Screening for Media Use in the Emergency Department Among Young Australians: Cross-sectional Study

Pravin Dullur; Joanne Joseph; Antonio Mendoza Diaz; Ping-I Lin; Rajeev Jairam; Rhian Davies; Anne Masi; Boaz Shulruf; Valsamma Eapen

doi:10.2196/42986

Screening for Media Use in the Emergency Department Among Young Australians: Cross-sectional Study

JMIR Form Res. 2023 May 15:7:e42986. doi: 10.2196/42986.

Authors

Pravin Dullur^#^{1

2}, Joanne Joseph^#¹, Antonio Mendoza Diaz^{1

2}, Ping-I Lin^{1

2}, Rajeev Jairam^{1

2

3}, Rhian Davies², Anne Masi¹, Boaz Shulruf⁴, Valsamma Eapen^{1

2}

Affiliations

¹ Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia.
² Infant, Child and Adolescent Mental Health Services, South Western Sydney Local Health District Liverpool, Sydney, Australia.
³ Discipline of Mental Health, Western Sydney University, Sydney, Australia.
⁴ Medical Education, Faculty of Medicine, University of New South Wales, Sydney, Australia.

^# Contributed equally.

PMID: 37184914
PMCID: PMC10227703
DOI: 10.2196/42986

Abstract

Background: Research on problematic internet use has largely adhered to addiction paradigms, possibly impeding the identification of specific internet behaviors related to psychopathology. This study presents a novel approach to screening for specific problematic internet behaviors by using a new measure, the emergency department media use screener (EDMUS).

Objective: The purpose of this study was to identify 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 3 months.

Methods: This cross-sectional retrospective study of Australian young people (N=149, aged 11-25 years; female: n=92, 61.7%) sought to use the EDMUS, a 24-item questionnaire, to identify problematic internet behaviors, including accessing or posting prosuicidal or proeating disorder content, cyberbullying, and inappropriate digital content. Data on each person's mental health were extracted from electronic medical records to look for associations with EDMUS responses and ED re-presentation over 3 months. EDMUS items were grouped into clusters for analysis using chi-square tests, binary logistic regression, and path analyses.

Results: Sharing suicidal digital content was the most common problematic internet use pattern identified by the EDMUS. However, this did not correlate with having a prior mental health diagnosis or predict readmission. Most participants had families with a concern for their internet use; however, this was less likely in participants with a diagnosis of personality disorder. Diagnoses of personality disorder or posttraumatic stress disorder were independent predictors of readmission (P=.003; P=.048).

Conclusions: Although a history of complex psychopathology increases the likelihood of subsequent ED presentations, its links to internet use-related behaviors are still unclear. The EDMUS has potential for identifying young people who are most vulnerable to problematic internet behaviors and offers the opportunity for early intervention and potential prevention of more entrenched difficulties.

Keywords: adolescent; emergency department; internet; internet behavior; internet use; mental health; mental illness; overuse; problematic internet behaviors; screening; technology use; young people; youth.

©Pravin Dullur, Joanne Joseph, Antonio Mendoza Diaz, Ping-I Lin, Rajeev Jairam, Rhian Davies, Anne Masi, Boaz Shulruf, Valsamma Eapen. Originally published in JMIR Formative Research (https://formative.jmir.org), 15.05.2023.