm); cognitive, psychological, and affective mechanisms (i.e., attention, salience, mood fluctuation, and anxiety), and aspects related to the social sphere (i.e., social desirability, popularity, and conflicts), resulting in a decreased perceived quality of life. Feedback from people belonging to the virtual social community can affect individual self-esteem and, generally, well-being (9– 13). A problematic use can also affect other aspects of a teenager’s daily life, such as academic performance, time management issues, procrastination, distraction (14), and sleep disturbances
(15). In severe cases, averse outcomes could arise and, if prolonged, can become highly impactful, with the further risk of developing psychiatric disorders (16). As the Internet and social media are a recent phenomenon, it is more likely that the effect of excessive or problematic usage will affect individuals during more sensitive temporal frames, such as childhood and adolescence. A survey conducted in the United States in 2018 reported that 45% of the teenagers interviewed say they are almost constantly online, without differences among sexes, ethnicities, family incomes, and parental level of education (for the full report, see Teens, Social Media & Technology 2018). Given the continuous exposure to the virtual environment, it is essential to understand the impact that online social relationships have on mental health and interpersonal functioning in developmental stages. The aim of our review, compared to other recent publications [see (17, 18)], is to provide a detailed overview of not only the effect of social media in general but also of the associations between specific platforms and psychopathology. We believe that this point is relevant, as it is important to distinguish among the different social media platforms given that each of them has specific, unique features that drive young users’ preferences.

Furthermore, social media usage is often included in the broader category of Internet usage, despite the social connotation that primarily describes and defines these kinds of sites. Moreover, the included articles were discussed according to specific disorders that can develop during childhood and adolescence, not merely depression and anxiety that are the most explored disorders but also addictive behaviors toward substances and eating disorders (EDs), as both start to develop during adolescence. In fact, developmental stages are more vulnerable to environmental insults just because of the greater plasticity of the central nervous system, the multiple biological changes, and the formation of psychological mechanisms that drive social behaviors (19, 20). Due to the differences that define each platform, one of the main purposes of the present review is to provide evidence related to targeted social media services, instead of a more general discussion on social media. In fact, we retain that the multifaceted manifestation of diverse psychological issues might be expressed differently through the multiple ways of communication, such as text, video, or picture. As social behavior and the risk for psychiatric disorders is related to the activity of determined brain regions and biological features (21, 22), and since we are addressing the outcomes of problematic social media usage (PSMU) under a biopsychosocial perspective, we will also provide an overview about the neuroscientific and gene-by-environment contribution to the interplay between social media and the development of psychiatric disorders in adolescence.