The good, the bad, and social media in adolescents with disability.

Abstract

Adolescence is characterized by numerous biological, psychological, cognitive, and social changes; establishing one's identity and social network are of paramount importance in this phase of life. Technology and social media platforms have transformed these processes and experiences in today's generation of young people, creating opportunities for adolescents to expand their communities from local to global groups. However, these technological advancements have both beneficial and detrimental effects on adolescent development.1 In adolescents with developmental, cognitive, and physical disabilities, social media usage may encourage socialization and engagement. The virtual world may help them connect to others with similar disabilities, overcoming barriers of inaccessibility and geographical distance. Social media provides a wealth of education on disability issues; it increases access to resources, and may also deliver interventions to promote health and address psychological disorders. On the other hand, adolescents with disabilities may be at greater risk of the negative effects of social media. For example, social media transforms the already potentially stressful peer status/approval interactions of adolescence by quantifying friendships (e.g. the number of ‘likes’ or ‘followers’), amplifying vulnerability and loneliness (e.g. if no comments are made to posts), and rapidly publicizing undesirable photographs or private information. While development of social identity is a distinctive aspect of adolescence, adolescents often construct two identities, the ‘real life’ identity and the ‘virtual’ one, which may consist of altered and exaggerated body images and experiences. Adolescents, who are at increased risk for depression and anxiety, may misconstrue these images as further validation for their own social isolation, low self-esteem, or distorted body image. Moreover, those already experiencing depression or anxiety are more likely to endorse a ‘fear of missing out’, which is associated with problematic and potentially addictive social media usage, particularly in females.2 During adolescence, the formation of complex thinking, including metacognition, occurs, as well as emotional changes. Combined with adolescents’ impulsiveness, these normative developmental characteristics may interfere with logical thinking, negatively impact decision-making ability, and lead to poor judgement. In the virtual world, these behaviors may translate to oversharing private information, intensifying problematic behavior, and accessing inappropriate content and contacts. There is also the potential for groupthink: normalizing risk-taking behaviors, such as substance use, self-injury, and sexual behaviors due to the perceived prevalence and visibility of those behaviors. One of the most concerning corollaries of social media is cyber-bullying, which may occur at any time across various media platforms. Adolescents with physical, developmental, and cognitive disabilities are at greater risk of cyber-bullying. Therefore, monitoring and addressing this activity is critical because of its detrimental impact on mental health.3 In 2014/2015, 73% of adolescents reported access to a smart phone; today the rate is 95%. During this period, the rate of being online on a near-constant basis has almost doubled from 24% to 45%.4 At this time of exponential growth in social media usage, we have to make meaning of the intersecting physical and virtual worlds and provide appropriate guidance and monitoring to young people. As adolescents with disabilities are more vulnerable to the detrimental effects of social media, we need to provide education and have forthright discussions on internet safety and the publicness and permanency of social media. We live in a world of two realities, physical and virtual, both fraught with opportunities and adversities. The challenge is to provide individualized mentorship to our adolescents, to facilitate the successful navigation of this developmental period and promote positive health and well-being.