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      “Is compulsive social media use amid COVID-19 pandemic addictive behavior or coping mechanism?

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      Asian Journal of Psychiatry
      Elsevier B.V.

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          Abstract

          Dear Sir, Owing to easy accessibility of internet, globally there are more than 3 billion social media users accounting for 49% of the world's population. In India, the number of social media users stands more than 376 million with a population of more than 1.36 billion (Statista, 2020). The mental health impact of COVID-19 is not limited to affected persons, their families and the healthcare force but embraces society’s response at large (Tandon, 2020). Amid the pandemic and subsequent nationwide lockdown, there has been a surge in social media usage which is also reflective of a social response worldwide. For instance, in India 87% people reported increase in its usage with 75% spending increasing amount of time on Facebook, Twitter and WhatsApp (Business Today, March 30, 2020). Given the backdrop of this alarming data, it is pertinent to debate two questions i.e. (a) “Does the current pattern of social media usage suggest a trend towards addictive behavior or has it become a coping mechanism to deal with current global crisis?” and (b) “What are the current and future implications of this trend on addictive behavior and mental health of people?”. Considering its widespread use across ages, social media is known to be a source of social reinforcement and validation. This platform provide people with an opportunity to share ideas, interact socially, form relationships, draw attention of others and create social image (Kietzmann et al., 2011). During the current global crises when ‘social distancing’ has become a norm, over-engagement in social media has become a ‘psychological necessity’ thereby helping people to address their needs of human interaction and coping with the pandemic. Therefore, despite the precautionary guidelines of social distancing, it provides people a platform to remain socially connected and universalize distress caused by the current crisis. Apart from socialization, social media is also being used for academic and work-related purposes like conducting online lectures, webinars, meetings and ensuring work from home. One of the major advantages of social media is that it facilitates awareness and provides mental health support by making resources available to those facing distress caused by lockdown and to those who are isolated as a result of being quarantined. With the help of this platform, data scientists and healthcare professionals have recently surfaced as social media influencers with the aim to mobilize people for taking proactive steps to deal with the crisis (The Economic Times, 2020). In the ongoing scenario, social media has become one of the major sources for updating information on COVID-19 for people. However, it’s irresponsible use poses the challenge of ‘infodemics’ i.e. a situation when ‘misinformation’ spreads rapidly thereby affecting thinking and subsequent behavior of people. Recently WHO had cautioned people against social media rumors which lead to panic, stigma and irrational behavior (WHO, 2020). Given the rise in usage of this media, it becomes necessary to address its association with mental health. The relationship between social media disorder and mental disorders becomes controversial which is attributable to diagnostic complications (Pantic, 2014). Research in the past has shown that compulsive usage of social media impacts physical and mental health including cardio-metabolic health, sleep, affect, self-esteem, well-being and functioning, especially in adolescents (Turel et al., 2016; Cheng and Li, 2014; Van Rooij and Schoenmakers, 2013). In light of the present pandemic, mental health conditions are found to be associated with the amount of social media exposure. For instance, a study during COVID-19 outbreak in Wuhan China, found the prevalence of depression, anxiety and a combination of depression and anxiety (CDA) to be 48%, 23% and 19% respectively. Moreover 82% participants who were frequently exposed to social media reported high odds of anxiety as well as CDA (Gao et al, 2020). It is well known to us and also resonated by research that ‘internet addiction’ is predominantly linked to increased social media or gaming activities (Van Rooij and Schoenmakers, 2013, Van Rooij and Prause, 2014). While DSM-5 (APA, 2013) and the stable version of ICD-11 (WHO, 2018) have identified ‘Internet gaming disorder’ (IGD) as a provisional disorder, social media disorder is still not acknowledged. Increasing research is advocating that social media disorder should be considered an addictive disorder just like IGD (Pantic, 2014; Ryan et al., 2014). According to the DSM-5, a person is diagnosed as having IGD if there is fulfillment of 5 (or more) of the 9 criteria (preoccupation, tolerance, withdrawal, persistence, escape, problems, deception, displacement, and conflict) during a period of 12 months. Since social-media disorder and IGD both relate to internet use, researches refer to nine IGD criterion of DSM-5 for constructing diagnostic tools and establishing internet / social media addiction (Regina et al, 2016; Van den Eijnden, 2016). Since COVID-19 outbreak began from end of 2019 and crossed international borders from the beginning of 2020, undeniably ‘12 months DSM 5 criterion’ is not applicable. But it is difficult to say if five or more IGD DSM-5 criteria are fulfilled by the excessive social media users. It comes with a word of caution that excessive social media usage is known to be highly addictive due to its psychological, social and neurobiological basis. During current pandemic, like many other uncertainties, it is unclear whether this compulsive use of social media is just a ‘phase’ and a coping mechanism or an indication of addictive behavior having mental health implications. Hence, in terms of current research implications and management, it is imperative to keep the contextual issue of global pandemic in mind and differentiate between addictive and extremely involved behavior. It can be explored whether (apart from the criterion of 12 month duration) people fulfill at least 5 out of 9 IGD criterion of DSM-5. Here it would be worthwhile to add that because of unique sociocultural context, experience of various Asian countries during COVID -19 pandemic needs to be studied and shared with the world (Tandon, 2020). Moreover, any research conducted on addictive behaviors in the current time should consider longitudinally the pre-present-post lockdown social media usage pattern and its mental health implications among individuals across all age groups. Financial support and sponsorship Nil. Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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          The Social Media Disorder Scale

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            The uses and abuses of Facebook: A review of Facebook addiction

            Abstract Background and aims: Recent research suggests that use of social networking sites can be addictive for some individuals. Due to the link between motivations for media use and the development of addiction, this systematic review examines Facebook-related uses and gratifications research and Facebook addiction research. Method: Searches of three large academic databases revealed 24 studies examining the uses and gratifications of Facebook, and nine studies of Facebook addiction. Results: Comparison of uses and gratifications research reveals that the most popular mo- tives for Facebook use are relationship maintenance, passing time, entertainment, and companionship. These motivations may be related to Facebook addiction through use that is habitual, excessive, or motivated by a desire for mood alteration. Examination of Facebook addiction research indicates that Facebook use can become habitual or excessive, and some addicts use the site to escape from negative moods. However, examination of Facebook addic- tion measures highlights inconsistency in the field. Discussion: There is some evidence to support the argument that uses and gratifications of Facebook are linked with Facebook addiction. Furthermore, it appears as if the social skill model of addiction may explain Facebook addiction, but inconsistency in the measurement of this condition limits the ability to provide conclusive arguments. Conclusions: This paper recommends that further research be performed to establish the links between uses and gratifications and Facebook addiction. Furthermore, in order to enhance the construct validity of Facebook addiction, researchers should take a more systematic approach to assessment.
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              The COVID-19 Pandemic Personal Reflections on Editorial Responsibility

              I have just returned from a 1-week academic/journal-related visit to Qatar and am informed by my medical school Dean that I will have to quarantine myself for 2 weeks before I can return to work because “I may be bringing back COVID-19 contagion”. As I am somewhat familiar with COVID-19 happenings, I am confused (and somewhat annoyed) by this directive. Although COVID-19 has affected people in half the countries around the world and the vast majority of those affected are in Asia, Qatar has just a single reported case and this individual was airlifted from Iran and has been quarantined since arrival into Qatar. It is true that over 90 percent of the confirmed cases are in Asia (China, South Korea and Iran) and Italy is reporting a dramatic increase in the number of those affected with a lockdown being declared in Northern Italy earlier today, but my travels did not take me to any of those places- I went directly from the USA to Qatar and back. After providing this explanation and noting the absence of any COVID-19 relevant symptoms, I am allowed to return to work immediately without any restrictions. Even though COVID-19 has no direct impact on me other than causing mild consternation, it gets me thinking about how this pandemic (I am not quite sure why the World Health Organization has not labelled it as one yet) will affect people and if there is any useful role that I (as the Editor-in-Chief of the Asian Journal of Psychiatry) can and should perform. I start by thinking about what just happened to me. Fear and incomplete information likely contributed to a lack of understanding that, in turn, contributed to the initial determination that I should not return to work. The fear was understandable- this is a new virus that appears to be highly contagious and deadly, we have no immunity against this virus, and while experiences in South Korea and Taiwan provide some encouragement initial trends in Italy are disturbing. Once I provided clear information about where in Asia I had travelled and that this was not where there was high COVID-19 contagion, the initial decision was immediately reversed. Accurate information leading to clear understanding was the key to enabling appropriate decision-making. Do I have any ability and responsibility as a Journal editor to enable provision of accurate COVID-19 information that is both relevant and timely? First, I ask if this fits the mission/scope of the Journal (Tandon and Keshavan, 2019; Tandon, 2020)- “a vehicle for exchange of relevant information and dissemination of knowledge and understanding across the countries of Asia and to and from the rest of the world” by addressing the following two questions: (i) Is COVID-19 relevant to psychiatry and is Psychiatry relevant to COVID-19? My instinctive answer is “of course, it is” since any international medical crisis should be of relevance to psychiatry because of both the impact of the medical condition itself on people (directly on affected persons and indirectly on their family and friends) as also the effects of society’s response (e.g., quarantine, lock-down, etc.) on mental health. As I discuss this opinion with my medical colleagues (including some psychiatrists), their immediate response is in the negative- COVID-19 is a respiratory infection/disease requiring the attention of pulmonologists, intensive care specialists, infectious disease specialists, and epidemiologists, not psychiatrists. When I discuss the mental health effects of any epidemic on the general population with specific reference to COVID-19 (Wang et al., 2020), and specific mental health challenges faced by the above healthcare professionals (Chen et al., 2020), they promptly change their opinion (some reluctantly!) and acknowledge an important place for Psychiatry. (ii) Is there any unique Asia-specific and Asian country-specific information or understanding that is worth sharing? The answer to this question is an obvious “Yes”. COVID-19 began in Asia, different Asian countries took different approaches to anticipating and managing this challenge, results vary across these Asian countries, and as other Asian countries and those around the world confront their COVID-19 challenge, there may be much to learn from the experiences of various Asian countries (particularly China with Hong Kong, Taiwan, South Korea, Singapore, and Iran). Second, there are unique circumstances across Asia that constrain what is possible such as conflict (Brennan et al., 2020), refugee crises, and political/economic realities. Having answered the first question in the affirmative, the second question I ask myself is “What information should I help disseminate, how should I seek contributions providing such useful material, and how should I review such submissions rapidly, yet fairly and effectively, so that the Journal can make relevant information available to the field in a timely manner. At this time, we had received ten submissions related to COVID-19; after an expeditious review, we accepted four for publication while finding the other six unsuitable. We published a case report in the previous issue (Goyal et al., 2020) and now publish the other three reports in the current issue (Banerjee, 2020; Bhat et al., 2020; Yao et al., 2020). I have asked Dr. Desai to compile a basic primer on must-know facts about COVID-19 for psychiatrists, which will hopefully be published in the next issue of the Journal. I have also sent out a specific request for COVID-19 mental health relevant publications focused on Asia and plan to review any such submissions expeditiously and prioritize publication of accepted articles. I hope you will find this collection of value Although COVID-19 has already caused a significant amount of devastation, we appear to be in the early stages of responding to this epidemic- it should accurately be called a pandemic as it spans across the globe. As East Asia (China, South Korea, Taiwan, Singapore) appears to have weathered the initial storm, Europe appears to be the current epicenter with North America likely to be next. It is unclear as to how many cycles of COVID-19 each country may encounter. While COVID-19 presents a healthcare crisis, the economic paralysis that nations will experience because of current and future anticipated shutdowns/lockdowns and mandatory quarantines will likely be even more catastrophic. Even as there is a critical need for the world to collectively engage with the virus SARS-CoV-2 and the COVID-19 disease it causes, there is a discernible lack of leadership at a global level. Unfortunately, there is little global coordination thus far and nations appear to have adopted a solitary (forget about other countries; violent competition for scarce resources such as personal protective equipment and ventilators; blaming and at times abusing each other; etc.) and incoherent (too little, too late; mixed messaging; etc.) response to the challenge. There is much that we can do to support each other. There is much that we can learn from each other. I hope the Journal can play a small role in helping this happen.
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                Author and article information

                Contributors
                Journal
                Asian J Psychiatr
                Asian J Psychiatr
                Asian Journal of Psychiatry
                Elsevier B.V.
                1876-2018
                1876-2026
                7 July 2020
                7 July 2020
                : 102290
                Affiliations
                [0005]Department of Psychiatry, King George’s Medical University, Lucknow, U.P, India
                [0010]Shafa Homes Deaddiction and Rehabilitation Centre, Kotdwara, Uttarakhan, India
                [0015]King George’s Medical University, Lucknow, U.P, India
                Author notes
                [* ]Corresponding author. shwetabhanu3@ 123456Gmail.com
                Article
                S1876-2018(20)30402-0 102290
                10.1016/j.ajp.2020.102290
                7338858
                32659658
                368ea18c-2b06-4c6d-ba74-774d8580921b
                © 2020 Elsevier B.V. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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                : 19 May 2020
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