182. The Impact of the COVID-19 Pandemic on Adolescent Social Media Use, Substance Use, and Depressive Symptoms: A Scoping Review

Abstract

Purpose We conducted a scoping review of published, peer-reviewed literature in order to characterize and synthesize the existing literature on the impact of COVID-19 on adolescent social media use, substance use (i.e. alcohol, cannabis, electronic vapor products, and prescription medication misuse), and depressive symptoms in the United States. Methods We utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines for the review. We searched PubMed, PsycINFO, and Embase and completed dual screening for both title and abstract screening and full text screening. Extraction of articles that passed through the full text screen was completed in two stages, with a primary extraction completed by a single individual followed by a review of the primary extraction by a second reviewer. We included quantitative or qualitative studies among 12 to 17 year-olds or their caregivers and provided results that were stratified to adolescents (age 10 to 19 years or middle school to high school) in the United States with data collected beginning March 2020 to reflect the beginning of the impact of the pandemic on daily life for the general public. Per University of Washington Human Subjects Division self-determination procedures, this review of published, peer-reviewed literature was not human subjects research and therefore did not require institutional review board review for approval or exemption. Results We identified 29 studies that met the criteria for inclusion, a majority of which reported on depressive symptoms and/or suicidality among adolescents. Relatively fewer studies reported on social media use and substance use. Depressive symptoms and/or suicidality during the pandemic differed by youth characteristics (e.g. sports participation). Cross-sectional assessments indicated increased depressive symptoms during the pandemic. However, studies that reported on the trajectory of depressive symptoms and suicidality early in the pandemic as compared to later in the pandemic suggest a possible decrease over time. The available literature on social media use was heterogenous with respect to the ways in which social media use behaviors were being queried, but broadly included studies suggest that adolescents used social media for connection and to cope during the pandemic. Findings for substance use were also varied, with some studies reporting decreases in substance use while others reported increased use. Conclusions Given potential increases in depressive symptoms and substance use during the COVID-19 pandemic, additional mental health support may be needed for adolescents and their caregivers in clinical and school settings. Further, adults with key roles in adolescent lives should discuss and model healthy social media use habits. As the impacts of the pandemic persist, both in terms of COVID-19 infections and the financial and emotional implications, continued monitoring of mental and behavioral outcomes will be necessary. Findings may inform future research, practice, or policy. Sources of Support This work was supported in part by a student project stipend from the Northwest Public Health Training Center at the Northwest Center for Public Health Practice and by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant #T76MC00011.