Andrea Chester

The uses and abuses of Facebook: A review of Facebook addiction

Abstract Background and aims: Recent research suggests that use of social networking sites can be addictive for some individuals. Due to the link between motivations for media use and the development of addiction, this systematic review examines Facebook-related uses and gratifications research and Facebook addiction research. Method: Searches of three large academic databases revealed 24 studies examining the uses and gratifications of Facebook, and nine studies of Facebook addiction. Results: Comparison of uses and gratifications research reveals that the most popular mo- tives for Facebook use are relationship maintenance, passing time, entertainment, and companionship. These motivations may be related to Facebook addiction through use that is habitual, excessive, or motivated by a desire for mood alteration. Examination of Facebook addiction research indicates that Facebook use can become habitual or excessive, and some addicts use the site to escape from negative moods. However, examination of Facebook addic- tion measures highlights inconsistency in the field. Discussion: There is some evidence to support the argument that uses and gratifications of Facebook are linked with Facebook addiction. Furthermore, it appears as if the social skill model of addiction may explain Facebook addiction, but inconsistency in the measurement of this condition limits the ability to provide conclusive arguments. Conclusions: This paper recommends that further research be performed to establish the links between uses and gratifications and Facebook addiction. Furthermore, in order to enhance the construct validity of Facebook addiction, researchers should take a more systematic approach to assessment.

Online counselling: a descriptive analysis of therapy services on the Internet

ABSTRACT This study investigated the emerging practice of online counselling. Although the traditional practice of counselling involves face-to-face interaction between counsellor and client, a growing number of practitioners are providing counselling or therapy services via the Internet. In the present study, a total of 67 online counsellors completed a questionnaire exploring the backgrounds, services, fees, and communication technologies of practitioners offering online counselling to the public. Results suggest that online counselling is conducted by relatively experienced, primarily Western-based practitioners and is characterised by the use of email. Online clients are mainly female and receive relatively short-term interventions. Although the field appears to be evolving as its popularity increases, some ethical concerns raised by early research remain inadequately addressed.

Shyness and the internet: Social problem or panacea?

Shyness is a debilitating experience for a large proportion of the population. Shyness can be defined as a form of excessive self-focus, a preoccupation with ones thoughts, feelings, and physical reactions and may vary from mild social awkwardness to total social inhibition. This article explores shyness, its prevalence and effects and examines the role of the internet in the experience and expression of shyness. Compared to research on shyness in the offline world, empirical work on shyness online is relatively scarce. Nevertheless, the research that does exist can be categorized into two seemingly contradictory positions. The first position views the internet as an isolating medium, attractive to shy people and enhancing shyness. The second position describes the internet as an empowering medium, offering opportunities to experience disinhibition and social competence. This paper considers how the two positions might be reconciled. In addition, in order to reduce inconsistencies in the literature and to determine how shy people use the internet, it is suggested that more research, incorporating objective measures and experimental methodologies, is needed.

A randomized head to head trial of MoodSwings.net.au: An internet based self-help program for bipolar disorder

BACKGROUND Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design. METHOD Participants with Bipolar I or II disorder (n=156) were randomized to receive either MoodSwings or MoodSwings-Plus. Outcomes included mood symptoms, the occurrence of relapse, functionality, Locus of Control, social support, quality of life and medication adherence. RESULTS Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality, quality of life and medication adherence. The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania, quality of life and social support, across both poles of the illness. MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at 12 months (p=0.02) but not on the incidence of recurrence. LIMITATIONS The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline. CONCLUSION This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder. They are feasible, readily accepted, and associated with improvement.

Development of an online intervention for bipolar disorder: www.moodswings.net.au

We describe the development process and completed structure, of a self-help online intervention for bipolar disorder, known as MoodSwings (www.moodswings.net.au). The MoodSwings program was adapted as an Internet intervention from an efficacious and validated face-to-face, group-based psychosocial intervention. The adaptation was created by a psychologist, who had previously been involved with the validation of the face-to-face program, in collaboration with website designers. The project was conducted under the supervision of a team of clinician researchers. The website is available at no cost to registered participants. Self-help modules are accessed sequentially. Other features include a mood diary and a moderated discussion board. There has been an average of 1,475,135 hits on the site annually (2008 and 2009), with some 7400 unique visitors each year. A randomised controlled trial based on this program has been completed. Many people with bipolar disorder are accepting of the Internet as a source of treatment and, once engaged, show acceptable retention rates. The Internet appears to be a viable means of delivering psychosocial self-help strategies.

Net‐effect? Online psychological interventions

Psychosocial interventions are effective in the treatment of a range of psychiatric disorders (1). Supply constraints, however, mean that access to specialist interventions is extremely limited (2). This is particularly salient for those in regional and rural areas that have limited contact with specialist services (3). Access is further compounded by a reticence of some to seek help from service providers (4), and the stigma associated with mental illness (5). It seems the Internet has become a place for people to seek help. The use and acceptability of the Internet as a medium for information on a range of physical and mental health issues iswell documented (6). This is supported by the Harris poll of 2000 adults in the United States, which found that depression, anxiety and bipolar disorder accounted for 42%ofhealth issues searched for on the web (7). While men are more likely go online on a typical day than women (61% of men, compared with 57% of women) (8), it is women who are more likely to seek help online (9). Increasingly physicians report of patients taking Internet printouts to their consultations (10). It seems the Internet has indeed been embraced as an information tool. More recently, the use of the Internet has extended beyond information. It has also become a vehicle in which psychological assessment can be conducted and treatment can be delivered (11). Compared with face-to-face treatment for psychological disorders, on-line interventions provide a less inhibiting communication method (12), which may be more appealing to those withmental illness (13). Online interventions are accessible, costeffective and enable 24-h access; the Internet has been described as a place where many who need services are’ (14). A range of therapy formats currently exist online, including the provision of synchronous or asynchronous online therapy through chat platforms or e-mail. A recent study by Chester and Glass (15) explored the burgeoning field of online counseling and found that online therapists reported an increasing number of online clients each year. Predominately clients were female andwith a broader and older age demographic predominating (25–44 years) than is reflected in the Internet use data. Adjunctive service management models also exist with usual care supplemented with access to computer-based psychoeducation, progress monitoring and some online consultations (16). Such programs, as described by Roberston et al. (17), provide a broad integrative package with clinicians able to monitor patient progress. The limited access to efficacious psychological treatments, particularly in rural areas (5) has also given rise to their online application. The highly structured approach of Cognitive Behavioural Therapy (CBT), with clearly defined processes and concepts is particularly well suited to an online format (18) and predominates the current pool of online interventions (19). The acceptance of the online modality is reflected in the number of people who register for such programs as MoodGYM, an open access preventative and treatment intervention for unipolar depression that received more than 800 000 hits over a 6-month period (20). The targets of online interventions are diverse, ranging from smoking cessation programs [eg (21, 22)], diabetes (23), tinnitus (24), encopresis (25), insomnia (26), headache (27), weight (28) and eating disorders (29). A number of studies evaluating the effectiveness of online interventions in the area ofmental health have been conducted, particularly in the area of unipolar depression and anxiety disorders. Since 2001, some 20 randomised controlled trials have been published that target symptoms of depression and anxiety. A little more than half of these studies (57%) have been published in the last 2 years, highlighting this as a new and fast growing area of research. Overall, the results of these studies support their effectiveness and show the ability of online interventions to significantly improve health outcomes (30). An additional appeal of these interventions is how the technology enables complex information to be conceptualised succinctly. Typically this is via a range of multimediamediums such as flash objects, video and audio clips. Often as part of the interventions, some automated feedback regarding progress is provided, such a through feedback from questionnaires (eg MoodGYM http://www.moodgym. anu.edu.au/), and can include strategies that enable participants to monitor and watch their own progress through the use of specifically tailored monitoring tools. At the back-end, the technology provides a range of data helpful in quantifying how engaged someone is with the intervention in general and which specific elements in particular. Most typically, this data include the length of time someone spent on the intervention, what areas of the site did they look at (and for how long) and what they download. In some ways, this level of detail is greater than what is collected in face-to-face interventions and enables the opportunity for the dose effect of an intervention to be assessed. While online interventions may be considered the way of the future (11), these interventions face a number of challenges

Online mental health resources for adolescents: Overview of research and theory

Adolescents use the Internet at higher rates than any other age group. The Internet therefore offers an obvious opportunity for the provision of mental health information for them. Little is known, however, about adolescent behaviour online, especially access of age-appropriate mental health resources. This review of the published literature examines theoretical and research studies to develop an understanding of adolescent mental health-seeking behaviour on the Internet. It is clear that adolescents do seek health information online, but little is known about its content, nature or mode of delivery. There appears to be no research specific to mental health resources for adolescents online.

The mental health implications of maternal employment: Working versus at-home mothering identities

Abstract Past research exploring the effect of employment on mothers’ mental health has largely constructed maternal employment as a problem of identity and energy supply within the theory of multiple roles. Specifically, maternal employment has been investigated as either beneficial (role enhancement hypothesis) or detrimental (role strain hypothesis) to women’s psychological wellbeing, with little consideration given towards a more complex relationship. As such, despite three decades of research, there is inconsistent support for both the role strain and role enhancement hypotheses. The few trends to emerge from this research suggest that while maternal employment may be associated with better psychological functioning, this effect may be mediated by the over-absorption of one’s time and resources within a particular identity role. Future research would benefit from revising the manner in which maternal employment is constructed as a variable in order to yield more consistent and usable findings.

What Makes Feminist Counselling Feminist

Feminist counselling is often characterized as a belief system. Described broadly in this way it has been difficult to clearly articulate its boundaries. The aims of this study were to provide clarification by exploring understandings of feminism among feminist practitioners and implications of these definitions for the rhetoric and practice of feminist counselling. Descriptions of feminism and feminist counselling were collected, via self-administered questionnaire, from 140 Australian feminists who were counsellors. Definitional categories were compared with previous North American research. Although comparisons across time and continent revealed few differences, inconsistencies emerged within the sample. These discrepancies underscored the need for a stronger theoretical base within feminist counselling in Australia.

www.moodswings : The highs and lows of an online intervention for bipolar disorder - preliminary findings

Advances in understanding recovery and effective communitybased and balanced care leave a dilemma. A significant subgroup of people treated for psychosis in affluent countries remain severely disabled, take little part in community life and are socially isolated, as illustrated by recent work in Australia and the UK. Most of those with psychosis in poorly resourced countries receive no formal care despite successful demonstration of community rehabilitation approaches. What can be done to make better use of community resources and the hospital and other components of balanced care, and to avoid reinstitutionalisation in any form?Aims: Although the age-dependent neurobiological processes leading to cognitive decline in the elderly remains to be fully understood, there is now growing evidence to suggest that age-dependent increases in pro-inflammatory cytokines, such as tumour necrosis factor alpha (TNF), might play a role in such age-associated cognitive decline. The aim of this work was to examine, using a mouse model, the effect of a deficiency of TNF (TNF−/−) on cognitive function throughout aging. Methods: A standardized survey on cognition-like behaviour assessing learning and retention, spatial learning/memory, and cognitive flexibility was used to measure the cognitive-behavioural profile of TNF knockout and wildtype mice, across three age periods; 3, 6 and 12 months of age, respectively. Results: All studied mice strains demonstrated successful exploration and learning processes during the training phases of the tests, which made the specific cognition like tests valid in these mice strains. In the specific cognition-like tests, the B6.TNF−/− mice demonstrated, at 3 months of age, significantly poorer learning and retention in the novel object test as compared to B6.WT mice. In addition, spatial learning and learning effectiveness were significantly poorer in B6.TNF−/− mice, at 3 months of age, as compared to B6.WT mice. While the absence of TNF was correlated with poor cognitive functioning in early adulthood, over time the deletion of TNF resulted in better cognitive performance compared to B6.WT mice. Conclusion: Low-levels of TNF under non-inflammatory immune conditions appear essential for normal cognitive function. Moreover, the absence of TNF with age appears to protect against age-associated cognitive decline. Collectively, these findings suggest a possible role for TNF in the molecular and cellular mechanisms subserving age-related changes in learning, memory and cognition.