Exploring online and offline social experiences and interaction patterns of young adults with psychosis with the social media and internet social engagement questionnaire: Analyses and future directions

Ivy Tran; Sunny X Tang; Amit Baumel; Tyler Moore; Sarah Berretta; Leily Behbehani; Michael L Birnbaum

doi:10.1177/20552076241277186

Exploring online and offline social experiences and interaction patterns of young adults with psychosis with the social media and internet social engagement questionnaire: Analyses and future directions

Digit Health. 2024 Aug 30:10:20552076241277186. doi: 10.1177/20552076241277186. eCollection 2024 Jan-Dec.

Authors

Ivy Tran^{1

2}, Sunny X Tang^{3

4

5}, Amit Baumel⁶, Tyler Moore⁷, Sarah Berretta⁸, Leily Behbehani^{3

4

5}, Michael L Birnbaum⁹

Affiliations

¹ Psychology Department, Hofstra University, Hempstead, NY, USA.
² School of Medicine, Department of Psychiatry, Boston Medical Center, Boston, MA, USA.
³ Psychiatry Research, Northwell Health Feinstein Institutes for Medical Research, Manhasset, NY, USA.
⁴ Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, NY, USA.
⁵ Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA.
⁶ Department of Community Mental Health, University of Haifa, Haifa, Israel.
⁷ Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
⁸ School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA.
⁹ Department of Psychiatry, New York State Psychiatric Institute, NY, USA.

Abstract

Objective: Social interactions and experiences are increasingly occurring online, including for young adults with psychosis. Healthy social interactions and experiences are widely recognized as a critical component of social recovery, yet research thus far has focused predominantly on offline interactions with limited understanding of these interactions online. We developed the Social Media and Internet sociaL Engagement (SMILE) questionnaire to assess the type, frequency, and nature of online social interactions and experiences among young adults with early psychosis to better assess online social activity and ultimately support personalized interventions.

Methods: Participants (N = 49) completed the SMILE questionnaire which asked about online platforms used, frequency of use, and if positive and negative experiences were more likely to happen online or offline. Participants completed additional self-report measures of victimization, positive psychotic symptoms, social functioning, and demographics. Exploratory factor analysis and correlations between identified factors and clinical measures of interest were completed.

Results: Exploratory factor analysis revealed three factors: positive engagement, victimization, and internalizing experiences. Most participants (6%-37%) experienced positive engagement offline. Victimization occurred equally online and offline (8%-27% and 4%-24%, respectively). Most participants (37%-51%) endorsed internalizing experiences as occurring equally offline and online, but approximately a third of participants reported internalizing experiences more frequently offline (20%-35%). Victimization was moderately (r = 0.34) correlated with overall online social experiences, suggesting more online time may increase the likelihood of victimization. Age was inversely related to the frequency of overall online social experiences.

Conclusion: Young adults with early psychosis experience positive and negative social experiences online and offline. New scales and measures to comprehensively assess the nature and function of online social interactions and experiences are needed.

Keywords: Social media; first episode psychosis; internet; schizophrenia spectrum disorders; social functioning; young adult.