The Use of Technology by Youth: Implications for Psychiatric Educators

Today’s youth are using technology in a variety of ways, from texting and tweeting to chatting, online gaming, and posting through a variety of Internet portals. Of US adults and those aged 18–29, respectively, 88% and 99% use the Internet [1]. As of 2017, approximately 95% of American adults have a cell phone and 77% a smartphone [1]. Social media—usually defined as web-based and mobile services that allow people to share a connection, monitor progress, and create/manipulate text, audio, photos, and/or video [2, 3]—is also exponentially growing [4]. Social media and networking options like Twitter and Facebook are common among the Digital Native (Z; 1998–present), Millennial (Y; 1981–1997), and X (1965– 1980) Generations (Table 1) [5, 6]. On a typical day, American teenagers (13to 17-year-olds) spend an average of six and a half hours and tweens spend an average of four and a half hours on screen media use. [1, 5, 6]. These behaviors, experiences, and events may be positive or negative, healthy or unhealthy, and normal or problematic. Positive aspects of technology for the youth include being able to speak more freely (finding one’s voice/community) online, learning/knowledge gains, communication/engagement with others, and creative exploration. Youth are also open to the use of technology for the assessment and interventions in healthcare, such as web-based technologies which support youth with depressive symptoms [7] and text messaging services as an intervention for adolescent obesity or suicidal thinking [8]. Despite these potential benefits, concerns about media use—especially excess use—of television and computer games have arisen due to potential changes in mood, promotion of sedentary lifestyles, withdrawal from other activities, and severely impaired sleep patterns [9]. Problematic social media behaviors may range from disinhibition and the posting of ill-advised photos, to more extreme examples like online bullying, sexting, frank exploitation, and other destructive or addictive behaviors [10–15]. Disinhibition of behaviors may be encouraged by the ability to post anonymously [16]. In addition, according to the New York Times, “The nearuniversal access to digital technology, starting at ever younger ages, is transforming modern society in ways that can have negative effects on physical and mental health, neurological development and personal relationships, not to mention safety on our roads and sidewalks” [17]. Concerns about adverse effects of the Internet have led to proactive efforts toward cyberhealth [18], discussion of risks associated with excess online and screen activity [19], and a call for research on how technology “changes” us [20]. Finally, the “opportunity costs” need to be accounted for, that is, time spent on one activity costs an opportunity to spend it on another (perhaps better, healthier) activity. This paper will examine these issues, with more breadth than depth, in order to: