Screening for media use in the ED: Are problematic internet behaviours related to young people’s mental health and their emergency department re-presentation? (Preprint)

Abstract

Research on problematic internet use has largely adhered to addiction paradigms, possibly impeding the identification of specific online behaviours related to psychopathology. This study presents a novel approach to screening for specific problematic internet behaviours by using a new measure: the Emergency Department Media Use Screener (EDMUS).

To describe patterns of internet use in young people presenting with mental health concerns to the emergency department (ED), ascertain associations with their mental health, and evaluate whether the EDMUS can be used to predict subsequent ED presentations within three months.

This cross-sectional retrospective study of Australian young people (n = 149, ages 11-25, 61.7% female) sought to use the EDMUS, a 24-item questionnaire, to identify problematic internet behaviours including accessing or posting pro-suicidal or pro-eating disorder content, cyberbullying and inappropriate content online. Data on each person’s mental health was extracted from electronic medical records to look for associations with EDMUS responses and ED re-presentation in 3 months. EDMUS items were grouped into clusters for analysis using chi-square tests and path analyses.

Diagnoses of Personality Disorder or Post Traumatic Stress Disorder were independent predictors of readmission (p=0.003; p=0.048), and were marginally non-significant in predicting readmission indirectly, through a lack of family concern over internet use (p=0.065), and concern over own internet use (p=0.066) indicated on the EDMUS.

A history of complex psychopathology increases the likelihood of subsequent ED presentations, with family support being a crucial protective factor. The EDMUS has potential for identifying young people with most vulnerable to problematic internet behaviours, who would benefit from a substantial focus on social support.