Teenage problem drinking could be detected on Facebook

By Dr. Ananya Mandal, MDOct 4 2011

A new study suggests that college students’ Facebook pages might hold clues to which of them are at risk for alcohol dependence and abuse.

The study authors noted that students who had pictures or posts about getting drunk or blacking out were more likely to be at risk of drinking problems, based on a screening test. That was not necessarily the case for students who mentioned alcohol or drinking on their pages, but not in a way that showed that they drank too much or in unhealthy situations.

The authors suggested that Facebook pages could help schools find out who needs to be assessed for alcohol-related problems. However privacy and ethical concerns might make that complicated, researchers agreed.

The question is whether “what's being found on these sites... is actually predictive of clinical conditions,” said Dr. James Niels Rosenquist, a social media researcher and psychiatrist from Massachusetts General Hospital who wasn't involved in the new study. The findings suggest that messages on Facebook sites do seem to be linked to what happens in the “real world,” he noted.

Dr. Megan Moreno from the University of Wisconsin-Madison led a team of researchers from her university and the University of Washington in Seattle who surveyed the Facebook pages, including photos and posts, of 224 undergrads with publicly-available profiles.

They found that nearly two-thirds (64%) of those students had no references to alcohol or drinking on their pages. The rest of the pages mentioned or had pictures of social, non-problematic drinking or more serious and risky alcohol use, including riding in a car while drunk or getting in trouble related to drinking. Those comments included such information as, “I have been hung over for two days” or not remembering details after getting drunk.

Two hundred and sixteen of the students took the test known as AUDIT (Alcohol Use Disorders Identification Test). Their scores ranged from zero to 26. The average was 5.8. A score of 8 or higher is the cutoff for at-risk problem drinking. In all, 35.4% of the students scored in the at-risk category.

Close to six in ten of the students whose Facebook pages had references to drunkenness and other dangerous drinking scored above the cutoff showing a risk for alcohol abuse and dependence, as well as other drinking-related problems. This was comparable to 38 percent of students who had more minor references to alcohol and 23 percent of those who didn't mention alcohol or drinking at all, according to findings published in the Archives of Pediatrics and Adolescent Medicine. Also close to one in five Facebook-implicated risky drinkers said they had an alcohol-related injury in the previous year.

Moreno and her colleagues proposed that peer leaders such as residential assistants could be trained to use Facebook to see who is at risk for problem drinking, and refer those students to get screening. Or, parents and administrators could talk to a school's counselors if they were worried about alcohol-related content on a student's page. “You might have someone who, if they write in a Facebook posting about being drunk... that might be a red flag,” Rosenquist said. But, he added, with social media “you get very small snapshots into people's lives,” so perusing Facebook pages alone might not be enough to see who needs to be screened for alcohol problems. And there are other concerns as well, he said, including how appropriate it is to go scouting on students' pages for certain information.

Moreno said that a college RA already has a connection with students and is there to look out for them - and this study is showing that “there is some legitimacy in approaching students that you're worried about,” including if that worry is coming from Facebook posts. But, she added, “Paying attention to people's privacy concerns is really big.”

Moreno suggested that universities could have links to the health center or to online screening tests show up as Facebook advertisements for students who use terms such as “blacked out”" on their pages. “With the targeted messaging, there's not that (feeling) that someone you don't know is creeping on your profile,” she said.

The findings make sense to W. Keith Campbell, professor of psychology at the University of Georgia. He has researched social networking and narcissism, a self-centeredness with a need for admiration. In his research, he has found that people who display narcissism are more likely to post provocative pictures, for instance.

Likewise, he says, the new research is finding that using Facebook is “'a reasonable way to gather information about someone that is accurate.” The finding could help those concerned about someone's possible problem drinking take action, Campbell said. “If you are a parent or a friend of someone and see lots of examples of drinking [posted online], it might be a cue or a clue to go talk to the person…I would not use this [information] as a diagnostic.” However, it could offer a clue to problem drinking that seems somewhat accurate, he said.