People’s love of social media, emails and texts has created a new category of tech users: "constant checkers," who relentlessly scan their smartphones, computers and tablets for the next wave of messages. And it is fueling some people’s anxiety. According to APA’s 2017 Stress in America survey, 43 percent of Americans qualify as constant checkers and almost a fifth of Americans report that technology use is a very or somewhat significant source of stress for them.
Increased stress is just one of the negative side effects that can come with too much technology use. Problematic smartphone use—addiction-like behavior in which excessive smartphone use results in negative outcomes in daily life—has been linked with depression and anxiety in a review of the literature by University of Toledo psychology professor Jon D. Elhai, PhD, and colleagues ( Journal of Affective Disorders , Vol. 207, 2017). "We can’t determine cause and effect, because most of the studies were correlational," says Elhai.
And while problematic device use in general does not yet qualify as an addiction, there is enough evidence about internet gaming in particular that the World Health Organization (WHO) added gaming disorder to the latest update of its International Classification of Diseases, and the American Psychiatric Association lists it as a condition that warrants further study in the latest version of the Diagnostic and Statistical Manual of Mental Disorders. In response to these controversial moves, APA’s Div. 46 (Society for Media Psychology and Technology) issued a statement expressing concern over WHO’s decision, noting that the research base is still insufficient; APA’s Div. 50 (Society of Addiction Psychology) created a task force to come up with a response.
In the meantime, a growing number of psychologist-led efforts aim at helping people develop healthier relationships with technology.
Children’s media use is of special concern. A 2017 United Nations Children’s Fund (UNICEF) report found that children under 18 represent a third of all internet users globally. And adolescents and young adults ages 15 to 24 are the most connected cohort, with 71 percent online versus just 48 percent of the overall population.
APA has issued guidance for promoting healthy technology use for children, which emphasizes the need for parents to discuss the benefits as well as the risks of technology with their children. The guidelines urge parents to monitor the websites their children are visiting, teach good online citizenship and discuss digital decision-making. APA CEO Arthur C. Evans Jr., PhD, says that the association "is concerned about the increasing amount of time children are spending on digital devices" and that APA is examining psychology’s role in technology development.
Now, a new Device Management and Intelligence Committee of Div. 46 is developing guidance for the public and psychologists on device and social media use. The document will address such topics as good online citizenship on social media and recovery from online embarrassment. One key concern is "absent presence"—the phenomenon of being physically present with other people but paying more attention to a phone or other device than to them, says Joanne Broder-Sumerson, PhD, a committee co-chair.
"One of our taglines is ‘Unplug and hug,’" she says. "Technology helps facilitate our relationships with people far away, but not the people sitting next to us."
Of course, screen time isn’t always a negative. In one study, Facebook use was associated with increased face-to-face communication, especially for introverts ( Psychology of Popular Media Culture , online first publication, 2017). Facebook may help introverts develop trust and rapport in a less threatening environment before they venture into real-life relationships, speculates lead author Alexander Spradlin, PhD, an instructor in the department of psychology at Washington State University.
Other psychologists are developing measures that clinicians can use to assess whether patients have a problematic relationship with digital technology. Sarah E. Domoff, PhD, an assistant professor of psychology at Central Michigan University, has developed and validated the Problematic Media Use Measure, which clinicians can use to assess whether screen-based media use is causing difficulties for children ages 4 to 11 ( Psychology of Popular Media Culture , online first publication, 2017).
"If a child becomes upset or has a meltdown when a parent tries to take away a tablet or screen, that could indicate a problem," says Domoff, who is now developing a similar assessment tool for older children.
Other red flags include disruption of family events by video games or other media, missing out on opportunities because of screen time and screen time as the only activity a child looks forward to.
For kids whose results indicate a problem, Domoff encourages a gradual weaning from devices coupled with alternative activities that help fill gaps in a child’s development. If a child is excessively gaming, for instance, Domoff recommends that parents provide opportunities to engage with peers offline. A family approach to reducing screen time is key, she adds. "A lot of times parents are also struggling with putting down their phones," she says, adding that her clinic at the Center for Children, Families and Communities treats children with problematic screen media use and serves as a practicum site for training future psychologists on how to assess and treat the problem.
Helping pediatricians screen for problematic digital media usage during well-child visits is the goal of the Media and Child Health Clinician Toolkit, developed by research scientist David Bickham, PhD, and colleagues at Boston Children’s Hospital’s Center on Media and Child Health.
The toolkit helps pediatricians, parents and children assess whether media use is contributing to such problems as aggression, obesity and attention deficit.
"Rather than saying, ‘Are you having trouble with media use?’ it is ‘Do you have these behaviors or experience these things, and how might media use be related to that?’" explains Bickham, also an instructor in pediatrics at Harvard Medical School.
The toolkit tries to get at the complexity of children’s media use and its impact, says Bickham, explaining that the problem may be either the content a child is exposed to via media or the amount of time a child spends on a device. "There are kids who are playing video games all night and missing school," says Bickham. "There are kids who are viewing a lot of porn and being exposed to violent porn. There are information seekers who get drawn down rabbit holes of Wikipedia and YouTube, which leads to huge amounts of use."
Adults often have different media use problems than their children, says Paula Durlofsky, PhD, a private practitioner in Bryn Mawr, Pennsylvania, who has seen the number of adults with social media concerns soar in recent years.
Durlofsky urges these adult patients to reflect on what they hope to get out of social media, whether it is new friends, deeper connections or networking. She counsels patients to use social media to enhance offline friendships, not replace them. She also advises patients to find alternative responses to feelings of boredom or whatever emotion is driving overuse of social media and to schedule social media breaks.
Specialized treatment clinics are also springing up. In Santa Monica, California, Don Grant, PhD, who co-chairs the Div. 46 Device Management and Intelligence Committee, runs an intensive outpatient program for adolescents called Resolutions Teen Center, which combines device-management help with mental health and substance use treatment. In addition to therapy, he encourages patients to connect with the present—to look at the ocean instead of taking a selfie with it, for instance. Meanwhile, a parents’ group he runs helps families create healthier household media environments.
"You can write ‘LOL’ all you want," says Grant. "It’s not going to have the same effect as laughing with people."
