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Brian Lehrer: It's The Brian Lehrer Show on WNYC. Good morning again, everyone. Did you see the new report or hear the reporting on NPR about an American Psychological Association study of teens' declining mental health and social media? We're going to talk about that now as part of our week-long Teen Mental Health series here on the show, part of the station's coverage of Mental Health Awareness Month, which is May.

This is not brand new. Back in 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association collectively called for child and adolescent mental health to be declared a national emergency by the Biden administration. Seeing this as the emergency that it is, we're trying this week to get to the root of the youth mental health crisis and hopefully coming up with some solutions so we can help the kids in our lives, and we'll open up the phones in just a minute.

If you were listening yesterday, we kicked off this series focusing on teens' declining mental health in conjunction with a guest, who said that a lack of independence, too much hovering by parents, too much structured time was a big contributor. In that guest's opinion, even more than social media, which is what we usually talk about, but the news on this today is about social media.

The American Psychological Association released a report issuing recommendations for adolescent social media use. We're going to talk to one of the co-chairs now of the APA panel behind this report. He's Mitch Prinstein, chief science officer for the American Psychological Association and professor of psychology and neuroscience at the University of North Carolina at Chapel Hill. Professor Prinstein, welcome to WNYC. Welcome back to WNYC. Thanks so much for coming on with us.

Professor Mitch Prinstein: Thank you.

Brian Lehrer: The APA's report begins by noting that social media itself is neutral. It's not inherently beneficial or harmful to young people to quote the report. Why start there?

Professor Mitch Prinstein: That's right. We are looking at this as scientists and we're looking at the hundreds and hundreds of psychological articles that have been studied with thousands of teens. Social media is not all good. It's not all bad. There are benefits and there are also potential harms.

Brian Lehrer: Content that promotes self-harm of any sort allowed on social media platforms. Why?

Professor Mitch Prinstein: Well, that's a great example of where I think there are some important warning signs that were seen. Remarkable percentage of kids report that they are not only seeing content, but they're seeing content that encourages them and teaches them how to engage in cutting or anorexia-like behaviors, and also how to conceal those behaviors from their parents. We just don't think that this is healthy for kids, of course.

Brian Lehrer: Looking at the APA's guidelines, there's a focus on ensuring the children aren't exposed to dangerous content, but that's so hard, right?

Professor Mitch Prinstein: Oh yes.

Brian Lehrer: You're calling for parents to monitor these things, but how much can parents, even with their best efforts, hover over their kids on their phones?

Professor Mitch Prinstein: Well, we're calling on tech companies to make this a lot easier. We're calling on policymakers to do something about this. In the meantime, we're giving parents some tips. That way, they can look after their kids. No, it's impossible for parents to look over everything that their kids would be doing. It would be great if it was easier for parents to monitor or block some of this content for the tech companies to do that. Essentially, the companies have made a product for adults. Now, kids are getting on and using it, but there's nothing on there that changes the experience of an eight-year-old versus an 80-year-old. Kids are being exposed to everything adults would be exposed to.

Brian Lehrer: Listeners, we invite your voices on this, parents especially. What are your kids up to online? If we have any teens listening, absolutely, you too, of course, 212-433-WNYC. How do you or how do you not regulate social media usage in your home? How do you strike the balance between keeping your kids safe and granting them privacy and autonomy?

Yesterday's segment was all about more autonomy, but here, we're talking about the need to know what they're doing, at least online, on social media in particular, 212-433-WNYC. Listeners, how do you strike the balance if you're a parent? What questions do you have for Mitch Prinstein, chief science officer for the American Psychological Association, which just issued a report on teen mental health, including suicide and social media? 212-433-WNYC, 212-433-9692 with stories or questions.

As I mentioned earlier in the intro, the CDC's report shows that girls and LGBTQ+ kids are struggling the most with their mental health as one in three girls have contemplated suicide, according to the CDC stats, and one in five LGBTQ+ kids have attempted suicide. NPR reported on that. Social psychologist at NYU Stern, Jonathan Haidt reported a substantial correlation between girls, social media use and mood disorders, depression and anxiety. He wrote, "For boys, moving from two to five hours of daily use is associated with a doubling of depression rates for girls that's associated with the tripling." Why do you think these differences?

Professor Mitch Prinstein: Well, girls are being socialized, studies say, from the day they're born to be experts in social relationships. I guess boys on the other hand are not expected to excel as well in that domain, but girls are. If you want to hit a girl where it hurts, you damage her social relationships. You make her feel socially incompetent. One of the issues with social media, of course, is that it really pulls for a lot of ways that you're expected to succeed by the number of your likes or followers or things like that. There may be ways that social media is exerting unique pressures therefore on girls.

Brian Lehrer: Our guest yesterday, as I mentioned in the intro, emphasized in his research at Boston College, the lack of independence of children today compared to generations ago to basically go out and play on their own. Now, the idea there is not sitting on their phones. He actually talked about how those two things interact. If kids are more depressed and anxious because their parents aren't giving them independence to go out on their own, go take the subway on their own if they're in New York City, just go out and do things with their friends without being monitored so closely or have time structured so closely.

I asked, well, these days if you give kids a lot of autonomy, they're going to spend a lot of time on their screens. Screens are being blamed for a lot of the depression and anxiety. Can both things coexist? He said yes because a lot of screen time, even if it's on "social media," means teenagers are spending time by themselves, physically by themselves, interacting on screens. I wonder if you're familiar with that Boston College research and if you see any kind of contradiction with what you're putting out at the American Psychological Association asking parents to more actively monitor their kids' screen time or if you see these two things interacting.

Professor Mitch Prinstein: Sure, I think that there's no single cause for the youth mental health crisis that we're seeing right now. Social media is not the primary contributor of the youth mental health crisis. Youth's autonomy or lack thereof is also not the primary cause. What we know from substantial research over many, many years is that stress tends to be the number one predictor of these generational increases that we see.

The kinds of stressors that kids are experiencing right now, sure, some of it is on social media and some of it might have to do with changes in parenting and autonomy. We're talking about stress for unrealistic academic achievement, pressure. We're talking about stress over climate change, school shootings, unrealistic standards towards physical appearance, so many factors that are really affecting kids right now.

Social media is certainly a contributor, but it's not the smoking gun here. I think that when it comes to thinking about how kids are on social media these days, we offer a wide range of recommendations. Parents' monitoring is not the big piece here that what we want people to walk away with. What we want people to walk away with is that these platforms need to be developed for kids' developing brains in mind, right? A 12-year-old brain is in the middle of one of the most important transitions in our entire lifetimes.

We need to be sensitive to the idea that these are kids who don't yet have a full neural inhibition center, able to stop them from those artificial intelligence algorithms that keep us staring at our screens longer than we want to. We see that as adults too. For kids, they literally haven't grown that muscle yet, that area of the brain, I should say. That's where we're really trying to focus on. Our recommendations, our health advisory are really focused on what needs to happen to keep kids safe by all stakeholders.

Brian Lehrer: Joan in Brooklyn, you're on WNYC. Hi, Joan.

Joan: Hi. Hi, Brian. This is actually a question more about kids' access to the internet. My daughter's 20 now. When she was about 15, she said to me, "Mom, I've seen the dark web." I've never seen the dark web. I said, "How'd you see the dark web?" She said, "Some friends had it." I said, "What'd you see there?" She said, "I cannot tell you. It was so disturbing." She has never told me what she saw. Now, just to add to this and she did go through a tremendous amount of anxiety and cutting. We've really been through it. She's better now. She's coming through that stuff, but I have to just say that the dark web is a huge source that parents have absolutely no control over of kids' exposure to bad stuff.

Brian Lehrer: Joan, thank you for that disturbing call. Is dark web a term that you use, Professor Prinstein?

Professor Mitch Prinstein: We haven't talked about it exactly in that way in the scientific literature, but we do know that about a third of kids are exposed before their eighteens who exactly the kinds of things that the caller is referring to and that her daughter saw and called the dark web. That's really concerning because as I think that anecdotes so richly illustrated, these are things that are freaking kids out.

It's stuff that's not only very, very damaging, but it's things that kids are instructed not to tell their parents about. Should kids offer an adaptive or a healthy solution for what they see on there, they're actually sanctioned by others on those forums and told that they're going to lose their friends, they're going to get dragged online. It is indeed pretty dangerous.

Brian Lehrer: Liza in Manhattan, you're on WNYC. Hi, Liza.

Liza: Hi, how are you?

Professor Mitch Prinstein: Hello.

Liza: Hi. A lot of what I see as an issue, and I will say I was a psychotherapist for students at a university for many, many years. I saw a lot of use of the web and what you might call the dark web and the anorexia sites and cutting sites because I had to go look for them and find them because I knew people were going to them. The thing which to me though seems to be the real problem is not the web.

The web is something that people use, that young people use because that's what they're left to in their own devices. Everybody's busy. Parents are busy. People are working. Everything is happening around them. They have to figure out how to socialize themselves, which is, in fact, an issue. What is really missing is actual physical face-to-face, real live socialization. In the olden days, people would go to church. They would see people. Every weekend, they would interact.

People would go to dances in the center of town. They would see people and they would interact. When a person has that kind of interaction, in their brain, that takes over beyond anything else. It takes over what happens on machines and that sort of thing. Unless the person is really skewed in a way where they're antisocial or they're so shy, in which case, socialization will still help, but real socialization is going to have a very much more powerful effect than anything that they see on the web.

Our lives and particularly people who live in the city, our lives are not constructed really to do that. People go to school and yay, and school is a jungle, right? School can be scary and school is a lot of pressure. There's a lot of parental pressure involved, but actual social construct outside of school where people have face-to-face meetings, family interaction, which doesn't happen a lot. Everybody sits down and has dinner.

Brian Lehrer: Liza, I'm going to leave it there. You put a lot of interesting things on the table. What were you thinking as you heard that, Professor Prinstein? I guess it comes down, the heart of what she was saying, to lack of face-to-face interaction.

Professor Mitch Prinstein: We are seeing some scientific evidence that kids are experiencing difficulties now face-to-face because of so much screen time, we think. A lot of social anxiety. Kids are having a hard time with spontaneous interactions because they're out of practice. I know of one study where kids were not developing the social skills you would expect them to develop in adolescence because maybe of all the screen time. It's hard to say cause and effect, but we are seeing that link. Absolutely, we completely encourage more face-to-face or voice-to-voice interaction.

Brian Lehrer: Stacy in Cape Elizabeth, Maine, you're on WNYC. Hi, Stacy.

Stacy: Hi, how are you?

Professor Mitch Prinstein: Hello.

Stacy: Yes, hi. I moved to Maine during the pandemic, but I raised three children. In New York City, I have four kids. They range in age from 10 to 25. I feel like I've seen this entire span of screen usage and social media. Whereas with my oldest one, she just really wasn't interested. She always loved books. She works in book publishing now. My youngest one, however, is dying for her own phone. I won't give her one.

She uses mine. She texts her friends. I see the texts coming through. I see kids texting ten, eleven o'clock at night, 6:00 in the morning. They are so addicted to screens and to connection via screens. I feel like I need to be a different parent. The art supplies and the dolls and the books that used to occupy my 10-year-olds in the early 2000s just aren't doing it anymore.

I think parents just really need to set limits, say no to devices at such a young age. She's not going to have her own phone until she's 13, at least, if not older. I think it's really up to the parents to set the limits like, "No, you're not having unfettered phone use. You're not going to have accounts on social media." I know kids that have burner phones at this age and set up Snapchat. I think parents just really need to get on the ball.

Brian Lehrer: Stacy, thank you. Thank you very much for sharing your experience. Professor Prinstein, I guess her question or her story raises the question of age appropriateness. Do you lay that out at all at the American Psychological Association like when it's appropriate at all to allow kids to do what, social media-wise or screen-wise at all?

Professor Mitch Prinstein: We do, and really, parents are the experts on their kids, so they're going to know when their kids are mature enough to be able to engage. For some kids, that might be a very mature 12-year-old. For others, it might be a kid who's 16 or 17. If you go to apa.org, we've created a couple of parent tips and sheets that are conversation starters between parents and kids to allow folks to get to that. That will hopefully be a really helpful resource. I will say that one of the things we're really interested in promoting is not just the age but teaching kids social media literacy.

That way, they're prepared to consume what they're going to see online. We use the analogy of driving a car. We don't just give the keys to a kid when they turn 17 to go drive the car. We teach them competencies. We test them. We make sure that they're capable and then we let them onto the road. Similar idea, and we've talked about social media literacy on there as well. I really appreciate this caller's comment about having kids wait. Most parents are feeling pressure that they don't want their kid to be the only one that's not on, but we have no data to suggest that staying off hurts kids in any way.

Brian Lehrer: We have a number of callers who are asking some version of the question. "Wait, there are things on social media that promote self-harm?" People can't even believe that that's a thing like, "Who would go online to promote cutting or suicide or any kind of self-harm?" What is this stuff and where does it come from?

Professor Mitch Prinstein: Most parents don't realize, which is one of the reasons why we were motivated to make these recommendations. Not just cutting, but also anorexia-like behaviors, showing pictures, and inspiring people to engage in very dangerous behaviors to achieve an emaciated body shape. It's very, very concerning. Moreover, there are algorithms and machine learning that directs kids when they indicate that they have natural, normal adolescent concerns about their appearance that might direct kids to these kinds of sites. This is why we need to band together and crack down on making sure that these platforms are safe for our children.

Brian Lehrer: Again, why? Who would promote anorexia?

Professor Mitch Prinstein: There are a number of folks out there who unfortunately are suffering from pretty severe psychological distress. They found each other and created a place where they can reinforce that what they're feeling and what they're concerning and what they're doing feels okay. As a way of providing each other's support, unfortunately, because these are unmonitored and there's no trained mental health professional present, they devolve into a conversation that actually ends up promoting the worst choices rather than really encouraging folks to find a healthier choice.

Brian Lehrer: Let me get one more caller in here. Virginia in Stony Brook, you're on WNYC. Hi, Virginia.

Virginia: Hi, how are you? I'm calling. This has recently touched my life. Yesterday, my daughter is only seven and was starting to have neighbor friends who are on TikTok all the time and she's requesting it. I could see where it's starting to change her. I just finished reading the book, Hold On to Your Kids, by Dr. Gordon Neufeld and Gabor Maté about the phenomenon of our culture now where peer attachment has surpassed parent attachment. I wonder if your guest incorporates some of that phenomenology into his work.

Also, just personally, I realized that I had encouraged peer attachment with my daughter because, A, it's what I knew, my own traumas, and it's their culture. I realized that because I was peer-attached and also because I have my own connection addictions, I actually just got off social media completely and told my daughter, "I'm getting off for you. Let's spend more time together." It's keeping me from being present even with my own kids sometimes. She so appreciated that. Actually, her fascination with social media has even changed. She's not as interested in it. We're just spending more and more time together. She's not interested in being on TikTok with her friends, which is great for me.

Brian Lehrer: So happy to hear a success story among the callers. Professor Prinstein, what are you thinking as you listen to Virginia?

Professor Mitch Prinstein: Really nice points. It's perfectly natural for kids to start to gravitate more towards peers and move away from parents in adolescents. Actually, scientists have recently demonstrated that that's biologically determined. Even other mammals do it. Probably because there's a design to make us crave peer interaction and become more autonomous as we mature. That's a good thing.

The concern is whether we're navigating that peer culture in a way that allows for the development of good skills and healthy limits on peer interaction or if it's now a 24/7 problematic connection to peers through social media, which now lets you even vote on how much you like what others have to say or what they look like with numerical counts. That's taken 60,000 years of evolution and hijacked it to make a profit.

Brian Lehrer: This goes back, I think, to something you were saying earlier in the segment about how teens don't even have fully-developed brains yet. Now, you're talking about how it is part of the developing brain to want more peer contact and less parent contact. I'm curious how you think social media particularly interacts with the developing brain at a time when peer interaction is more attractive.

Professor Mitch Prinstein: The quick version is that one of the first regions to develop in our brain is an area with dopamine and oxytocin receptors. Basically, that just means that we crave social interactions with our peers. You can even see it in mice as I mentioned. There's another part of our brain that's one of the last to develop. It's like the brain's brakes. It's called the prefrontal cortex. That's our inhibition center.

Well, from about 12 until 25, you've got kids that are really motivated to do whatever they can to get positive feedback from peers, but they don't have the fully-developed brakes yet to stop them from impulsive behaviors. Now, enter social media. That's created an opportunity, almost like a rat in a box to keep on pressing the bar to get a pellet. On social media in the form of likes, a lot more than our brains are used to. There's some research that's starting to look at, "Is this overuse actually changing how the brain grows?"

We don't know yet for sure, but preliminary evidence says it looks like it may be. It's actually changing how the brain grows. As kids are using it instead of sleeping, it's changing the size of the brain. This is taking what we're biologically primed to do and putting it on steroids, right? Now, we've got kids developing their brains in a whole new artificial context. We don't even know yet what the long-term implications could be, but it's pretty worrying.

Brian Lehrer: Last question, really practical. The American Psychological Association recommends parents regularly screen their children for signs of problematic social media use. What should they look for? 30 seconds.

Professor Mitch Prinstein: If your kid can't quit even when they want to, if they're engaging in extreme activities and lying just to get more access, if it's interfering with their daily routines like their chores or looking at you in the eyes at the dinner table, those are signs of addictive or problematic social media use. You need to talk with them about it and assert some limits.

Brian Lehrer: Mitch Prinstein, chief science officer for the American Psychological Association and professor of psychology and neuroscience at the University of North Carolina at Chapel Hill. The American Psychological Association's new report on teens and social media, just out. Thank you so much for joining us.

Professor Mitch Prinstein: Thank you.

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