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Published article available at: Primack BA, Karim SA, Shensa A, Bowman B, Knight J, Sidani JE. Positive and negative social media experiences and social isolation. American Journal of Health Promotion. 2018. and negative experiences on social media and social isolationBrian A. Primack, MD, PhD1,2,3Sabrina A. Karim, BA1Ariel Shensa, MA1,2Nicholas Bowman, PhD4Jennifer Knight, MA4Jaime E. Sidani, PhD1,21Center for Research on Media, Technology, and Health, University of Pittsburgh, Pittsburgh, PA2Department of Medicine, University of Pittsburgh, Pittsburgh, PA3University Honors College, University of Pittsburgh, Pittsburgh, PA4Department of Communication, University of West Virginia, Morgantown, WVShort Title: Experiences on social media and social isolationWords in abstract: 250Words in text: 4688References: 43Tables: 3ABSTRACTPurpose. To examine the association between positive and negative experiences on social media (SM) and perceived social isolation (PSI).Design. Cross-sectional survey.Setting. One large mid-Atlantic University.Subjects. 1178 students ages 18 to 30 were recruited in August 2016.Measures. Subjects completed an online survey assessing SM use and PSI. We assessed positive and negative experiences on SM by directly asking participants to estimate what percentage of their SM experiences involved positive and negative experiences, respectively. Social isolation was measured using the established Patient-Reported Outcomes Measures Information System (PROMIS) scale.Analysis. We used multivariable logistic regression to assess associations between both positive and negative experiences on SM and PSI. Primary models controlled for sex, age, race/ethnicity, educational status, relationship status, and living situation.Results. Participants had an average age of 20.9 (SD=2.9) and were 62% female. Just over one quarter (28%) were non-White. After controlling for all socio-demographic covariates, each 10% increase in positive experiences was not significantly associated with social isolation (AOR=0.97; 95% CI=0.93-1.005). However, each 10% increase in negative experiences was associated with a 13% increase in odds of PSI (AOR=1.13; 95% CI=1.05-1.21).Conclusion. Having positive experiences on SM is not associated with lower social isolation, whereas having negative experiences on SM is associated with higher social isolation. These findings are consistent with the concept of negativity bias, which suggests that humans tend to give greater weight to negative entities compared with positive ones.KEYWORDSSocial isolation, social media, university students, young adults, PROMIS, perceived social isolation, connectedness, social capital, collegeINTRODUCTIONSocial isolation, defined as disengagement from social ties, institutional connections, or community participation,ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/S1047-2797(96)00095-6","ISBN":"1047-2797","ISSN":"10472797","PMID":"8915476","abstract":"This article explores the relationship between level of social integration and various aspects of health. A search of the literature published since the mid-1970s (under the MEDLINE key words, 'socialties,' 'social network,' 'social isolation,' 'social environment') presented strong evidence that social integration leads to reduced mortality risks, and to a better state of mental health. The evidence on physical health outcomes is less conclusive. There is no consistent evidence that social integration affects the incidence of disease (at least for cardiovascular outcomes). However, social integration does appear to have a highly beneficial effect on post-myocardial infarction prognosis (functioning and longevity). A physiologic basis for these effects on health outcomes is also indicated by research demonstrating that both social isolation and nonsupportive social interactions can result in lower immune function and higher neuroendocrine and cardiovascular activity while socially supportive interactions have the opposite effects. In conclusion, available data suggest that, although social integration is generally associated with better outcomes, the quality of existing ties also appears to influence the extent of such health benefits. Clearly, individuals' networks of social relationships represent dynamic and complex social systems that affect health outcomes.","author":[{"dropping-particle":"","family":"Seeman","given":"Teresa E.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Annals of Epidemiology","id":"ITEM-1","issue":"5","issued":{"date-parts":[["1996"]]},"page":"442-451","title":"Social ties and health: the benefits of social integration","type":"article-journal","volume":"6"},"uris":["",""]}],"mendeley":{"formattedCitation":"¹","plainTextFormattedCitation":"1","previouslyFormattedCitation":"¹"},"properties":{"noteIndex":0},"schema":""}1 can be either objective or subjective (“perceived”). Objective social isolation refers to physical isolation or a lack of social ties, while subjective social isolation refers to one’s perception of his or her own isolation or disconnectedness.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/1745691614568352","abstract":"Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.","author":[{"dropping-particle":"","family":"Holt-Lunstad","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"T B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Baker","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harris","given":"T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stephenson","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Perspectives on Psychological Science","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2015"]]},"page":"227-237","title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"²","plainTextFormattedCitation":"2","previouslyFormattedCitation":"²"},"properties":{"noteIndex":0},"schema":""}2 This study focuses on subjective isolation, hereafter referred to as perceived social isolation (PSI), because this form of isolation in particular has been linked to negative health outcomes and increased mortality.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/1745691614568352","abstract":"Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.","author":[{"dropping-particle":"","family":"Holt-Lunstad","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"T B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Baker","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harris","given":"T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stephenson","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Perspectives on Psychological Science","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2015"]]},"page":"227-237","title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","type":"article-journal","volume":"10"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.tics.2009.06.005","ISSN":"1364-6613","PMID":"19726219","abstract":"Social species, from Drosophila melanogaster to Homo sapiens, fare poorly when isolated. Homo sapiens, an irrepressibly meaning-making species, are, in normal circumstances, dramatically affected by perceived social isolation. Research indicates that perceived social isolation (i.e. loneliness) is a risk factor for, and may contribute to, poorer overall cognitive performance, faster cognitive decline, poorer executive functioning, increased negativity and depressive cognition, heightened sensitivity to social threats, a confirmatory bias in social cognition that is self-protective and paradoxically self-defeating, heightened anthropomorphism and contagion that threatens social cohesion. These differences in attention and cognition impact on emotions, decisions, behaviors and interpersonal interactions that can contribute to the association between loneliness and cognitive decline and between loneliness and morbidity more generally.","author":[{"dropping-particle":"","family":"Cacioppo","given":"J T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hawkley","given":"L C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Trends in Cognitive Sciences","id":"ITEM-2","issue":"10","issued":{"date-parts":[["2009","10"]]},"page":"447-454","title":"Perceived social isolation and cognition","type":"article-journal","volume":"13"},"uris":[""]}],"mendeley":{"formattedCitation":"^2,3","plainTextFormattedCitation":"2,3","previouslyFormattedCitation":"^2,3"},"properties":{"noteIndex":0},"schema":""}2,3 Specifically, there are clear linkages between PSI and deficits in the cardiovascular system (increased hypertension, coronary artery disease, cardiac failure), neuroendocrine system (increased glucocorticoid levels and glucocorticoid resistance), and cognitive functioning (increased depressive symptoms, suicidal ideation and dementia in old age).ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.2105/AJPH.2013.301261","ISSN":"1541-0048","PMID":"24028260","abstract":"OBJECTIVES We explored the relationship between social isolation and mortality in a nationally representative US sample and compared the predictive power of social isolation with that of traditional clinical risk factors. METHODS We used data on 16,849 adults from the Third National Health and Nutrition Examination Survey and the National Death Index. Predictor variables were 4 social isolation factors and a composite index. Comparison predictors included smoking, obesity, elevated blood pressure, and high cholesterol. Unadjusted Kaplan-Meier tables and Cox proportional hazards regression models controlling for sociodemographic characteristics were used to predict mortality. RESULTS Socially isolated men and women had worse unadjusted survival curves than less socially isolated individuals. Cox models revealed that social isolation predicted mortality for both genders, as did smoking and high blood pressure. Among men, individual social predictors included being unmarried, participating infrequently in religious activities, and lacking club or organization affiliations; among women, significant predictors were being unmarried, infrequent social contact, and participating infrequently in religious activities. CONCLUSIONS The strength of social isolation as a predictor of mortality is similar to that of well-documented clinical risk factors. Our results suggest the importance of assessing patients' level of social isolation.","author":[{"dropping-particle":"","family":"Pantell","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rehkopf","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jutte","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Syme","given":"S L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Balmes","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Adler","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Public Health","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2013","11"]]},"page":"2056-2062","title":"Social isolation: a predictor of mortality comparable to traditional clinical risk factors.","type":"article-journal","volume":"103"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1136/heartjnl-2015-308790","ISSN":"1355-6037","abstract":"Background The influence of social relationships on morbidity is widely accepted, but the size of the risk to cardiovascular health is unclear. Objective We undertook a systematic review and meta-analysis to investigate the association between loneliness or social isolation and incident coronary heart disease (CHD) and stroke. Methods Sixteen electronic databases were systematically searched for longitudinal studies set in high-income countries and published up until May 2015. Two independent reviewers screened studies for inclusion and extracted data. We assessed quality using a component approach and pooled data for analysis using random effects models. Results Of the 35 925 records retrieved, 23 papers met inclusion criteria for the narrative review. They reported data from 16 longitudinal datasets, for a total of 4628 CHD and 3002 stroke events recorded over follow-up periods ranging from 3 to 21 years. Reports of 11 CHD studies and 8 stroke studies provided data suitable for meta-analysis. Poor social relationships were associated with a 29% increase in risk of incident CHD (pooled relative risk: 1.29, 95% CI 1.04 to 1.59) and a 32% increase in risk of stroke (pooled relative risk: 1.32, 95% CI 1.04 to 1.68). Subgroup analyses did not identify any differences by gender. Conclusions Our findings suggest that deficiencies in social relationships are associated with an increased risk of developing CHD and stroke. Future studies are needed to investigate whether interventions targeting loneliness and social isolation can help to prevent two of the leading causes of death and disability in high-income countries.","author":[{"dropping-particle":"","family":"Valtorta","given":"N K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Kanaan","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gilbody","given":"S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ronzi","given":"S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hanratty","given":"B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Heart","id":"ITEM-2","issued":{"date-parts":[["2016","4","18"]]},"title":"Loneliness and social isolation as risk factors for coronary heart disease and stroke: Systematic review and meta-analysis of longitudinal observational studies","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"^4,5","plainTextFormattedCitation":"4,5","previouslyFormattedCitation":"^4,5"},"properties":{"noteIndex":0},"schema":""}4,5 Overarching conclusions across several studies support a direct association between PSI and morbidity/mortality, or an inverse relationship between social support and morbidity/mortality.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.2105/AJPH.2013.301261","ISSN":"1541-0048","PMID":"24028260","abstract":"OBJECTIVES We explored the relationship between social isolation and mortality in a nationally representative US sample and compared the predictive power of social isolation with that of traditional clinical risk factors. METHODS We used data on 16,849 adults from the Third National Health and Nutrition Examination Survey and the National Death Index. Predictor variables were 4 social isolation factors and a composite index. Comparison predictors included smoking, obesity, elevated blood pressure, and high cholesterol. Unadjusted Kaplan-Meier tables and Cox proportional hazards regression models controlling for sociodemographic characteristics were used to predict mortality. RESULTS Socially isolated men and women had worse unadjusted survival curves than less socially isolated individuals. Cox models revealed that social isolation predicted mortality for both genders, as did smoking and high blood pressure. Among men, individual social predictors included being unmarried, participating infrequently in religious activities, and lacking club or organization affiliations; among women, significant predictors were being unmarried, infrequent social contact, and participating infrequently in religious activities. CONCLUSIONS The strength of social isolation as a predictor of mortality is similar to that of well-documented clinical risk factors. Our results suggest the importance of assessing patients' level of social isolation.","author":[{"dropping-particle":"","family":"Pantell","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rehkopf","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jutte","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Syme","given":"S L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Balmes","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Adler","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Public Health","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2013","11"]]},"page":"2056-2062","title":"Social isolation: a predictor of mortality comparable to traditional clinical risk factors.","type":"article-journal","volume":"103"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1177/1745691614568352","abstract":"Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.","author":[{"dropping-particle":"","family":"Holt-Lunstad","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"T B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Baker","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harris","given":"T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stephenson","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Perspectives on Psychological Science","id":"ITEM-2","issue":"2","issued":{"date-parts":[["2015"]]},"page":"227-237","title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"^2,4","plainTextFormattedCitation":"2,4","previouslyFormattedCitation":"^2,4"},"properties":{"noteIndex":0},"schema":""}2,4Social media (SM)—which may represent an opportunity for socially isolated individuals to connect—has been increasing in use substantially. For example, in the United States the percentage of young adults using SM skyrocketed from 12% in 2005 to 90% in 2015.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","accessed":{"date-parts":[["2018","11","27"]]},"author":[{"dropping-particle":"","family":"Perrin","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Pew Research Center","id":"ITEM-1","issued":{"date-parts":[["2015"]]},"title":"Social media usage: 2005-2015","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"⁶","plainTextFormattedCitation":"6","previouslyFormattedCitation":"⁶"},"properties":{"noteIndex":0},"schema":""}6 Among online adults in 2016, Facebook remains the most popular social media platform (79%, a 7-percentage point increase from 2015), followed by Instagram (32%), Pinterest (31%), LinkedIn (29%), and Twitter (24%).ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Greenwood","given":"S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Perrin","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Duggan","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2016"]]},"number-of-pages":"1-4","publisher-place":"Washington, D.C.","title":"Social media update 2016","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷","plainTextFormattedCitation":"7","previouslyFormattedCitation":"⁷"},"properties":{"noteIndex":0},"schema":""}7 Of note, as of 2016, a marked proportion (62%) of American adults reported getting their news from social media.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","abstract":"A majority of U.S. adults – 62% – get news on social media, and 18% do so often, according to a new survey by Pew Research Center, conducted in association with the John S. and James L. Knight Foundation. In 2012, based on a slightly different question, 49% of U.S. adults reported seeing news on social media.1","accessed":{"date-parts":[["2018","11","27"]]},"author":[{"dropping-particle":"","family":"Gottfried","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shearer","given":"E","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Pew Research Center","id":"ITEM-1","issued":{"date-parts":[["2016"]]},"page":"19","title":"News use across social media platforms 2016","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"⁸","plainTextFormattedCitation":"8","previouslyFormattedCitation":"⁸"},"properties":{"noteIndex":0},"schema":""}8Because the explicit goal of SM platforms is to connect individuals, it is not surprising that studies suggest the ability of SM to positively influence social connectedness. For example, Facebook may help to maintain existing relationships among college students, which particularly benefits those individuals with low self-esteem and low life-satisfaction.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/jcc4.12078","ISSN":"10836101","abstract":"This study explores the relationship between perceived bridging social capital and specific Facebook-enabled communication behaviors using survey data from a sample of U.S. adults (N=614). We explore the role of a specific set of Facebook behaviors that support relationship maintenance and assess the extent to which demographic variables, time on site, total and “actual” Facebook Friends, and this new measure (Facebook Relationship Maintenance Behaviors) predict bridging social capital. Drawing upon scholarship on social capital and relationship maintenance, we discuss the role of social grooming and attention-signaling activities in shaping perceived access to resources in one's network as measured by bridging social capital.","author":[{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitak","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gray","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lampe","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Computer-Mediated Communication","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2014","7"]]},"page":"855-870","title":"Cultivating social resources on social network sites: Facebook relationship maintenance behaviors and their role in social capital processes","type":"article-journal","volume":"19"},"uris":[""]}],"mendeley":{"formattedCitation":"⁹","plainTextFormattedCitation":"9","previouslyFormattedCitation":"⁹"},"properties":{"noteIndex":0},"schema":""}9 In addition to preserving existing social ties, social media facilitates the formation of new connections, which provides people with an alternative way to connect with others who share similar interests or relational goals.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1083-6101.2007.00367.x","ISBN":"0521832969","ISSN":"10836101","PMID":"10540012","abstract":"This study examines the relationship between use of Facebook, a popular online social network site, and the formation and maintenance of social capital. In addition to assessing bonding and bridging social capital, we explore a dimension of social capital that assesses one’s ability to stay connected with members of a previously inhabited community, which we call maintained social capital. Regression analyses conducted on results from a survey of undergraduate students (N = 286) suggest a strong association between use of Facebook and the three types of social capital, with the strongest relationship being to bridging social capital. In addition, Facebook usage was found to interact with measures of psychological well-being, suggesting that it might provide greater","author":[{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Steinfield","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lampe","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Computer-Mediated Communication","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2007","7"]]},"page":"1143-1168","title":"The benefits of Facebook \"friends\": social capital and college students' use of online social network sites","type":"article-journal","volume":"12"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1111/j.1083-6101.2006.00020.x","ISBN":"1083-6101","ISSN":"1083-6101","PMID":"20492508","abstract":"This study investigates self-presentation strategies among online dating participants, exploring how participants manage their online presentation of self in order to accomplish the goal of finding a romantic partner. Thirty-four individuals active on a large online dating site participated in telephone interviews about their online dating experiences and perceptions. Qualitative data analysis suggests that participants attended to small cues online, mediated the tension between impression management pressures and the desire to present an authentic sense of self through tactics such as creating a profile that reflected their \"ideal self,\" and attempted to establish the veracity of their identity claims. This study provides empirical support for Social Information Processing theory in a naturalistic context while offering insight into the complicated way in which \"honesty\" is enacted online.","author":[{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Heino","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gibbs","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Computer-Mediated Communication","id":"ITEM-2","issued":{"date-parts":[["2006"]]},"page":"415-441","title":"Managing impressions online: self-presentation processes in the online dating environment","type":"article-journal","volume":"11"},"uris":["",""]}],"mendeley":{"formattedCitation":"^10,11","plainTextFormattedCitation":"10,11","previouslyFormattedCitation":"^10,11"},"properties":{"noteIndex":0},"schema":""}10,11 Similarly, individuals with a greater number of SM connections report having greater social capital, which also tends to enhance social connectedness.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.appdev.2008.07.002","ISSN":"01933973","abstract":"A longitudinal analysis of panel data from users of a popular online social network site, Facebook, investigated the relationship between intensity of Facebook use, measures of psychological well-being, and bridging social capital. Two surveys conducted a year apart at a large U.S. university, complemented with in-depth interviews with 18 Facebook users, provide the study data. Intensity of Facebook use in year one strongly predicted bridging social capital outcomes in year two, even after controlling for measures of self-esteem and satisfaction with life. These latter psychological variables were also strongly associated with social capital outcomes. Self-esteem served to moderate the relationship between Facebook usage intensity and bridging social capital: those with lower self-esteem gained more from their use of Facebook in terms of bridging social capital than higher self-esteem participants. We suggest that Facebook affordances help reduce barriers that lower self-esteem students might experience in forming the kinds of large, heterogeneous networks that are sources of bridging social capital.","author":[{"dropping-particle":"","family":"Steinfield","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lampe","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Applied Developmental Psychology","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2008","11"]]},"page":"434-445","title":"Social capital, self-esteem, and use of online social network sites: a longitudinal analysis","type":"article-journal","volume":"29"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1111/jcc4.12078","ISSN":"10836101","abstract":"This study explores the relationship between perceived bridging social capital and specific Facebook-enabled communication behaviors using survey data from a sample of U.S. adults (N=614). We explore the role of a specific set of Facebook behaviors that support relationship maintenance and assess the extent to which demographic variables, time on site, total and “actual” Facebook Friends, and this new measure (Facebook Relationship Maintenance Behaviors) predict bridging social capital. Drawing upon scholarship on social capital and relationship maintenance, we discuss the role of social grooming and attention-signaling activities in shaping perceived access to resources in one's network as measured by bridging social capital.","author":[{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Vitak","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gray","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lampe","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Computer-Mediated Communication","id":"ITEM-2","issue":"4","issued":{"date-parts":[["2014","7"]]},"page":"855-870","title":"Cultivating social resources on social network sites: Facebook relationship maintenance behaviors and their role in social capital processes","type":"article-journal","volume":"19"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1177/1461444810385389","ISSN":"1461-4448","author":[{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Steinfield","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lampe","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"New Media & Society","id":"ITEM-3","issue":"6","issued":{"date-parts":[["2011","9"]]},"page":"873-892","title":"Connection strategies: Social capital implications of Facebook-enabled communication practices","type":"article-journal","volume":"13"},"uris":[""]}],"mendeley":{"formattedCitation":"^9,12,13","plainTextFormattedCitation":"9,12,13","previouslyFormattedCitation":"^9,12,13"},"properties":{"noteIndex":0},"schema":""}9,12,13 In turn, those with greater social capital can draw on resources from other members of their networks, leading to useful information, new personal relationships, and employment connections.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1086/210268","ISSN":"0002-9602","abstract":"Despite a great deal of interest in a possible decline of social capital in the United States, scholars have not reached a consensus on the trend. This article improves upon previous research by providing a model of social capital that has explicit links to theories of social capital and that analyzes multiple indicators of social capital over a 20‐year period. The results do not consistently support Putnam's claim of a decline in social capital, showing instead some decline in a general measure of social capital, a decline in trust in individuals, no general decline in trust in institutions, and no decline in associations.","author":[{"dropping-particle":"","family":"Paxon","given":"P","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Sociology","id":"ITEM-1","issue":"1","issued":{"date-parts":[["1999"]]},"page":"88-127","title":"Is social capital declining in the United States? a multiple indicator assessment","type":"article-journal","volume":"105"},"uris":["",""]},{"id":"ITEM-2","itemData":{"DOI":"10.1086/225469","abstract":"Analysis of social networks is sugested as a tool for linking micro and macro levels of sociological theory. the procedure is illustrated by eleaboration of the macro implications of one aspect of small-scale interaction: the strength of dyadic ties. It is argued that the degree of overlap of two indiciduals' friendship networks varies directly with the strength of their tie to one another. The impact of this principle on diffusion of influence and information, mobility opportunity, and community organization is explored. Stress is laid on the cohesive power of weak ties. Most network models deal, implicitly with strong ties, thus confining their applicability to small, well-defined groups. Emphasis on weak ties lends itself to discussion of relations between groups and to analysis of segments of social sturcture not easily defined in terms of primary groups.","author":[{"dropping-particle":"","family":"Granovetter","given":"M S","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Sociology","id":"ITEM-2","issue":"6","issued":{"date-parts":[["1973"]]},"page":"1360-1380","title":"The strength of weak ties","type":"article-journal","volume":"78"},"uris":[""]}],"mendeley":{"formattedCitation":"^14,15","plainTextFormattedCitation":"14,15","previouslyFormattedCitation":"^14,15"},"properties":{"noteIndex":0},"schema":""}14,15 Having a larger Facebook audience also has been associated with increased life satisfaction, perceived social support, and subjective well-being.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1037/a0026338","ISSN":"1939-0599","PMID":"22288367","abstract":"Is there a trade-off between having large networks of social connections on social networking sites such as Facebook and the development of intimacy and social support among today's generation of emerging adults? To understand the socialization context of Facebook during the transition to adulthood, an online survey was distributed to college students at a large urban university; participants answered questions about their relationships by systematically sampling their Facebook contacts while viewing their Facebook profiles online. Results confirmed that Facebook facilitates expansive social networks that grow disproportionately through distant kinds of relationship (acquaintances and activity connections), while also expanding the number of close relationships and stranger relationships, albeit at slower rates. Those with larger networks estimated that larger numbers of contacts in their networks were observing their status updates, a form of public communication to one's entire contact list. The major function of status updates was emotional disclosure, the key feature of intimacy. This finding indicates the transformation of the nature of intimacy in the environment of a social network site. In addition, larger networks and larger estimated audiences predicted higher levels of life satisfaction and perceived social support on Facebook. These findings emphasize the psychological importance of audience in the Facebook environment. Findings also suggest that social networking sites help youth to satisfy enduring human psychosocial needs for permanent relations in a geographically mobile world--college students with higher proportions of maintained contacts from the past (primarily high school friends) perceived Facebook as a more useful tool for procuring social support.","author":[{"dropping-particle":"","family":"Manago","given":"A M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Taylor","given":"T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Greenfield","given":"P M","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Developmental Psychology","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2012","3"]]},"page":"369-380","title":"Me and my 400 friends: the anatomy of college students' Facebook networks, their communication patterns, and well-being","type":"article-journal","volume":"48"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1089/cyber.2010.0374","ISSN":"2152-2723","PMID":"21117983","abstract":"The current study investigates whether and how Facebook increases college-age users' subjective well-being by focusing on the number of Facebook friends and self-presentation strategies (positive vs. honest). A structural equation modeling analysis of cross-sectional survey data of college student Facebook users (N=391) revealed that the number of Facebook friends had a positive association with subjective well-being, but this association was not mediated by perceived social support. Additionally, we found that there was a negative curvilinear (inverted U-shape curve) relationship between Facebook friends and perceived social support. As for self-presentation strategies, whereas positive self-presentation had a direct effect on subjective well-being, honest self-presentation had a significant indirect effect on subjective well-being through perceived social support. Our study suggests that the number of Facebook friends and positive self-presentation may enhance users' subjective well-being, but this portion of happiness may not be grounded in perceived social support. On the other hand, honest self-presentation may enhance happiness rooted in social support provided by Facebook friends. Implications of our findings are discussed in light of affirmation of self-worth, time and effort required for building and maintaining friendships, and the important role played by self-disclosure in signaling one's need for social support.","author":[{"dropping-particle":"","family":"Kim","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"J R","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Cyberpsychology, Behavior and Social Networking","id":"ITEM-2","issue":"6","issued":{"date-parts":[["2011","6"]]},"page":"359-364","title":"The Facebook paths to happiness: effects of the number of Facebook friends and self-presentation on subjective well-being","type":"article-journal","volume":"14"},"uris":[""]}],"mendeley":{"formattedCitation":"^16,17","plainTextFormattedCitation":"16,17","previouslyFormattedCitation":"^16,17"},"properties":{"noteIndex":0},"schema":""}16,17However, other studies suggest that increased SM exposure may counter-intuitively be associated with increased PSI.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1007/s10900-015-0128-8","ISSN":"0094-5145","PMID":"26613936","abstract":"Low emotional support is associated with poor health outcomes. Engagement with face-to-face social networks is one way of increasing emotional support. However, it is not yet known whether engagement with proliferating electronic social networks is similarly associated with increased emotional support. Thus, the purpose of this study was to assess associations between social media use and perceived emotional support in a large, nationally-representative sample. In October 2014, we collected data from 1796 U.S. adults ages 19–32. We assessed social media use using both total time spent and frequency of visits to each of the 11 most popular social media platforms. Our dependent variable was perceived emotional support as measured by the brief Patient-Reported Outcomes Measurement Information System (PROMIS) emotional support scale. A multivariable model including all sociodemographic covariates and accounting for survey weights demonstrated that, compared with the lowest quartile of time on social media, being in the highest quartile (spending two or more hours per day) was significantly associated with decreased odds of having higher perceived emotional support (AOR 0.62, 95 % CI 0.40, 0.94). However, compared with those in the lowest quartile, being in the highest quartile regarding frequency of social media use was not significantly associated with perceived emotional support (AOR 0.70, 95 % CI 0.45, 1.09). In conclusion, while the cross-sectional nature of these data hinder inference regarding directionality, it seems that heavy users of social media may actually feel less and not more emotional support.","author":[{"dropping-particle":"","family":"Shensa","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sidani","given":"J E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lin","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bowman","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Primack","given":"B A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Community Health","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2016","6","27"]]},"page":"541-549","title":"Social media use and perceived emotional support among US young adults","type":"article-journal","volume":"41"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁸","plainTextFormattedCitation":"18","previouslyFormattedCitation":"¹⁸"},"properties":{"noteIndex":0},"schema":""}18 This may be because SM facilitates engagement in social comparison, giving users the impression that others tend to be more connected and meaningfully engaged.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1089/cyber.2011.0324","ISSN":"2152-2723","PMID":"22165917","abstract":"Facebook, as one of the most popular social networking sites among college students, provides a platform for people to manage others' impressions of them. People tend to present themselves in a favorable way on their Facebook profile. This research examines the impact of using Facebook on people's perceptions of others' lives. It is argued that those with deeper involvement with Facebook will have different perceptions of others than those less involved due to two reasons. First, Facebook users tend to base judgment on examples easily recalled (the availability heuristic). Second, Facebook users tend to attribute the positive content presented on Facebook to others' personality, rather than situational factors (correspondence bias), especially for those they do not know personally. Questionnaires, including items measuring years of using Facebook, time spent on Facebook each week, number of people listed as their Facebook \"friends,\" and perceptions about others' lives, were completed by 425 undergraduate students taking classes across various academic disciplines at a state university in Utah. Surveys were collected during regular class period, except for two online classes where surveys were submitted online. The multivariate analysis indicated that those who have used Facebook longer agreed more that others were happier, and agreed less that life is fair, and those spending more time on Facebook each week agreed more that others were happier and had better lives. Furthermore, those that included more people whom they did not personally know as their Facebook \"friends\" agreed more that others had better lives.","author":[{"dropping-particle":"","family":"Chou","given":"H T G","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Edge","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Cyberpsychology, Behavior and Social Networking","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2012","2"]]},"page":"117-121","title":"\"They are happier and having better lives than I am\": the impact of using Facebook on perceptions of others' lives","type":"article-journal","volume":"15"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1080/15533610802052654","ISSN":"1553-3611","abstract":"Despite the recent popularity of online social networks, there are few available studies that explain the differences between real life and internet social networks. Authoritative information about the outcomes of using social networking websites is even more sparse. In an attempt to close this literature gap, this exploratory study found that online social networks and real life social networks are significantly different in terms of social network size. The results also show that gender and extroversion are the major predictors of both online social network size and time spent online for social networking. Perhaps the most interesting finding is the negative impact of self-esteem on inclusion of strangers in online social networks. Additionally, directions for future research are provided.","author":[{"dropping-particle":"","family":"Acar","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Website Promotion","id":"ITEM-2","issue":"1-2","issued":{"date-parts":[["2008","5","28"]]},"page":"62-83","title":"Antecedents and consequences of online social networking behavior: the case of Facebook","type":"article-journal","volume":"3"},"uris":[""]},{"id":"ITEM-3","itemData":{"DOI":"10.1089/cyber.2014.0560","ISSN":"2152-2715","abstract":"Abstract As the use and influence of social networking continues to grow, researchers have begun to explore its consequences for psychological well-being. Some research suggests that Facebook use can have negative consequences for well-being. Instagram, a photo-sharing social network created in 2010, has particular characteristics that may make users susceptible to negative consequences. This study tested a theoretically grounded moderated meditation model of the association between Instagram use and depressive symptoms through the mechanism of negative social comparison, and moderation by amount of strangers one follows. One hundred and seventeen 18–29 year olds completed online questionnaires containing demographics, frequency of Instagram use, amount of strangers followed on Instagram, the Center for Epidemiological Resources Scale for Depression, and the Social Comparison Rating Scale. Instagram use was marginally positively associated with depressive symptoms, and positive social comparison was signi...","author":[{"dropping-particle":"","family":"Lup","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Trub","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rosenthal","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Cyberpsychology, Behavior, and Social Networking","id":"ITEM-3","issue":"5","issued":{"date-parts":[["2015","5","12"]]},"language":"en","page":"247-252","publisher":"Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA","title":"Instagram #instasad?: exploring associations among Instagram use, depressive symptoms, negative social comparison, and strangers followed","type":"article-journal","volume":"18"},"uris":[""]}],"mendeley":{"formattedCitation":"^19–21","plainTextFormattedCitation":"19–21","previouslyFormattedCitation":"^19–21"},"properties":{"noteIndex":0},"schema":""}19–21 Consistent with this, a large nationally-representative study recently found that increased SM use—both in terms of time per day and frequency of site visits—was associated with low emotional support in a linear fashion.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1007/s10900-015-0128-8","ISSN":"0094-5145","PMID":"26613936","abstract":"Low emotional support is associated with poor health outcomes. Engagement with face-to-face social networks is one way of increasing emotional support. However, it is not yet known whether engagement with proliferating electronic social networks is similarly associated with increased emotional support. Thus, the purpose of this study was to assess associations between social media use and perceived emotional support in a large, nationally-representative sample. In October 2014, we collected data from 1796 U.S. adults ages 19–32. We assessed social media use using both total time spent and frequency of visits to each of the 11 most popular social media platforms. Our dependent variable was perceived emotional support as measured by the brief Patient-Reported Outcomes Measurement Information System (PROMIS) emotional support scale. A multivariable model including all sociodemographic covariates and accounting for survey weights demonstrated that, compared with the lowest quartile of time on social media, being in the highest quartile (spending two or more hours per day) was significantly associated with decreased odds of having higher perceived emotional support (AOR 0.62, 95 % CI 0.40, 0.94). However, compared with those in the lowest quartile, being in the highest quartile regarding frequency of social media use was not significantly associated with perceived emotional support (AOR 0.70, 95 % CI 0.45, 1.09). In conclusion, while the cross-sectional nature of these data hinder inference regarding directionality, it seems that heavy users of social media may actually feel less and not more emotional support.","author":[{"dropping-particle":"","family":"Shensa","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sidani","given":"J E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lin","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bowman","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Primack","given":"B A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Community Health","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2016","6","27"]]},"page":"541-549","title":"Social media use and perceived emotional support among US young adults","type":"article-journal","volume":"41"},"uris":[""]}],"mendeley":{"formattedCitation":"¹⁸","plainTextFormattedCitation":"18","previouslyFormattedCitation":"¹⁸"},"properties":{"noteIndex":0},"schema":""}18 Another study specifically concluded that amount of Facebook use is significantly correlated with negative psychosocial variables such as loneliness and depression.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.2190/EC.46.1.e","ISBN":"0735-6331, 0735-6331","ISSN":"0735-6331","PMID":"75127212","abstract":"College students are using social network sites such as Facebook to communicate with their families and friends. However, empirical evidence is needed to examine whether there exists a reciprocal relationship between students' use of social network sites and their psychological well-being. The present study focused on two reciprocally-related research questions: (a) Is there an impact of loneliness on Facebook intensity and motive for using Facebook among first-year college students? (b) Is there an impact of Facebook intensity and motive for using Facebook on loneliness? Data were collected from a sample of 340 first-year college students and were analyzed through structural equation modeling. No reciprocal relationship was found in the study: Facebook intensity had a positive impact on loneliness and, motive for using Facebook did not have any impact on loneliness, whereas loneliness influenced neither Facebook intensity nor motive for using Facebook. (Contains 1 table and 2 figures.)","author":[{"dropping-particle":"","family":"Lou","given":"L L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yan","given":"Z","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Nickerson","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McMorris","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Educational Computing Research","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2012"]]},"page":"105-117","title":"An examination of the reciprocal relationship of loneliness and Facebook use among first-year college students","type":"article-journal","volume":"46"},"uris":[""]}],"mendeley":{"formattedCitation":"²²","plainTextFormattedCitation":"22","previouslyFormattedCitation":"²²"},"properties":{"noteIndex":0},"schema":""}22 It is important to note that that not all ties are inherently positive in quality, potentially limiting positive outcomes from social ties. In fact, there are circumstances in which the number of ties may have negative effects on health. For example, in some studies adolescents with either too large or too small a network have higher levels of depressive symptoms.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1353/sof.0.0189","ISBN":"0037-7732","ISSN":"0037-7732","PMID":"43205360","abstract":"Using a nationally representative sample of adolescents, we examine associations among social integration (network size), network cohesion (alter-density), perceptions of social relationships (e.g., social support) and adolescent depressive symptoms. We find that adolescents with either too large or too small a network have higher levels of depressive symptoms. Among girls, however, the ill effects of over-integration only occur at low levels of network cohesion. For boys, in contrast, the ill effects of over-integration only occur at high levels of network cohesion. Large social networks tend not to compromise positive perceptions of friend support or belonging; whereas, small networks are associated with low perceptions of friend support and belonging. Hence, perceptions of social relationships mediate the ill effects of under integration, but not over-integration, on depressive symptoms.","author":[{"dropping-particle":"","family":"Falci","given":"Christina","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"McNeely","given":"Clea","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Social Forces","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2009"]]},"page":"2031-2061","title":"Too many friends: social integration, network cohesion and adolescent depressive symptoms","type":"article-journal","volume":"87"},"uris":[""]}],"mendeley":{"formattedCitation":"²³","plainTextFormattedCitation":"23","previouslyFormattedCitation":"²³"},"properties":{"noteIndex":0},"schema":""}23Filling gaps in the literature may help to clarify prior mixed findings surrounding positive and negative experiences on SM and PSI. First, because previous studies have focused on one platform, such as FacebookADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1371/journal.pone.0069841","ISSN":"1932-6203","PMID":"23967061","abstract":"Over 500 million people interact daily with Facebook. Yet, whether Facebook use influences subjective well-being over time is unknown. We addressed this issue using experience-sampling, the most reliable method for measuring in-vivo behavior and psychological experience. We text-messaged people five times per day for two-weeks to examine how Facebook use influences the two components of subjective well-being: how people feel moment-to-moment and how satisfied they are with their lives. Our results indicate that Facebook use predicts negative shifts on both of these variables over time. The more people used Facebook at one time point, the worse they felt the next time we text-messaged them; the more they used Facebook over two-weeks, the more their life satisfaction levels declined over time. Interacting with other people \"directly\" did not predict these negative outcomes. They were also not moderated by the size of people's Facebook networks, their perceived supportiveness, motivation for using Facebook, gender, loneliness, self-esteem, or depression. On the surface, Facebook provides an invaluable resource for fulfilling the basic human need for social connection. Rather than enhancing well-being, however, these findings suggest that Facebook may undermine it.","author":[{"dropping-particle":"","family":"Kross","given":"E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Verduyn","given":"P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Demiralp","given":"E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Park","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lee","given":"D S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lin","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shablack","given":"H","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Jonides","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ybarra","given":"O","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"PLOS ONE","id":"ITEM-1","issue":"8","issued":{"date-parts":[["2013","1"]]},"page":"e69841","title":"Facebook use predicts declines in subjective well-being in young adults","type":"article-journal","volume":"8"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁴","plainTextFormattedCitation":"24","previouslyFormattedCitation":"²⁴"},"properties":{"noteIndex":0},"schema":""}24 or Instagram,ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1089/cyber.2014.0560","ISSN":"2152-2715","abstract":"Abstract As the use and influence of social networking continues to grow, researchers have begun to explore its consequences for psychological well-being. Some research suggests that Facebook use can have negative consequences for well-being. Instagram, a photo-sharing social network created in 2010, has particular characteristics that may make users susceptible to negative consequences. This study tested a theoretically grounded moderated meditation model of the association between Instagram use and depressive symptoms through the mechanism of negative social comparison, and moderation by amount of strangers one follows. One hundred and seventeen 18–29 year olds completed online questionnaires containing demographics, frequency of Instagram use, amount of strangers followed on Instagram, the Center for Epidemiological Resources Scale for Depression, and the Social Comparison Rating Scale. Instagram use was marginally positively associated with depressive symptoms, and positive social comparison was signi...","author":[{"dropping-particle":"","family":"Lup","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Trub","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rosenthal","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Cyberpsychology, Behavior, and Social Networking","id":"ITEM-1","issue":"5","issued":{"date-parts":[["2015","5","12"]]},"language":"en","page":"247-252","publisher":"Mary Ann Liebert, Inc. 140 Huguenot Street, 3rd Floor New Rochelle, NY 10801 USA","title":"Instagram #instasad?: exploring associations among Instagram use, depressive symptoms, negative social comparison, and strangers followed","type":"article-journal","volume":"18"},"uris":[""]}],"mendeley":{"formattedCitation":"²¹","plainTextFormattedCitation":"21","previouslyFormattedCitation":"²¹"},"properties":{"noteIndex":0},"schema":""}21 it may be useful to examine SM as a general construct. While Facebook and Instagram are important and commonly used platforms, as noted above, an increasing number of individuals are using a more diverse set of platforms,ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","accessed":{"date-parts":[["2018","11","27"]]},"author":[{"dropping-particle":"","family":"Perrin","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Pew Research Center","id":"ITEM-1","issued":{"date-parts":[["2015"]]},"title":"Social media usage: 2005-2015","type":"webpage"},"uris":[""]},{"id":"ITEM-2","itemData":{"author":[{"dropping-particle":"","family":"Greenwood","given":"S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Perrin","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Duggan","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-2","issued":{"date-parts":[["2016"]]},"number-of-pages":"1-4","publisher-place":"Washington, D.C.","title":"Social media update 2016","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"^6,7","plainTextFormattedCitation":"6,7","previouslyFormattedCitation":"^6,7"},"properties":{"noteIndex":0},"schema":""}6,7 with 56% of online adults using more than one of five social media platforms among Twitter, Instagram, Pinterest, LinkedIn, and Facebook.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Greenwood","given":"S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Perrin","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Duggan","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2016"]]},"number-of-pages":"1-4","publisher-place":"Washington, D.C.","title":"Social media update 2016","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"⁷","plainTextFormattedCitation":"7","previouslyFormattedCitation":"⁷"},"properties":{"noteIndex":0},"schema":""}7 Second, prior studies have not assessed associations between both positive and negative experiences and PSI in the same study. It may be useful to assess these associations synchronously to allow for comparison of effect sizes.Therefore, the purpose of this study was to examine, in a large cohort of university students, associations between positive and negative SM experiences and PSI. Based on prior research described above, we hypothesized that reporting a greater proportion of positive experiences on social media would be associated with lower levels of PSI (H1). Second, we hypothesized that reporting a greater proportion of negative experiences on social media would be associated with greater levels of PSI (H2). Our third aim was to compare the effect sizes associated with positive and negative experiences in the same statistical model. For this more exploratory aim, we did not have a specific a priori hypothesis.METHODSParticipants and ProceduresFor this cross-sectional study, we recruited young adults from one large mid-Atlantic state university to assess the associations between SM use and social isolation. In August 2016, all registered students—both undergraduate and graduate—were invited to participate in the online survey via e-mail.To be eligible for this study, participants had to be between 18 and 30 years of age. For primary analyses, we only included individuals with complete data for our primary dependent variable (PSI) and independent variables (positive and negative experiences on SM). Therefore, of the 1228 eligible participants, 50 (4.1%) were excluded because of missing data. Online informed consent was obtained by asking the participants to agree to participate after reading the consent form. In order to thank participants for their time, and to increase participation, participants were entered into a drawing for a $50 Amazon gift card for every 25 participants enrolled in the study. This study was approved by the West Virginia University Institutional Review Board and the survey was administered via Qualtrics.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Qualtrics","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2015"]]},"publisher-place":"Provo, Utah, USA","title":"Qualtrics","type":"article"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁵","plainTextFormattedCitation":"25","previouslyFormattedCitation":"²⁵"},"properties":{"noteIndex":0},"schema":""}25 The median completion time for the survey was 16 minutes. Data from this study are available upon request via a structured form, which researchers can obtain from the senior author.MeasuresPerceived Social Isolation (Dependent Variable). We assessed PSI using the 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) scale.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"URL":"","accessed":{"date-parts":[["2018","11","27"]]},"id":"ITEM-1","issued":{"date-parts":[["2017"]]},"title":"HealthMeasures PROMIS","type":"webpage"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁶","plainTextFormattedCitation":"26","previouslyFormattedCitation":"²⁶"},"properties":{"noteIndex":0},"schema":""}26 PROMIS is a National Institutes of Health (NIH) Roadmap initiative that aims at providing precise, reliable, valid and standardized questionnaires measuring patient-reported outcomes across the domains of physical, mental and social health.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.jclinepi.2010.04.011","ISSN":"1878-5921","PMID":"20685078","abstract":"OBJECTIVES: Patient-reported outcomes (PROs) are essential when evaluating many new treatments in health care; yet, current measures have been limited by a lack of precision, standardization, and comparability of scores across studies and diseases. The Patient-Reported Outcomes Measurement Information System (PROMIS) provides item banks that offer the potential for efficient (minimizes item number without compromising reliability), flexible (enables optional use of interchangeable items), and precise (has minimal error in estimate) measurement of commonly studied PROs. We report results from the first large-scale testing of PROMIS items. STUDY DESIGN AND SETTING: Fourteen item pools were tested in the U.S. general population and clinical groups using an online panel and clinic recruitment. A scale-setting subsample was created reflecting demographics proportional to the 2000 U.S. census. RESULTS: Using item-response theory (graded response model), 11 item banks were calibrated on a sample of 21,133, measuring components of self-reported physical, mental, and social health, along with a 10-item Global Health Scale. Short forms from each bank were developed and compared with the overall bank and with other well-validated and widely accepted (\"legacy\") measures. All item banks demonstrated good reliability across most of the score distributions. Construct validity was supported by moderate to strong correlations with legacy measures. CONCLUSION: PROMIS item banks and their short forms provide evidence that they are reliable and precise measures of generic symptoms and functional reports comparable to legacy instruments. Further testing will continue to validate and test PROMIS items and banks in diverse clinical populations.","author":[{"dropping-particle":"","family":"Cella","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Riley","given":"W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stone","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rothrock","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Reeve","given":"B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yount","given":"S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Amtmann","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Bode","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Buysse","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Choi","given":"S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cook","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Devellis","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"DeWalt","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Fries","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Gershon","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hahn","given":"E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lai","given":"Ji","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pilkonis","given":"P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Revicki","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rose","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Weinfurt","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Hays","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Clinical Epidemiology","id":"ITEM-1","issue":"11","issued":{"date-parts":[["2010","11"]]},"page":"1179-1194","title":"The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008","type":"article-journal","volume":"63"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁷","plainTextFormattedCitation":"27","previouslyFormattedCitation":"²⁷"},"properties":{"noteIndex":0},"schema":""}27 According to NIH-developed documentation for this scale, it is appropriate for clinical populations or as a population-based screening tool.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Patient-Reported Outcomes Measurement Information System","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2015"]]},"number-of-pages":"1-7","publisher-place":"Bethesda, MD","title":"Social Isolation: A brief guide to the PROMIS Social Isolation instruments","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁸","plainTextFormattedCitation":"28","previouslyFormattedCitation":"²⁸"},"properties":{"noteIndex":0},"schema":""}28 The scale has been validated using a combination of techniques designed to explore content, construct, and criterion validity, and Cronbach’s alpha consistently indicates strong internal consistency reliability.Our dependent variable of interest was specifically the PROMIS Social Isolation scale, which assesses perceptions of being avoided, excluded, disconnected from, or unknown by others and has been validated against other commonly used measures of social isolation.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1007/s10597-014-9774-z","ISSN":"0010-3853","abstract":"Upon immigration to the rural areas in the US, Latino families may experience cultural, geographic, linguistic and social isolation, which can detrimentally affect their wellbeing by acting as chronic stressors. Using a community engagement approach, this is a pilot mixed-method study with an embedded design using concurrent qualitative and quantitative data. The purpose of this study is to evaluate family and social environments in terms of protective factors and modifiable risks associated with mental well-being in Latino immigrants living in rural areas of Florida. Latino immigrant mother and adolescent dyads were interviewed by using in-depth ethnographic semistructured interviews and subsequent quantitative assessments, including a demographic questionnaire and three structured instruments: the Family Environment Scale Real Form, the SF-12v2? Health Survey and the short version (eight items) of PROMIS Health Organization Social Isolation. This mixed-method pilot study highlighted how family, rural, and social environments can protect or impair wellbeing in rural Latino immigrant mother and adolescent dyads.","author":[{"dropping-particle":"","family":"Stacciarini","given":"J M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Garvan","given":"C W","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Wiens","given":"B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Cottler","given":"L B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Community Mental Health Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2015","5","4"]]},"page":"404-413","title":"Rural Latinos’ mental wellbeing: a mixed-methods pilot study of family, environment and social isolation factors","type":"article-journal","volume":"51"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1007/s11136-015-1131-3","ISSN":"0962-9343","abstract":"PURPOSE: Our work as a primary research site of the Patient-Reported Outcomes Measurement Information System (PROMIS(?)), combined with support from the Patient-Centered Outcomes Research Institute, allowed us to evaluate the real-world applicability and acceptability of PROMIS measures in an addiction medicine setting. METHODS: As part of a 3-month prospective observational study, 225 outpatients at a substance abuse treatment clinic completed PROMIS item banks for alcohol use (as well as 15 additional item banks from 8 other PROMIS domains, including emotional distress, sleep, and pain), with assessments at intake, 1-month follow-up, and 3-month follow-up. A subsample of therapists and their patients completed health domain importance ratings and qualitative interviews to elicit feedback regarding the content and format of the patients' assessment results. RESULTS: The importance ratings revealed that depression, anxiety, and lack of emotional support were rated highest of the non-alcohol-related domains among both patients and clinicians. General alcohol use was considered most important by both patients and clinicians. Based on their suggestions, changes were made to item response feedback to facilitate comprehension and communication. CONCLUSIONS: Both therapists and patients agreed that their review of the graphical display of scores, as well as individual item responses, helped them to identify areas of greatest concern and was useful for treatment planning. The results of our pilot work demonstrated the value and practicality of incorporating a comprehensive health assessment within a substance abuse treatment setting.","author":[{"dropping-particle":"","family":"Johnston","given":"K L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lawrence","given":"S M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dodds","given":"N E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Yu","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Daley","given":"D C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Pilkonis","given":"P A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Quality of Life Research","id":"ITEM-2","issue":"3","issued":{"date-parts":[["2016","3","9"]]},"page":"615-624","title":"Evaluating PROMIS? instruments and methods for patient-centered outcomes research: patient and provider voices in a substance use treatment setting","type":"article-journal","volume":"25"},"uris":[""]}],"mendeley":{"formattedCitation":"^29,30","plainTextFormattedCitation":"29,30","previouslyFormattedCitation":"^29,30"},"properties":{"noteIndex":0},"schema":""}29,30 Each of the four items is assessed on a 5-point Likert scale. Specifically, the items assess how many times in the past 7 days a participant has (1) felt left out; (2) felt that people barely know him/her; (3) felt isolated from others; (4) felt that people are around him/her but not with him/her. Summing the numerical score for the 4 items gave a raw score for PSI between 4 and 20. Because the distribution of the social isolation variable was skewed right and no variable transformation resulted in normal distribution, it was not possible to use the dependent variable as continuous. Therefore, for analysis, we collapsed the raw scores into tertiles of “low,” “medium,” and “high” PSI. Because no established clinical cut-offs for PSI exist, we approximated tertiles using the xtile command in Stata 14 (Stata Corp, College Station, Texas). As a result, 35% of participants were considered to have low PSI, 41% had medium PSI, and 24% had high PSI. The raw PROMIS scores for low, medium, and high PSI were 4-8, 9-12, and 13 and above, respectively. The scale displayed excellent internal consistency and reliability (Cronbach’s α=0.89).Positive and Negative Experiences on Social Media (Independent Variables). We assessed positive and negative experiences on SM by directly asking participants to estimate what percentage of their SM experiences involved positive and negative experiences, respectively. We presented participants with sliders ranging from 0 to 100 as the response choice for each item. The resulting 2 scores served as independent variables. For logistic regression analyses, we transformed responses into a 10-point scale (1 point for every 10%), based on the natural distribution of responses around these anchors and to improve interpretability of results.No formal scale has been developed to assess positive and negative experiences on social media. Therefore, we conducted iterative discussions with a convenience sample of 8 individuals in order to explore how best to assess these constructs with maximal validity. All participants were all in the target age range of young adults. Males and females were represented equally, and 25% of participants were non-White.Two key pieces of information obtained from this group led to the final items used in this study. First, we determined that it would be most useful for participants to interpret the meaning of “positive” and “negative” experiences for themselves. We could have presented specific “negative experiences” by asking about the frequency of online arguments or being “de-friended.”ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1016/j.amepre.2017.01.010","ISSN":"07493797","author":[{"dropping-particle":"","family":"Primack","given":"B A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Shensa","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Sidani","given":"J E","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Whaite","given":"E O","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lin","given":"L","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Rosen","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Colditz","given":"J B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Radovic","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Miller","given":"E","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Preventive Medicine","id":"ITEM-1","issued":{"date-parts":[["2017","3"]]},"title":"Social media use and perceived social isolation among young adults in the U.S.","type":"article-journal"},"uris":[""]}],"mendeley":{"formattedCitation":"³¹","plainTextFormattedCitation":"31","previouslyFormattedCitation":"³¹"},"properties":{"noteIndex":0},"schema":""}31 However, our participants felt that not all people would view these as “negative” and that forcing specific interpretations of positive and negative would be counter-productive, too leading, or too nonspecific. For example, several pre-testing participants suggested that agreeing or disagreeing with items such as “People like what I present on social media” would be too nonspecific for a meaningful response.Second, the scale development team determined that it would be best for participants to answer about an overall sense of negative/positive instead of focusing on a specific time frame such as 7 days. Participants preferred phrasing of the question aimed to capture a more overarching average of the subject’s experiences, noting that a short time frame such as 7 days did not generally capture their overall experiences. Socio-demographic Factors (Covariates). Participants were asked to report their age, sex, race/ethnicity, highest level of education, relationship status, and living situation. We assessed age as a categorical variable in years (18 to 30) and collapsed race/ethnicity into two categories (White and non-White). Multiple choice items were used to assess relationship status (single [inclusive of separated/divorced/widowed]; dating; in a committed relationship [inclusive of married/engaged]) and living situation (with parent/guardian; with significant other; with friends; alone; other). We collapsed categories with < 5% responses for model stability in analyses.AnalysesWe performed chi-square tests for sex and race/ethnicity (categorical variables) and T-tests for age (continuous variable) to assess patterns of missing data and determine if there were any socio-demographic differences between those with complete and those with incomplete data. There were no significant differences by sex (P=0.22), race/ethnicity (P=0.23), or age (P=0.48).We described our sample reporting counts and percentages. We then tested our analytic models to ensure the appropriate assumptions had been met. We examined our multivariable models for collinearity using the average variance inflation factor (VIF) and verified that the proportional odds assumption had been met for both ordered logistic regression models.Based upon the 3-level ordered categorical scale of our dependent variable, we assessed the bivariable and multivariable associations between each independent and dependent variables using ordered logistic regression. We decided a priori to adjust for all socio-demographic covariates in our multivariable models regardless of significance level in bivariable analyses. We defined statistical significance with a 2-tailed alpha of 0.05 and analyzed all data using Stata 14.36 Our single primary multivariable model included both positive experiences and negative experiences in the same model. However, we also conducted secondary analyses with each of these independent variables in different models in order to confirm findings. Finally, we triangulated our multivariable results with regression analyses that stratified for key sociodemographic variables.We conducted three sets of sensitivity analyses to examine robustness of results. First, we conducted all analyses using continuous variables when they were available (e.g., for age). Second, we re-conducted all analyses using only covariates with a P<0.20 association with the outcome in order to ensure that we were not overcontrolling in our models. Finally, we re-conducted all analyses using PSI as a dichotomous variable instead of in tertiles. Because all of these additional analyses demonstrated similar results to primary models, only primary results are presented here.For our primary multivariable analysis, based upon our observed R-squared value, the number of predictors, and the desired effect size to be detected (0.1), we had >90% power. Because of this slight overpowering, we interpreted with caution statistically significant results to ensure that they were also clinically meaningful.RESULTSOur final sample consisted of 1178 individuals with complete data on our 2 independent variables and 1 dependent variable. There were no significant differences by age, race/ethnicity, or sex when comparing those with and without missing data. In addition, our sample demonstrated a similar demographic profile to the overall population assessed. When the survey was conducted, this university had a total student population of approximately 28,500 undergraduate (78%) and graduate students (22%). Just over half (54%) identified as male, 78% identified as White, 5% as Black/African-American, and 4% as Hispanic or Latino ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"West Virginia University","given":"","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["0"]]},"title":"Main Campus Enrollment Trends: Fall 1995 through Fall 2016","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"³²","plainTextFormattedCitation":"32","previouslyFormattedCitation":"³²"},"properties":{"noteIndex":0},"schema":""}32. While this does not ensure that our sample was entirely representative of the population, it lends some confidence in the external generalizability of our findings.As shown in Table 1, the majority of our sample was female (62%) and White, non-Hispanic (72%, hereafter referred to as “White”). Our sample ranged in age from 18 to 30 years old, with a median age of 20 (IQR=19-22). About half of participants reported being single (51%) and reported living with friends (48%). Variables significantly associated with PSI in bivariable analyses included positive experiences, negative experiences, sex (“Other”), relationship status (“Dating”), and living situation (“Other”).We screened our three multivariable models for collinearity among covariates and confirmed that each model met the proportional odds assumption. An average VIF of 1.4 indicated no issues of multicollinearity among each independent variable and covariates. Moreover, pairwise correlations among the independent variable and covariates for each multivariable model were below 0.72 (where 0.72 was the correlation between education and age) using Pearson’s r. All models met the proportional odds assumption, indicated by non-significant p-values ranging from 0.82 to 0.91.The distribution of each independent variable was skewed right. Participants reported that about 72% (SD=31) of their SM experiences were positive. This corresponded with a median of 85% (IQR=50-97). However, participants reported that about 11% (SD=16) of their SM experiences were negative, and this corresponded with a median of 5% (IQR=1-14).After controlling for all socio-demographic covariates, in a model only including positive experiences, each 10% increase in positive experiences on social media was associated with a 4% decrease in PSI (AOR=0.96; 95% CI=0.93-0.995), supporting hypothesis H1 (Table 2, Model 1). In a model only including negative experiences, each 10% increase in negative experiences on social media was associated with a 14% increase in PSI (AOR=1.14; 95% CI=1.07-1.22), supporting hypothesis H2 (Table 2, Model 2). As shown in Table 2, Covariates significantly associated with PSI in each model included positive experiences, negative experiences, sex (“Other”), relationship status (“Dating”), and living situation (“Other”).When independent variables were in the same model (Table 2, Model 3), results were only slightly different. Each 10% increase in positive experiences on social media was associated with a 3% decrease in PSI (AOR=0.97; 95% CI=0.93-1.005), although this result was not statistically significant. In this same model, each 10% increase in negative experiences was associated with a 13% increase in odds of PSI (AOR=1.13; 95% CI=1.05-1.21), which was statistically significant. Covariates significantly associated with PSI in this model with both independent variables included positive experiences, negative experiences, sex (“Other”), relationship status (“Dating”), and living situation (“Other”).We triangulated our multivariable results with regression analyses that stratified for key sociodemographic variables (Table 3). These results were generally consistent with multivariable results, but in some cases they provided additional insight. For example, there was a stronger association between negative experiences on SM and social isolation among females vs. males (OR=1.25, 95% CI=1.14–1.38 vs. OR=1.07, 95% CI=0.97–1.18).DISCUSSIONThis study of a convenience sample of young adult university students found that having positive experiences on SM was only weakly associated with lower PSI, while having negative experiences on SM was strongly associated with higher PSI. Because 83% of SM users are within the age range of our study population,ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"abstract":"Young adults are more likely than older adults to use social media. Women, African - Americans , and Latinos show high interest in sites like Twitter, Instagram , and Pinterest .","author":[{"dropping-particle":"","family":"Duggan","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Brenner","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2013"]]},"publisher-place":"Washington, DC","title":"The demographics of social media users — 2012","type":"report"},"uris":[""]}],"mendeley":{"formattedCitation":"³³","plainTextFormattedCitation":"33","previouslyFormattedCitation":"³³"},"properties":{"noteIndex":0},"schema":""}33 it is valuable to know that the quality of online experiences may be associated with important outcomes such as PSI in this population. These findings may encourage individuals to pay closer attention to their online exchanges and experiences.Importantly, the effect sizes for positive experiences and negative experiences were quite different. The effect size for negative experiences would be considered high. This is because the noted 15% increase in odds of depression was associated with a relatively slight (10% increase) in SM negativity. Thus, the associated increase in odds of PSI would be very large for a more substantial change (e.g., 10% negativity to 40% negativity). At these levels, the effect size of the change was as large a change as has been seen for the most important currently known risk factors for PSI.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/1745691614568352","abstract":"Actual and perceived social isolation are both associated with increased risk for early mortality. In this meta-analytic review, our objective is to establish the overall and relative magnitude of social isolation and loneliness and to examine possible moderators. We conducted a literature search of studies (January 1980 to February 2014) using MEDLINE, CINAHL, PsycINFO, Social Work Abstracts, and Google Scholar. The included studies provided quantitative data on mortality as affected by loneliness, social isolation, or living alone. Across studies in which several possible confounds were statistically controlled for, the weighted average effect sizes were as follows: social isolation odds ratio (OR) = 1.29, loneliness OR = 1.26, and living alone OR = 1.32, corresponding to an average of 29%, 26%, and 32% increased likelihood of mortality, respectively. We found no differences between measures of objective and subjective social isolation. Results remain consistent across gender, length of follow-up, and world region, but initial health status has an influence on the findings. Results also differ across participant age, with social deficits being more predictive of death in samples with an average age younger than 65 years. Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality.","author":[{"dropping-particle":"","family":"Holt-Lunstad","given":"J","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Smith","given":"T B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Baker","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Harris","given":"T","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Stephenson","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Perspectives on Psychological Science","id":"ITEM-1","issue":"2","issued":{"date-parts":[["2015"]]},"page":"227-237","title":"Loneliness and social isolation as risk factors for mortality: a meta-analytic review","type":"article-journal","volume":"10"},"uris":[""]}],"mendeley":{"formattedCitation":"²","plainTextFormattedCitation":"2","previouslyFormattedCitation":"²"},"properties":{"noteIndex":0},"schema":""}2 The effect size for positive experiences was quite low, however. Because there was only a 5% decrease in odds of PSI for each 10% change in SM positivity, even a relatively large change in positivity (say 10% to 40%) would still only be associated with about a 20% decrease in odds of PSI; this kind of decrease would be considered meaningful but not extremely large.Because these data were cross-sectional, it is not clear whether people with higher PSI seek out negative SM experiences or vice versa. If it is the latter, one potential explanation for the association between quality of SM experiences and PSI is that individuals use and experience SM in very different ways. For example, some individuals use SM for social engagement, information seeking, passing time, relaxation, or entertainment.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1108/QMR-06-2013-0041","ISBN":"1352-2752","ISSN":"1352-2752","PMID":"7754995","abstract":"Purpose – This paper seeks to demonstrate the importance of uses and gratifications theory to social media. By applying uses and gratifications theory, this paper will explore and discuss the uses and gratifications that consumer receive from using social media. This paper seeks to provide a better and more comprehensive understanding of why consumers use social media. Design/methodology/approach – Exploratory study was conducted. 25 in-depth interviews were conducted with individuals who use social media. Findings – This study identified ten uses and gratifications for using social media. The ten uses and gratifications are: social interaction, information seeking, pass time, entertainment, relaxation, communicatory utility, convenience utility, expression of opinion, information sharing, and surveillance/knowledge about others. Research limitations/implications – Limitations are small sample size. Research implications are that uses and gratifications theory has specific relevance to social media and should be given more prominence. Uses and gratifications theory helps explain the many and varied reasons why consumers use social media. Practical implications – This paper helps organizations to understand why consumers use social media and what gratifications they receive from social media. Originality/value – This paper makes the contribution that uses and gratifications theory has specific relevance and should be given more prominence within the area of social media. This paper also provides a rich and vivid understanding of why consumers use social media. Keywords Social media, Web 2.0, Consumer generated media, Uses and gratifications theory, Uses of social media, Exploratory study, Qualitative study, In-depth interviews Paper","author":[{"dropping-particle":"","family":"Whiting","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Williams","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Qualitative Market Research: An International Journal","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2013"]]},"page":"362-369","title":"Why people use social media: a uses and gratifications approach","type":"article-journal","volume":"16"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁴","plainTextFormattedCitation":"34","previouslyFormattedCitation":"³⁴"},"properties":{"noteIndex":0},"schema":""}34 In these various contexts, some users tend to have positive exchanges that bolster their feeling of connectedness, while others engage in negative exchanges and arguments that may leave them feeling lonely or disconnected.The fact that quality of social relationships and exchanges is associated with feelings of connectedness is consistent with social network theory.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Krackhardt","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Networks and organizations: Structure, form, and action","editor":[{"dropping-particle":"","family":"Nohria","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eccles","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["1992"]]},"publisher":"Harvard Business School Press","publisher-place":"Cambridge, MA","title":"The strength of strong ties: the importance of Philos in organizations","type":"chapter"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1086/225469","abstract":"Analysis of social networks is sugested as a tool for linking micro and macro levels of sociological theory. the procedure is illustrated by eleaboration of the macro implications of one aspect of small-scale interaction: the strength of dyadic ties. It is argued that the degree of overlap of two indiciduals' friendship networks varies directly with the strength of their tie to one another. The impact of this principle on diffusion of influence and information, mobility opportunity, and community organization is explored. Stress is laid on the cohesive power of weak ties. Most network models deal, implicitly with strong ties, thus confining their applicability to small, well-defined groups. Emphasis on weak ties lends itself to discussion of relations between groups and to analysis of segments of social sturcture not easily defined in terms of primary groups.","author":[{"dropping-particle":"","family":"Granovetter","given":"M S","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Sociology","id":"ITEM-2","issue":"6","issued":{"date-parts":[["1973"]]},"page":"1360-1380","title":"The strength of weak ties","type":"article-journal","volume":"78"},"uris":[""]}],"mendeley":{"formattedCitation":"^15,35","plainTextFormattedCitation":"15,35","previouslyFormattedCitation":"^15,35"},"properties":{"noteIndex":0},"schema":""}15,35 This theory posits that “strong ties” among individuals—which are based on trust and affection and are more likely to manifest in positive experiences—lead to greater levels of emotional support. Alternately, “weak ties” are helpful for finding new information and resources, but may provide low levels of intimacy and relationship intensity.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"author":[{"dropping-particle":"","family":"Krackhardt","given":"D","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Networks and organizations: Structure, form, and action","editor":[{"dropping-particle":"","family":"Nohria","given":"N","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Eccles","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["1992"]]},"publisher":"Harvard Business School Press","publisher-place":"Cambridge, MA","title":"The strength of strong ties: the importance of Philos in organizations","type":"chapter"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1086/225469","abstract":"Analysis of social networks is sugested as a tool for linking micro and macro levels of sociological theory. the procedure is illustrated by eleaboration of the macro implications of one aspect of small-scale interaction: the strength of dyadic ties. It is argued that the degree of overlap of two indiciduals' friendship networks varies directly with the strength of their tie to one another. The impact of this principle on diffusion of influence and information, mobility opportunity, and community organization is explored. Stress is laid on the cohesive power of weak ties. Most network models deal, implicitly with strong ties, thus confining their applicability to small, well-defined groups. Emphasis on weak ties lends itself to discussion of relations between groups and to analysis of segments of social sturcture not easily defined in terms of primary groups.","author":[{"dropping-particle":"","family":"Granovetter","given":"M S","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Journal of Sociology","id":"ITEM-2","issue":"6","issued":{"date-parts":[["1973"]]},"page":"1360-1380","title":"The strength of weak ties","type":"article-journal","volume":"78"},"uris":[""]}],"mendeley":{"formattedCitation":"^15,35","plainTextFormattedCitation":"15,35","previouslyFormattedCitation":"^15,35"},"properties":{"noteIndex":0},"schema":""}15,35 In the complex milieu of SM—where the average Facebook user has 217 network “friends”ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1080/15533610802052654","ISSN":"1553-3611","abstract":"Despite the recent popularity of online social networks, there are few available studies that explain the differences between real life and internet social networks. Authoritative information about the outcomes of using social networking websites is even more sparse. In an attempt to close this literature gap, this exploratory study found that online social networks and real life social networks are significantly different in terms of social network size. The results also show that gender and extroversion are the major predictors of both online social network size and time spent online for social networking. Perhaps the most interesting finding is the negative impact of self-esteem on inclusion of strangers in online social networks. Additionally, directions for future research are provided.","author":[{"dropping-particle":"","family":"Acar","given":"A","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Website Promotion","id":"ITEM-1","issue":"1-2","issued":{"date-parts":[["2008","5","28"]]},"page":"62-83","title":"Antecedents and consequences of online social networking behavior: the case of Facebook","type":"article-journal","volume":"3"},"uris":[""]}],"mendeley":{"formattedCitation":"²⁰","plainTextFormattedCitation":"20","previouslyFormattedCitation":"²⁰"},"properties":{"noteIndex":0},"schema":""}20 and the average size of a real-life social network is around 125ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1007/s12110-003-1016-y","ISBN":"1045-6767","ISSN":"1045-6767","PMID":"4739","abstract":"This paper examines social network size in contemporary Western society based on the exchange of Christmas cards. Maximum network size averaged 153.5 individuals, with a mean network size of 124.9 for those individuals explicitly contacted; these values are remarkably close to the group size of 150 predicted for humans on the basis of the size of their neocortex. Age, household type, and the relationship to the individual influence network structure, although the proportion of kin remained relatively constant at around 21%. Frequency of contact between network members was primarily determined by two classes of variable: passive factors (distance, work colleague, overseas) and active factors (emotional closeness, genetic relatedness). Controlling for the influence of passive factors on contact rates allowed the hierarchical structure of human social groups to be delimited. These findings suggest that there may be cognitive constraints on network size.","author":[{"dropping-particle":"","family":"Hill","given":"R. A.","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Dunbar","given":"R. I. M.","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Human Nature","id":"ITEM-1","issue":"1","issued":{"date-parts":[["2003"]]},"page":"53-72","title":"Social network size in humans","type":"article-journal","volume":"14"},"uris":["",""]}],"mendeley":{"formattedCitation":"³⁶","plainTextFormattedCitation":"36","previouslyFormattedCitation":"³⁶"},"properties":{"noteIndex":0},"schema":""}36—frequent engagement with weak ties may increase misunderstandings and negative experiences, ultimately leading to greater PSI. The difference between these two average sizes of friend networks (217-125 = 92), suggests that 92 additional “friends” are associated with membership on a social media site. If the ties are weak, these relationships could potentially increase disconnectedness rather than engender meaningful connections. However, it should be noted that there are circumstances under which the strength of ties is less important than the content of the ties. For example, weak ties used for professional networking may actually lead to other resources that enhance one’s social support.After controlling for all socio-demographic covariates and including both independent variables in the same model, positive experiences on social media was not significantly associated with social isolation. The direction of the result is consistent with studies demonstrating value for SM in developing and maintaining social capital and social connectedness, entities that are inversely correlated with PSI.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/j.1083-6101.2007.00367.x","ISBN":"0521832969","ISSN":"10836101","PMID":"10540012","abstract":"This study examines the relationship between use of Facebook, a popular online social network site, and the formation and maintenance of social capital. In addition to assessing bonding and bridging social capital, we explore a dimension of social capital that assesses one’s ability to stay connected with members of a previously inhabited community, which we call maintained social capital. Regression analyses conducted on results from a survey of undergraduate students (N = 286) suggest a strong association between use of Facebook and the three types of social capital, with the strongest relationship being to bridging social capital. In addition, Facebook usage was found to interact with measures of psychological well-being, suggesting that it might provide greater","author":[{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Steinfield","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lampe","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Computer-Mediated Communication","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2007","7"]]},"page":"1143-1168","title":"The benefits of Facebook \"friends\": social capital and college students' use of online social network sites","type":"article-journal","volume":"12"},"uris":[""]},{"id":"ITEM-2","itemData":{"DOI":"10.1016/j.appdev.2008.07.002","ISSN":"01933973","abstract":"A longitudinal analysis of panel data from users of a popular online social network site, Facebook, investigated the relationship between intensity of Facebook use, measures of psychological well-being, and bridging social capital. Two surveys conducted a year apart at a large U.S. university, complemented with in-depth interviews with 18 Facebook users, provide the study data. Intensity of Facebook use in year one strongly predicted bridging social capital outcomes in year two, even after controlling for measures of self-esteem and satisfaction with life. These latter psychological variables were also strongly associated with social capital outcomes. Self-esteem served to moderate the relationship between Facebook usage intensity and bridging social capital: those with lower self-esteem gained more from their use of Facebook in terms of bridging social capital than higher self-esteem participants. We suggest that Facebook affordances help reduce barriers that lower self-esteem students might experience in forming the kinds of large, heterogeneous networks that are sources of bridging social capital.","author":[{"dropping-particle":"","family":"Steinfield","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ellison","given":"N B","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Lampe","given":"C","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Journal of Applied Developmental Psychology","id":"ITEM-2","issue":"6","issued":{"date-parts":[["2008","11"]]},"page":"434-445","title":"Social capital, self-esteem, and use of online social network sites: a longitudinal analysis","type":"article-journal","volume":"29"},"uris":[""]}],"mendeley":{"formattedCitation":"^10,12","plainTextFormattedCitation":"10,12","previouslyFormattedCitation":"^10,12"},"properties":{"noteIndex":0},"schema":""}10,12 However, each 10% increase in negative experiences was significantly associated with a 14% increase in odds of PSI (AOR=1.14; 95% CI=1.07-1.22). It is interesting that when analyzed in the same model, negative experiences remain significantly associated with PSI, whereas positive experiences do not. This may lead to the conclusion that negative SM experiences may be more “potent” than positive experiences as related to PSI. This reasoning is consistent with the concept of negativity bias, which purports that there is a tendency for humans to give greater weight to negative entities (e.g., events, objects, personal traits) compared with positive ones.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1207/S15327957PSPR0504","ISBN":"1088-8683, 1088-8683","ISSN":"1088-8683","PMID":"5328967","abstract":"Despite the increasing use ofpsychophysiological measures to investigate social and in- terpersonalphenomena,few studies ofadult romantic attachment have taken advantage ofthis approach. In this article Iarguefora biologically-specific, theory-based integra- tion ofpsychophysiological measures into adult attachment research. This approach would help elucidate the normative psychobiological properties ofthe attachment sys- tem, which have received little study in humans. Specifically, it would allow researchers to test targeted hypotheses regarding affect and arousal regulation in attachment rela- tionships. Iprovide a general introduction to 2 biological systems that holdparticular promisefor adult attachment research: the parasympathetic branch of the autonomic nervous system and the hypothalamic-pituitary-adrenocortical axis of the endocrine system. I highlight the relevance ofthese systemsfor attachmentphenomena and review findingsfrom selected social psychophysiological research. I conclude by outlining a tentative theoretical modelofthepsychobiology ofadultattachment and identifying spe- cific directions forfuture research.","author":[{"dropping-particle":"","family":"Rozin","given":"P","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Royzman","given":"E B","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Personality and Social Psychology Review","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2001"]]},"page":"296-320","title":"Negativity bias, negativity dominance, and contagion","type":"article-journal","volume":"5"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁷","plainTextFormattedCitation":"37","previouslyFormattedCitation":"³⁷"},"properties":{"noteIndex":0},"schema":""}37 This idea may be particularly relevant in the context of SM use. For example, while positive experiences may be associated with fleeting positive reinforcement, negative experiences such as public SM arguments may rapidly escalate due to a need to shape or defend one’s “digital identity”ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"ISBN":"9780128004272","abstract":"Online Identities: Creating and Communicating the Online Self presents a critical investigation of the ways in which representations of identities have shifted since the advent of digital communications technologies. Critical studies over the past century have pointed to the multifaceted nature of identity, with a number of different theories and approaches used to explain how everyday people have a sense of themselves, their behaviors, desires, and representations. In the era of interactive, digital, and networked media and communication, identity can be understood as even more complex, with digital users arguably playing a more extensive role in fashioning their own self-representations online, as well as making use of the capacity to co-create common and group narratives of identity through interactivity and the proliferation of audio-visual user-generated content online. Makes accessible complex theories of identity from the perspective of today's contemporary, digital media environment. Examines how digital media has added to the complexity of identity. Takes readers through examples of online identity such as in interactive sites and social networking. Explores implications of inter-cultural access that emerges from globalization and world-wide networking.","author":[{"dropping-particle":"","family":"Cover","given":"R","non-dropping-particle":"","parse-names":false,"suffix":""}],"id":"ITEM-1","issued":{"date-parts":[["2015"]]},"number-of-pages":"1-294","publisher":"Elsevier","publisher-place":"London, UK","title":"Digital identities: creating and communicating the online self","type":"book"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁸","plainTextFormattedCitation":"38","previouslyFormattedCitation":"³⁸"},"properties":{"noteIndex":0},"schema":""}38 and may in turn leave a lasting, potentially traumatic impression on the individual.Because these data are cross-sectional, it may also be that individuals with PSI tend to subsequently have more negative experiences and fewer positive experiences on SM. This explanation is plausible, because socially isolated individuals may seek out SM relationships due to their limited in-person social opportunities.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1177/0093650203257842","ISSN":"00936502","abstract":"The model introduced and tested in the current study suggests that lonely and depressed individuals may develop a preference for online social interaction, which, in turn, leads to negative outcomes associated with their Internet use. Participants completed measures of preference for online social interaction, depression, loneliness, problematic Internet use, and negative outcomes resulting from their Internet use.Results indicated that psychosocial health predicted levels of preference for online social interaction, which, in turn, predicted negative outcomes associated with problematic Internet use. In addition, the results indicated that the influence of psychosocial distress on negative outcomes due to Internet use is mediated by preference for online socialization and other symptoms of problematic Internet use.T he results support the current hypothesis that that individuals’ preference for online, rather than face-to-face, social interaction plays an important role in the development of negative consequences associated with problematic Internet use.","author":[{"dropping-particle":"","family":"Caplan","given":"S E","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Communication Research","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2003","12","1"]]},"page":"625-648","title":"Preference for online social interaction: a theory of problematic Internet use and psychosocial well-being","type":"article-journal","volume":"30"},"uris":[""]}],"mendeley":{"formattedCitation":"³⁹","plainTextFormattedCitation":"39","previouslyFormattedCitation":"³⁹"},"properties":{"noteIndex":0},"schema":""}39 This tendency could be reflected in personality traits such as increased aggression or ability to “handle” negative experiences. For example, one study showed that when controlling for socio-demographic covariates and time spent online, “problematic internet use” (PIU) was related to higher neuroticism and lower conscientiousness,ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1111/ajsp.12056","ISSN":"13672223","abstract":"The effects of the Big Five personality traits on cognitions regarding problematic Internet use (PIU) have not been studied. The present paper aims to evaluate the effects of personality traits on cognitions regarding PIU that are classified as loneliness/depression, diminished impulse control, distraction and social control. Additionally, the mediator effect of the Big Five personality traits on the relationship between time spent online and cognitions regarding PIU was tested in a sample of 494 Turkish university students. Hierarchical regression analysis results reveal that controlling the effects of socio-demographic variables and time spent online, higher neuroticism and lower conscientiousness were related to cognitions regarding PIU. Moreover, results of structural equation modelling indicate that the relationship between time spent online and cognitions regarding PIU was independently mediated by extraversion, openness and agreeableness. Examining the role of all of the Big Five personality traits (especially neuroticism and conscientiousness) on PIU will increase understanding in further studies.","author":[{"dropping-particle":"","family":"Durak","given":"M","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Senol-Durak","given":"E","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Asian Journal of Social Psychology","id":"ITEM-1","issue":"3","issued":{"date-parts":[["2014","9","8"]]},"page":"206-218","publisher":"WILEY-BLACKWELL, 111 RIVER ST, HOBOKEN 07030-5774, NJ USA","title":"Which personality traits are associated with cognitions related to problematic Internet use?","type":"article-journal","volume":"17"},"uris":[""]}],"mendeley":{"formattedCitation":"⁴⁰","plainTextFormattedCitation":"40","previouslyFormattedCitation":"⁴⁰"},"properties":{"noteIndex":0},"schema":""}40 while another study stated that loneliness, depression and computer self-efficacy were significant predictors of PIU.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1089/cpb.2007.0255","ISBN":"1094-9313","ISSN":"1094-9313","PMID":"19072150","abstract":"This study investigated whether university students' levels of loneliness, depression, and computer self-efficacy were significant predictors of their problematic Internet use levels. The study was carried out with 559 Turkish university students. The research data were analyzed by multiple regression analysis. The findings indicated that loneliness, depression, and computer self-efficacy were significant predictors of problematic Internet use. Loneliness was found as the most important predictive variable. Depression predicted problematic Internet use on the second rank, and computer self-efficacy on the third rank.","author":[{"dropping-particle":"","family":"Ceyhan","given":"A A","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Ceyhan","given":"E","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"CyberPsychology & Behavior","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2008"]]},"page":"699-701","title":"Loneliness, depression, and computer self-efficacy as predictors of problematic internet use","type":"article-journal","volume":"11"},"uris":[""]}],"mendeley":{"formattedCitation":"⁴¹","plainTextFormattedCitation":"41","previouslyFormattedCitation":"⁴¹"},"properties":{"noteIndex":0},"schema":""}41 It may of course also be that the association between SM experiences and PSI is bi-directional in nature. Aside from positive experiences and negative experiences on SM, three covariates were associated with PSI. First, compared with those who were single, participants who were dating demonstrated a 25% decrease in odds of PSI (AOR=0.75; 95% CI=0.58-0.97). It may be that dating is a proxy for being socially integrated, and therefore a marker of being less socially isolated. Second, compared with those who identified as male, participants who identified as “other” had three-fold odds of increased PSI (AOR=3.14; 95% CI=1.04-9.53). This is consistent with other research demonstrating that gender-fluid individuals tend to feel marginalized.ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.3928/00485713-20160418-01","ISBN":"1938-2456(Electronic),0048-5713(Print)","ISSN":"0048-5713","abstract":"Transgender and gender nonconform-ing (TGNC) people encounter health dis-parities in the United States, perpetuated by limited TGNC-related content in medical ed-ucation and training. Recognition of the ef-fects of discrimination and stigma on TGNC communities has contributed to a resur-gence of interest in these populations. Ex-ploring the diversity of TGNC identities and recognizing patterns of institutionalized bias enable health care providers, including psychiatrists and other mental health prac-titioners, to promote health equity for these historically underserved populations. [Psy-chiatr Ann. 2016;46(6):334-339.] T","author":[{"dropping-particle":"","family":"Grubb","given":"H M","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"Psychiatric Annals","id":"ITEM-1","issue":"6","issued":{"date-parts":[["2016"]]},"page":"334-339","title":"Marginalization of transgender identities: implications for health equity","type":"article-journal","volume":"46"},"uris":[""]}],"mendeley":{"formattedCitation":"⁴²","plainTextFormattedCitation":"42","previouslyFormattedCitation":"⁴²"},"properties":{"noteIndex":0},"schema":""}42 However, because of the relative paucity of research in this area, it would be useful for future research to explore this relationship quantitatively and/or qualitatively. Finally, compared with those who lived with parents, participants who reported an “other” living situation—versus living with a significant other, friends, or alone—had 64% odds of increased PSI (AOR=1.64; 95% CI=1.05-2.56). It may be that these individuals live with others whom they do not consider “friends,” which may make them feel isolated.While these early findings need to be replicated, they still may be useful to public health practitioners. Directionality cannot be ascertained from this study, making a strong suggestion to educate the public about possible risks associated with engaging with negative encounters online premature. However, public health practitioners may wish to encourage the public to be more cognizant and thoughtful regarding their online experiences. In turn, this could help to interrupt a potential cycle of negative experiences and PSI. Many environments, such as universities, workplaces, and community spaces, which are home to an abundance of social media users, may be leveraged to increase awareness and education around positive and negative online SM experiences.Although the association between positive experiences and lower PSI was not significant in our model including both independent variables, and only weakly significant in the model including only positive experiences, it still may be valuable for individuals to have positive SM experiences. In general, engaging in various forms of SM has been shown to enhance communication, social connection and even technical skills amongst children and adolescents ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemData":{"DOI":"10.1542/peds.2011-0054","ISBN":"1098-4275 (Electronic)\\r0031-4005 (Linking)","ISSN":"1098-4275","PMID":"21444588","abstract":"Using social media Web sites is among the most common activity of today's children and adolescents. Any Web site that allows social interaction is considered a social media site, including social networking sites such as Facebook, MySpace, and Twitter; gaming sites and virtual worlds such as Club Penguin, Second Life, and the Sims; video sites such as YouTube; and blogs. Such sites offer today's youth a portal for entertainment and communication and have grown exponentially in recent years. For this reason, it is important that parents become aware of the nature of social media sites, given that not all of them are healthy environments for children and adolescents. Pediatricians are in a unique position to help families understand these sites and to encourage healthy use and urge parents to monitor for potential problems with cyberbullying, \"Facebook depression,\" sexting, and exposure to inappropriate content.","author":[{"dropping-particle":"","family":"O'Keeffe","given":"G S","non-dropping-particle":"","parse-names":false,"suffix":""},{"dropping-particle":"","family":"Clarke-Pearson","given":"K","non-dropping-particle":"","parse-names":false,"suffix":""}],"container-title":"American Academy of Pediatrics","id":"ITEM-1","issue":"4","issued":{"date-parts":[["2011"]]},"page":"800-804","title":"The impact of social media on children, adolescents, and families.","type":"article-journal","volume":"127"},"uris":[""]}],"mendeley":{"formattedCitation":"⁴³","plainTextFormattedCitation":"43","previouslyFormattedCitation":"⁴³"},"properties":{"noteIndex":0},"schema":""}43. Effective SM use—such as communication and knowledge transfer, maintenance of existing connections, and fellowship building—can also lend itself to positive SM experiences for individuals, which may in turn lead to lower PSI.We found some interesting differences according to sex. While in multivariable results there were not independent associations between sex and social isolation, bivariable associations between positive and negative experiences were sometimes slightly different when stratifying by demographic variables. For example, there was a stronger association between negative experiences on SM and social isolation among females vs. males (OR=1.25, 95% CI=1.14–1.38 vs. OR=1.07, 95% CI=0.97–1.18). While our analyses were not powered to determine differences among these smaller subgroups, the magnitude of the association (1.25 vs. 1.07) is interesting to consider. In particular, it may be that females are more sensitive to negative experiences compared with males. Although the magnitudes of effect sizes are relatively small in a sample that is relatively large, it could be valuable to continue to examine differences according to sex in future fully-powered analyses.Based on feedback from our pre-testing participants, we used an open assessment of positive and negative SM experiences that did not limit participants to assessment of specific activities on social media or over a specific time frame. This decision should be considered in interpretation of results. For example, because we did not ask about specific activities that were considered negative, we do not know whether something a participant considered negative was severe cyber-bullying or simply being “un-friended” by someone. It would be valuable in future research to provide more fine-grained assessments.Similarly, pre-testing participants felt it was preferable in terms of overall validity of the measure to assess negativity overall instead of given a specific time frame, such as 7 days. This is because participants did not feel that the past 7 days reflected their overall experiences. However, it should be noted that this choice did introduce the complexity that the positivity/negativity measures were assessed generally while the PSI, which came from a well-established, validated scale, was assessed over a 7-day time period. Therefore, results should be interpreted accordingly. For example, a participant may have had a highly negative life experience in the past 7 days and a remote history of negative SM experiences. In this case, we may be inappropriately be inferring associations. Thus, it may be valuable for future analyses to explore these issues and experiment with comparison of overall positivity/negativity in the SM milieu with positivity/negativity in certain recent time-frames.LimitationsThe primary limitation of this study is that the data is from a cross-sectional study. This design not only limiting our ability to assess directionality of the noted associations; it also affects our ability to determine if there is a third factor that might explain the associations. Therefore, it will be useful for future studies to address these issues using other designs such as longitudinal cohort studies and/or qualitative assessments.Another limitation is that this study focused on young adults and university students, which could have resulted in sampling bias, thus limiting our ability to generalize our results to other populations.It should also be noted that the data set did not include a well-validated measure of socioeconomic status that we were able to use as a covariate. While we attempted to compensate by including educational status, which is sometimes used as an approximation of socioeconomic status, it would be useful for future studies to include more direct measures of socioeconomic status, such as household income.Future studies would also benefit from incorporating more qualitative approaches—such as free text answers from subjects regarding their experiences and symptoms—to supplement quantitative models.A final limitation is the possibility that participants may have under-reported PSI due to the sensitive nature of this topic. While we attempted to minimize this by assuring participants of confidentiality and having participants self-administer the survey, this remains a consideration.ConclusionsHaving positive experiences on SM is not associated with lower social isolation, whereas having negative experiences on SM is associated with higher social isolation. This pattern seems consistent with negativity bias. It will be especially important to attempt to assess directionality in future work. In the meantime, however, it may be useful to view having negative experiences on SM with caution in order to interrupt a potential cycle of negative exchanges on SM and PSI.SO WHAT? Implications for Health Promotion Practitioners and ResearchersWhat is already known on this topic?Prior research suggests that total social media (SM) use is positively associated with increased perceived social isolation (PSI). However, not all social media use is the same, and until now the associations between positive experiences on SM and PSI vs. the association between negative experiences on SM and PSI have not been systematically compared.What does this article add?This study demonstrates that—in a large population of young adults—positive experiences on SM were not significantly associated with reduced PSI. However, each 10% increase in negative experiences was associated with a 13% increase in odds of PSI.What are the implications for health promotion practice or research?These results may be very important to consider when developing interventions. For example, in order to reduce PSI, it may be useful to specifically try to reduce an individual’s negative experiences on SM. This might be more feasible and effective than trying to reduce overall SM exposure. In terms of research, it would be valuable to explore why negative experiences may be more potent than positive ones in the SM milieu with regard to PSI.ACKNOWLEDGEMENTSWe acknowledge Michelle Woods for editorial assistance.FUNDINGWe acknowledge funding from the Fine Foundation.CONFLICT OF INTEREST DISCLOSUREThe authors have no conflicts of interest to report. 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Whole sample characteristics and bivariable associations between independent variables, covariates, and depressive symptoms (N = 1178)Independent variable/covariateWhole sampleN (%)Perceived Social IsolationN (%)P bLowMediumHighPositive exp., mean (SD)71 (31)73 (32)72 (30)67 (32)0.04Positive exp., median (IQR)85 (50, 96)90 (53, 99)85 (52, 95)80 (45, 95)0.008Negative exp., mean (SD)11 (16)9 (14)12 (16)14 (19)0.0004Negative exp., median (IQR)5 (1, 14)3 (0, 10)5 (1, 15)5 (1, 20)0.0001Sex, %a0.03Male455 (37)170 (39)177 (36)107 (36)Female757 (62)259 (60)317 (64)179 (61)Other16 (1)4 (1)4 (1)8 (3)Age, y, median (IQR)0.0618264 (22)108 (20)84 (23)72 (26)19-20393 (33)164 (31)129 (36)100 (35)21-24377 (32)190 (36)102 (28)85 (30)25-30144 (12)71 (13)48 (13)25 (9) Race/Ethnicity, %a0.25White, non-Hispanic842 (72)393 (74)256 (71)193 (69)Non-Whitec331 (28)138 (26)105 (29)88 (31)Relationship status, %a0.04Single605 (51)248 (47)193 (53)162 (57)Dating322 (27) 162 (30)92 (25)68 (24)In a committed relationship d251 (21)123 (23)76 (21)52 (18)Living situation, %a0.02With a parent or guardian172 (15)70 (13)54 (15)48 (17)With a significant other122 (10)63 (12)38 (10)21 (7)With friends564 (48)266 (50)175 (48)123 (44)Alone201 (17)90 (17)65 (18)46 (16)Other119 (10)44 (8)31 (9)44 (16)Education0.07HS Diploma or less268 (23)118 (22)79 (22)71 (25)Some college590 (50)251 (47)186 (51)153 (54)Two-year/technical degree193 (16)104 (20)58 (16)31 (11)Bachelor’s degree127 (11)60 (11)40 (11)27 (10) a Column percentages may not total 100 due to rounding.b Significance level determined using the non-parametric Kruskal-Wallis test for continuous independent variables and Chi-square tests for categorical socio-demographic variables.c Includes Black, Hispanic, Asian, Native American, and Multiracial.d Included being engaged, married, or in a domestic partnership.Table 2. Multivariable associations between SM experiences, socio-demographic characteristics, and perceived social isolation (N = 1178)Independent variable/covariatePerceived Social IsolationModel 1a Model 2aModel 3aAOR (95% CI)bAOR (95% CI)bAOR (95% CI)bPositive experiences c0.96 (0.93 - 0.995)—0.97 (0.93 - 1.005)Negative experiences c—1.14 (1.07 - 1.22)1.13 (1.05 - 1.21)SexMalereferencereferencereferenceFemale1.17 (0.93 - 1.47)1.19 (0.95 - 1.50)1.21 (0.96 - 1.52)Other2.92 (0.98 - 8.74)3.41 (1.13 - 10.23)3.14 (1.04 - 9.53)Age18referencereferencereference19-200.87 (0.62 - 1.24)0.88 (0.62 - 1.25)0.88 (0.62 - 1.24)21-240.71 (0.473 - 1.06)0.74 (0.49 - 1.10)0.72 (0.48 - 1.07)25-300.76 (0.43 - 1.33)0.81 (0.46 - 1.43)0.79 (0.45 - 1.38)Race/EthnicityWhite, non-Hispanic referencereferencereferenceNon-Whited0.80 (0.62 - 1.01)0.80 (0.63 - 1.02)0.81 (0.64 - 1.03)Relationship statusSinglereferencereferencereferenceDating0.74 (0.57 - 0.96)0.75 (0.58 - 0.97)0.75 (0.58 - 0.97)In a committed relationshipe0.88 (0.64 - 1.22)0.90 (0.65 - 1.25)0.89 (0.64 - 1.23)Living situationWith a parent or guardianreferencereferencereferenceWith a significant other0.91 (0.54 - 1.52)0.87 (0.52 - 1.46)0.86 (0.51 - 1.44)With friends0.86 (0.62 - 1.20)0.86 (0.62 - 1.20)0.85 (0.61 - 1.19)Alone1..00 (0.67 - 1.51)0.98 (0.65 - 1.47)0.97 (0.64 - 1.45)Other1.69 (1.08 - 2.63)1.66 (1.07 - 2.60)1.64 (1.05 - 2.56)a Model 1 includes positive experiences and all covariates included in the table. Model 2 includes negative experiences and all covariates included in the table. Model 3 includes both of these independent variables and all covariates included in the table. b AOR = adjusted odds ratio; CI = confidence interval; adjusted for age, sex, race, relationships status, and living situation.c Each independent variable indicates the proportion of participants’ SM experiences they perceive as being positive or negative. Associated odds represent the increase in perceived social isolation for every 10% increase in the independent variable. d Includes Black, Multiracial, Hispanic, Asian, and Native American.e Included being engaged, married, or in a domestic partnership.Table 3. Bivariable associations between SM experiences and perceived social isolation, stratified by sex, age, and race (N = 1178)OR (95% CI) aOR (95% CI) aNegative experiences bPositive experiences bSexMale1.07 (0.97 – 1.18)1.03 (0.98 – 1.10)Female1.25 (1.14 – 1.38)0.91 (0.87 – 0.96)Age181.35 (1.16 - 1.57)0.86 (0.79 – 0.94)19-201.18 (1.05 – 1.33)0.99 (0.93 – 1.05)21-241.03 (0.92 – 1.16)0.99 (0.94 – 1.05)25-301.02 (0.86 – 1.22)0.90 (0.82 – 0.99)Race/EthnicityWhite, non-Hispanic 1.11 (0.99 – 1.23)0.92 (0.86 – 0.98)Non-White c1.16 (1.07 – 1.26)0.99 (0.95 – 1.02)a OR = odds ratio; CI = confidence intervalb Each independent variable indicates the proportion of participants’ SM experiences they perceive as being positive or negative. Associated odds represent the increase in perceived social isolation for every 10% increase in the independent variable. c Includes Black, Multiracial, Hispanic, Asian, and Native American. ................
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