does the internet harm children's health? a critical review of the evidence
DESCRIPTION
Presentation delivered at MeCCSA 2013 by Dr. Vera Slavtcheva-Petkova, highlighting findings of a paper co-authored with Dr. Monica Bulger and Dr. Victoria Nash of the Oxford Internet Institute Abstract: Moral panics about the Internet’s “harmful effects” have been ongoing in current years, recently exacerbated by a UK parliamentary inquiry into online child protection. Is there scientific evidence supporting these fears? Does the Internet harm children and especially their health? This paper will present the findings from a narrative review of more than 300 journal articles discussing the scale and scope of online harms that young people experience. We will first present the three main types of harms identified in the literature: health-related harms, sex-related harms and cyber-bullying. Then the paper will focus in more detail on the evidence about health-related harms incurred as a result of online risks. We not only identify the kinds of health harms discussed in the literature – mainly related to pro-eating disorder websites, self-injury websites and problematic Internet use – but we also investigate whether and how the researchers operationalize harm. We also scrutinize the research methods used in the studies, which tend to differ significantly among the disciplines studied.TRANSCRIPT
Does the Internetharm children’shealth?Dr Vera Slavtcheva-‐Petkova, University of Chester
Dr Monica Bulger, Dr Victoria Nash, OxfordInternet Ins4tute, University of Oxford
Contents• Child protec4on and online harms: Academicand policy context
• Methods
• Scope, scale and opera4onalisa4on of health-‐related harms
• Conclusions
Academic context• Growing body of research on level and characterof Internet by under 18s, and nature of risks andopportuni4es experienced (e.g., Livingstone &Haddon, 2009; Schrock & Boyd, 2008)
• Research suggests that risks are greatest for thosemost vulnerable offline, and that overall, theopportuni4es of Internet use outweigh risks (e.g.Mitchell et al., 2010, Livingstone et al., 2011)
• Real lack of research which quan4fies or analyseslevel of actual harm rather than poten4al risk.
Policy context
• Wide array of policy measures across Europe: hotlinesfor repor4ng child abuse images, industry codes ofconduct regula4ng use of mobile content and services,and increasing provision of parental controls by ISPs.
• Much of this is result of self or co-‐regula4on
• Possible and actual conflicts with other rights, e.g.freedom of expression, legal due process.
• Policy purportedly informed by research (e.g. mul4-‐stakeholder UK Council for Child Internet Safety), butsuscep4ble to media pressure and “moral panics”
“While new discoveries almost always have both benefits anddisadvantages, breathless nega4ve coverage of technology frightensparents, prevents teenagers from learning responsible use, and fuelspanics, resul4ng in misguided or uncons4tu4onal legisla4on” (Marwick
2008).
Perceived risks vs. actual harms
Our study• Evidence on the extent of harmsexperienced by children as a result ofonline risks: A cri4cal synthesis of research• Funded by the Oxford University Press'sFell Fund• A review of empirical studies of harmsassociated with young people’s (under18s) Internet use, published in Englishbetween 1997-‐2012 + interviews with keystakeholders
Methods• Keywords: “harm AND Internet AND children”, “harmAND Internet AND adolescents”, “harm AND InternetAND minors”, “harm AND Internet AND teens” and“harm AND Internet AND teenagers”• Categories for inclusion:1.Empirical work
2.Published in peer-‐reviewed journal
3.Main focus of study was young people (aged under 18)4.Addressed Internet use
5.Addressed incidents of harm related to onlineinterac4ons
Methods• Original search yielded over 4,000 publica4ons• Aher a first-‐pass review, corpus narrowed to 271studies.• 271 were reviewed but only 148 ar4cles werefully coded aher strict applica4on of theinclusion criteria.• Coding framework adapted from the EU KidsOnline public repository. It included 21 items,including details of method, target popula4on,context and how and whether harm wasopera4onalised.
Three categories of harms• Three main categories of harms:
1.Health-‐related harms: 63 ar4cles
1.Sex-‐related harms: 49 ar4cles
1.Cyberbullying – 36 ar4cles
Health studies: Methods
Scope of harms
Operationalization of harm• Harm is opera4onalized in less than half of the studies –44.5%
• Self-‐harm: The most common defini4on (33.3% of allstudies and 75% of those that opera4onalize the term)• Examples:
• “Parasuicide”, “self-‐mu4la4on” or “self-‐injury” (Adamset al., 2005, p. 1293)
• “A form of ac4vely managed self-‐destruc4ve behaviorthat is not intended to be lethal”, which “subsumes anextensive range of behaviours” such as self-‐mu4la4on,self-‐injurious behavior, deliberate self-‐harm and self-‐wounding (Murray et al., 2008, p. 29)
Other deCinitions of harm2. “Desensi4za4on to violence in real life and
impairment in the process and outcome ofmoral evalua4on”
3. Physical harm
4. Emo4onal harm
Scale of Pro-‐ED harms• Much of the discussion pertains to perceived or poten,alharm rather than evidence of actual harm
• Pro-‐ea4ng disorder websites:1.Even “suppor4ve” websites contain poten4ally harmfulcontent – “pro-‐ED websites tend to be perceived assuppor4ve by users, but instead appear to exacerbate or mainusers’ ea4ng disorder symptoms”
2.Three “possible risks”:
a.“Opera4on under the guise of ‘support’b.Reinforcement of disordered ea4ng
c. Preven4on of help-‐seeking and recovery” (Rouleau and vonRanson, 2011, p. 525)
Scale of Pro-‐ED harms• 85% of the pro-‐ea4ng disorder websites contain“thinspira?on” material – images of very thin models orcelebri4es used to inspire weight loss, 70% have “?ps andtricks” on die?ng and fas?ng or purging, laxa4ves and pills(Borzekowski et al., 2010)
• 96% of users of pro-‐ea4ng disorder websites and 46.4% ofusers of pro-‐recovery sites report “learning new weight lossor purging techniques” (Wilson et al., 2006, p. e1635)
• 19.2% of users say they feel the pro-‐ea4ng disorder websitesare harmful to them because they encourage thedisorders/compe44on among par4cipants and have “nega4veimpact on self-‐effect” (Csipke and Horne, 2007, p. 200)
Scale of Pro-‐ED harms• Talbot (2010) argues that viewing pro-‐ea4ng disorderwebsites is linked to a number of nega4ve effects:
1.“Higher levels of die4ng and exercise2.Higher levels of drive for thinness, body dissa4sfac4on andperfec4onism
3.Posi4ve correla4on between viewing pro-‐ED websites, diseasedura4on and hospitaliza4ons” (p. 686)
BUT:1.Viewing pro-‐ED websites may INCREASE ea4ng disorderbehaviour but MIGHT NOT CAUSE it
2.More research is needed to determine if these websites DOHARM and if so, TO WHOM and OF WHAT FORM (Talbot,2010, p. 694)
Scale of self-‐harm• A “normalizing” and a “pathologizing” discourse(Franzén & Goszén, 2011, p. 279)
• Lisle evidence regarding the prevalence of self-‐injurious behavior and its rela4onship to use of self-‐harm websites or forums
• 80% of the users of self-‐harm message boards arefound to be between 14 and 20 years old (Whitlock,Powers, & Eckenrode, 2006).
• The typical adolescent self-‐injurer is female, ohenwith a history of abuse and an ea4ng disorder, mostcommonly cutng her arms and legs and hiding it.
Scale: pro-‐suicidal sites• Much more conclusive in the claims about harms
• A meta-‐study (Durkee et al., 2011) concludesthat “pro-‐suicide websites and online suicidepacts” are “high-‐risk factors for facilita4ngsuicidal behaviours, par4cularly among isolatedand suscep4ble individuals” BUT some forumsprovide opportuni4es for people to meet otherswith similar experiences, “wherein theirthoughts and feeling are not condemned norlectured about” (p. 3944)
Scale of “Internet addiction”• 35% of people with Problema4c Internet experienceare <18• BUT “virtually all of the Internet problem behaviors”are “extensions of problem behaviors that pre-‐existed the advent of the Internet” (Mitchell,Becker-‐Blease, & Finkelhor, 2005, p. 506)• The typical problema4c Internet user is a teenagerwho spends most of his/her 4me on the computer,including at night. He/she is socially isolated andplays games 12-‐14 hours a day• A counsellor: “It’s the same thing as with drugaddicts” (Acier and Kern, 2011, p. 986)
Conclusions• It seems indisputable that some children experiencea variety of health harms as a result of using theInternet.
• Documented examples include young peopleassisted or encouraged in their suicide asemptsaher visi4ng pro-‐suicide forums and young girlsencouraged to maintain or exacerbate their ea4ngdisorders or self-‐injurious behavior.
• Rela4vely low numbers – specific case studies basedon interviews with health professionals and/ormedical records
Conclusions• Interes4ng textual analysis studies and surveys, sugges4nghigh prevalence of poten4al harms and risks but lisleevidence on actual harms, especially in rela4on to low-‐riskchildren
• For example, whether and how are healthy children affectedby using ea4ng disorders websites – are they “harmed” by thepro-‐ED websites?
• Limita4ons of studies: reliance on surveys – they tell us a lotabout risks and perceived harms but lisle about actual harms
• Limita4ons of our study: focus strictly on harms and studiesthat use the term, hence poten4ally relevant studies mighthave been omised
Any questions?
•Dr Vera Slavtcheva-‐Petkova, [email protected]
•Dr Monica Bulger, [email protected]
•Dr Victoria Nash, [email protected]