• Anonymity can help individuals with stigmatizing conditions connect with others
• Young adults with mental illness commonly form online relationships
• Social media use in individuals with serious mental illness associated with greater community and civic engagement
• Individuals with depressive symptoms prefer communicating on social media than in-person
• Online conversations do not require iimnediate responses or non-verbal cues
Social media platforms offer near continuous opportunities to connect and interact with others, regardless of time of day or geographic location. This on demand ease of communication may be especially important for facilitating social interaction among individuals with mental disorders experiencing difficulties interacting in face-to-face settings. For example, impaired social functioning is a common deficit in schizophrenia spectrum disorders, and social media may facilitate communication and interacting with others for these individuals ( Torous & Keshavan, 2016 ). This was suggested in one study where participants with schizophrenia indicated that social media helped them to interact and socialize more easily ( Miller et al., 2015 ). Like other online communication, the ability to connect with others anonymously may be an important feature of social media, especially for individuals living with highly stigmatizing health conditions ( Berger, Wagner, & Baker, 2005 ), such as serious mental disorders ( Highton-Williamson, Priebe, & Giacco, 2015 ).
Studies have found that individuals with serious mental disorders ( Spinzy, Nitzan, Becker, Bloch, & Fennig, 2012 ) as well as young adults with mental illness ( Gowen, Deschaine, Gruttadara, & Markey, 2012 ) appear to form online relationships and connect with others on social media as often as social media users from the general population. This is an important observation because individuals living with serious mental disorders typically have few social contacts in the offline world, and also experience high rates of loneliness ( Badcock et al., 2015 ; Giacco, Palumbo, Strappelli, Catapano, & Priebe, 2016 ). Among individuals receiving publicly funded mental health services who use social media, nearly half (47%) reported using these platforms at least weekly to feel less alone ( Brusilovskiy, Townley, Snethen, & Salzer, 2016 ). In another study of young adults with serious mental illness, most indicated that they used social media to help feel less isolated ( Gowen et al., 2012 ). Interestingly, more frequent use of social media among a sample of individuals with serious mental illness was associated with greater community participation, measured as participation in shopping, work, religious activities or visiting friends and family, as well as greater civic engagement, reflected as voting in local elections ( Brusilovskiy et al., 2016 ).
Emerging research also shows that young people with moderate to severe depressive symptoms appear to prefer communicating on social media rather than in-person ( Rideout & Fox, 2018 ), while other studies have found that some individuals may prefer to seek help for mental health concerns online rather than through in-person encounters ( Batterham & Calear, 2017 ). In a qualitative study, participants with schizophrenia described greater anonymity, the ability to discover that other people have experienced similar health challenges, and reducing fears through greater access to information as important motivations for using the Internet to seek mental health information ( Schrank, Sibitz, Unger, & Amering, 2010 ). Because social media does not require the immediate responses necessary in face-to-face communication, it may overcome deficits with social interaction due to psychotic symptoms that typically adversely affect face-to-face conversations ( Docherty et al., 1996 ). Online social interactions may not require the use of non-verbal cues, particularly in the initial stages of interaction ( Kiesler, Siegel, & McGuire, 1984 ), with interactions being more fluid, and within the control of users, thereby overcoming possible social anxieties linked to in-person interaction ( Indian & Grieve, 2014 ). Furthermore, many individuals with serious mental disorders can experience symptoms including passive social withdrawal, blunted affect and attentional impairment, as well as active social avoidance due to hallucinations or other concerns ( Hansen, Torgalsbøen, Melle, & Bell, 2009 ); thus, potentially reinforcing the relative advantage, as perceived by users, of using social media over in person conversations.
There is growing recognition about the role that social media channels could play in enabling peer support ( Bucci et al., 2019 ; Naslund, Aschbrenner, et al., 2016b ), referred to as a system of mutual giving and receiving where individuals who have endured the difficulties of mental illness can offer hope, friendship, and support to others facing similar challenges ( Davidson, Chinman, Sells, & Rowe, 2006 ; Mead, Hilton, & Curtis, 2001 ). Initial studies exploring use of online self-help forums among individuals with serious mental illnesses have found that individuals with schizophrenia appeared to use these forums for self-disclosure, and sharing personal experiences, in addition to providing or requesting information, describing symptoms, or discussing medication ( Haker, Lauber, & Rössler, 2005 ), while users with bipolar disorder reported using these forums to ask for help from others about their illness ( Vayreda & Antaki, 2009 ). More recently, in a review of online social networking in people with psychosis, Highton-Williamson et al (2015) highlight that an important purpose of such online connections was to establish new friendships, pursue romantic relationships, maintain existing relationships or reconnect with people, and seek online peer support from others with lived experience ( Highton-Williamson et al., 2015 ).
Online peer support among individuals with mental illness has been further elaborated in various studies. In a content analysis of comments posted to YouTube by individuals who self-identified as having a serious mental illness, there appeared to be opportunities to feel less alone, provide hope, find support and learn through mutual reciprocity, and share coping strategies for day-to-day challenges of living with a mental illness ( Naslund, Grande, Aschbrenner, & Elwyn, 2014 ). In another study, Chang (2009) delineated various communication patterns in an online psychosis peer-support group ( Chang, 2009 ). Specifically, different forms of support emerged, including ‘informational support’ about medication use or contacting mental health providers, ‘esteem support’ involving positive comments for encouragement, ‘network support’ for sharing similar experiences, and ‘emotional support’ to express understanding of a peer’s situation and offer hope or confidence ( Chang, 2009 ). Bauer et al. (2013) reported that the main interest in online self-help forums for patients with bipolar disorder was to share emotions with others, allow exchange of information, and benefit by being part of an online social group ( Bauer, Bauer, Spiessl, & Kagerbauer, 2013 ).
For individuals who openly discuss mental health problems on Twitter, a study by Berry et al. (2017) found that this served as an important opportunity to seek support and to hear about the experiences of others ( Berry et al., 2017 ). In a survey of social media users with mental illness, respondents reported that sharing personal experiences about living with mental illness and opportunities to learn about strategies for coping with mental illness from others were important reasons for using social media ( Naslund et al., 2017 ). A computational study of mental health awareness campaigns on Twitter provides further support with inspirational posts and tips being the most shared ( Saha et al., 2019 ). Taken together, these studies offer insights about the potential for social media to facilitate access to an informal peer support network, though more research is necessary to examine how these online interactions may impact intentions to seek care, illness self-management, and clinically meaningful outcomes in offline contexts.
Many individuals living with mental disorders have expressed interest in using social media platforms for seeking mental health information ( Lal, Nguyen, & Theriault, 2018 ), connecting with mental health providers ( M. L. Birnbaum et al., 2017 ), and accessing evidence-based mental health services delivered over social media specifically for coping with mental health symptoms or for promoting overall health and wellbeing ( Naslund et al., 2017 ). With the widespread use of social media among individuals living with mental illness combined with the potential to facilitate social interaction and connect with supportive peers, as summarized above, it may be possible to leverage the popular features of social media to enhance existing mental health programs and services. A recent review by Biagianti et al (2018) found that peer-to-peer support appeared to offer feasible and acceptable ways to augment digital mental health interventions for individuals with psychotic disorders by specifically improving engagement, compliance, and adherence to the interventions, and may also improve perceived social support ( Biagianti, Quraishi, & Schlosser, 2018 ).
Among digital programs that have incorporated peer-to-peer social networking consistent with popular features on social media platforms, a pilot study of the HORYZONS online psychosocial intervention demonstrated significant reductions in depression among patients with first episode psychosis ( Alvarez-Jimenez et al., 2013 ). Importantly, the majority of participants (95%) in this study engaged with the peer-to-peer networking feature of the program, with many reporting increases in perceived social connectedness and empowerment in their recovery process ( Alvarez-Jimenez et al., 2013 ). This moderated online social therapy program is now being evaluated as part of a large randomized controlled trial for maintaining treatment effects from first episode psychosis services ( Alvarez-Jimenez et al., 2019 ).
Other early efforts have demonstrated that use of digital environments with the interactive peer-to-peer features of social media can enhance social functioning and wellbeing in young people at high risk of psychosis ( Alvarez-Jimenez et al., 2018 ). There has also been a recent emergence of several mobile apps to support symptom monitoring and relapse prevention in psychotic disorders. Among these apps, the development of PRIME (Personalized Real-time Intervention for Motivational Enhancement) has involved working closely with young people with schizophrenia to ensure that the design of the app has the look and feel of mainstream social media platforms, as opposed to existing clinical tools ( Schlosser et al., 2016 ). This unique approach to the design of the app is aimed at promoting engagement, and ensuring that the app can effectively improve motivation and functioning through goal setting and promoting better quality of life of users with schizophrenia ( Schlosser et al., 2018 ).
Social media platforms could also be used to promote engagement and participation in in-person services delivered through community mental health settings. For example, the peer-based lifestyle intervention called PeerFIT targets weight loss and improved fitness among individuals living with serious mental illness through a combination of in-person lifestyle classes, exercise groups, and use of digital technologies ( Aschbrenner, Naslund, Shevenell, Kinney, & Bartels, 2016 ; Aschbrenner, Naslund, Shevenell, Mueser, & Bartels, 2016 ). The intervention holds tremendous promise as lack of support is one of the largest barriers toward exercise in patients with serious mental illness ( Firth et al., 2016 ) and it is now possible to use social media to counter such. Specifically, in PeerFIT, a private Facebook group is closely integrated into the program to offer a closed platform where participants can connect with the lifestyle coaches, access intervention content, and support or encourage each other as they work towards their lifestyle goals ( Aschbrenner, Naslund, & Bartels, 2016 ; Naslund, Aschbrenner, Marsch, & Bartels, 2016a ). To date, this program has demonstrate preliminary effectiveness for meaningfully reducing cardiovascular risk factors that contribute to early mortality in this patient group ( Aschbrenner, Naslund, Shevenell, Kinney, et al., 2016 ), while the Facebook component appears to have increased engagement in the program, while allowing participants who were unable to attend in-person sessions due to other health concerns or competing demands to remain connected with the program ( Naslund, Aschbrenner, Marsch, McHugo, & Bartels, 2018 ). This lifestyle intervention is currently being evaluated in a randomized controlled trial enrolling young adults with serious mental illness from a variety of real world community mental health services settings ( Aschbrenner, Naslund, Gorin, et al., 2018 ).
These examples highlight the promise of incorporating the features of popular social media into existing programs, which may offer opportunities to safely promote engagement and program retention, while achieving improved clinical outcomes. This is an emerging area of research, as evidenced by several important effectiveness trials underway ( Alvarez-Jimenez et al., 2019 ; Aschbrenner, Naslund, Gorin, et al., 2018 ), including efforts to leverage online social networking to support family caregivers of individuals receiving first episode psychosis services ( Gleeson et al., 2017 ).
The science on the role of social media for engaging persons with mental disorders needs a cautionary note on the effects of social media usage on mental health and well being, particularly in adolescents and young adults. While the risks and harms of social media are frequently covered in the popular press and mainstream news reports, careful consideration of the research in this area is necessary. In a review of 43 studies in young people, many benefits of social media were cited, including increased self-esteem, and opportunities for self-disclosure ( Best, Manktelow, & Taylor, 2014 ). Yet, reported negative effects were an increased exposure to harm, social isolation, depressive symptoms and bullying ( Best et al., 2014 ). In the sections that follow (see Table 1 for a summary), we consider three major categories of risk related to use of social media and mental health. These include: 1) Impact on symptoms; 2) Facing hostile interactions; and 3) Consequences for daily life.
Studies consistently highlight that use of social media, especially heavy use and prolonged time spent on social media platforms, appears to contribute to increased risk for a variety of mental health symptoms and poor wellbeing, especially among young people ( Andreassen et al., 2016 ; Kross et al., 2013 ; Woods & Scott, 2016 ). This may partly be driven by the detrimental effects of screen time on mental health, including increased severity of anxiety and depressive symptoms, which have been well documented ( Stiglic & Viner, 2019 ). Recent studies have reported negative effects of social media use on mental health of young people, including social comparison pressure with others and greater feeling of social isolation after being rejected by others on social media ( Rideout & Fox, 2018 ). In a study of young adults, it was found that negative comparisons with others on Facebook contributed to risk of rumination and subsequent increases in depression symptoms ( Feinstein et al., 2013 ). Still, the cross sectional nature of many screen time and mental health studies makes it challenging to reach causal inferences ( Orben & Przybylski, 2019 ).
Quantity of social media use is also an important factor, as highlighted in a survey of young adults ages 19 to 32, where more frequent visits to social media platforms each week were correlated with greater depressive symptoms ( Lin et al., 2016 ). More time spent using social media is also associated with greater symptoms of anxiety ( Vannucci, Flannery, & Ohannessian, 2017 ). The actual number of platforms accessed also appears to contribute to risk as reflected in another national survey of young adults where use of a large number of social media platforms was associated with negative impact on mental health ( Primack et al., 2017 ). Among survey respondents using between 7 and 11 different social media platforms compared to respondents using only 2 or fewer platforms, there was a 3 times greater odds of having high levels of depressive symptoms and a 3.2 times greater odds of having high levels of anxiety symptoms ( Primack et al., 2017 ).
Many researchers have postulated that worsening mental health attributed to social media use may be because social media replaces face-to-face interactions for young people ( Twenge & Campbell, 2018 ), and may contribute to greater loneliness ( Bucci et al., 2019 ), and negative effects on other aspects of health and wellbeing ( Woods & Scott, 2016 ). One nationally representative survey of US adolescents found that among respondents who reported more time accessing media such as social media platforms or smartphone devices, there was significantly greater depressive symptoms and increased risk of suicide when compared to adolescents who reported spending more time on non-screen activities, such as in-person social interaction or sports and recreation activities ( Twenge, Joiner, Rogers, & Martin, 2018 ). For individuals living with more severe mental illnesses, the effects of social media on psychiatric symptoms have received less attention. One study found that participation in chat rooms may contribute to worsening symptoms in young people with psychotic disorders ( Mittal, Tessner, & Walker, 2007 ), while another study of patients with psychosis found that social media use appeared to predict low mood ( Berry, Emsley, Lobban, & Bucci, 2018 ). These studies highlight a clear relationship between social media use and mental health that may not be present in general population studies ( Orben & Przybylski, 2019 ), and emphasize the need to explore how social media may contribute to symptom severity and whether protective factors may be identified to mitigate these risks.
Popular social media platforms can create potential situations where individuals may be victimized by negative comments or posts. Cyberbullying represents a form of online aggression directed towards specific individuals, such as peers or acquaintances, which is perceived to be most harmful when compared to random hostile comments posted online ( Hamm et al., 2015 ). Importantly, cyberbullying on social media consistently shows harmful impact on mental health in the form of increased depressive symptoms as well as worsening of anxiety symptoms, as evidenced in a review of 36 studies among children and young people ( Hamm et al., 2015 ). Furthermore, cyberbullying disproportionately impacts females as reflected in a national survey of adolescents in the United States, where females were twice as likely to be victims of cyberbullying compared to males ( Alhajji, Bass, & Dai, 2019 ). Most studies report cross-sectional associations between cyberbullying and symptoms of depression or anxiety ( Hamm et al., 2015 ), though one longitudinal study in Switzerland found that cyberbullying contributed to significantly greater depression over time ( Machmutow, Perren, Sticca, & Alsaker, 2012 ).
For youth ages 10 to 17 who reported major depressive symptomatology, there was over 3 times greater odds of facing online harassment in the last year compared to youth who reported mild or no depressive symptoms ( Ybarra, 2004 ). Similarly, in a 2018 national survey of young people, respondents ages 14 to 22 with moderate to severe depressive symptoms were more likely to have had negative experiences when using social media, and in particular, were more likely to report having faced hostile comments, or being “trolled”, from others when compared to respondents without depressive symptoms (31% vs. 14%) ( Rideout & Fox, 2018 ). As these studies depict risks for victimization on social media and the correlation with poor mental health, it is possible that individuals living with mental illness may also experience greater hostility online compared to individuals without mental illness. This would be consistent with research showing greater risk of hostility, including increased violence and discrimination, directed towards individuals living with mental illness in in-person contexts, especially targeted at those with severe mental illnesses ( Goodman et al., 1999 ).
A computational study of mental health awareness campaigns on Twitter reported that while stigmatizing content was rare, it was actually the most spread (re-tweeted) demonstrating that harmful content can travel quickly on social media ( Saha et al., 2019 ). Another study was able to map the spread of social media posts about the Blue Whale Challenge, an alleged game promoting suicide, over Twitter, YouTube, Reddit, Tumblr and other forums across 127 countries ( Sumner et al., 2019 ). These findings show that it is critical to monitor the actual content of social media posts, such as determining whether content is hostile or promotes harm to self or others. This is pertinent because existing research looking at duration of exposure cannot account for the impact of specific types of content on mental health and is insufficient to fully understand the effects of using these platforms on mental health.
The ways in which individuals use social media can also impact their offline relationships and everyday activities. To date, reports have described risks of social media use pertaining to privacy, confidentiality, and unintended consequences of disclosing personal health information online ( Torous & Keshavan, 2016 ). Additionally, concerns have been raised about poor quality or misleading health information shared on social media, and that social media users may not be aware of misleading information or conflicts of interest especially when the platforms promote popular content regardless of whether it is from a trustworthy source ( Moorhead et al., 2013 ; Ventola, 2014 ). For persons living with mental illness there may be additional risks from using social media. A recent study that specifically explored the perspectives of social media users with serious mental illnesses, including participants with schizophrenia spectrum disorders, bipolar disorder, or major depression, found that over one third of participants expressed concerns about privacy when using social media ( Naslund & Aschbrenner, 2019 ). The reported risks of social media use were directly related to many aspects of everyday life, including concerns about threats to employment, fear of stigma and being judged, impact on personal relationships, and facing hostility or being hurt ( Naslund & Aschbrenner, 2019 ). While few studies have specifically explored the dangers of social media use from the perspectives of individuals living with mental illness, it is important to recognize that use of these platforms may contribute to risks that extend beyond worsening symptoms and that can affect different aspects of daily life.
In this commentary we considered ways in which social media may yield benefits for individuals living with mental illness, while contrasting these with the possible harms. Studies reporting on the threats of social media for individuals with mental illness are mostly cross-sectional, making it difficult to draw conclusions about direction of causation. However, the risks are potentially serious. These risks should be carefully considered in discussions pertaining to use of social media and the broader use of digital mental health technologies, as avenues for mental health promotion, or for supporting access to evidence-based programs or mental health services. At this point, it would be premature to view the benefits of social media as outweighing the possible harms, when it is clear from the studies summarized here that social media use can have negative effects on mental health symptoms, can potentially expose individuals to hurtful content and hostile interactions, and can result in serious consequences for daily life, including threats to employment and personal relationships. Despite these risks, it is also necessary to recognize that individuals with mental illness will continue to use social media given the ease of accessing these platforms and the immense popularity of online social networking. With this in mind, it may be ideal to raise awareness about these possible risks so that individuals can implement necessary safeguards, while also highlighting that there could also be benefits. For individuals with mental illness who use social media, being aware of the risks is an essential first step, and then highlighting ways that use of these popular platforms could also contribute to some benefits, ranging from finding meaningful interactions with others, engaging with peer support networks, and accessing information and services.
To capitalize on the widespread use of social media, and to achieve the promise that these platforms may hold for supporting the delivery of targeted mental health interventions, there is need for continued research to better understand how individuals living with mental illness use social media. Such efforts could inform safety measures and also encourage use of social media in ways that maximize potential benefits while minimizing risk of harm. It will be important to recognize how gender and race contribute to differences in use of social media for seeking mental health information or accessing interventions, as well as differences in how social media might impact mental wellbeing. For example, a national survey of 14- to 22-year olds in the United States found that female respondents were more likely to search online for information about depression or anxiety, and to try to connect with other people online who share similar mental health concerns, when compared to male respondents ( Rideout & Fox, 2018 ). In the same survey, there did not appear to be any differences between racial or ethnic groups in social media use for seeking mental health information ( Rideout & Fox, 2018 ). Social media use also appears to have a differential impact on mental health and emotional wellbeing between females and males ( Booker, Kelly, & Sacker, 2018 ), highlighting the need to explore unique experiences between gender groups to inform tailored programs and services. Research shows that lesbian, gay, bisexual or transgender individuals frequently use social media for searching for health information and may be more likely compared to heterosexual individuals to share their own personal health experiences with others online ( Rideout & Fox, 2018 ). Less is known about use of social media for seeking support for mental health concerns among gender minorities, though this is an important area for further investigation as these individuals are more likely to experience mental health problems and more likely to experience online victimization when compared to heterosexual individuals ( Mereish, Sheskier, Hawthorne, & Goldbach, 2019 ).
Similarly, efforts are needed to explore the relationship between social media use and mental health among ethnic and racial minorities. A recent study found that exposure to traumatic online content on social media showing violence or hateful posts directed at racial minorities contributed to increases in psychological distress, PTSD symptoms, and depression among African American and Latinx adolescents in the United States ( Tynes, Willis, Stewart, & Hamilton, 2019 ). These concerns are contrasted by growing interest in the potential for new technologies including social media to expand the reach of services to underrepresented minority groups ( Schueller, Hunter, Figueroa, & Aguilera, 2019 ). Therefore, greater attention is needed to understanding the perspectives of ethnic and racial minorities to inform effective and safe use of social media for mental health promotion efforts.
Research has found that individuals living with mental illness have expressed interest in accessing mental health services through social media platforms. A survey of social media users with mental illness found that most respondents were interested in accessing programs for mental health on social media targeting symptom management, health promotion, and support for communicating with health care providers and interacting with the health system ( Naslund et al., 2017 ). Importantly, individuals with serious mental illness have also emphasized that any mental health intervention on social media would need to be moderated by someone with adequate training and credentials, would need to have ground rules and ways to promote safety and minimize risks, and importantly, would need to be free and easy to access.
An important strength with this commentary is that it combines a range of studies broadly covering the topic of social media and mental health. We have provided a summary of recent evidence in a rapidly advancing field with the goal of presenting unique ways that social media could offer benefits for individuals with mental illness, while also acknowledging the potentially serious risks and the need for further investigation. There are also several limitations with this commentary that warrant consideration. Importantly, as we aimed to address this broad objective, we did not conduct a systematic review of the literature. Therefore, the studies reported here are not exhaustive, and there may be additional relevant studies that were not included. Additionally, we only summarized published studies, and as a result, any reports from the private sector or websites from different organizations using social media or other apps containing social media-like features would have been omitted. Though it is difficult to rigorously summarize work from the private sector, sometimes referred to as “gray literature”, because many of these projects are unpublished and are likely selective in their reporting of findings given the target audience may be shareholders or consumers.
Another notable limitation is that we did not assess risk of bias in the studies summarized in this commentary. We found many studies that highlighted risks associated with social media use for individuals living with mental illness; however, few studies of programs or interventions reported negative findings, suggesting the possibility that negative findings may go unpublished. This concern highlights the need for a future more rigorous review of the literature with careful consideration of bias and an accompanying quality assessment. Most of the studies that we described were from the United States, as well as from other higher income settings such as Australia or the United Kingdom. Despite the global reach of social media platforms, there is a dearth of research on the impact of these platforms on the mental health of individuals in diverse settings, as well as the ways in which social media could support mental health services in lower income countries where there is virtually no access to mental health providers. Future research is necessary to explore the opportunities and risks for social media to support mental health promotion in low-income and middle-income countries, especially as these countries face a disproportionate share of the global burden of mental disorders, yet account for the majority of social media users worldwide ( Naslund et al., 2019 ).
As we consider future research directions, the near ubiquitous social media use also yields new opportunities to study the onset and manifestation of mental health symptoms and illness severity earlier than traditional clinical assessments. There is an emerging field of research referred to as ‘digital phenotyping’ aimed at capturing how individuals interact with their digital devices, including social media platforms, in order to study patterns of illness and identify optimal time points for intervention ( Jain, Powers, Hawkins, & Brownstein, 2015 ; Onnela & Rauch, 2016 ). Given that most people access social media via mobile devices, digital phenotyping and social media are closely related ( Torous et al., 2019 ). To date, the emergence of machine learning, a powerful computational method involving statistical and mathematical algorithms ( Shatte, Hutchinson, & Teague, 2019 ), has made it possible to study large quantities of data captured from popular social media platforms such as Twitter or Instagram to illuminate various features of mental health ( Manikonda & De Choudhury, 2017 ; Reece et al., 2017 ). Specifically, conversations on Twitter have been analyzed to characterize the onset of depression ( De Choudhury, Gamon, Counts, & Horvitz, 2013 ) as well as detecting users’ mood and affective states ( De Choudhury, Gamon, & Counts, 2012 ), while photos posted to Instagram can yield insights for predicting depression ( Reece & Danforth, 2017 ). The intersection of social media and digital phenotyping will likely add new levels of context to social media use in the near future.
Several studies have also demonstrated that when compared to a control group, Twitter users with a self-disclosed diagnosis of schizophrenia show unique online communication patterns ( Michael L Birnbaum, Ernala, Rizvi, De Choudhury, & Kane, 2017 ), including more frequent discussion of tobacco use ( Hswen et al., 2017 ), symptoms of depression and anxiety ( Hswen, Naslund, Brownstein, & Hawkins, 2018b ), and suicide ( Hswen, Naslund, Brownstein, & Hawkins, 2018a ). Another study found that online disclosures about mental illness appeared beneficial as reflected by fewer posts about symptoms following self-disclosure (Ernala, Rizvi, Birnbaum, Kane, & De Choudhury, 2017). Each of these examples offers early insights into the potential to leverage widely available online data for better understanding the onset and course of mental illness. It is possible that social media data could be used to supplement additional digital data, such as continuous monitoring using smartphone apps or smart watches, to generate a more comprehensive ‘digital phenotype’ to predict relapse and identify high-risk health behaviors among individuals living with mental illness ( Torous et al., 2019 ).
With research increasingly showing the valuable insights that social media data can yield about mental health states, greater attention to the ethical concerns with using individual data in this way is necessary ( Chancellor, Birnbaum, Caine, Silenzio, & De Choudhury, 2019 ). For instance, data is typically captured from social media platforms without the consent or awareness of users ( Bidargaddi et al., 2017 ), which is especially crucial when the data relates to a socially stigmatizing health condition such as mental illness ( Guntuku, Yaden, Kern, Ungar, & Eichstaedt, 2017 ). Precautions are needed to ensure that data is not made identifiable in ways that were not originally intended by the user who posted the content, as this could place an individual at risk of harm or divulge sensitive health information ( Webb et al., 2017 ; Williams, Burnap, & Sloan, 2017 ). Promising approaches for minimizing these risks include supporting the participation of individuals with expertise in privacy, clinicians, as well as the target individuals with mental illness throughout the collection of data, development of predictive algorithms, and interpretation of findings ( Chancellor et al., 2019 ).
In recognizing that many individuals living with mental illness use social media to search for information about their mental health, it is possible that they may also want to ask their clinicians about what they find online to check if the information is reliable and trustworthy. Alternatively, many individuals may feel embarrassed or reluctant to talk to their clinicians about using social media to find mental health information out of concerns of being judged or dismissed. Therefore, mental health clinicians may be ideally positioned to talk with their patients about using social media, and offer recommendations to promote safe use of these sites, while also respecting their patients’ autonomy and personal motivations for using these popular platforms. Given the gap in clinical knowledge about the impact of social media on mental health, clinicians should be aware of the many potential risks so that they can inform their patients, while remaining open to the possibility that their patients may also experience benefits through use of these platforms. As awareness of these risks grows, it may be possible that new protections will be put in place by industry or through new policies that will make the social media environment safer. It is hard to estimate a number needed to treat or harm today given the nascent state of research, which means the patient and clinician need to weigh the choice on a personal level. Thus offering education and information is an important first step in that process. As patients increasingly show interest in accessing mental health information or services through social media, it will be necessary for health systems to recognize social media as a potential avenue for reaching or offering support to patients. This aligns with growing emphasis on the need for greater integration of digital psychiatry, including apps, smartphones, or wearable devices, into patient care and clinical services through institution-wide initiatives and training clinical providers ( Hilty, Chan, Torous, Luo, & Boland, 2019 ). Within a learning healthcare environment where research and care are tightly intertwined and feedback between both is rapid, the integration of digital technologies into services may create new opportunities for advancing use of social media for mental health.
As highlighted in this commentary, social media has become an important part of the lives of many individuals living with mental disorders. Many of these individuals use social media to share their lived experiences with mental illness, to seek support from others, and to search for information about treatment recommendations, accessing mental health services, and coping with symptoms ( Bucci et al., 2019 ; Highton-Williamson et al., 2015 ; Naslund, Aschbrenner, et al., 2016b ). As the field of digital mental health advances, the wide reach, ease of access, and popularity of social media platforms could be used to allow individuals in need of mental health services or facing challenges of mental illness to access evidence-based treatment and support. To achieve this end and to explore whether social media platforms can advance efforts to close the gap in available mental health services in the United States and globally, it will be essential for researchers to work closely with clinicians and with those affected by mental illness to ensure that possible benefits of using social media are carefully weighed against anticipated risks.
Dr. Naslund is supported by a grant from the National Institute of Mental Health (U19MH113211). Dr. Aschbrenner is supported by a grant from the National Institute of Mental Health (1R01MH110965-01).
Publisher's Disclaimer: This Author Accepted Manuscript is a PDF file of a an unedited peer-reviewed manuscript that has been accepted for publication but has not been copyedited or corrected. The official version of record that is published in the journal is kept up to date and so may therefore differ from this version.
Conflict of Interest
The authors have nothing to disclose.
Oxford University Press's Academic Insights for the Thinking World
Oxford Intersections is a new concept in interdisciplinary academic publishing from Oxford University Press (OUP). This online-only product will provide access to large, interdisciplinary works, with each focused on a complex, global topic. Each topic will contain around 300 peer-reviewed original research articles, all helpfully organized into themed sections.
Addressing today’s most pressing challenges requires a new approach to thinking. An interdisciplinary transformative approach can advance knowledge by exploiting and harmonizing the strengths of various disciplines within a unified framework. This approach deepens our collective understanding by bringing together the disparate and sometimes contradictory perspectives of many disciplines, all of which offer valuable insights.
Recognizing the value of this integrated approach, we can apply it to understand the complexity of social networks in our increasingly connected world. Social media platforms are at the intersection of different technologies and media types; they combine text, images, video, and interactive elements, often integrating features. This convergence influences how content is created, consumed, and shared, and changes the dynamics of communication and marketing.
Every day, people from a variety of backgrounds engage in online social interactions. At the heart of this digital transformation is the evolution of individual and cultural identity in a globally connected world. Social platforms such as YouTube, Facebook, TikTok, and Instagram serve as digital public squares, where identities are formed and expressed. These spaces also allow the construction of digital diasporas, allowing users from different backgrounds to maintain cultural links and create new common links between geographical divisions. On social networks, personal interactions can strengthen or remodel local traditions and societal norms.
The blending of the global and the local extends into the realm of religious expression. Social media facilitates a new form of religious engagement, where traditional practices are reimagined in the digital landscape. Online prayer groups and live services illustrate how religious communities adapt and flourish in these new media environments. This shift to digital worship prompts scholars from theological, sociological, and digital communication fields to offer a richer understanding of spirituality in the digital age.
This interdisciplinary exploration is essential for the development of strategies that promote a diverse and balanced media landscape, essential for a healthy democratic society.
In the realm of news and journalism, the advent of generative AI and sophisticated algorithms has transformed how information is curated and consumed, often reinforcing existing biases through echo chambers. Social media is a battleground where misinformation can spread as swiftly as legitimate information. Given that public discourse faces significant challenges to its integrity and authenticity, it is essential to engage experts in the field of information technology, psychology, and media studies in a collaborative effort to carefully examine and address the implications of these technologies. This interdisciplinary exploration is essential for the development of strategies that promote a diverse and balanced media landscape, essential for a healthy democratic society.
Similarly, the intersection of social media with commerce and marketing has sparked a transformation in consumer behavior and business strategies. Influencers and digital marketers now play pivotal roles in shaping consumer preferences and purchasing decisions, highlighting the need for insights from economics, marketing, and data analytics.
The vigorous debate on freedom of expression, data confidentiality, and platform responsibility underlines the need for sound governance and ethical surveillance in social networks. As legal frameworks race to catch up with technological advances, a collaborative approach involving legal scholars, ethicists, and technologists is essential. Their joint efforts aim to balance innovation with the protection of individual rights and social well-being, addressing key issues such as data confidentiality, content regulation, and platform responsibility. These efforts also analyze wider societal implications such as disruptions to traditional business models and privacy concerns.
In the educational sphere, social networks have revolutionized traditional learning environments, introducing tools that combine entertainment with education. The effective integration of these instruments into pedagogical practices requires the combined knowledge of educational theorists, technologists, and cognitive psychologists. This collaboration is essential to understanding how digital interactions can improve or prevent processes and learning outcomes, ensuring that educational progress keeps pace with technological innovations.
Finally, the impact of social networks on mental health and physical well-being cannot be overlooked. The role of social media in shaping social interactions and personal identity has profound health implications, requiring a joint effort from psychologists, health professionals, and digital communication experts. Together, they can develop strategies to mitigate the risks associated with digital involvement, such as cyber harassment and information overload, while unearthing the positive aspects of social connectivity.
These varied investigations make it clear that a robust interdisciplinary approach is essential for understanding the societal impacts of social media. As we traverse this digital landscape, the insights gained from such an approach are crucial in developing informed strategies and policies, which aim to maximize the benefits of social media while minimizing its risks. Each disciplinary perspective enriches our understanding and promotes a more careful and effective interaction with the digital world, equipping societies to manage the complexities of this evolving environment.
Featured image by mikoto.raw Photographer via Pexels . Public domain.
Dr. Laeeq Khan is an Associate Professor at the Scripps College of Communication and founding Director of the Social Media Analytics Research Team (SMART) Lab at Ohio University. With 18 years of international teaching and research experience, Dr. Khan has served as editor for several academic journals and worked on numerous funded research grants. His interdisciplinary expertise spans public health and crises, social data analytics, marketing, audience engagement, and information literacy. He earned his Ph.D. in media and information studies from Michigan State University, focusing on social media and audience engagement, and is committed to leveraging technology for societal benefits.
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Almost a year after APA issued its health advisory on social media use in adolescence , society continues to wrestle with ways to maximize the benefits of these platforms while protecting youth from the potential harms associated with them. 1
By early 2024, few meaningful changes to social media platforms had been enacted by industry, and no federal policies had been adopted. There remains a need for social media companies to make fundamental changes to their platforms.
Psychological science continues to reveal benefits from social media use , as well as risks and opportunities that certain content, features, and functions present to young social media users. The science discussed below highlights the need to enact new, responsible safety standards to mitigate harm. 2
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Platforms built for adults are not inherently suitable for youth. i Youth require special protection due to areas of competence or vulnerability as they progress through the childhood, teenage, and late adolescent years. ii This is especially true for youth experiencing psychological, physical, intellectual, mental health, or other developmental challenges; chronological age is not directly associated with social media readiness . iii
Brain development starting at ages 10–13 (i.e., the outset of puberty) until approximately the mid-twenties is linked with hypersensitivity to social feedback/stimuli. iv In other words, youth become especially invested in behaviors that will help them get personalized feedback, praise, or attention from peers.
Adolescence is a critical period for the development of more complex relationship skills, characterized by the ability to form emotionally intimate relationships. viii The adolescent years should provide opportunities to practice these skills through one-on-one or small group interactions.
Adolescence is a period of heightened susceptibility to peer influence, impressionability, and sensitivity to social rejection. x Harmful content, including cyberhate, the depiction of illegal behavior, and encouragement to engage in self-harm (e.g., cutting or eating-disordered behavior) is associated with increased mental health difficulties among both the targets and witnesses of such content. xi
Youths’ developing cortical system (particularly in the brain’s inhibitory control network) makes them less capable of resisting impulses or stopping themselves from behavior that may lead to temporary benefit despite negative longer-term consequences. xii This can lead to adolescents making decisions based on short-term gain, lower appreciation of long-term risks, and interference with focus on tasks that require concentration.
Other than the first year of life, puberty is the most important period of brain growth and reorganization in our lifetimes. xviii Sleep is essential for healthy brain development and mental health in adolescence. xix Sleep delay or disruptions have significant negative effects on youths’ attention, behavior, mood, safety, and academic performance.
Youth are easily deceived by predators and other malicious actors who may attempt to interact with them on social media channels. xxi
Research indicates that youth benefit from parental support to guide them toward safe decisions and to help them understand and appropriately respond to complex social interactions. xxii Granting parents oversight of youths’ accounts should be offered in balance with adolescents’ needs for autonomy, privacy, and independence. However, it should be easier for parents to partner with youth online in a manner that fits their family’s needs.
Health advisory on social media use in adolescence
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Change is needed soon. Solutions should reflect a greater understanding of the science in at least three ways.
First, youth vary considerably in how they use social media. Some uses may promote healthy development and others may create harm. As noted in the APA health advisory , using social media is not inherently beneficial or harmful to young people. The effects of social media depend not only on what teens can do and see online, but teens’ pre-existing strengths or vulnerabilities, and the contexts in which they grow up.
Second, science has highlighted biological and psychological abilities/vulnerabilities that interact with the content, functions, and features built into social media platforms, and it is these aspects of youths’ social media experience that must be addressed to attenuate risks. xxiv Social media use, functionality, and permissions/consenting should be tailored to youths’ developmental capabilities. Design features created for adults may not be appropriate for children.
Third, youth are adept at working around age restrictions. Substantial data reveal a remarkable number of children aged 12 years and younger routinely using social media, indicating that current policies and practices to restrict use to older youth are not working. xxv
Policies will not protect youth unless technology companies are required to reduce the risks embedded within the platforms themselves.
As policymakers at every level assess their approach to this complex issue, it is important to note the limitations of frequently proposed policies, which are often misreported and fall far short of comprehensive safety solutions that will achieve meaningful change.
Restricting application downloads at the device level does not fully restrict youths’ access and will not meaningfully improve the safety of social media platforms. Allowing platforms to delegate responsibility to app stores does not address the vulnerabilities and harms built into the platforms.
Focusing only on age restrictions does not improve the platforms or address the biological and psychological vulnerabilities that persist past age 18. While age restriction proposals could offer some benefits if effectively and equitably implemented, they do not represent comprehensive improvements to social media platforms, for at least four reasons:
Granting parents and caregivers greater access to their children’s social media accounts will not address risks embedded within platforms themselves. More robust and easy-to-use parental controls would help some younger age groups, but as a sole strategy, this approach ignores the complexities of adolescent development, the importance of childhood autonomy and privacy, and disparities in time or resources available for monitoring across communities. xxvi
[Related: Keeping teens safe on social media: What parents should know to protect their kids ]
Some parents might be technologically ill-equipped, lack the time or documentation to complete requirements, or simply be unavailable to complete these requirements. Disenfranchising some young people from these platforms creates inequities. xxvii
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1 These recommendations enact policies and resolutions approved by the APA Council of Representatives including the APA Resolution on Child and Adolescent Mental and Behavioral Health and the APA Resolution on Dismantling Systemic Racism in contexts including social media. These are not professional practice guidelines but are intended to provide information based on psychological science.
2 This report seeks to elaborate on extant psychological science findings, which may be particularly relevant in the creation of policy solutions that protect young people, and to inform the development of social media safety standards.
We wish to acknowledge the outstanding contributions to this report made by the following individuals:
Mary Ann McCabe, PhD, ABPP, member-at-large, Board of Directors, American Psychological Association; associate clinical professor of pediatrics, The George Washington University School of Medicine and Health Sciences
Mitchell J. Prinstein, PhD, ABPP, chief science officer, American Psychological Association; John Van Seters Distinguished Professor of Psychology and Neuroscience, University of North Carolina at Chapel Hill
Mary K. Alvord, PhD, founder, Alvord, Baker & Associates; board president, Resilience Across Borders; adjunct associate professor of psychiatry and behavioral sciences, The George Washington University School of Medicine and Health Sciences
Dawn T. Bounds, PhD, PMHNP-BC, FAAN, assistant professor, Sue & Bill Gross School of Nursing, University of California, Irvine
Linda Charmaraman, PhD, senior research scientist, Wellesley Centers for Women, Wellesley College
Sophia Choukas-Bradley, PhD, assistant professor, Department of Psychology, University of Pittsburgh
Dorothy L. Espelage, PhD, William C. Friday Distinguished Professor of Education, University of North Carolina at Chapel Hill
Joshua A. Goodman, PhD, assistant professor, Department of Psychology, Southern Oregon University
Jessica L. Hamilton, PhD, assistant professor, Department of Psychology, Rutgers University
Brendesha M. Tynes, PhD, Dean’s Professor of Educational Equity, University of Southern California
L. Monique Ward, PhD, professor, Department of Psychology (Developmental), University of Michigan
Lucía Magis-Weinberg, MD, PhD, assistant professor, Department of Psychology, University of Washington
We also wish to acknowledge the contributions to this report made by Katherine B. McGuire, chief advocacy officer, and Corbin Evans, JD, senior director of congressional and federal relations, American Psychological Association.
i Maza, M. T., Fox, K. A., Kwon, S. J., Flannery, J. E., Lindquist, K. A., Prinstein, M. J., & Telzer, E. H. (2023). Association of habitual checking behaviors on social media with longitudinal functional brain development. JAMA Pediatrics , 177 (2), 160–167; Prinstein, M. J., Nesi, J., & Telzer, E. H. (2020). Commentary: An updated agenda for the study of digital media use and adolescent development—Future directions following Odgers & Jensen (2020). Journal of Child Psychology and Psychiatry , 61 (3), 349–352. https://doi.org/10.1111/jcpp.13219
ii Nesi, J., Choukas-Bradley, S., & Prinstein, M. J. (2018). Transformation of adolescent peer relations in the social media context: Part 1—A theoretical framework and application to dyadic peer relationships. Clinical Child and Family Psychology Review , 21 (3), 267–294. https://doi.org/10.1007/s10567-018-0261-x
iii Valkenburg, P. M., & Peter, J. (2013). The differential susceptibility to media effects model. Journal of Communication , 63 (2), 221–243. https://doi.org/10.1111/jcom.12024
iv Fareri, D. S., Martin, L. N., & Delgado, M. R. (2008). Reward-related processing in the human brain: Developmental considerations. Development and Psychopathology , 20 (4), 1191–1211; Somerville, L. H., & Casey, B. J. (2010). Developmental neurobiology of cognitive control and motivational systems. Current Opinion in Neurobiology , 20 (2), 236–241. https://doi.org/10.1016/j.conb.2010.01.006
v Shin, D. (2020). How do users interact with algorithm recommender systems? The interaction of users, algorithms, and performance. Computers in Human Behavior , 109 , 106344. https://doi.org/10.1016/j.chb.2020.106344
vi Sherman, L. E., Payton, A. A., Hernandez, L. M., Greenfield, P. M., & Dapretto, M. (2016). The power of the Like in adolescence: Effects of peer influence on neural and behavioral responses to social media. Psychological Science , 27 (7), 1027–1035. https://doi.org/10.1177/0956797616645673
vii Albert, D., Chein, J., & Steinberg, L. (2013). The teenage brain: Peer influences on adolescent decision making. Current Directions in Psychological Science , 22 (2), 114–120. https://doi.org/10.1177/0963721412471347
viii Armstrong-Carter, E., & Telzer, E. H. (2021). Advancing measurement and research on youths’ prosocial behavior in the digital age. Child Development Perspectives , 15 (1), 31–36. https://doi.org/10.1111/cdep.12396 ; Newcomb, A. F., & Bagwell, C. L. (1995). Children’s friendship relations: A meta-analytic review. Psychological Bulletin , 117 (2), 306.
ix Nesi, J., & Prinstein, M. J. (2019). In search of likes: Longitudinal associations between adolescents’ digital status seeking and health-risk behaviors. Journal of Clinical Child & Adolescent Psychology , 48 (5), 740–748. https://doi.org/10.1080/15374416.2018.1437733 ; Rotondi, V., Stanca, L., & Tomasuolo, M. (2017). Connecting alone: Smartphone use, quality of social interactions and well-being. Journal of Economic Psychology , 63 , 17–26. https://doi.org/10.1016/j.joep.2017.09.001
x Sherman, L. E., Payton, A. A., Hernandez, L. M., Greenfield, P. M., & Dapretto, M. (2016). The power of the Like in adolescence: Effects of peer influence on neural and behavioral responses to social media. Psychological Science , 27 (7), 1027–1035. https://doi.org/10.1177/0956797616645673
xi Susi, K., Glover-Ford, F., Stewart, A., Knowles Bevis, R., & Hawton, K. (2023). Research review: Viewing self-harm images on the internet and social media platforms: Systematic review of the impact and associated psychological mechanisms. Journal of Child Psychology and Psychiatry , 64 (8), 1115–1139.
xii Hartley, C. A., & Somerville, L. H. (2015). The neuroscience of adolescent decision-making. Current Opinion in Behavioral Sciences , 5 , 108–115. https://doi.org/10.1016/j.cobeha.2015.09.004
xiii Atherton, O. E., Lawson, K. M., & Robins, R. W. (2020). The development of effortful control from late childhood to young adulthood. Journal of Personality and Social Psychology , 119 (2), 417–456. https://doi.org/10.1037/pspp0000283
xiv Boer, M., Stevens, G. W., Finkenauer, C., & Van den Eijnden, R. J. (2022). The course of problematic social media use in young adolescents: A latent class growth analysis. Child Development , 93 (2), e168–e187.
xv Hall, A. C. G., Lineweaver, T. T., Hogan, E. E., & O’Brien, S. W. (2020). On or off task: The negative influence of laptops on neighboring students’ learning depends on how they are used. Computers & Education , 153 , 103901. https://doi.org/10.1016/j.compedu.2020.103901 ; Sana, F., Weston, T., & Cepeda, N. J. (2013). Laptop multitasking hinders classroom learning for both users and nearby peers. Computers & Education , 62 , 24–31. https://doi.org/10.1016/j.compedu.2012.10.003
xvi von Bastian, C. C., & Druey, M. D. (2017). Shifting between mental sets: An individual differences approach to commonalities and differences of task switching components. Journal of Experimental Psychology: General , 146 (9), 1266–1285. https://doi.org/10.1037/xge0000333
xvii Andrews, J. C., Walker, K. L., & Kees, J. (2020). Children and online privacy protection: Empowerment from cognitive defense strategies. Journal of Public Policy & Marketing , 39 (2), 205–219. https://doi.org/10.1177/0743915619883638 ; Romer D. (2010). Adolescent risk taking, impulsivity, and brain development: Implications for prevention. Developmental Psychobiology , 52 (3), 263–276. https://doi.org/10.1002/dev.20442
xviii Orben, A., Przybylski, A. K., Blakemore, S.-J., Kievit, R. A. (2022). Windows of developmental sensitivity to social media. Nature Communications , 13 (1649). https://doi.org/10.1038/s41467-022-29296-3
xix Paruthi, S., Brooks, L. J., D’Ambrosio, C., Hall, W. A., Kotagal, S., Lloyd, R. M., Malow, B. A., Maski, K., Nichols, C., Quan, S. F., Rosen, C. L., Troester, M. M., & Wise, M. S. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine , 12 (6), 785–786. https://doi.org/10.5664/jcsm.5866
xx Perrault, A. A., Bayer, L., Peuvrier, M., Afyouni, A., Ghisletta, P., Brockmann, C., Spiridon, M., Hulo Vesely, S., Haller, D. M., Pichon, S., Perrig, S., Schwartz, S., & Sterpenich, V. (2019). Reducing the use of screen electronic devices in the evening is associated with improved sleep and daytime vigilance in adolescents. Sleep , 42 (9), zsz125. https://doi.org/10.1093/sleep/zsz125 ; Telzer, E. H., Goldenberg, D., Fuligni, A. J., Lieberman, M. D., & Gálvan, A. (2015). Sleep variability in adolescence is associated with altered brain development. Developmental Cognitive Neuroscience , 14, 16–22. https://doi.org/10.1016/j.dcn.2015.05.007
xxi Livingstone, S., & Smith, P. K. (2014). Annual research review: Harms experienced by child users of online and mobile technologies: The nature, prevalence and management of sexual and aggressive risks in the digital age. Journal of Child Psychology and Psychiatry , 55 (6), 635–654. https://doi.org/10.1111/jcpp.12197 ; Wolak, J., Finkelhor, D., Mitchell, K. J., & Ybarra, M. L. (2008). Online “predators” and their victims: Myths, realities, and implications for prevention and treatment. American Psychologist , 63 (2), 111–128. https://doi.org/10.1037/0003-066X.63.2.111
xxii Wachs, S., Costello, M., Wright, M. F., Flora, K., Daskalou, V., Maziridou, E., Kwon, Y., Na, E.-Y., Sittichai, R., Biswal, R., Singh, R., Almendros, C., Gámez-Guadix, M., Görzig, A., & Hong, J. S. (2021). “DNT LET ’EM H8 U!”: Applying the routine activity framework to understand cyberhate victimization among adolescents across eight countries. Computers & Education , 160 , Article 104026. https://doi.org/10.1016/j.compedu.2020.104026 ; Padilla-Walker, L. M., Stockdale, L. A., & McLean, R. D. (2020). Associations between parental media monitoring, media use, and internalizing symptoms during adolescence. Psychology of Popular Media , 9 (4), 481. https://doi.org/10.1037/ppm0000256
xxiii Dietvorst, E., Hiemstra, M., Hillegers, M. H. J., & Keijsers, L. (2018). Adolescent perceptions of parental privacy invasion and adolescent secrecy: An illustration of Simpson’s paradox. Child Development , 89 (6), 2081–2090. https://doi.org/10.1111/cdev.13002 ; Auxier, B. (2020, July 28). Parenting Children in the Age of Screens. Pew Research Center: Internet, Science & Tech; Pew Research Center. https://www.pewresearch.org/internet/2020/07/28/parenting-children-in-the-age-of-screens/
xxiv National Academies of Sciences, Engineering, and Medicine. (2024). Social media and adolescent health . The National Academies Press. https://doi.org/10.17226/27396
xxv Charmaraman, L., Lynch, A. D., Richer, A. M., & Zhai, E. (2022). Examining early adolescent positive and negative social technology behaviors and well-being during the Covid -19 pandemic. Technology, Mind, and Behavior , 3 (1), Feb 17 2022. https://doi.org/10.1037/tmb0000062
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xxvii Charmaraman, L., Lynch, A. D., Richer, A. M., & Zhai, E. (2022). Examining early adolescent positive and negative social technology behaviors and well-being during the Covid -19 pandemic. Technology, Mind, and Behavior , 3 (1), Feb 17 2022. https://doi.org/10.1037/tmb0000062
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September 4, 2024
This article has been reviewed according to Science X's editorial process and policies . Editors have highlighted the following attributes while ensuring the content's credibility:
fact-checked
trusted source
by Meredith Bauer, University of Florida
A recent study shows social media influencers are more important than previously thought when it comes to getting out vital information in a crisis.
The study suggested partnerships that could improve public communication between governments, non-profits and social media influencers during crises.
The study, conducted by UF/IFAS assistant professor Kimberly Kay Wiley, a researcher in the family, youth and community sciences department, and Bridgewater State University associate professor Seth Meyer, shows how these groups can collaborate to effectively disseminate information and manage public health emergencies on social media.
"In this case, the informal public health authorities seem to be able to reach the at-risk audiences and build on the trust that they have in a way that the formal health authorities just weren't able to do," Wiley said. "There are strong partnership opportunities here."
The study, titled "A Framework for Messy Communication: A Qualitative Study of Competing Voices of Authority on Social Media," explores social media communication during the 2022 mpox outbreak. It was published in Administrative Sciences .
By analyzing 1,392 social media posts from governments, non-profits and influencers across six platforms, the researchers identified how these groups could improve their reach and impact.
One of the central findings of the study is the importance of partnerships with non-traditional allies. Governments and non-profits can significantly enhance their communication efforts by partnering with influencers who are trusted by specific communities—in this case, the LGBTQIA+ community. This approach allows for a more targeted strategy to get the word out to hard-to-reach groups, particularly to isolated or minority groups that may be more vulnerable during crises.
Non-profits can tailor messages to address specific needs and concerns, while influencers, with their broad reach, trusted relationships with their followers and engaging content, can amplify these messages to a wider audience.
During the 2022 mpox outbreak, the study found, the most successful communication strategies were those that used partnerships to manage a rocky start. Initially, there was a vacuum of information from official sources such as governments, leading to confusion and misinformation.
However, as governments began to collaborate with influencers, the messaging became more organized and audience-specific. These findings highlight the need for proper planning and for groups to set up partnerships before a crisis happens.
The researchers also emphasized the importance of trust in these public-private partnerships. Influencers, in particular, must be selected based on their credibility and reliability to ensure that the information they disseminate is accurate and helpful. At the same time, influencers need the freedom to frame messaging for their audiences, even when it falls outside of a government 's branded social media approach.
"Formal health authorities can step in with resources and evidence-based action steps, but influencer partnerships can reach specific communities with the right messaging and get right into their social media feeds," Wiley said.
Provided by University of Florida
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Donald trump promised potential investors in his media company that they would see massive revenue. he has not delivered..
Donald Trump’s media company initially presented some grandiose projections to attract potential shareholders. Cut to two years later, and those projections have proved to be completely misleading, according to a Meidas Touch report published Friday.
The original pitch deck that Trump Media & Technology Group showed to its investors in 2022, including “hundreds of thousands of retail shareholders,” per CEO Devin Nunes, contained some pretty fantastical numbers. The company projected revenue of $114 million in 2023, which would then balloon to $835 million in 2024.
The reality of Trump’s struggling stock couldn’t live up to the fantasy that was promised.
In 2023, TMTG’s revenue was only $4.1 million, and the company reported a loss of more than $58 million. The projection fed to investors was off by a whopping $110 million—and that was before the election cycle had even really begun. Since then, things have become even more dire.
Since spiking around the Republican National Convention, the value of Truth Social stock has steadily declined. Shares of Trump’s media stock have often corresponded with how well investors think Trump’s presidential campaign is going, according to The New York Times .
The company’s current state is a far cry from the massive jump it was projected to make this year. By the end of the second quarter of 2024, TMTG had only taken in $836,000 and reported losses of $343 million.
Trump’s majority stake in the company, which is 115 million shares, a roughly 60 percent stake, was once worth a whopping $6 billion. Now it’s worth only $2 billion.
TMTG stock has continued to crater this week, as it hit its lowest value since it became publicly traded, closing beneath $17 on Wednesday.
Donald trump indicated he only wants loyalists in his camp..
Donald Trump apparently doesn’t care whether or not he wins in November anymore.
At a Fox News town hall on Thursday, the Republican presidential nominee revealed that his 2024 campaign strategy excludes anyone who he doesn’t believe supported him in the last election cycles.
Responding to a question from Sean Hannity about the economy, Trump spun a thread about a would-be supporter in the Republican primary who hadn’t voted for him before.
“One person who didn’t support me—he said, ‘I must admit I had the most successful four years of my life but I’m gonna vote for some—’ and now that person came back to me. I don’t want that person,” Trump said to muffled applause. “I don’t want that person.
“You know, they say you should take everybody, but that’s not the way I’m built. It’s one of those little problems,” he added.
"They say you should take everybody, but that's not the way I'm built" --Trump says he doesn't want voters who didn't support him in 2020 pic.twitter.com/xtIX7omoao — Aaron Rupar (@atrupar) September 6, 2024
It’s not the first time Trump has attempted to wash his hands of the labor required to win a fair election. Speaking in Detroit in June, Trump said of his campaign, “We don’t need [the] votes,” and “We got more votes than anybody’s ever had.” Instead, he argued that the campaign needed to “guard the vote” in anticipation of a “steal.”
Failing to draw more voters to his cause would, frankly, prove to be a huge problem for Trump, who finally admitted earlier this week that he actually did lose the 2020 election. The former president lost to President Joe Biden by more than seven million votes.
Neglecting to court those voters would surely spell disaster for his chances in November, especially during a fresher election season that has drawn renewed energy since Vice President Kamala Harris has taken over the Democratic ticket—though Trump may not understand the depth of the problem. While Trump’s support levels have held steady, Harris’s have slowly grown, indicating that she is picking up crucial undecided voters.
Later in the town hall, Trump made an outlandishly hyperbolic statement about his support around the country while discussing the September 10 debate on ABC News, arguing that the network better “be fair” to him or else it would alienate “75, 80 percent of the country.”
The florida senator says that massive russian propaganda scheme wasn’t a big deal, actually..
Senator Marco Rubio doesn’t think that Russia paying off right-wing influencers is a big deal.
The ranking member of the Senate Foreign Relations Committee was asked on Fox News Thursday about the Justice Department revelation that several conservative commentators were paid by assets of the Russian government to produce propaganda and disinformation. Rubio defended the influencers, calling them “victims.”
“We are talking about preexisting political opinions in the United States. These are preexisting political opinions that have existed well before any Russian engagement or involvement or what have you,” Rubio said to Sean Hannity. “These people that they say that were being funded by the secret donor that was hiding their true identity, they already had these opinions, they already believed in these things.”
“They legitimately believe in the views that they’re espousing,” Rubio added . “They were victims, they were targets of a fraud in which someone posing as just a regular investor had Russian money behind them.”
Marco Rubio downplays Russia paying prominent rightwing influencers because "we're talking about preexisting political opinions in the United States ... they legitimately believe in the views they're espousing. They were victims." pic.twitter.com/HGgnyJSLmG — Aaron Rupar (@atrupar) September 6, 2024
Rubio is joining his fellow conservatives in defending the commentators at Tenet Media, which the DOJ revealed Wednesday was secretly funded by Russian state media employees in “a scheme to create and distribute content to U.S. audiences with hidden Russian government messaging.” These influencers included Tim Pool, Dave Rubin, Lauren Chen, and Benny Johnson. One right-wing media organization, Blaze Media, has already fired Chen as a result of the indictment.
Not surprisingly, these commentators described themselves as victims in the scheme, a point that was not only echoed by Rubio, but also by MAGA Republicans like Representative Matt Gaetz, pundit Ben Shapiro, and even Donald Trump. But, how do they explain that these “preexisting ideas” popular among Republicans right now seem to be exactly what Vladimir Putin’s government wanted to fund?
Previous Russian operations in the United States appear to have been aimed at promoting conflict and discord to undermine faith in the country’s institutions, such as the electoral process, and promote foreign policy favorable to Russia . It stands to reason that funding conservative influencers had similar aims. Right-wing figures like Rubio, Trump (whose political rise has been very useful to Putin ), and Gaetz have to ask themselves if the ideas they’re espousing can really be good for America if Putin himself wants to put money behind them.
New court documents reveal that russia is keeping a very, very long list of influencers to spread its propaganda..
The Russian disinformation plot revealed in a Justice Department indictment this week may just be the tip of the iceberg, according to newly unsealed court documents.
On Wednesday, the DOJ announced it would seize 32 internet domains linked to a larger Kremlin scheme to promote disinformation and influence the 2024 election. The Russian campaign, known as Doppelganger, uses AI-generated content to create “fake news” boosted through social media with the aim of electing Donald Trump.
“Today’s announcement exposes the scope of the Russian government’s influence operations and their reliance on cutting-edge AI to sow disinformation,” FBI Director Christopher Wray said in a statement about the charges. According to records, the plan was well known at even the highest levels of the Russian government—and Russian President Vladimir Putin himself may have been aware of the campaign.
Of particular note, the documents released Wednesday included an affidavit that noted a Russian company is keeping a list of more than 2,800 influencers world wide, about one-fifth of whom are based in the United States, to monitor and potentially groom to spread Russian propaganda. The affidavit does not mention the full list of influencers, but is still a terrifying indicator of how deep the Russian plot to interfere in U.S. politics really goes.
The Doppelganger program and its “Good Old USA Project” aimed to mimic mainstream media outlets to push pro-Russian policies through fake social media accounts. Documents show that the Kremlin specifically targeted Trump supporters, minorities, gamers, and swing-state voters by spreading far-right conspiracies and capitalizing on existing divisions in U.S. politics.
”They are afraid of losing the American way of life and the ‘American dream,’” Ilya Gambashidze, an architect of the project, wrote, outlining his scheme. “It is these sentiments that should be exploited in the course of an information campaign in/for the United States.” To do so, the Russian government would emphasize that Republicans are “victims of discrimination of people of color” and promote conspiracies that white middle-class people are being discriminated against.
The “guerrilla media” plan needed to not only plant falsehoods, but also spread them far and wide. They targeted gamers and chatroom users, who they described as the “backbone of the right-wing trends in the US segment of the Internet,” and monitored social media influencers. The Russians planned to build relationships with prolific posters who were “proponents of traditional values, who stand up for ending the war in Ukraine and peaceful relations between the US and Russia, and who are ready to get involved in the promotion of the project narratives.”
“We need influencers! A lot of them and everywhere. We are ready to wine and dine them,” wrote Gambashidze in a note from a meeting with Russian government officials.
Though this specific campaign has no official link with recent findings about Tenet Media’s work with Russian state media network RT, the goals are the same: “To secure victory for [Donald Trump].”
Vance, who has repeatedly opposed gun control measures, seems to think that school shootings are simply inevitable..
J.D. Vance completely fumbled his response to Wednesday’s mass shooting at Apalachee High School in Georgia, in which he resigned to school shootings as a bleak “fact of life.”
“Now look, the Kamala Harris answer to this is to take law-abiding citizens’ guns away from them. That is what Kamala Harris wants to do,” Vance said during a rally Thursday in Arizona.
“Look, I don’t like this. I don’t like to admit this. I don’t like that this is a fact of life,” Vance said. “But if you’re—if you are a psycho and you want to make headlines, you’d realize that our schools are soft targets.”
“We’ve got to bolster security so that if a psycho wants to walk through the front door and kill a bunch of children, they’re not able to,” Vance said, sharing his fatalistic view of what are entirely avoidable tragedies. There is just no way to prevent young people from committing gross acts of violence with tools that the government already supposedly regulates. Just no way!
JD Vance responds to the deadly shooting in Georgia by saying school shootings are just “a fact of life” and attacking common sense gun safety reform pic.twitter.com/ISNRuXneg6 — Kamala HQ (@KamalaHQ) September 6, 2024
Vance’s limp policy idea imagines public schools as the only venue for a mass shooting—increased security there would not prevent, say, a shooting at a university campus, church, grocery store, mall, or really anywhere else. Plus, even he admitted he didn’t like the idea of beefed up security around his children.
“And again, as a parent, do I want my school to have additional security? No, of course I don’t,” Vance said. Then why did he just pitch it? “I don’t want my kids to go to school in a place where they feel like they’ve got to have additional security. But that is increasingly the reality that we live in.”
Vance’s cynical response to the deadly shooting, which killed four people and injured nine others, is particularly grim in light of Kamala Harris’s response : “It doesn’t have to be this way.”
One of the two staffers involved is a deputy campaign manager for donald trump’s presidential bid..
The fallout from last week’s Arlington National Cemetery fight is still plaguing the Trump campaign.
The Trump staffers reportedly involved in accosting a cemetery official are Justin Caporale, a deputy campaign manager for Donald Trump’s reelection bid, and Michel Picard, a member of Trump’s advance team, NPR reported Thursday evening.
Caporale had previously worked under former First Lady Melania Trump, and served under Florida Governor Ron DeSantis as director of external affairs, according to the Tampa Bay Times . Caporale was also listed as an on-site contact during the January 6 riot at the U.S. Capitol. He was, at the time, a project manager for the Women for America First rally, before some of the crowd stormed into the halls of Congress.
Trump’s decision to film at the military graveyard—and in Section 60, where recent military casualties are buried—violated federal law, which prohibits politically related activities in the cemetery such as taking photos and videos in support of a political campaign. The criminal behavior sparked a verbal and physical fight between Trump’s surrogates and an Arlington National Cemetery official who attempted to rein in the politico’s videotaping.
The Trump campaign claimed that they had been given permission to videotape by the families of fallen service members, but unfortunately for Trump, that doesn’t change federal law. In a rare statement last week, the Army said that it considered the case closed but sided with the cemetery official, writing that they believed the official had been “abruptly pushed aside” and “unfairly attacked” by Trump staffers.
Trump has even begun this week to insist the fight did not happen at all, making the involvement of a senior campaign staffer all the more damaging. Trump’s campaign has repeatedly promised to release video exonerating both him and his staffers, but no video has appeared.
The Republican presidential nominee’s anti-military rhetoric has been a point of contention with current and former service members in recent weeks. In August, the reputed Vietnam-era draft dodger came under fire for arguing that the Presidential Medal of Freedom he awarded to one of his billionaire donors was “much better” than the nation’s highest military honor, the Medal of Honor. That comment struck a nerve with veterans, who connected Trump’s disrespectful rhetoric to a 2020 Atlantic report that caught the former president repeatedly referring to fallen soldiers as “suckers and losers.”
Representative tony gonzalez knows his party is in deep trouble this november..
The Republican Party is in trouble this election, and may lose its majority in the House of Representatives—so says Texas Representative Tony Gonzalez, a Republican himself.
Speaking at the Texas Tribune Festival on Thursday, the congressman said he believed the party would lose in November due its own actions.
“What’s frustrating me is I firmly believe that House Republicans are going to lose the majority—and we’re going to lose it because of ourselves,” Gonzales said.
Gonzalez said that a culture of blame had taken hold of his party, as well as the Democrats, pointing to a cycle of oversight hearings opposed to whichever party was in power.
“It’s not rocket science here. You know the economy, it’s really real. I mean, more and more middle-class Americans are falling further and further behind in access to quality health care,” said Gonzalez. “Are we talking about this? Are we talking about some of these kind of kitchen table issues? No—it’s all about who we’re going to impeach.”
Gonzalez was censured by the Texas state Republican Party earlier this year for voting for gun safety legislation, and increasing same-sex marriage protections. He also directed some of his criticism toward Democrats, who failed to break through for a major victory in the state.
“Texas Democrats are failing to deliver the message. They are stuck in all-or-nothing, and guess what? They’re getting nothing,” Gonzalez said. “That works out well for Republicans.”
Texas Democrats “haven’t evolved into going, ‘How do I win a race? How do I deliver a message for the general population, and not just my base?’” Gonzalez added. “And anytime you get stuck in that, you’re going to lose.”
Gonzalez hasn’t shied away from criticizing his party in the past, attacking Representative Matt Gaetz for “paying minors to have sex with them at drug parties” and Representative Bob Good for endorsing his opponent, “a known neo-Nazi,” in a CNN interview in April.
“These people used to walk around with white hoods at night. Now they’re walking around with white hoods in the daytime,” Gonzalez said at the time.
The Texas congressman isn’t the only member of his party who has been critical of the GOP’s lack of results recently. Last November, Representative Chip Roy yelled at his colleagues for failing to accomplish anything significant, and in January, Representative Andy Biggs complained on Newsmax that his party has accomplished “nothing” since winning control of the House in 2022.
Gonzalez isn’t likely to win over many of his colleagues, though: The National Republican Congressional Committee immediately issued a statement saying that they “disagree” with him.
One of donald trump’s former campaign advisers was just charged over his work for russian state media. but trump doesn’t seem to care..
Hours after the Justice Department announced it is charging a former Trump adviser over his work with Russian media, Donald Trump made a shocking promise: He’ll lift U.S. sanctions on Russia.
The Justice Department on Thursday charged Trump’s 2016 campaign adviser Dimitri Simes, as well as his wife, Anastasia, for working with a sanctioned Russian state television network and laundering the profit. According to the indictment, the couple received over $1 million, a personal car, and a driver for their work with Russia’s Channel One. (Simes, by the way, is mentioned over 100 times in the Mueller report, for his relationship with Trump allies like Jared Kushner.)
Given the news, when Trump took the stage at the Economic Club of New York on Thursday, the first question from the panel of business leaders was about Russian sanctions. H. Rodgin Cohen, senior chair of law firm Sullivan & Cromwell, asked the former president if he “would strengthen or modify any of these economic sanction programs, particularly Russia.”
Trump then went on a rant about the problems of sanctions, stating clearly, “I want to use sanctions as little as possible.”
Trump suggests he will lift US sanctions on Russia and Iran if he wins pic.twitter.com/oPRLRK4P77 — Kamala HQ (@KamalaHQ) September 5, 2024
“You’re losing Iran, you’re losing Russia. China is out there trying to get their currency to be the dominant currency,” he said, explaining that he believes sanctions of countries like Russia weaken the dollar. “There’s so much conflict with all these countries that you’re going to lose” the dominance of the dollar.
During his time in office, Trump imposed new sanctions on Iran and North Korea but was so reluctant to impose sanctions on Russia, despite election interference and its use of chemical weapons, that lawmakers had to force his hand . As he described to Cohen on Thursday, Trump was quick to take the punishment away. “I use sanctions very powerfully against countries who deserve it, then I take them off.”
The sanctions that Dimitri and Anastasia Simes violated were put in place “in response to Russia’s illegal aggression in Ukraine,” U.S. Attorney Matthew M. Graves said in a statement.
Thursday’s indictment comes on the heels of another Justice Department case charging two Russian state media employees in “a scheme to create and distribute content to U.S. audiences with hidden Russian government messaging.” Several prominent pro-Trump influencers were implicated in the case.
Try to make any sense of what trump said here..
Donald Trump couldn’t come up with a meaningful answer when asked about how he would make childcare affordable Thursday.
Speaking at the Economic Club of New York, the Republican presidential nominee gave a long, meandering answer to the question and didn’t even mention children or any possible solutions to the issue, even though he was asked what specific legislation he would pass.
“It’s a very important issue. But I think when you talk about the kind of numbers that I’m talking about that, because, look, childcare is childcare. It’s something you know you have to have it, in this country you have to have it,” Trump’s answer began, before he went off on a tangent about economic numbers.
“We’re going to be taking in trillions of dollars, and as much as childcare is talked about as being expensive, it’s, relatively speaking, not very expensive compared to the kind of numbers we’ll be taking in. We’re going to make this into an incredible country that can afford to take care of its people,” Trump added , still failing to actually answer the question.
Donald Trump’s answer on how he will make childcare more affordable: pic.twitter.com/Hwu7R5aIt6 — Acyn (@Acyn) September 5, 2024
Trump’s incoherent answer was somehow worse than the one his running mate, J.D. Vance, gave Wednesday at a Turning Point Action event in Arizona when asked a similar question. Vance told conservative pundit Charlie Kirk that he would suggest people turn to their family members to help with childcare, or, if family members were not available, to loosen education requirements for childcare workers.
Aside from the fact that these answers indicate that the ostensibly pro-family Republican Party has poor solutions to making childcare less expensive, they also show Trump’s increasing cognitive decline . He was asked a straightforward question on how he would make childcare less expensive and the specific legislation he would pursue to make that possible. Trump either had no interest in a coherent answer or wasn’t capable of providing one. Kamala Harris’s presidential campaign had a quick response.
“Billionaire-bought Donald Trump’s ‘plan’ for making child care more affordable is to impose a $3,900 tax hike on middle class families,” Harris campaign spokesperson Joseph Costello said in a statement. “The American people deserve a President who will actually cut costs for them, like Vice President Harris’ plan to bring back a $3,600 Child Tax Credit for working families and an expanded $6,000 tax cut for families with newborn children.”
Is Trump capable of presenting, or even understanding, substantive policy ideas? His apparent mental state says he is not, and media coverage seems to gloss over discussions about his condition. Perhaps the upcoming debate with Harris next week will finally expose him in front of a national audience.
Donald trump has tapped elon musk, who wrecked twitter in the name of cost-cutting, to run a task force aimed at cutting federal overspending..
X owner, Tesla chief, and SpaceX executive Elon Musk could pick up another role should Donald Trump win in November: leading a government efficiency task force.
The task force would have the authority to audit federal spending and regulations, and came at the recommendation of Musk himself, Trump said in remarks Thursday to the Economic Club of New York.
“At the suggestion of Elon Musk, who has given me his complete and total endorsement—that’s nice, a smart guy, he knows what he’s doing, he knows what he’s doing! It’s very much appreciated—I will create a government efficiency commission tasked with conducting a complete financial and performance audit of the entire federal government and making recommendations for drastic reforms,” Trump told the subdued crowd of business executives. “We need to do it. Can’t go on the way we are now.”
Trump says that Elon Musk has agreed to serve in his administration pic.twitter.com/yRV9u7usOk — Aaron Rupar (@atrupar) September 5, 2024
According to Trump, the commission would develop a plan to “totally eliminate fraud and improper payments within six months,” aiming to slash trillions of dollars from the federal budget while promising not to alter government services. He did not identify any specific programs that could be slashed to save the cash, making budget experts from both parties very wary of the ambitious promise, according to The Washington Post ’s White House economics reporter Jeff Stein . The commission as a whole represents an apparent dig at spending under the Biden-Harris administration.
Musk and Trump have grown closer since the tech billionaire formally endorsed the Republican presidential nominee after an assassination attempt in July. That same month, Musk pledged to give $45 million a month to a pro-Trump super PAC (a promise he later walked back .) The pair also shared a long, sprawling talk on X in August (the details of which may have violated FEC regulations.)
Ahead of Trump’s speech, Musk took to X to confirm that he would be open to such a role.
“I look forward to serving America if the opportunity arises,” Musk wrote in a post . “No pay, no title, no recognition is needed.”
Musk had already previewed his potential federal job on Tuesday, tweeting that he “can’t wait” to take on a cust-cutting role. “There is a lot of waste and needless regulation in government that needs to go,” he warned.
But regardless of his enthusiasm, Musk’s previous attempts to rein in spending at his companies don’t bode well for the government should he take on such a role. After acquiring Twitter, Musk laid off roughly 75 percent of its staff—a decision that infuriated investors and ended up tanking the social media behemoth’s value by 90 percent, in Musk’s own words.
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