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Rethinking Time Spent on Social Media: Exploring Dissociation

People sometimes experience daydreaming or become engrossed in reading a page of a book and then realize that their mind was somewhere else, occupied in an unrelated train of thought. In a similar way, many have become completely absorbed in a movie or computer game, resulting in losing track of external stimuli.  These experiences are described as normative dissociation.

Researchers at the University of Washington wondered if people enter a similar state of dissociation when surfing social media, and if that explains why users might feel out of control after spending so much time on their favorite app. (There are multiple types of dissociation including trauma-based dissociation and the everyday dissociation associated with spacing out or focusing intently on a task)

A study presented at the recent CHI Conference on Human Factors in Computing Systems entitled “I Don’t Even Remember What I Read”: How Design Influences Dissociation on Social Media observed how participants interacted with a Twitter-like platform to show that some people are spacing out while they’re scrolling. Researchers also designed intervention strategies that social media platforms could use to help people retain more control over their online experiences. 

The research team designed and built an app called Chirp, which was connected to participants’ Twitter accounts. Through Chirp, users’ likes and tweets appear on the real social media platform, but researchers can control people’s experience, adding new features or quick pop-up notices or surveys. 

Researchers asked 43 Twitter users from across the U.S. to use Chirp for a month. For each session, after three minutes users would see a dialog box asking them to rate on a scale from one to five how much they agreed with this statement: “I am currently using Chirp without really paying attention to what I am doing.” The dialog box continued to pop up every 15 minutes. 

“We used their rating as a way to measure dissociation,” lead author Baughan said. “It captured the experience of being really absorbed and not paying attention to what’s around you, or of scrolling on your phone without paying attention to what you’re doing.”

Over the course of the month, 42% of participants (18 people) agreed or strongly agreed with that statement at least once. After the month, the researchers did in-depth interviews with 11 participants. Seven described experiencing dissociation while using Chirp. 

In addition to receiving the dissociation survey while using Chirp, users experienced different intervention strategies. The researchers divided the strategies into two categories: changes within the app’s design (internal interventions) and broader changes that mimicked the lockout mechanisms and timers that are available to users now (external interventions). Over the course of the month, participants spent one week with no interventions, one week with only internal interventions, one week with only external interventions and one week with both.  

When internal interventions were activated, participants got a “you’re all caught up!” message when they had seen all new tweets. People also had to organize the accounts they followed into lists. 

For external interventions, participants had access to a page that displayed their activity on Chirp for the current session. A dialog box also popped up every 20 minutes asking users if they wanted to continue using Chirp. 

In general, participants liked the changes to the app’s design. The “you’re all caught up!” message together with the lists allowed people to focus on what they cared about. 

The problem with social media platforms, the researchers said, is not that people lack the self-control needed to not get sucked in, but instead that the platforms themselves are not designed to maximize what people value.

“Taking these so-called mindless breaks can be really restorative,” Baughan said. “But social media platforms are designed to keep people scrolling. When we are in a dissociative state, we have a diminished sense of agency, which makes us more vulnerable to those designs and we lose track of time. These platforms need to create an end-of-use experience, so that people can have it fit in their day with their time-management goals.”

Study:
Baugnan A, Zhang MR, Rao R, et al. “I Don’t Even Remember What I Read”: How Design Influences Dissociation on Social Media. CHI ’22: CHI Conference on Human Factors in Computing Systems. April 2022 Article No.: 18, Pages 1–13 https://doi.org/10.1145/3491102.3501899

[Link to slides with audio of presentation at CHI Conference 5/22]

Patient influencers’ the new frontier in direct-to-consumer drug marketing

Pharma companies are increasingly partnering with patients to share stories and advocate for brands online. 

It began in 2015, when a celebrity influencer named Kim Kardashian was pregnant and began singing the praises of a new morning sickness drug called Diclegis to her tens of millions followers on Instagram.

In addition to a selfie and picture of the pill bottle, she wrote, “It’s been studied and there’s no increased risk to the baby, I’m so excited and happy with the results.” The Food and Drug Administration swiftly flagged the post for omitting risks, and required Kardashian to remove the post and sent the drug maker a serious warning letter.

But seven years later, so-called patient influencers are alive and well, with pharmaceutical companies increasingly partnering with real-life patients who share their personal stories and advocate for brands online.

A Trend Again?

This trend has drawn the attention of Erin Willis, an associate professor of Advertising, Public Relations and Media Design at CU Boulder. In a new paper, published in the Journal of Medical Internet Research, she calls on the academic community to take a closer look. “This is a growing phenomenon, but there is virtually no research on it and very little regulation,” said Willis, who is interviewing dozens of patient influencers for a new study. “Is it going to help patients be better informed? Or is it going to get patients to ask their doctors for drugs they don’t really need? We just don’t know, because no one has studied it.”

New twist on ‘direct to consumer’ marketing

In one of the first academic papers to date to explore the phenomenon, Willis and co-author Marjorie Delbaere, a professor of marketing at the University of Saskatchewan, framed patient influencers as “the next frontier in direct-to-consumer (DTC) pharmaceutical marketing.”

This controversial form of marketing, which is legal only in the United States and New Zealand, enables drug companies to target consumers directly, rather than through physicians. Since the first DTC ad ran in the 1980s, the ads have exploded, leading patients to ask their doctors about drugs they see on TV or in print. As Willis notes, aproximately 44% who ask their doctor about a drug, get it.

Having learned from the Kardashian incident, many ad agencies now avoid celebrity influencers altogether and instead engage “micro-influencers” like individual patients who share their personal stories and endorsements in condition-specific support groups (diabetes, heart disease, etc.) or those with a niche social media following.

“It’s a lot like what we used to see with doctors and pharmaceutical companies,” said Willis. “Only now it is patients using social media to advocate for disease awareness, and in some cases—pharmaceutical medications.”

A blurring of the lines between ad and opinion

The Federal Trade Commission (FTC) now requires that patient influencers disclose whether they are being paid (influencers use #ad or #sponcon to alert followers). And the FDA has published rules about what can and cannot be said on social posts. But such rules are open to interpretation and hard to enforce, said Willis.

The authors also have concerns that “a blurring of the lines” between ad and opinion could potentially deceive patients.

Unlike other forms of DTC advertising, social media is interactive.

“If an influencer recommends a drug, there is an entire community of voices that get to weigh in on it and support it or share their negative experiences,” said Willis.

Thus far in her interviews of patient influencers, Willis said she has found that only a small number  are paid to post (some get free trips to conferences or are paid to sit on advisory boards). Some aren’t paid at all.

“They all say they are really doing this so that other patients have information and can have a better life,” said Willis. “That is their No. 1 motivation and I think that’s awesome.”

She said she hopes that her work, funded in part by the Arthur W. Page Center for Integrity in Public Communication, and the new research agenda she has launched, will lead to a set of best practices for both patient influencers and the companies they work with.

“There is both value and risk in this growing trend and, like anything, it has the potential to become dangerous if we’re not careful,” Willis said.

Source: Willils E, Delbaere M. Patient Influencers: The Next Frontier in Direct-to-Consumer Pharmaceutical Marketing. JMIR Published on 1.3.2022 in Vol 24, No 3 (2022): March

Social media use shown to be linked to depression in adults

Data shows that individuals over age 35 were mostly likely to be negatively affected by highly visual apps, such as TikTok and Snapchat.

A number of recent studies have focused on adolescents and young adults being negatively affected by frequent use of social media. Symptoms of diminished well-being and greater levels of anxiety and depression were commonly reported. A research question asked if these same symptoms might apply to older consumers of social media.

To investigate this question, data from multiple waves of an ongoing 50-state US survey as used. The surveys, conducted from May 2020 through May 2021, were initially focused on learning more about how adults were coping during the Covid-19 pandemic. Over time, researchers increasingly became interested in whether social media use might be linked to changes in mental health.

The survey initially asked people who were not expressing depressed feelings about their social media use, with subsequent queries to see if the people who were using certain kinds of social media were more likely to be depressed. The research does not prove social media causes depression. Indeed, it is possible that people already prone to feeling sad were more likely to log on to such sites.

Compared to adults who did not use social media, “people who were using Facebook, people who were using TikTok, and people who were using Snapchat were substantially more likely to come back and tell us they felt depressed the next time they filled out the survey,” reported Roy H Perlis, MD, a professor of psychiatry at Harvard Medical School and Massachusetts General Hospital.

The research also found age differences in how certain platforms impacted mental health. Depressive symptoms were more commonly reported among Facebook users under age 35 than older adults. The opposite was true for users of Snapchat and TikTok more depressive symptoms were reported among people over age 35.

The reasons for such findings were unclear. It could be that because Snapchat and TikTok are more visual mediums, perhaps affecting older adults differently. Or it could suggest that a person is out of sync with his or her peers. Perlis said more research is needed to interpret the results appropriately. Ultimately, experts recommend remaining mindful of time spent on social media.

The authors concluded that  “Among survey respondents who did not report depressive symptoms initially, social media use was associated with greater likelihood of subsequent increase in depressive symptoms after adjustment for sociodemographic features and news sources. These data cannot elucidate the nature of this association, but suggest the need for further study to understand how social media use may factor into depression among adults.”

Mitch Prinstein, PhD, chief science officer for the American Psychological Association commenting on this research pointed out that “Our brains were not built for this kind of social interaction. And social media is kind of hijacking the need for social interaction with something very artificial and insufficient,” he said. “Social media is the empty calories of social interaction.”

Sources:

Perils RH, Green J, Simonsson M, et al. Association Between Social Media Use and Self-reported Symptoms of Depression in US Adults. JAMA Netw Open. 2021;4(11):e2136113. doi:10.1001/jamanetworkopen.2021.36113

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