Social networking sites and its relation to social comparison and psychological well-being among medical university students.

BACKGROUND: Social networking sites (SNSs) have become an indispensable part of young adults in India. The content on one's profile and that of others on social media makes social comparison easier among young adults leading to poor mental health and life dissatisfaction. AIMS: To assess the relationship between the pattern of SNS use among young adults and depression, anxiety, and social comparison.
MATERIALS AND METHODS: This was a cross-sectional study among medical students done using a questionnaire consisting of pattern of SNS use and scales for social comparison, depression, and anxiety.
RESULTS: We collected data from 220 students (mean age 20.44 years). Impression management was associated with higher social comparison, depression, and anxiety scores. Social comparison had a significant correlation between depression and anxiety scores.
CONCLUSION: A complex association exists between duration or time spent on SNS use and psychopathology. Copyright:

INTRODUCTION

Social networking sites (SNSs) as conceptualized by Ellison and Boyd are sites that are a web-based communication platform that allows users to create a unique profile and generate content that can be put online and shared with other users in a continuous stream of information.[1] Popular examples of SNSs include Facebook, Twitter, Myspace, and Instagram. The use of SNSs has increased exponentially in the last few years, especially among young adults in India with nearly 70–100 million users.[2] Social media have become an indispensable part of our social interactions sparking growing interest among researchers. Some of the important variables found to be associated with the psychological well-being of individuals using SNS are amount of exposure to SNS, self-presentation or impression management, the number of friends or followers, tendency for social comparison, and self-esteem.[3] We found a very limited number of studies in India on use of SNSs and mental health. A study in Kolkata among medical students concluded that use of SNSs and dependence on it were associated with anxiety and depression.[4] Another qualitative study among adolescents in Mumbai reported selective self-representation and online social comparison pervasive among the SNSs users.[5] To the best of our knowledge, no research has been done on social comparison, use of social media, and psychological health among Indian medical college students. Hence, this study aimed at finding out the relationship between exposure to SNS and self-presentation, social comparison, and psychological well-being among college students.

MATERIALS AND METHODS

This was a cross-sectional study done among a sample of college students of medical, nursing, and physiotherapy colleges from a medical university (with approximately 800 students) from September 2018 to March 2019. 300 potential students were approached by convenience sampling. Out of these, 242 consented to participate in the study. Data were collected using a pen and pencil questionnaire after written informed consent. Time taken to finish the questionnaire was approximately 20–30 min. Ethical clearance for the study was obtained from the institutional ethical clearance committee.

The questionnaire consisted of the following:

Sociodemographic details and pattern of SNS questionnaire:

Our questionnaire consisted of questions related to the frequency of checking the SNS account, time spent in engaging in various SNS sites, and the number of followers in most commonly used SNS account, i.e., Instagram

Scale for Social Comparison Orientation (Incom, Iowa-Netherlands Comparison Orientation Scale): The core instrument of the INCOM scale contains 11 items. In these items, people are given statements about their self-comparisons with others, to which they can respond on a five-point scale ranging from A, strongly disagree, to E, strongly agree.[6] Higher scores reflect a higher tendency for social comparison

Depression, anxiety, and stress scale (DASS 21): The DASS is a set of three self-report scales designed to measure the negative emotional states of depression, anxiety, and stress. It is a 21-item scale and subjects are asked to use 4-point severity/frequency scales to rate the extent to which they have experienced each state over the past week[7]

Minitab 17 was used for statistical analysis.[8] Percentages and mean are used to describe the descriptive data. Analysis of means was done by t-test for social comparison scores and Kruskal–Wallis test for depression and anxiety scores.

RESULTS

A total of 242 students answered the study questionnaire, out of that 22 responses could not be included in the final study due to missing/incomplete data. The final sample size was 220 for the study. However, since the response and type of SNS use differ among various individuals, the total number of respondents differed across the data on patterns of use of SNS as reflected in Table 1.

Table 1

Pattern of social networking sites use

Questions	Response	Total (n=220), n (%)	Female (n=121), n (%)	Male (n=99), n (%)
Number of followers on instagram	<100	16 (8.04)	10 (9.43)	6 (6.45)
n=199 * (n=21 didn’t use instagram)	100-500	129 (64.82)	71 (66.98)	58 (62.37)
	More than 500	54 (27.14)	25 (23.58)	29 (31.18)
Frequency of use of SNS	Daily	127 (57.98)	71 (58.33)	57 (57.58)
	Weekly	74 (33.64)	39 (32.50)	35 (35.35)
	Whenever the need arises	18 (8.18)	11 (9.17)	7 (7.07)
Time spent on SNS	Up to 2 h	124 (56.36)	72 (59.50)	52 (52.53)
	More than 2 h	96 (43.64)	49 (40.50)	47 (47.47)
Change profile	Everyday/weekly	18 (8.18)	10 (8.26)	8 (8.08)
How frequently do you change your facebook profile?	Rarely/monthly	202 (91.82)	111 (91.74)	91 (91.92)
Filter use	Everyday/weekly	49 (22.27)	23 (19.01)	26 (26.26)
How often do you use filters/photoshopping applications to make yourself look better?	Monthly rarely	171 (77.73)	98 (80.99)	73 (73.74)

SNS – Social networking sites

General description of the study sample: Males were 55% and females 45% of the total study subjects. Most of the subjects were pursuing medicine (178, 80.91%) and the rest belonged to nursing and physiotherapy courses (42, 29%).

The majority of the study subjects, n = 124 (56.36%) had accounts both on Facebook and Instagram, while 8.64% (n = 19) had accounts only on Facebook and 9.55% (n = 21) on Instagram. Rest (n = 56) had accounts on more than two SNSs.

The pattern of use of SNSs is depicted in Table 1.

The mean age of subjects in the study sample was 20.44 (standard deviation [SD] 1.33). The mean scores for the social comparison scale, depression, and anxiety scores on DASS 21 were 31.62 (SD 6.89), 11.55 (SD 10.03), and 11.76 (SD 8.76), respectively.

In both female and male subjects, the frequency of use of SNS, frequency of changing profile, and time spent on SNS were not found to be significantly associated with social comparison, depression, and anxiety.

The number of followers on Instagram was significantly associated with anxiety (H (2)=6.10, P = 0.04) and depression in females (H (2) =5.91, P = 0.05). Higher anxiety and depression scores were seen in those having less number of followers. This association was not found to be significant in males.

Frequent use of filters was associated with higher social comparison, depression, and anxiety scores [Table 2].

Table 2

Association of use of filters with social comparison, depression, and anxiety in both gender

Gender	Frequency of use of filters Everyday/weekly	Monthly/rarely	Significance
Social comparison scale
Female	34.78 (6.04)	31.62 (6.8) 1	T (36)=2.20 P=0.034
Male	33.12 (8.76)	30.11 (6.16)	T (34)=1.61 P=0.116
Depression
Female	14	10	H (1)=6.06 P=0.014
Male	14	6	H (1)=6.45 P=0.011
Anxiety
Female	16	10	H (1)=5.36 P=0.021
Male	15	8	H (1)=4.25 P=0.039

There was a significant correlation between social comparison scores and depression (0.505, P < 0.01) and anxiety (0.439, P < 0.01) in females.

In males too, the association between social comparison and depression (0.355, P < 0.01) and anxiety (0.419, P < 0.01) was found to be significant.

DISCUSSION

The interaction between SNSs and psychological well-being is complex and is mediated by several variables.[9] These findings of our study are consistent with previous research. A systematic review found that the total frequency or time spent on SNSs has mixed associations with depression and anxiety. Of the 30 studies they examined, 8 studies found a direct positive association with depression and 16 found a nonsignificant association. For anxiety (and social anxiety), 3 studies found a direct positive association and 7 found nonsignificant association.[9]

In our study, we did not find any association between depression and anxiety and time spent on SNS. Wright et al. argued that it is not time spent using Facebook which is likely to be of importance, but what people do while they are using it.[10] Thus, current research fails to specify the relationship and causal directionality between the nature and motivations for SNS use and psychological well-being leading to conflicting results.[91112]

Impression management is a term coined by Erving Goffman in 1958 to describe the strategic behavior involved in presenting a favorable image of oneself in the company of others.[13] The use of filters, a special feature on most SNS sites, provides an easy opportunity to do the same, more effective than face to face communication.[14] Perceived online attractiveness is important as it influences behavior, e.g., individuals are more likely to make friends with members of the opposite sex if they consider them attractive. In our study, we found a significant association between frequent filter use and higher social comparison, depression, and anxiety scores. Inauthentic self-presentation has been shown to be associated with low self-esteem and elevated levels of social anxiety, neuroticism, and narcissism.[15]

Many studies have demonstrated that the association between depressive symptoms and SNS use is mediated by online social comparison. This may be especially true for college students since they may still be struggling to establish their identities, and, consequently, may be more susceptible to peer influences.[16] Social comparison, in general, leads to poor self-esteem and unhappiness and life dissatisfaction.[17181920] Our study has shown a similar association between social comparison and SNS use.

To the best of our knowledge, our study is the first Indian study done among college students exploring the association between SNS use, social comparison, and psychological well-being. Nevertheless, our study has certain limitations. Selection, self-report, and social desirability bias may affect the generalizability of our study findings. The diversity and variability of SNSs make it difficult to define and research under one common concept of SNS.

CONCLUSION

Changes in the way in which people use technology for social purposes have important health implications. With the increasing use of SNSs, an understanding of risk and protective factors and mechanisms explaining the complex relationship between SNS use and psychological well-being such as presented in our study has become imperative.

Financial support and sponsorship

Ramdas Pai Research Grant Fund by Sikkim Manipal University.

Conflicts of interest

There are no conflicts of interest.