Author: Sophia Petrillo
The health impacts of social media addiction remain somewhat unknown. Recent studies indicate variable health effects depending on the severity of the addiction, and increased social media use predicts more significant health consequences. One study investigating the impact of social media addiction on stress among employees of 13 companies in Thailand found that those with a higher degree of addiction appear to have a lower capacity for mindfulness (i.e. the ability to be fully engaged with the present moment). Social media addiction may reduce productivity and success in work, education, and other areas of life. Additionally, the study revealed that individuals experiencing addiction to social media choose emotion-focused coping to alleviate stress rather than problem-focused coping. In contrast to problem-focused coping, in which an individual takes actions targeted at the source of the problem, emotion-focused coping involves efforts to reduce the emotional severity of a situation as a means of resolving the problem. However, the employment of social media to reduce stress qualifies as unhealthy use and may increase emotional exhaustion. Those who are addicted often rely on social media to distract from real-life problems, which masks them and prevents addressing underlying issues.1
Generally, social media has been linked with several adverse health impacts, particularly in transitional-age youths and adolescents. For example, more frequent daily social media site visits have been associated with higher odds of depression among U.S. individuals between the ages of 19 and 32, and corresponding findings have been reported internationally.2 Furthermore, two separate studies, one on Scottish adolescents and another on U.S. college students, both indicated a relationship between increased use of social media and heightened levels of anxiety.3,4 Associations between social media use and poor sleep and unhealthy eating habits have also been supported by nationally- and internationally-based studies.5,6 Taken together, these findings suggest that the implications of social media addiction can be damaging to both individual and population health.
One social media platform that has seen a significant increase in popularity recently is TikTok. Reminiscent of newly-retired platforms, Vine and Musical.ly, regarding the type and format of app content, TikTok features short-form videos on every topic imaginable. At first featuring lip-synching and dancing to popular songs, current content has expanded to now include comedy, technical skill instruction, fitness inspiration, and myriad other categories. In addition, users can create original content and respond to content made by others through likes, comments, and reshares. Another key component of the app is the “For You” page, a feed specifically curated for each user by the app based on user activity and interaction with other content. Certain individuals have taken advantage of the platform as a marketing tool, establishing themselves as “influencers;” many companies also utilize the app to promote their products and messages. The global audience is heavily skewed towards younger generations, with almost half of its users under age 34, and teenagers make up nearly one-third of accounts. Overall, the platform had over 800 million users in 2019 and is expected to exceed 1 billion users by the end of 2020. Its current economic valuation of $75 million qualifies it as the world’s most valuable startup. Since its popularity spike in 2018, TikTok has surpassed other traditional social media apps such as Instagram and Facebook as the most-downloaded social media app.7 Clearly, TikTok is well-established, rivaling other platforms for supremacy in the social-media world.
The ‘like’ button is a hallmark of nearly all social media platforms. The action of ‘liking’ social media content has recently become so popular that Merriam Webster now lists an alternative definition of ‘like’ in the dictionary as “to electronically register one’s approval of (something such as an online post or comment) for others to see (as by clicking on an icon designed for that purpose).”8 The button was first created in 2005 on Vimeo as an alternative way for users to react to videos that felt less concrete than ‘favoriting’ them; its later introduction to Facebook in 2009 and subsequent alterations to its functionality contributed to its establishment as a fixture of social media platforms.9 ‘Likes’ provide information on social norms and indicate the societal view of particular media that is posted, influencing how individuals perceive it. Additionally, ‘likes’ offer information to social media companies and other websites where there are ‘like’ button plugins so they can more specifically tailor their content to users to keep them more engaged without directly asking their preferences.10 The ‘like’ button was instrumental in the rapid growth of Facebook in 2010 and has had similar effects on TikTok over the past few years. Thus, although the platforms differ in their content and audiences, they are remarkably alike at the structural level.
In alignment with traditional mechanisms of reward-based learning and facilitation of the habit and addiction loops, ‘likes’ serve as a reward for social media users. A study utilizing a functional MRI paradigm to mimic the “Instagram experience” of viewing “liked” photos demonstrated increased neural activity in regions traditionally associated with reward, namely the nucleus accumbens, and provided evidence for the influence of virtual peer endorsement through ‘likes’ as a form of quantifiable social endorsement among users; accordingly, receipt of a ‘like’ indicates that others approve of an individual’s content.11 This satisfies the human desire for acceptance by others, particularly those they respect and whose opinions they value; these individuals often comprise one’s ‘friends’ or ‘followers’ on social media. Dopamine release is a key part of the positive feedback loop that drives reward-based learning; increased dopaminergic activity in the brain in response to receiving a ‘like’ encourages future social media use and continued content publication in hopes that the pleasurable experience will re-occur.12 ‘Likes’ also keep users engaged with social media platforms by representing a form of investment; ‘liking’ content elicits the psychological experience of investment in the platform, and the more invested people are, the more likely they are to care about it and return to the website or app in the future. Evidently, ‘likes’ are gratifying in multiple ways — it feels good to receive likes from other people, and it also feels good to give ‘likes’ to other people in the same way that it feels good to give people gifts. For both forms, the presence of the like button allows instant gratification, which drives habitual use and addiction through positive reinforcement.13
Undoubtedly, the appeal and entertainment value of content posted on TikTok is a major factor in its popularity. Users are intrigued by videos posted by others and may recreate these videos or publish original content. However, the platform’s success is also heavily influenced by elements of the app itself, and it has been argued that certain app features drive the formation and sustenance of addictions to the platform. Recent reports reveal that users spend an average of 46 minutes per day on the app and open it eight times daily; considering the maximum length of videos is 15 seconds, they may watch upwards of 180 videos per day on average.14 Like other social media platforms, the infinite scroll and variable reward pattern of TikTok likely increase the addictive quality of the app as they may induce a flow-like state for users that is characterized by a high degree of focus and productivity at the task at hand,15 whether that be a game, one’s social media feed, or another virtual activity. Once immersed in the flow-like state, users may experience a distorted sense of time in which they do not realize how much time has passed. Furthermore, the app interface itself is straightforward and user-friendly, with only a limited number of buttons and sections of the app for users to navigate, which further enables entrance into “flow.”16 Videos are short, which is ideal given the decreasing attention capacity of youths in the 21st century. When they play, they consume the entire device screen, which creates an immersive experience for users.17
The personalized “For You” stream created by artificial intelligence (AI) for each user has also been identified as a key contributor to TikTok addiction. TikTok differs from other social media apps because an individual’s feed is not based on deliberate choices made about the content they want to see. Instead, AI presents individuals with content and uses their reactions to it (in the form of likes, comments, and reshares) to determine other content they might like, facilitating a continuous cycle that starts from the first use and becomes increasingly accurate with repeated engagement.18 All of the in-app features prolong the time that users spend on the app, which increases the addictive capacity of the platform. To further support this effort, developers constantly change the app layout and add new features so that users spend more time on the app navigating and adjusting to the new design.
Although the similarity may not be immediately evident, analysis of social media apps reveals that they are designed to function like slot machines — the “swipe down” feature required to refresh one’s feed mirrors pulling a slot machine lever, and the variable pattern of reward in the form of entertaining videos on TikTok simulates the intermittent reward pattern of winning or losing on a slot machine; this pattern keeps individuals engaged under the impression that the next play might be “the one.”19 The striking parallelism between social media apps and slot machines is intriguing given that gambling is the only behavioral addiction currently recognized by the DSM-5. Provided that social media apps are functionally akin to slot machines, it is likely that the use of these apps is just as addictive as slot machines and fosters social media addiction, much like how slot machines contribute to gambling addiction.
Taken together, specific consideration of TikTok in the larger context of social media platforms reveals that “TikTok addiction” is likely a result of a combination of effects. Like other substance and behavioral addictions, it is expected that there are dispositional factors involved in the development of addiction to TikTok. This is because certain lived experiences and personality traits are believed to predict a tendency for engagement in habitual behaviors and addiction. Although these characteristics are often unpreventable, therapeutic and medicative treatments may effectively reduce their influence on an individual’s behavior, so this driver of TikTok addiction may not be too significant.
Unfortunately, it appears that structural and contextual aspects of TikTok are greater contributors to addiction than dispositional attributes of users. Elements of app design and functionality, namely the variable reward pattern of the content stream, the simple, “flow-inducing” interface, and the capability for “endless scroll,” capitalize on classical conditioning and reward-based learning processes to facilitate the formation of habit loops and encourage addictive use. Unlike dispositional drivers of “TikTok addiction,” situational elements of the platform are engineered by app developers, and thus, could be eliminated. However, developers are unwilling to relent with the knowledge that their app’s success depends on its ability to manipulate users to continue use despite any adverse consequences. Although this behavior is conscious and deliberate, whereas dispositional factors are often unconscious and uncontrollable, changing the attitudes and behavior of those in the social media industry may pose a greater challenge to public health efforts to reduce “TikTok addiction” than simply treating misaligned personality traits; this is the reality of living in an increasingly digital and technologically-based world.
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