Accepted for/Published in: JMIR Mental Health
Date Submitted: Apr 5, 2024
Date Accepted: May 26, 2024
Media Use and its Associations with Paranoia: Ecological Momentary Assessment in Schizophrenia and Bipolar Disorder
ABSTRACT
Background:
Paranoia is a spectrum of fear-related experiences that spans diagnostic categories and is influenced by social and cognitive factors. The extent to which social media and other types of media use are associated with paranoia remains unknown.
Objective:
We aimed to examine associations between media use and paranoia at the within- and between-person levels.
Methods:
Participants were 409 individuals diagnosed with schizophrenia spectrum or bipolar disorder. Measures included sociodemographic and clinical characteristics at baseline, followed by ecological momentary assessments (EMA) collected three times daily over 30 days. EMA evaluated paranoia and five types of media use: social media, television, music, reading or writing, and other internet or computer use. Generalized linear mixed models were used to examine paranoia as a function of each type of media use and vice-versa at the within- and between-person levels.
Results:
In total, 261 (63.8%) participants used social media at least once. Users of other types of media ranged between 191 (46.7%) for reading or writing and 385 (94.1%) for television. Gender, ethnoracial groups, educational attainment, and diagnosis of schizophrenia vs. bipolar disorder were differentially associated with the likelihood of media use. There was a within-person association between social media use and paranoia: using social media was associated with a subsequent decrease in paranoia of 5.5% (fold-change=0.945; 95% CI: 0.904, 0.987). The reverse association, from paranoia to subsequent changes in social media use, was not statistically significant. Other types of media use were not significantly associated with paranoia.
Conclusions:
This study found that social media use was associated with a modest decrease in paranoia, perhaps reflecting clinical benefits of social connection. However, structural disadvantage and individual factors may hamper the accessibility of media activities, and the mental health correlates of media use may further vary as a function of contents and contexts of use.
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