Current Challenges to Adolescent Well-being

Current Challenges to Adolescent Well-being | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Current Challenges to Adolescent Well-being Vincent Jeevar, Bonneta Chapman-Little, Sarah Jackson This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-1447988/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Mental health problems are increasing among adolescents with depression, anxiety, and multiple areas where self-esteem is negatively impacted on the rise. Dangers of social media use include social comparison and the risk of not receiving positive feedback. This study focused on a review of previous research literature and used data supplied by RemedyLive. The purpose of this paper is to examine the influence of social media on an adolescent’s well-being. The data were provided and complied by RemedyLive with all individual user data scrubbed. RemedyLive is an organization offering support to students in middle and high school around the United States. RemedyLive operates the ‘Get Schooled Tour’, giving talks in schools and asking students to respond to questions regarding family, friends, school, and other areas that may influence mental health. The findings suggest that school and homework are top stressors for students, with 35% of high school students reporting high levels of anxiety. There are numerous concerns with social media relating to increases in depression, anxiety, and lower self-esteem. The content, especially on Instagram, significantly lowers mental health, However, with 60% of students reporting 4 or more hours of non-academic screen time each day there is less time being spent on productive and academic tasks. The conclusion of the research points to a concerning relationship between social media platforms and decreasing adolescent mental health that suggest the dangers of social media are indirect and often unnoticed by adolescents and young adults. An ongoing analysis of social media on development is recommended for further investigation to determine the long-term effects. Psychology social media self-esteem mental health bullying cyberbullying anxiety depression 1. Introduction There are many challenges to adolescent development, with social media increasingly becoming the latest revolution in human interaction, allowing people to stay connected and stay up-to-date in an ever-changing world in real-time. Social circles have been expanded, presenting exposure to new cultures, ideas, and relationships. Additional benefits include being able to connect to loved ones and friends across distance in ways unimaginable to previous generations. However, the increase in quantity and ease of maintaining relationships does not necessarily correlate with quality, and research suggests that a higher frequency of social media use correlates to a lower sense of emotional support (Shensa et al., 2016 ). This paper presents how social media is directly or indirectly a factor is multiple areas negatively affecting adolescent well-being. The number of young Americans experiencing mental health challenges has seen a significant rise in the last decade, and this decline has coincided with the rapid rise of social media. Twenge et al. ( 2019 ) reviewed responses from over 200,000 adolescents from the ages of 12 to 17 from the years of 2005 to 2017, and over 400,000 adults from the years 2008 to 2017. From 2005 to 2017, the rate of reported symptoms among adolescents consistent with major depression increased 52%. Young adults fared worse, reporting an increase of 63% from 2009 to 2017. Twenge et al. ( 2019 ) found a 71% increase in young adults experiencing serious psychological distress from 2008 to 2017 and a 47% increase among young adults with suicidal thoughts or other suicide-related outcomes for the same period. Not only does social media negatively affect mood, but the increase in social media use has also correlated to shallowing of cognitive and moral shallowness (Annisette & Lafreniere, 2017 ). Madore et al. ( 2020 ), studied 80 young adults to explore differences in the ability to maintain attention by studying how well the subjects were able to identify a gradual change in an image. Media multitasking was assessed by having participants describe how well they could commit to multiple media sources, such as texting and watching television within a given hour. The researchers compared memory performance between participants, and found that individuals with lower sustained attention ability and heavier media multitaskers both performed worse on memory tasks. With teens using social media at an ever-increasing rate, and algorithms in applications specifically designed to keep a user tied to the platform, the landscape is a perilous one concerning adolescent development, with cognitive and emotional challenges becoming apparent. Cognitive and moral shallowness are concerns enough (Annisette & Lafreniere, 2017 ), but it is also important to examine the content adolescents are viewing. An adolescent being unable to accurately understand and evaluate the information they are exposed to will influence every area of life, including peer relationships and identity formation, both critical components of this stage of development. Technology has created a reality where access to content traditionally considered to be of an adult nature is only a fingertip away. Bark, a company that monitors online activities of tweens and teens state the following information for online exposure of teens: 94.1% have expressed or experienced violent subject matter or thoughts, 66.3% have engaged in conversations about depression, 82% experienced bullying as a bully, victim or witness, 91.1% engaged in conversations about drugs or alcohol, 66.6% were involved in self-harm or suicidal situation, and 87.9% encountered nudity or content of a sexual nature (Bark’s Annual Report, 2020). With reduced cognitive and relationship skills and an increase in exposure to complex and potentially troublesome content, it is no surprise there is a mental health crisis in young adults in the United States, with anxiety (60.7%), depression (48.6%), and stress (47%) leading the mental health struggles for college students using counseling services (LeViness et al., 2019 ). There are many ways in which social media is problematic to adolescent development, and “large studies consistently find that more frequent digital-media use is associated with lower well-being among adolescents,” (Twenge, 2019 ). Kelly et al., ( 2018 ) found four criteria make up an increase in depressive symptoms associated with social media use. These are poor sleep, online harassment, poor self-esteem, and body image. These areas relate to an increase in depressive symptoms when social media is used. These areas will be examined in further depth and discussed using data provided by RemedyLive. This paper examines how the influence of current cultural pressures, online socializing, and other social influences can have a detrimental effect on adolescent health. There will be a literature review of current research, followed by results shared based on data from the RemedyLive Get Schooled Tour. Finally, a discussion exploring how social media is a common link in the majority of challenges faced by adolescents. 1.1 Social Media and Self-Esteem A positive self-image is an important factor in living a happy life, especially for an adolescent where identity is the primary factor in development. Today, adolescents are viewing their peers' lives on social media, as well as following social media influencers, exposing themselves to a constant stream of highlight reels. This creates the unrealistic perception that someone is living a better life, has a better body, is more gifted, and continuously judges themselves based on what someone posts on social media. Krause et al. ( 2019 ) proposed three areas as the criteria that influence self-esteem: social comparison, social feedback, and self-reflection. These three criteria derive from self-evaluation and combine to create self-esteem. Valkenburg et al., ( 2006 ) conducted a study with 881 adolescents aged 10 to 19 years old who found that their self-esteem correlated with the feedback they received from others on their profiles. If there was positive feedback, this created an increase in self-esteem, and vice versa if they received negative feedback. This suggests that adolescents will have higher self-esteem if they receive the feedback they desire. It should be noted that the above study is 15 years old, and social media was still in a fledgling state of development. More recently, Jan et al. ( 2017 ) found that one hour on Facebook each day results in a 5.574 decrease in self-esteem score. Another study conducted by Saint-Georges and Vaillancourt ( 2020 ), “found evidence for the vulnerability model (self-esteem predicting depression) and the symptoms-driven model (depression predicting peer victimization).” Further, they also found that “poor self-esteem initiated a developmental cascade that led to poor mood and poor peer relations.” Fardouly and Vartanian ( 2016 ) conducted a review of existing research, and found in 2016 that “Correlational studies consistently show that social media usage (particularly Facebook) is associated with body image concerns among young women and men Facebook and companies being exposed to negative news is nothing new.” In 2014, Kramer et al. stated that the emotions of users were manipulated by pushing positive or negative content to their timeline. Results found that users who had been exposed to more emotional content, whether positive or negative, were more likely to respond in a like manner in their posts, demonstrating that emotions are contagious. This is a concerning result when taking into consideration the findings from Carlyle et al. ( 2018 ) that posts about suicide had higher levels of engagement. Continuing this theme, Marengo et al. ( 2021 ), found that 67% of Facebook aged 18–25 years old had a positive correlation between an increased amount of likes on their social media and increased self-esteem. In the study, only a low number of participants received negative feedback on their posts, but when they did, it correlated with low self-esteem. Social media has created a shallow world in which the number of followers and likes received makes an adolescent possibly feel successful socially. However, the adolescents who are most suffering are the ones who do not have a large following and do not have a high number of likes. Although it is positive for an adolescent to have increased self-esteem based on their following, it is important to consider the consequences of using social media and not receiving a positive response and the resulting low self-esteem. One of the core problems is that many social media users struggle to accept that social media and real-life are not in alignment and judge their own lives on a false reality. This is an important aspect to consider in light of the Krause et al. ( 2019 ) proposal that social comparison is a major influence on self-esteem. Many people fail to recognize that celebrities and friends they follow only present highlights or snapshots, often using carefully selected posts to gain more likes and followers, resulting in a self-esteem boost for the poster, and a self-esteem reducing effect for the viewer. This is especially evident on the female fitness pages on social media today. Davies et al. ( 2020 ) randomly assigned images to female social media users aged 18 to 25 of fit women on Instagram and found a positive correlation of lower self-image when they presented photos of fit women. Social media can increase and decrease self-esteem, but when a user signs on to their account they are confronted with a timeline of people presenting the idea they have a better life than the user it creates a false and vastly exaggerated world for an adolescent to compare themselves to. 1.2 Social Media and Mental Health There are many ways in which social media can bring distress, and one of the most prevalent is in the form of social comparison. Krayer et al. ( 2007 ) analyzed 20 interviews with 12- to 14-year-old boys and girls, concluding that “comparison processes are used for the purpose of identity development.” It is important to note that when this study was conducted, social media was in its infancy, with Facebook and MySpace having launched only three and four years previous, respectively. An additional concern with social comparison was discussed by Jan et al. ( 2017 ), who found that 88% of people engage in making social comparisons on Facebook, and of the 88% engaged in comparison, 98% of the comparisons are upward social comparisons. Perhaps more concerning is that this study was conducted on adults, not adolescents in the critical stage of building an identity. Krause et al. ( 2019 ) conducted their literature review from 821 studies and found that social comparison on social networks “mostly results in decreases of users’ self-esteem,” with eight out of 13 studies reviewed for comparison finding a negative effect, with five of those eight showing upward comparison. Karim et al. ( 2020 ) conducted a review of 16 papers, comprising eight cross-sectional studies, three longitudinal studies, two qualitative studies, and systematic reviews. Their findings were classified into two outcomes of mental health: anxiety and depression. While social networking has become a necessity for social connection, studies have recently been directed at the negative influence of time spent on social media, and the negative outcomes of its use overall. Karim et al., ( 2020 ) stated that social media influences how individuals view, maintain, and interact within their social network. This is supported by Martin et al. ( 2018 ) who state that the prolonged use of social media platforms such as Facebook may be related to negative signs and symptoms of depression, anxiety, and stress. The above findings are supported by Barry et al. ( 2017 ) who found that the higher the number of social media accounts and adolescent users, there is a moderate correlation with “parent-reported DSM-5 symptoms of inattention, hyperactivity/impulsivity, ODD, anxiety, and depressive symptoms, as well as adolescent-reported fear of missing out (FoMO) and loneliness.” Weinstein ( 2017 ) conducted studies on adolescents using a simulation of Instagram and found that participants who reported negative social comparison responses also reported an immediate reduction in emotional well-being. However, Weinstein explored another important factor, that of authenticity, and found that adolescents who had lower negative comparison recognized that what they were viewing was a highlight reel, and not necessarily authentic. However, adolescents in the higher negative comparison group stated that it might be forgotten or overlooked that people share a highlight reel, and is not a full reflection of real-life. With social comparison causing more damage to the mental health of the user than the good it provides it becomes necessary to explore what people are comparing themselves to. As a testament to how fast the social media landscape shifts, it should be noted that the research of Weinstein was conducted before the rise of Snapchat ad TikTok, used by 25% and 21% of the US population respectively (Auxier, & Anderson, 2021 ). Above other social networking sites, Instagram appears to be particularly troublesome. Carlyle et al. ( 2018 ) state that “posts portraying suicidal intentions had significantly higher likes frequency than posts that did not exhibit an intention to attempt suicide.” As concerning as this is, Carlyle et al. conclude that “given the absence of suicide awareness posts from public and mental health entities, this indicates that Instagram is a likely conduit for suicidal ideation and the normalization of suicidal ideation and self-harm intent.” Compared with Tumblr and Twitter, Miguel et al. ( 2017 ) found that Instagram has the “highest proportions of graphic posts and posts with negative self-evaluations, as well as the lowest proportion of posts offering recovery‐oriented resources.” The pattern of self-harm was also found in a review of literature by Picardo et al. ( 2020 ) who found that although there have been concerns about self-harm and suicide on Instagram, they were only able to find 10 studies from 2010 to 2019 on the subject, and a range of between 9–66% of the posts studied contained content relating to either suicide or self-harm. Further cause for concern is that only one of the reports studied the relationship between viewing self-harm and actual self-harm, finding preliminary evidence of a correlation between content viewed and behavior. Body dissatisfaction is another area where social media has influenced adolescent development negatively. According to Khanna and Sharma ( 2017 ), social media, specifically the posting of “selfies”, has increased plastic surgery rates among individuals with body dysmorphia, with an increase of 10% in rhinoplasty, 7% increase in hair transplants, and a 6% increase in eyelid surgeries in 2013. Research by de Vries et al., (2019) found that “on average, social media use was positively associated with body dissatisfaction, but this relationship was weaker among adolescents who reported a more positive mother-adolescent relationship.” This is supported by documents leaked to the Wall Street Journal in September 2021 stating that up to 13% of UK teen girls and 6% of US teen girls have had thoughts of suicide they can trace directly to Instagram. The report is quoted as stating “We make body image issues worse for one in three teen girls” (Wells et al., 2021 ). In response, Instagram posted a statement accepting those findings, suggesting they may not be in context, but they are working to improve user experience (Instagram, n.d.). 1.3 Cyberbullying Cyberbullying is a growing problem, with Patchin and Hinduja ( 2019 ) finding the number of individuals experiencing it increasomg from 18–37% from 2007 to 2019. According to Diliberti et al. ( 2019 ) bullying is reported in 28% of middle schools and 16% of high schools. However, the numbers for cyberbullying are slightly higher at 33% and 30% respectively. The risks of bullying are substantial to not only the victim but also the perpetrator. The victim has an increased risk of depression, anxiety, sleep problems, and lower academic achievement which may be the result of skipping or dropping out of school (Farrington & Baldry, 2010 ). However, there are also risks of increased future exposure to violence, substance abuse, and lower academic performance for the perpetrator (Farrington & Baldry, 2010 ). It should also be noted that there is a duality between being a victim and a perpetrator of cyberbullying. Lozano-Blasco et al. ( 2020 ) found a correlation between being a victim and being a perpetrator, with Quintana-Orts and Rey ( 2018 ) giving further clarification that one of the primary factors in becoming a cyberbully was being a former cybervictim. The connection between each of these areas can be found in research by Skilbred-Fjeld et al. ( 2020 ). Skilbred-Fjeld et al. categorized participants into three groups: cybervictims, cyberbullies, and cyberbully-victims. They found no significant difference between these three groups concerning anxiety, depression, self-harm, or antisocial behavior. The one area there was a significant difference was suicide attempts, where cyberbullies were significantly lower than cybervictims and cyberbully-victims. Cyberbullying, whether as a perpetrator or victim, is an important aspect to consider when exploring the online lives of adolescents and their mental health. 2. Data Gathering Data for this study were provided through a partnership with RemedyLive and were compiled during the 2019–2020 academic school year. The data were gathered from school visits across the Midwest and has been provided with all data being anonymous. The data from RemedyLive is compiled from thousands of middle school and high school students and gives insight into the experiences teenagers are living through. These data were extremely valuable in that they present an important insight into many areas where teenagers are struggling. With an online world at their fingertips, teens are accessing materials that shape their view of the world, often away from the eyes of parents or caregivers. Ongoing research and understanding of this stage of development are critical to understanding how best to lead teenagers into adulthood in a healthy and pro-social manner. No data were gathered directly by the researchers and this relationship was built from RemedyLive having a great deal of data but no researchers, and a group of willing researchers with no data. 3. Results Following, the results from RemedyLive will be shared and discussed in light of the research previously discussed. Responses are grouped in such a way as to give an overview of the questions relating to the same area, with an overview, an exploration of bullying, and finally, mental health. 3.1 Overall Well-being Table 1 From the list below, select that which stresses you the most: n School / Homework Relationships Athletics Home Life Body Image / Self Esteem Social Media Safety / Bullying The Future MS 1308 33% 11% 9% 9% 13% 5% 7% 14% HS 2937 29% 13% 7% 11% 13% 5% 4% 17% Total 4245 31% 12% 8% 10% 13% 5% 6% 16% Table 2 On an average day, how many hours do you use a smartphone or tablet, for something other than schoolwork? N Prefer not to answer MS 908 5% 6% 20% 17% 17% 34% 3% HS 2518 2% 3% 11% 17% 19% 46% 2% Total 3426 3% 4% 13% 17% 18% 42% 2% Table 3 How many hours of sleep do you get per night during the school week? n MS 1899 15% 10% 24% 27% 19% 5% HS 4573 27% 18% 29% 18% 6% 2% Total 6472 22% 25% 26% 22% 12% 3% Self-reported data from students participating are not supported by the weight of research that suggests social media is a major stressor in the life of many adolescents. However, middle school students report that social media is the least of presented stressors, at only 5%, a number that remains consistent for high school students, although bullying is reported to be the lowest stressor in high school. This is likely because of a disconnect in understanding that many of the stressors that appear more obvious to the student have an indirect negative relationship with social media. Interpretation At 13%, body image is a serious concern, and the issues associated with this have been discussed by Khanna and Sharma ( 2017 ), de Vries et al. (2019), and Wells et al. ( 2021 ). An interesting aspect is that with only 5% of respondents stating social media as a cause of stress, it might appear there is a disconnect between the source of body dissatisfaction, which even Instagram insiders admit to, and the experience of it. At a combined 31%, school and homework were reported to be the highest stressor for both middle and high school students. Tables 2 and 3 may give some insight into this. Almost half of all students report 6 or fewer hours each night, and 6 out of 10 respondents report using their mobile phone or tablet for 4 hours or more each day, with more than 4 out of 10 reporting 5 or more hours of use each day. The first-generation iPhone was introduced in 2005, Netflix introduced streaming services in 2007, and in 2021 the iPad is over a decade old, being first released in 2010. While television and video games have been around for decades, the last two decades have offered a wider range of access to content on mobile devices. This access has prompted psychologists to put guidelines on screen time (Pappas, 2020 ). Cleland Woods and Scott ( 2016 ) tie multiple areas of concern together, specifically exploring the lack of sleep. They found that social media use is tied to poor sleep, anxiety, depression, and low self-esteem, with nighttime use of social media having a strong association with poor sleep. This research is extremely important when considering social media use, especially as it relates to the RemedyLive data. This study and the RemedyLive data also tie with the research of Kelly et al. ( 2018 ), who found that a lack of sleep is strongly associated with depressive symptoms. With almost half of students reporting 6 or fewer hours of sleep, and over 70% reporting 7 or fewer hours, it is clear that sleep is taking a back seat to screen time. The link between stress from school, which requires strong cognitive functioning, can be explained with a correlation to the increase in social media use/screen time, and a reduction in the amount of sleep needed to maintain a healthy state of mind. Twenge ( 2020 ) also concluded that time on technology contributes to the declining well-being of adolescents from 2011 to 2018. The correlation between technology use and lower well-being could be associated with reduced sleep. The demands on adolescents today are no lower than in the past, but with the majority of adolescents spending 4 or more hours on devices each day, there is less time to complete all the work needed for school and other responsibilities. 3.2 Mental Health Table 4 Rate your level of depression over the last 30 days: n I have not felt depressed. I sometimes feel depressed. I have felt depressed more than average. I feel very depressed. I prefer not to answer MS 1791 31% 39% 15% 11% 4% HS 5948 30% 36% 17% 14% 3% Total 7638 30% 37% 16% 13% 3% Table 5 Rate your level of anxiety: n I have not felt anxious Low Average High I prefer not to answer MS 1396 9% 25% 32% 31% 3% HS 5251 11% 20% 29% 39% 1% Total 6647 10% 23% 31% 35% 2% Table 6 Have you intentionally hurt yourself in the past 30 days? n Yes No I prefer not to answer MS 1217 19% 72% 10% HS 1292 15% 80% 5% Total 2509 17% 76% 7% Table 7 Do you know someone who struggles with suicidal thinking? n Yes No I prefer not to answer MS 3053 53% 42% 5% HS 7431 60% 37% 4% Total 10484 56% 39% 4% Table 8 During the past 12 months, have you ever seriously considered ending your life? n Yes No I prefer not to answer MS 3074 30% 58% 12% HS 7437 35% 58% 7% Total 10511 33% 58% 4% Table 9 What type of home life do you have? n My siblings/ parents/ guardians abuse me My siblings/ parents/ guardians ignore me My siblings/ parents/ guardians support and encourage me I prefer not to answer MS 424 4% 12% 74% 10% HS 322 4% 19% 68% 10% Total 746 4% 15% 71% 10% Interpretation Concerning findings in these final tables show a growing trend of mental health challenges faced by adolescents. One major concern from Table 13 is the increase of almost 17% of students who seriously considered ending their life from middle school to high school. This, along with fewer high school students knowing others who have struggled with suicidal ideation increasing from middle to high school is an interesting report when viewed along with the first two questions of experiencing depression and anxiety. Self-reported levels of not experiencing depression decreased slightly between middle and high school, while anxiety increased. However, one important factor to note is the increase in the more extreme ends of feeling very depressed increasing from 11% in middle school to 14% in high school, and feelings of anxiety increasing from 31% in middle school to 39% in high school. These results suggest that the storm and stress theory proposed by Hall ( 1904 ) maintains relevance. Although adolescence may not be a period of wild emotion, and most people entering and leaving the stage relatively unscathed, the intensity of the storms increase. One area where storms increase concerns parent-child relationships. It should perhaps be no surprise that anxiety increases as the adolescent gains more autonomy and experiences less support and more freedom. The increase in anxiety continues into college. The Association for University and College Counseling Center Directors (AUCCCD) report compiled data from July 2018 to June 2019 and included results from 562 counseling center directors and over 155,000 students from colleges and universities nationwide. Of the institutions responding, 43.9% had gained staff positions, for a total of 325.4 gained positions, while only 22 positions were lost. The mean expense for counseling center salaries across 298 responding institutions was $ 1,035,895 putting the cost in the hundreds of millions of dollars (LeViness et al., 2019 ). However, the cost of not providing these services may be even greater. 66.2% of students using counseling services stated the services helped them with academic performance, and 62.3% stated the services helped them stay in school. Although increasing positions are being added, the situation is declining, and the AUCCID report states that 87.3% of directors reported an increase in demand during the year with a 12.2% increase between 2018 and 2019. There is a crisis concerning the mental health of young adults in the United States, with anxiety (60.7%), depression (48.6%), and stress (47%) leading the mental health struggles for college students using counseling services (LeViness et al., 2019 ). Overall, the picture for adolescents is mixed. Around 1-in-3 report no experience of depression, compared to 1-in-8 reporting feeling very depressed. Over 7 in 10 students report a supportive and encouraging home, with 4% reporting an abusive home. At 1 in 3 students experiencing suicidal ideation, this is something to be concerned about, especially with the potential contagious nature of suicidal ideation shared on social media, especially Instagram (Carlyle et al., 2018 ). 3.3 Bullying Table 10 Has being bullied ever caused you to want to hurt yourself? n Yes No I've not been bullied I prefer not to answer MS 547 40% 24% 30% 6% HS 2554 23% 35% 38% 4% Total 3101 28% 32% 36% 5% Table 11 During the past 30 days, on how many days did you not go to school because you felt you would be unsafe at school or on your way to or from school? n 0 days 1 day 2 or 3 days 4 or 5 days 6 or more days I prefer not to answer MS 311 83% 7% 5% 0% 1% 4% HS 1209 82% 5% 6% 2% 4% 2% Total 1520 82% 5% 6% 1% 3% 2% Table 12 Regarding the abuse of bullying, choose from the following: n I have bullied others online I have bullied others verbally I have bullied others physically I have watched others be bullied None of the above I prefer not to answer MS 1309 5% 14% 5% 41% 30% 5% HS 844 9% 14% 5% 41% 27% 3% Total 2153 6% 14% 5% 41% 29% 5% Table 13 Select any way(s) you have been bullied in the past 12 months (multiple choices allowed before clicking submit): n I have been bullied on school property I have been bullied outside of school property I have been electronically bullied via texting I have been electronically bullied via a social media app I have not been bullied I prefer not to answer MS 1576 30% 17% 8% 8% 30% 6% HS 3874 19% 13% 11% 13% 40% 4% Total 5450 24% 15% 10% 11% 35% 5% Table 14 In your opinion, what’s the biggest problem your school faces? n Illegal Drugs Alcohol Sexual Harassment Bullying Safety Mental Health None of the above I prefer not to answer MS 1304 5% 4% 7% 37% 11% 15% 12% 2% HS 9625 17% 14% 9% 15% 6% 19% 2% 1% Total 10929 11% 9% 7% 26% 9% 16% 7% 1% Interpretation Cyberbullying is a growing problem and more than doubled between 2007 and 2019 (Patchin & Hinduja, 2019 ). During this time a generation has grown up in the digital world with parents and caregivers unequipped and inexperienced at dealing with child and adolescent development in the digital world. Unlike previous generations where bullying ended at the door of their home (assuming there was no abuse in the home), the reach of cyberbullying has few limitations. Although many sites have blocking features and options for reporting abuse, many victims do not report the bullying for reasons including fear of retribution and increased bullying, loss of freedom or social media access, not knowing who they should report the incident to, or believing nothing would change if it was reported. The lack of reporting might account for the discrepancy between the Department of Education ( 2019 ) figures that just over 1-in-5 students report bullying and the findings of Remedy that 60% of students report having been bullied, with only 35% stating they have never been bullied. Another aspect of concern can be found in the 41% of students who have witnessed bullying. Students who witness bullying can also influence the well-being of a victim (Davis & Nixon, 2010 ), but can also be negatively affected themselves through feelings of hopelessness (Centers for Disease Control and Prevention, 2014). Patchin and Hinduja ( 2019 ) state that two-thirds of students are prepared to support the victim, whether through intervention or defense, whether online or in person, but there are also concerns of exacerbating the situation and making things worse. Inaction, it seems, feeds the control a bully is often seeking to maintain, but the fear of reprisal does nothing to check the behavior. 4. Discussion The research from RemedyLive presents a picture in which the majority of adolescents appear to live in loving and encouraging environments, but also live with a great deal of anxiety. Adolescents are under a great deal of pressure, and with a seemingly unending flow of information from social media, anxiety to present the best snapshots of life and post content that increases self-esteem (or, at least, minimize the risk of self-esteem being negatively affected). Adolescents have to navigate the dangers of life with little training or guidance from parents who grew up in a different era and find ways to understand that comparison to others is a comparison based on a carefully tailored picture people are presenting. Students are doing all of this with reduced sleep, increased risk of bullying, and exposure to contagious mental health issues. We agree with Twenge et al. ( 2019 ) and support the message that: Young people can't change their genetics or the economic situation of the country, but they can choose how they spend their leisure time. First and most important is to get enough sleep. Make sure your device use doesn't interfere with sleep, don't keep phones or tablets in the bedroom at night, and put devices down within an hour of bedtime…Overall, make sure digital media use doesn't interfere with activities more beneficial to mental health such as face-to-face social interaction, exercise, and sleep. One area of concern is that adolescents have not connected the use of technology and lack of sleep to areas of struggle in their lives, including experiencing depression and anxiety. Of course, this is a multifaceted problem, and no one area is the ‘fix’ for the challenges of adolescent development, but sleep is a good start. However, with 60% of students responding to the RemedyLive survey as reporting 4 or more hours of non-academic screen time a day, limited this time would help students recover a great deal of time for more productive activities. With academic and productive activities completed on time, a student would be able to get more sleep, with the added benefit of less exposure to unhealthy content on social media. As parents gain greater awareness of the dangers of social media, it is hoped they will take a more structured approach to both, the amount of time spent and the content exposure their children and adolescents are exposed to. Education on the dangers of social media and screen time should be directed not just at the adolescent user, but also at parents and caregivers. Social media is not going away, and the current trends for youth mental health and suicidal ideation are concerning. It is recommended that future studies examine the influence of better sleep habits and reduced screen time as it relates to mental health, primarily anxiety, which appears to be the greater threat and can be negatively influenced by almost every area of life where social media has a direct or indirect influence. Declarations There are no competing interests and no financial obligations of any kind. References Annisette, L. E., & Lafreniere, K. D. (2017). Social media, texting, and personality: A test of the shallowing hypothesis. Personality and Individual Differences, 115 , 154–158. doi: 10.1016/j.paid.2016.02.043 Auxier, B., & Anderson, M. (2021, April 09). Social Media Use in 2021. Retrieved from https://www.pewresearch.org/internet/2021/04/07/social-media-use-in-2021/ Bark's Annual Report: 2020 Research on Kids and Technology. https://www.bark.us/annual-report Barry, C. T., Sidoti, C. L., Briggs, S. M., Reiter, S. R., & Lindsey, R. A. (2017). Adolescent social media use and mental health from adolescent and parent perspectives. Journal of Adolescence , 61 , 1. Carlyle, K. E., Guidry, J. P., Williams, K., Tabaac, A., & Perrin, P. B. (2018). Suicide conversations on Instagram™: Contagion or caring? 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(2010) Individual risk factors for school bullying. Journal of Aggression, Conflict and Peace Research 2 (1):4–16. Retrieved from https://doi.org/10.5042/jacpr.2010.0001 Fardouly, J., & Vartanian, L. (2016). Social Media and Body Image Concerns: Current Research and Future Directions. Current Opinion In Psychology, 9 , 1–5. https://doi.org/10.1016/j.copsyc.2015.09.005 Hall, G. S. (1904). Adolescence . Appleton. Instagram. (n.d.). Social Media and Well-Being: Instagram's Research and Actions: Instagram Blog. Retrieved from https://about.instagram.com/blog/announcements/using-research-to-improve-your-experience Jan, M., Soomro, S., & Ahmad, N. (2017). Impact of social media on self-esteem. European Scientific Journal , 13 (23), 329–341. doi: 10.19044/esj.2017.v13n23p329 Karim, F., Oyewande, A., Abdalla, L. F., Chaudhry Ehsanullah, R., & Khan, S. (2020). Social Media Use and Its Connection to Mental Health: A Systematic Review. Cureus. https://doi.org/10.7759/cureus.8627 Kelly, Y., Zilanawala, A., Booker, C., & Sacker, A. (2018). Social Media Use and Adolescent Mental Health: Findings From the UK Millennium Cohort Study. Eclinicalmedicine, 6, 59–68. https://doi.org/10.1016/j.eclinm.2018.12.005 Khanna, A., & Sharma, M. K. (2017). Selfie use: The implications for psychopathology expression of body dysmorphic disorder . Industrial psychiatry journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5810159/ . Kramer, A. D., Guillory, J. E., & Hancock, J. T. (2014). Experimental evidence of massive-scale emotional contagion through social networks. Proceedings of the National Academy of Sciences, 111(24), 8788–8790. doi: 10.1073/pnas.1320040111 Krause, H-V., Baum, K., Baumann, A., & Krasnova, H. (2019). Unifying the detrimental and beneficial effects of social network site use on self-esteem: a systematic literature review. Media Psychology, 24 (1), 10–47. https://doi.org/10.1080/15213269.2019.1656646 Krayer, A., Ingledew, D. K., & Iphofen, R. (2007). Social comparison and body image in adolescence: A grounded theory approach. Health Education Research, 23 (5), 892–903. doi: 10.1093/her/cym076 LeViness, P., Gorman, K., Braun, L., Koenig, L., & Bershad, C. (2019). The association for university and college counseling center directors annual survey. Retrieved from https://www.aucccd.org/assets/documents/Survey/2019%20AUCCCD%20Survey-2020-05-31-PUBLIC.pdf20surveypublicapr26.pdf . Lozano-Blasco, R., Cortés-Pascual, A., & Latorre-Martínez, M. (2020). Being a cybervictim and a cyberbully – The duality of cyberbullying: A meta-analysis. Computers In Human Behavior, 111 , 106444. https://doi.org/10.1016/j.chb.2020.106444 Madore, K. P., Khazenzon, A. M., Backes, C. W., Jiang, J., Uncapher, M. R., Norcia, A. M., & Wagner, A. D. (2020). Memory failure predicted by attention lapsing and media multitasking. Nature, 587 (7832), 87–91. https://doi.org/10.1038/s41586-020-2870-z Marengo, D., Montag, C., Sindermann, C., Elhai, J. D., & Settanni, M. (2021). Examining the links between active Facebook use, received likes, self-esteem and happiness: A study using objective social media data. Telematics and Informatics, 58 , 101523. https://doi.org/10.1016/j.tele.2020.101523 Martin, F., Wang, C., Petty, T., Wang, W., & Wilkins, P. (2018). Middle School Students’ Social Media Use. Journal of Educational Technology & Society, 21 (1), 213–224. http://www.jstor.org/stable/26273881 Miguel, E. M., Chou, T., Golik, A., Cornacchio, D., Sanchez, A. L., DeSerisy, M., & Comer, J. S. (2017). Examining the scope and patterns of deliberate self-injurious cutting content in popular social media. Depression & Anxiety (1091–4269), 34 (9), 786–793. https://doi-org.nmu.idm.oclc.org/10.1002/da.22668 Pappas, S. (2020). What do we really know about kids and screens?. Monitor On Psychology , 51 (3), 42. Retrieved 22 December 2021, from https://www.apa.org/monitor/2020/04/cover-kids-screens . Patchin, J. W., & Hinduja, S. (2019). 2019 Cyberbullying Data. Cyberbullying Research Center. Retrieved from https://cyberbullying.org/2019-cyberbullying-data Picardo, J., Mckenzie, S. K., Collings, S., & Jenkin, G. (2020). Suicide and self-harm content on Instagram: A systematic scoping review. Plos One, 15(9). doi: 10.1371/journal.pone.0238603 Quintana-Orts, C., & Rey, L. (2018). Forgiveness and cyberbullying in adolescence: Does willingness to forgive help minimize the risk of becoming a cyberbully?. Computers In Human Behavior, 81 , 209–214. https://doi.org/10.1016/j.chb.2017.12.021 RemedyLive (2020). Get Schooled Tour, Unpublished raw data. Saint-Georges, Z., & Vaillancourt, T. (2020). The temporal sequence of depressive symptoms, peer victimization, and self-esteem across adolescence: Evidence for an integrated self-perception driven model. Development and Psychopathology, 32(3), 975–984. doi: 10.1017/S0954579419000865 . Shensa, A., Sidani, J. E., Lin, L. Y., Bowman, N. D., & Primack, B. A. (2016). Social Media Use and Perceived Emotional Support Among US Young Adults. Journal of community health, 41 (3), 541–549. https://doi.org/10.1007/s10900-015-0128-8 Skilbred-Fjeld, S., Reme, S. E., & Mossige, S. (2020). Cyberbullying involvement and mental health problems among late adolescents. Cyberpsychology: Journal of Psychosocial Research on Cyberspace, 14 (1), Article 5. https://doi.org/10.5817/CP2020-1-5 Twenge, J. M. (2019). More Time on Technology, Less Happiness? Associations Between Digital-Media Use and Psychological Well-Being. Current Directions in Psychological Science, 28 (4), 372–379. doi: 10.1177/0963721419838244 Twenge, J. M., Cooper, A. B., Joiner, T. E., Duffy, M. E., & Binau, S. G. (2019). Age, period, and cohort trends in mood disorder indicators and suicide-related outcomes in a nationally representative dataset, 2005–2017. Journal of Abnormal Psychology, 128(3), 185–199. doi: 10.1037/abn0000410 Twenge, J. M. (2020). Why increases in adolescent depression may be linked to the technological environment. Current opinion in psychology, 32 , 89–94. https://doi.org/10.1016/j.copsyc.2019.06.036 Valkenburg, P. M., Peter, J., & Schouten, A. P. (2006). Friend Networking Sites and Their Relationship to Adolescents' Well-Being and Social Self-Esteem. CyberPsychology & Behavior, 9 (5), 584–590. https://doi.org/10.1089/cpb.2006.9.584 Weinstein, E. (2017). Adolescents’ differential responses to social media browsing: Exploring causes and consequences for intervention. Computers in Human Behavior, 76 , 396–405 Wells, G., Horwitz, J., & Seetharaman, D. (2021, September 14). Facebook Knows Instagram Is Toxic for Teen Girls, Company Documents Show. Wall Street Journal. Retrieved from https://www.wsj.com/articles/facebook-knows-instagram-is-toxic-for-teen-girls-company-documents-show-11631620739 Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-1447988","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":90454349,"identity":"7818a8d5-f4b8-4b40-a742-00263b6e89fa","order_by":0,"name":"Vincent Jeevar","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAtUlEQVRIiWNgGAWjYFCCA2BSDsJhI0GLMSlaICCxgWgtBgcPH3zMU3MvfbvYGQOGD2WHidBy4FiyMc+x4tyds3MMGGecI0KLZMMZM8kZbAm5G27nGDDzthGl5fz3nzP+JaQbgLT8JUYLP8MZNoaPbQkJYC2MxGk5ZizxsS/BcMPttIKDPefSCWthkzj88EPCtwR5g9vJGx/8KLMmrIVB4gCCfQCXIjSXNRCnbhSMglEwCkYwAACN/D2tmXflkQAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-8813-9685","institution":"Northern Michigan University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Vincent","middleName":"","lastName":"Jeevar","suffix":""},{"id":90454397,"identity":"147c32e7-cef7-4360-8d39-ab2b59bbc8af","order_by":1,"name":"Bonneta Chapman-Little","email":"","orcid":"","institution":"Northern Michigan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Bonneta","middleName":"","lastName":"Chapman-Little","suffix":""},{"id":90454398,"identity":"2c1dd43d-668b-4cd9-9858-90dd4e7cc814","order_by":2,"name":"Sarah Jackson","email":"","orcid":"","institution":"Northern Michigan University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sarah","middleName":"","lastName":"Jackson","suffix":""}],"badges":[],"createdAt":"2022-03-13 23:14:52","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false,"coiExplicitlySet":false},"doi":"10.21203/rs.3.rs-1447988/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-1447988/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":19309185,"identity":"1e71deec-0b9c-4384-96a9-9d3f64599ac4","added_by":"auto","created_at":"2022-03-16 21:18:24","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":226947,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-1447988/v1/ae7ef741-dbef-412d-910a-bc7037c46b76.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eCurrent Challenges to Adolescent Well-being\u003c/p\u003e\u003cp\u003e\u003cbr\u003e\u003c/p\u003e","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eThere are many challenges to adolescent development, with social media increasingly becoming the latest revolution in human interaction, allowing people to stay connected and stay up-to-date in an ever-changing world in real-time. Social circles have been expanded, presenting exposure to new cultures, ideas, and relationships. Additional benefits include being able to connect to loved ones and friends across distance in ways unimaginable to previous generations. However, the increase in quantity and ease of maintaining relationships does not necessarily correlate with quality, and research suggests that a higher frequency of social media use correlates to a lower sense of emotional support (Shensa et al., \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). This paper presents how social media is directly or indirectly a factor is multiple areas negatively affecting adolescent well-being.\u003c/p\u003e \u003cp\u003eThe number of young Americans experiencing mental health challenges has seen a significant rise in the last decade, and this decline has coincided with the rapid rise of social media. Twenge et al. (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) reviewed responses from over 200,000 adolescents from the ages of 12 to 17 from the years of 2005 to 2017, and over 400,000 adults from the years 2008 to 2017. From 2005 to 2017, the rate of reported symptoms among adolescents consistent with major depression increased 52%. Young adults fared worse, reporting an increase of 63% from 2009 to 2017. Twenge et al. (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) found a 71% increase in young adults experiencing serious psychological distress from 2008 to 2017 and a 47% increase among young adults with suicidal thoughts or other suicide-related outcomes for the same period.\u003c/p\u003e \u003cp\u003eNot only does social media negatively affect mood, but the increase in social media use has also correlated to shallowing of cognitive and moral shallowness (Annisette \u0026amp; Lafreniere, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Madore et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), studied 80 young adults to explore differences in the ability to maintain attention by studying how well the subjects were able to identify a gradual change in an image. Media multitasking was assessed by having participants describe how well they could commit to multiple media sources, such as texting and watching television within a given hour. The researchers compared memory performance between participants, and found that individuals with lower sustained attention ability and heavier media multitaskers both performed worse on memory tasks. With teens using social media at an ever-increasing rate, and algorithms in applications specifically designed to keep a user tied to the platform, the landscape is a perilous one concerning adolescent development, with cognitive and emotional challenges becoming apparent.\u003c/p\u003e \u003cp\u003eCognitive and moral shallowness are concerns enough (Annisette \u0026amp; Lafreniere, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), but it is also important to examine the content adolescents are viewing. An adolescent being unable to accurately understand and evaluate the information they are exposed to will influence every area of life, including peer relationships and identity formation, both critical components of this stage of development. Technology has created a reality where access to content traditionally considered to be of an adult nature is only a fingertip away.\u003c/p\u003e \u003cp\u003eBark, a company that monitors online activities of tweens and teens state the following information for online exposure of teens: 94.1% have expressed or experienced violent subject matter or thoughts, 66.3% have engaged in conversations about depression, 82% experienced bullying as a bully, victim or witness, 91.1% engaged in conversations about drugs or alcohol, 66.6% were involved in self-harm or suicidal situation, and 87.9% encountered nudity or content of a sexual nature (Bark\u0026rsquo;s Annual Report, 2020). With reduced cognitive and relationship skills and an increase in exposure to complex and potentially troublesome content, it is no surprise there is a mental health crisis in young adults in the United States, with anxiety (60.7%), depression (48.6%), and stress (47%) leading the mental health struggles for college students using counseling services (LeViness et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). There are many ways in which social media is problematic to adolescent development, and \u0026ldquo;large studies consistently find that more frequent digital-media use is associated with lower well-being among adolescents,\u0026rdquo; (Twenge, \u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Kelly et al., (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) found four criteria make up an increase in depressive symptoms associated with social media use. These are poor sleep, online harassment, poor self-esteem, and body image. These areas relate to an increase in depressive symptoms when social media is used. These areas will be examined in further depth and discussed using data provided by RemedyLive.\u003c/p\u003e \u003cp\u003eThis paper examines how the influence of current cultural pressures, online socializing, and other social influences can have a detrimental effect on adolescent health. There will be a literature review of current research, followed by results shared based on data from the RemedyLive Get Schooled Tour. Finally, a discussion exploring how social media is a common link in the majority of challenges faced by adolescents.\u003c/p\u003e \u003cdiv id=\"Sec2\" class=\"Section2\"\u003e \u003ch2\u003e1.1 Social Media and Self-Esteem\u003c/h2\u003e \u003cp\u003eA positive self-image is an important factor in living a happy life, especially for an adolescent where identity is the primary factor in development. Today, adolescents are viewing their peers' lives on social media, as well as following social media influencers, exposing themselves to a constant stream of highlight reels. This creates the unrealistic perception that someone is living a better life, has a better body, is more gifted, and continuously judges themselves based on what someone posts on social media. Krause et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) proposed three areas as the criteria that influence self-esteem: social comparison, social feedback, and self-reflection. These three criteria derive from self-evaluation and combine to create self-esteem.\u003c/p\u003e \u003cp\u003eValkenburg et al., (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2006\u003c/span\u003e) conducted a study with 881 adolescents aged 10 to 19 years old who found that their self-esteem correlated with the feedback they received from others on their profiles. If there was positive feedback, this created an increase in self-esteem, and vice versa if they received negative feedback. This suggests that adolescents will have higher self-esteem if they receive the feedback they desire.\u003c/p\u003e \u003cp\u003eIt should be noted that the above study is 15 years old, and social media was still in a fledgling state of development. More recently, Jan et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) found that one hour on Facebook each day results in a 5.574 decrease in self-esteem score. Another study conducted by Saint-Georges and Vaillancourt (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), \u0026ldquo;found evidence for the vulnerability model (self-esteem predicting depression) and the symptoms-driven model (depression predicting peer victimization).\u0026rdquo; Further, they also found that \u0026ldquo;poor self-esteem initiated a developmental cascade that led to poor mood and poor peer relations.\u0026rdquo;\u003c/p\u003e \u003cp\u003eFardouly and Vartanian (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) conducted a review of existing research, and found in 2016 that \u0026ldquo;Correlational studies consistently show that social media usage (particularly Facebook) is associated with body image concerns among young women and men Facebook and companies being exposed to negative news is nothing new.\u0026rdquo; In 2014, Kramer et al. stated that the emotions of users were manipulated by pushing positive or negative content to their timeline. Results found that users who had been exposed to more emotional content, whether positive or negative, were more likely to respond in a like manner in their posts, demonstrating that emotions are contagious. This is a concerning result when taking into consideration the findings from Carlyle et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) that posts about suicide had higher levels of engagement.\u003c/p\u003e \u003cp\u003eContinuing this theme, Marengo et al. (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), found that 67% of Facebook aged 18\u0026ndash;25 years old had a positive correlation between an increased amount of likes on their social media and increased self-esteem. In the study, only a low number of participants received negative feedback on their posts, but when they did, it correlated with low self-esteem. Social media has created a shallow world in which the number of followers and likes received makes an adolescent possibly feel successful socially. However, the adolescents who are most suffering are the ones who do not have a large following and do not have a high number of likes. Although it is positive for an adolescent to have increased self-esteem based on their following, it is important to consider the consequences of using social media and not receiving a positive response and the resulting low self-esteem.\u003c/p\u003e \u003cp\u003eOne of the core problems is that many social media users struggle to accept that social media and real-life are not in alignment and judge their own lives on a false reality. This is an important aspect to consider in light of the Krause et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) proposal that social comparison is a major influence on self-esteem. Many people fail to recognize that celebrities and friends they follow only present highlights or snapshots, often using carefully selected posts to gain more likes and followers, resulting in a self-esteem boost for the poster, and a self-esteem reducing effect for the viewer. This is especially evident on the female fitness pages on social media today. Davies et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) randomly assigned images to female social media users aged 18 to 25 of fit women on Instagram and found a positive correlation of lower self-image when they presented photos of fit women. Social media can increase and decrease self-esteem, but when a user signs on to their account they are confronted with a timeline of people presenting the idea they have a better life than the user it creates a false and vastly exaggerated world for an adolescent to compare themselves to.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e1.2 Social Media and Mental Health\u003c/h2\u003e \u003cp\u003eThere are many ways in which social media can bring distress, and one of the most prevalent is in the form of social comparison. Krayer et al. (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) analyzed 20 interviews with 12- to 14-year-old boys and girls, concluding that \u0026ldquo;comparison processes are used for the purpose of identity development.\u0026rdquo; It is important to note that when this study was conducted, social media was in its infancy, with Facebook and MySpace having launched only three and four years previous, respectively. An additional concern with social comparison was discussed by Jan et al. (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), who found that 88% of people engage in making social comparisons on Facebook, and of the 88% engaged in comparison, 98% of the comparisons are upward social comparisons. Perhaps more concerning is that this study was conducted on adults, not adolescents in the critical stage of building an identity. Krause et al. (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) conducted their literature review from 821 studies and found that social comparison on social networks \u0026ldquo;mostly results in decreases of users\u0026rsquo; self-esteem,\u0026rdquo; with eight out of 13 studies reviewed for comparison finding a negative effect, with five of those eight showing upward comparison.\u003c/p\u003e \u003cp\u003eKarim et al. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) conducted a review of 16 papers, comprising eight cross-sectional studies, three longitudinal studies, two qualitative studies, and systematic reviews. Their findings were classified into two outcomes of mental health: anxiety and depression. While social networking has become a necessity for social connection, studies have recently been directed at the negative influence of time spent on social media, and the negative outcomes of its use overall. Karim et al., (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) stated that social media influences how individuals view, maintain, and interact within their social network. This is supported by Martin et al. (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) who state that the prolonged use of social media platforms such as Facebook may be related to negative signs and symptoms of depression, anxiety, and stress.\u003c/p\u003e \u003cp\u003eThe above findings are supported by Barry et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) who found that the higher the number of social media accounts and adolescent users, there is a moderate correlation with \u0026ldquo;parent-reported DSM-5 symptoms of inattention, hyperactivity/impulsivity, ODD, anxiety, and depressive symptoms, as well as adolescent-reported fear of missing out (FoMO) and loneliness.\u0026rdquo; Weinstein (\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) conducted studies on adolescents using a simulation of Instagram and found that participants who reported negative social comparison responses also reported an immediate reduction in emotional well-being. However, Weinstein explored another important factor, that of authenticity, and found that adolescents who had lower negative comparison recognized that what they were viewing was a highlight reel, and not necessarily authentic. However, adolescents in the higher negative comparison group stated that it might be forgotten or overlooked that people share a highlight reel, and is not a full reflection of real-life. With social comparison causing more damage to the mental health of the user than the good it provides it becomes necessary to explore what people are comparing themselves to. As a testament to how fast the social media landscape shifts, it should be noted that the research of Weinstein was conducted before the rise of Snapchat ad TikTok, used by 25% and 21% of the US population respectively (Auxier, \u0026amp; Anderson, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAbove other social networking sites, Instagram appears to be particularly troublesome. Carlyle et al. (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) state that \u0026ldquo;posts portraying suicidal intentions had significantly higher likes frequency than posts that did not exhibit an intention to attempt suicide.\u0026rdquo; As concerning as this is, Carlyle et al. conclude that \u0026ldquo;given the absence of suicide awareness posts from public and mental health entities, this indicates that Instagram is a likely conduit for suicidal ideation and the normalization of suicidal ideation and self-harm intent.\u0026rdquo; Compared with Tumblr and Twitter, Miguel et al. (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2017\u003c/span\u003e) found that Instagram has the \u0026ldquo;highest proportions of graphic posts and posts with negative self-evaluations, as well as the lowest proportion of posts offering recovery‐oriented resources.\u0026rdquo; The pattern of self-harm was also found in a review of literature by Picardo et al. (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) who found that although there have been concerns about self-harm and suicide on Instagram, they were only able to find 10 studies from 2010 to 2019 on the subject, and a range of between 9\u0026ndash;66% of the posts studied contained content relating to either suicide or self-harm. Further cause for concern is that only one of the reports studied the relationship between viewing self-harm and actual self-harm, finding preliminary evidence of a correlation between content viewed and behavior.\u003c/p\u003e \u003cp\u003eBody dissatisfaction is another area where social media has influenced adolescent development negatively. According to Khanna and Sharma (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), social media, specifically the posting of \u0026ldquo;selfies\u0026rdquo;, has increased plastic surgery rates among individuals with body dysmorphia, with an increase of 10% in rhinoplasty, 7% increase in hair transplants, and a 6% increase in eyelid surgeries in 2013. Research by de Vries et al., (2019) found that \u0026ldquo;on average, social media use was positively associated with body dissatisfaction, but this relationship was weaker among adolescents who reported a more positive mother-adolescent relationship.\u0026rdquo; This is supported by documents leaked to the Wall Street Journal in September 2021 stating that up to 13% of UK teen girls and 6% of US teen girls have had thoughts of suicide they can trace directly to Instagram. The report is quoted as stating \u0026ldquo;We make body image issues worse for one in three teen girls\u0026rdquo; (Wells et al., \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In response, Instagram posted a statement accepting those findings, suggesting they may not be in context, but they are working to improve user experience (Instagram, n.d.).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e1.3 Cyberbullying\u003c/h2\u003e \u003cp\u003eCyberbullying is a growing problem, with Patchin and Hinduja (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) finding the number of individuals experiencing it increasomg from 18\u0026ndash;37% from 2007 to 2019. According to Diliberti et al. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) bullying is reported in 28% of middle schools and 16% of high schools. However, the numbers for cyberbullying are slightly higher at 33% and 30% respectively. The risks of bullying are substantial to not only the victim but also the perpetrator. The victim has an increased risk of depression, anxiety, sleep problems, and lower academic achievement which may be the result of skipping or dropping out of school (Farrington \u0026amp; Baldry, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). However, there are also risks of increased future exposure to violence, substance abuse, and lower academic performance for the perpetrator (Farrington \u0026amp; Baldry, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). It should also be noted that there is a duality between being a victim and a perpetrator of cyberbullying. Lozano-Blasco et al. (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) found a correlation between being a victim and being a perpetrator, with Quintana-Orts and Rey (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) giving further clarification that one of the primary factors in becoming a cyberbully was being a former cybervictim.\u003c/p\u003e \u003cp\u003eThe connection between each of these areas can be found in research by Skilbred-Fjeld et al. (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Skilbred-Fjeld et al. categorized participants into three groups: cybervictims, cyberbullies, and cyberbully-victims. They found no significant difference between these three groups concerning anxiety, depression, self-harm, or antisocial behavior. The one area there was a significant difference was suicide attempts, where cyberbullies were significantly lower than cybervictims and cyberbully-victims. Cyberbullying, whether as a perpetrator or victim, is an important aspect to consider when exploring the online lives of adolescents and their mental health.\u003c/p\u003e \u003c/div\u003e"},{"header":"2. Data Gathering","content":"\u003cp\u003eData for this study were provided through a partnership with RemedyLive and were compiled during the 2019\u0026ndash;2020 academic school year. The data were gathered from school visits across the Midwest and has been provided with all data being anonymous. The data from RemedyLive is compiled from thousands of middle school and high school students and gives insight into the experiences teenagers are living through. These data were extremely valuable in that they present an important insight into many areas where teenagers are struggling. With an online world at their fingertips, teens are accessing materials that shape their view of the world, often away from the eyes of parents or caregivers. Ongoing research and understanding of this stage of development are critical to understanding how best to lead teenagers into adulthood in a healthy and pro-social manner. No data were gathered directly by the researchers and this relationship was built from RemedyLive having a great deal of data but no researchers, and a group of willing researchers with no data.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003eFollowing, the results from RemedyLive will be shared and discussed in light of the research previously discussed. Responses are grouped in such a way as to give an overview of the questions relating to the same area, with an overview, an exploration of bullying, and finally, mental health.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e3.1 Overall Well-being\u003c/h2\u003e \u003cp\u003eTable 1\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFrom the list below, select that which stresses you the most:\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSchool / Homework\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eRelationships\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAthletics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eHome Life\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eBody Image / Self Esteem\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSocial Media\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eSafety / Bullying\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eThe Future\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e1308\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e2937\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e29%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e4245\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e31%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e12%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e16%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOn an average day, how many hours do you use a smartphone or tablet, for something other than schoolwork?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e\u003cem\u003eN\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e\u0026lt; 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e5 \u0026gt;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003ePrefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e908\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e34%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e2518\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e19%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e46%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.333333333333334%\"\u003e\n \u003cp\u003e3426\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.375%\"\u003e\n \u003cp\u003e18%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e42%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHow many hours of sleep do you get per night during the school week?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"603\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u0026lt; 6 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e7 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e8 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e9 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e10 \u0026gt;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1899\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e24%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e27%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e19%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e4573\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e27%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e18%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e29%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e18%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6472\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e22%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e26%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e22%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e12%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\u003cp\u003eSelf-reported data from students participating are not supported by the weight of research that suggests social media is a major stressor in the life of many adolescents. However, middle school students report that social media is the least of presented stressors, at only 5%, a number that remains consistent for high school students, although bullying is reported to be the lowest stressor in high school. This is likely because of a disconnect in understanding that many of the stressors that appear more obvious to the student have an indirect negative relationship with social media.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInterpretation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eAt 13%, body image is a serious concern, and the issues associated with this have been discussed by Khanna and Sharma (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), de Vries et al. (2019), and Wells et al. (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). An interesting aspect is that with only 5% of respondents stating social media as a cause of stress, it might appear there is a disconnect between the source of body dissatisfaction, which even Instagram insiders admit to, and the experience of it.\u003c/p\u003e \u003cp\u003eAt a combined 31%, school and homework were reported to be the highest stressor for both middle and high school students. Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e3\u003c/span\u003e may give some insight into this. Almost half of all students report 6 or fewer hours each night, and 6 out of 10 respondents report using their mobile phone or tablet for 4 hours or more each day, with more than 4 out of 10 reporting 5 or more hours of use each day. The first-generation iPhone was introduced in 2005, Netflix introduced streaming services in 2007, and in 2021 the iPad is over a decade old, being first released in 2010. While television and video games have been around for decades, the last two decades have offered a wider range of access to content on mobile devices. This access has prompted psychologists to put guidelines on screen time (Pappas, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eCleland Woods and Scott (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) tie multiple areas of concern together, specifically exploring the lack of sleep. They found that social media use is tied to poor sleep, anxiety, depression, and low self-esteem, with nighttime use of social media having a strong association with poor sleep. This research is extremely important when considering social media use, especially as it relates to the RemedyLive data. This study and the RemedyLive data also tie with the research of Kelly et al. (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), who found that a lack of sleep is strongly associated with depressive symptoms. With almost half of students reporting 6 or fewer hours of sleep, and over 70% reporting 7 or fewer hours, it is clear that sleep is taking a back seat to screen time. The link between stress from school, which requires strong cognitive functioning, can be explained with a correlation to the increase in social media use/screen time, and a reduction in the amount of sleep needed to maintain a healthy state of mind. Twenge (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) also concluded that time on technology contributes to the declining well-being of adolescents from 2011 to 2018. The correlation between technology use and lower well-being could be associated with reduced sleep. The demands on adolescents today are no lower than in the past, but with the majority of adolescents spending 4 or more hours on devices each day, there is less time to complete all the work needed for school and other responsibilities.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003e3.2 Mental Health\u003c/h2\u003e \u003cp\u003eTable 4\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRate your level of depression over the last 30 days:\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003eI have not felt depressed.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eI sometimes feel depressed.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003eI have felt depressed more than average.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003eI feel very depressed.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e1791\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e31%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e39%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e5948\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e36%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.458333333333334%\"\u003e\n \u003cp\u003e7638\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.791666666666668%\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e37%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.583333333333334%\"\u003e\n \u003cp\u003e16%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.541666666666666%\"\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 5\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRate your level of anxiety:\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003eI have not felt anxious\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003eLow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003eAverage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003eHigh\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\n \u003cp\u003e1396\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e32%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e31%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\n \u003cp\u003e5251\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e29%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e39%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"10.1010101010101%\"\u003e\n \u003cp\u003e6647\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e23%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e31%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.171717171717173%\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 6\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHave you intentionally hurt yourself in the past 30 days?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e1217\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e19%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e72%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e1292\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e80%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e2509\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e76%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 7\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDo you know someone who struggles with suicidal thinking?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e3053\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e53%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e42%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e7431\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e37%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e10484\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e56%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e39%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 8\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDuring the past 12 months, have you ever seriously considered ending your life?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"633\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e3074\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e58%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e12%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e7437\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e58%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e10511\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e58%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" width=\"20%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 9\u003c/p\u003e\n\u003cp\u003eWhat type of home life do you have?\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003eMy siblings/ parents/ guardians abuse me\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003eMy siblings/ parents/ guardians ignore me\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003eMy siblings/ parents/ guardians support and encourage me\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e424\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e12%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e74%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e322\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e19%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e68%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.371134020618557%\"\u003e\n \u003cp\u003e746\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.49484536082474%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e71%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.587628865979383%\"\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003e \u003cb\u003eInterpretation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eConcerning findings in these final tables show a growing trend of mental health challenges faced by adolescents. One major concern from Table\u0026nbsp;\u003cspan refid=\"Tab10\" class=\"InternalRef\"\u003e13\u003c/span\u003e is the increase of almost 17% of students who seriously considered ending their life from middle school to high school. This, along with fewer high school students knowing others who have struggled with suicidal ideation increasing from middle to high school is an interesting report when viewed along with the first two questions of experiencing depression and anxiety. Self-reported levels of not experiencing depression decreased slightly between middle and high school, while anxiety increased.\u003c/p\u003e \u003cp\u003eHowever, one important factor to note is the increase in the more extreme ends of feeling very depressed increasing from 11% in middle school to 14% in high school, and feelings of anxiety increasing from 31% in middle school to 39% in high school. These results suggest that the storm and stress theory proposed by Hall (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e1904\u003c/span\u003e) maintains relevance. Although adolescence may not be a period of wild emotion, and most people entering and leaving the stage relatively unscathed, the intensity of the storms increase. One area where storms increase concerns parent-child relationships. It should perhaps be no surprise that anxiety increases as the adolescent gains more autonomy and experiences less support and more freedom.\u003c/p\u003e \u003cp\u003eThe increase in anxiety continues into college. The Association for University and College Counseling Center Directors (AUCCCD) report compiled data from July 2018 to June 2019 and included results from 562 counseling center directors and over 155,000 students from colleges and universities nationwide. Of the institutions responding, 43.9% had gained staff positions, for a total of 325.4 gained positions, while only 22 positions were lost. The mean expense for counseling center salaries across 298 responding institutions was \u003cspan\u003e$\u003c/span\u003e1,035,895 putting the cost in the hundreds of millions of dollars (LeViness et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). However, the cost of not providing these services may be even greater. 66.2% of students using counseling services stated the services helped them with academic performance, and 62.3% stated the services helped them stay in school. Although increasing positions are being added, the situation is declining, and the AUCCID report states that 87.3% of directors reported an increase in demand during the year with a 12.2% increase between 2018 and 2019. There is a crisis concerning the mental health of young adults in the United States, with anxiety (60.7%), depression (48.6%), and stress (47%) leading the mental health struggles for college students using counseling services (LeViness et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eOverall, the picture for adolescents is mixed. Around 1-in-3 report no experience of depression, compared to 1-in-8 reporting feeling very depressed. Over 7 in 10 students report a supportive and encouraging home, with 4% reporting an abusive home. At 1 in 3 students experiencing suicidal ideation, this is something to be concerned about, especially with the potential contagious nature of suicidal ideation shared on social media, especially Instagram (Carlyle et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec9\" class=\"Section2\"\u003e \u003ch2\u003e3.3 Bullying\u003c/h2\u003e \u003cp\u003eTable 10\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eHas being bullied ever caused you to want to hurt yourself?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eI\u0026apos;ve not been bullied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e547\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e24%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e2554\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e23%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e38%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e3101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e28%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e32%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e36%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"16.666666666666668%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 11\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDuring the past 30 days, on how many days did you not go to school because you felt you would be unsafe at school or on your way to or from school?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1 day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e2 or 3 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e4 or 5 days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6 or more days\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e83%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1209\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e82%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1520\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e82%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 12\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRegarding the abuse of bullying, choose from the following:\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have bullied others online\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have bullied others verbally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have bullied others physically\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have watched others be bullied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eNone of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1309\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e41%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e844\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e41%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e27%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e2153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e41%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e29%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 13\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSelect any way(s) you have been bullied in the past 12 months (multiple choices allowed before clicking submit):\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have been bullied on school property\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have been bullied outside of school property\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have been electronically bullied via texting\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have been electronically bullied via a social media app\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI have not been bullied\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e1576\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e3874\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e19%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5450\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e24%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e10%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.5%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 14\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eIn your opinion, what\u0026rsquo;s the biggest problem your school faces?\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellpadding=\"0\" cellspacing=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\u003cbr\u003e\u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eIllegal Drugs\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eAlcohol\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.903225806451612%\"\u003e\n \u003cp\u003eSexual Harassment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eBullying\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eSafety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eMental Health\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eNone of the above\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eI prefer not to answer\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eMS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e1304\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.903225806451612%\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e37%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e12%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eHS\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e9625\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.903225806451612%\"\u003e\n \u003cp\u003e9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e15%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e19%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e10929\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.903225806451612%\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e26%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e9%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e16%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.67741935483871%\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\u003cp\u003e \u003cb\u003eInterpretation\u003c/b\u003e \u003c/p\u003e \u003cp\u003eCyberbullying is a growing problem and more than doubled between 2007 and 2019 (Patchin \u0026amp; Hinduja, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). During this time a generation has grown up in the digital world with parents and caregivers unequipped and inexperienced at dealing with child and adolescent development in the digital world. Unlike previous generations where bullying ended at the door of their home (assuming there was no abuse in the home), the reach of cyberbullying has few limitations. Although many sites have blocking features and options for reporting abuse, many victims do not report the bullying for reasons including fear of retribution and increased bullying, loss of freedom or social media access, not knowing who they should report the incident to, or believing nothing would change if it was reported. The lack of reporting might account for the discrepancy between the Department of Education (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) figures that just over 1-in-5 students report bullying and the findings of Remedy that 60% of students report having been bullied, with only 35% stating they have never been bullied.\u003c/p\u003e \u003cp\u003eAnother aspect of concern can be found in the 41% of students who have witnessed bullying. Students who witness bullying can also influence the well-being of a victim (Davis \u0026amp; Nixon, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2010\u003c/span\u003e), but can also be negatively affected themselves through feelings of hopelessness (Centers for Disease Control and Prevention, 2014). Patchin and Hinduja (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) state that two-thirds of students are prepared to support the victim, whether through intervention or defense, whether online or in person, but there are also concerns of exacerbating the situation and making things worse. Inaction, it seems, feeds the control a bully is often seeking to maintain, but the fear of reprisal does nothing to check the behavior.\u003c/p\u003e \u003c/div\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eThe research from RemedyLive presents a picture in which the majority of adolescents appear to live in loving and encouraging environments, but also live with a great deal of anxiety. Adolescents are under a great deal of pressure, and with a seemingly unending flow of information from social media, anxiety to present the best snapshots of life and post content that increases self-esteem (or, at least, minimize the risk of self-esteem being negatively affected). Adolescents have to navigate the dangers of life with little training or guidance from parents who grew up in a different era and find ways to understand that comparison to others is a comparison based on a carefully tailored picture people are presenting. Students are doing all of this with reduced sleep, increased risk of bullying, and exposure to contagious mental health issues. We agree with Twenge et al. (\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) and support the message that:\u003c/p\u003e \u003cp\u003eYoung people can't change their genetics or the economic situation of the country, but they can choose how they spend their leisure time. First and most important is to get enough sleep. Make sure your device use doesn't interfere with sleep, don't keep phones or tablets in the bedroom at night, and put devices down within an hour of bedtime\u0026hellip;Overall, make sure digital media use doesn't interfere with activities more beneficial to mental health such as face-to-face social interaction, exercise, and sleep.\u003c/p\u003e \u003cp\u003eOne area of concern is that adolescents have not connected the use of technology and lack of sleep to areas of struggle in their lives, including experiencing depression and anxiety. Of course, this is a multifaceted problem, and no one area is the \u0026lsquo;fix\u0026rsquo; for the challenges of adolescent development, but sleep is a good start. However, with 60% of students responding to the RemedyLive survey as reporting 4 or more hours of non-academic screen time a day, limited this time would help students recover a great deal of time for more productive activities. With academic and productive activities completed on time, a student would be able to get more sleep, with the added benefit of less exposure to unhealthy content on social media.\u003c/p\u003e \u003cp\u003eAs parents gain greater awareness of the dangers of social media, it is hoped they will take a more structured approach to both, the amount of time spent and the content exposure their children and adolescents are exposed to. Education on the dangers of social media and screen time should be directed not just at the adolescent user, but also at parents and caregivers. Social media is not going away, and the current trends for youth mental health and suicidal ideation are concerning. It is recommended that future studies examine the influence of better sleep habits and reduced screen time as it relates to mental health, primarily anxiety, which appears to be the greater threat and can be negatively influenced by almost every area of life where social media has a direct or indirect influence.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eThere are no competing interests and no financial obligations of any kind.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAnnisette, L. E., \u0026amp; Lafreniere, K. D. (2017). Social media, texting, and personality: A test of the shallowing hypothesis. 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Retrieved from \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.wsj.com/articles/facebook-knows-instagram-is-toxic-for-teen-girls-company-documents-show-11631620739\u003c/span\u003e\u003cspan address=\"https://www.wsj.com/articles/facebook-knows-instagram-is-toxic-for-teen-girls-company-documents-show-11631620739\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Northern Michigan University","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"social media, self-esteem, mental health, bullying, cyberbullying, anxiety, depression","lastPublishedDoi":"10.21203/rs.3.rs-1447988/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-1447988/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eMental health problems are increasing among adolescents with depression, anxiety, and multiple areas where self-esteem is negatively impacted on the rise. Dangers of social media use include social comparison and the risk of not receiving positive feedback. This study focused on a review of previous research literature and used data supplied by RemedyLive. The purpose of this paper is to examine the influence of social media on an adolescent\u0026rsquo;s well-being. The data were provided and complied by RemedyLive with all individual user data scrubbed. RemedyLive is an organization offering support to students in middle and high school around the United States. RemedyLive operates the \u0026lsquo;Get Schooled Tour\u0026rsquo;, giving talks in schools and asking students to respond to questions regarding family, friends, school, and other areas that may influence mental health. The findings suggest that school and homework are top stressors for students, with 35% of high school students reporting high levels of anxiety. There are numerous concerns with social media relating to increases in depression, anxiety, and lower self-esteem. The content, especially on Instagram, significantly lowers mental health, However, with 60% of students reporting 4 or more hours of non-academic screen time each day there is less time being spent on productive and academic tasks. The conclusion of the research points to a concerning relationship between social media platforms and decreasing adolescent mental health that suggest the dangers of social media are indirect and often unnoticed by adolescents and young adults. An ongoing analysis of social media on development is recommended for further investigation to determine the long-term effects.\u003c/p\u003e","manuscriptTitle":"Current Challenges to Adolescent Well-being","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2022-03-16 21:18:20","doi":"10.21203/rs.3.rs-1447988/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5aafa1fd-d40b-4983-9ef6-0aa05dddd8b6","owner":[],"postedDate":"March 16th, 2022","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":11049789,"name":"Psychology"}],"tags":[],"updatedAt":"2022-03-16T21:18:20+00:00","versionOfRecord":[],"versionCreatedAt":"2022-03-16 21:18:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-1447988","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-1447988","identity":"rs-1447988","version":["v1"]},"buildId":"ApUGefWb6u5IBVtyqm6d5","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}