Teenage patients often ask Megan Moreno, assistant professor of pediatrics at University of Wisconsin, if they have to drink alcohol when they go to college. These patients are often not yet aware of the dangers of alcohol addiction among college students, she said.
“It’s not adult-style alcoholism, but they’re at higher risk, and they’re less experienced,” said Moreno during a phone interview Tuesday. “And it’s a behavior that’s not yet legal.”
Yet, teens see their friends refer to drinking on Facebook, and they want to know what it means. Moreno wanted to know what it meant as well, she said. (Full disclosure: Washington Post Co. Chairman and chief executive Donald E. Graham is a member of Facebook's board of directors.)
Moreno, along with researchers from the University of Wisconsin, the University of Washington, and Seattle Children’s Research Institute (SCRI), uncovered an association between alcohol references on Facebook and alcohol addiction in college students ages 18 to 20.
According to the study, published on Oct. 3, students who refer to alcohol use and drunkenness on Facebook are more likely to be at risk for problem drinking. This indicates the way Facebook and other social networking sites could possibly be used identify behavioral problems that might go otherwise unreported.
“You can’t treat a problem if you can’t diagnose it,” said Dimitri Christakis, director of the Center for Child Health, Behavior and Development at SCRI and a co-author of the study. “We’ve found a way to identify kids at risk who would not otherwise be diagnosed.”
The report stated that nearly 60 percent of students who displayed references to intoxication on Facebook were at risk for problem drinking in real life. However, only 22 percent of students who did not make alcohol-related references on Facebook met the at-risk criteria for problem drinking.
“As a general concept, we’re finding … that, for most people, what they put on Facebook is reflective of what they actually feel and what they’re actually doing,” Christakis said.
According to Christakis, researchers have often recommended that pediatricians screen adolescents for risky behaviors, including sexual activity and alcohol use. However, there has never been a consistent way to identify those patients for treatment until now.
Up to 98 percent of all adolescents use Facebook, and many of them display risky behaviors quite openly on the Web site. This study sought to determine whether these teens are actually at risk, Moreno said.
“We went into the study with curiosity about whether you could apply the similar clinical keywords and judgments to Facebook as you could to statements patients would make in our clinic rooms,” Moreno said.
Researchers screened study participants and sorted them into three categories: non-displayers, alcohol displayers and intoxication displayers. The latter two categories allowed researchers to distinguish between different clinical concerns, such as “wine night with friends” versus “I got drunk and don’t know how I got home,” Moreno said.
Participants then took the Alcohol Use Disorders Identification Test (AUDIT), a validated test used by many college health centers to predict drinking behavior. AUDIT scores range from 0 to 40; a score of 8 or higher indicates that a person is at risk for problem drinking.
According to the published report, AUDIT scores for study participants ranged from 0 to 26, with a median score of 5. Of the study’s 216 participants, 61 received AUDIT scores higher than 8. This indicated that 35.4 percent of the students were at high risk for problem drinking
“If you look at the prevalence of scoring into that problematic category, it was a very statistically significant result,” Moreno said.
Now, health-care providers are in a place to decide how to apply this research to promote adolescent health, she said.
“On the one hand, it makes so much sense; it seems obvious,” Moreno said. “But there’s still this prevalent idea that anything on the internet is not connected to the real world.”
That is not the case, she said.
“Facebook is really representative of what people are doing, and they’re placing it in a really public place,” she said.
Christakis said this study’s findings confirm his previous work regarding children, media and risky behavior. The parallels between Facebook and the real world have always been striking, he said.
The study’s results suggest that a health-care provider can use consistent clinical criteria to evaluate a patient, whether in a treatment center or on social networking sites like Facebook. This novel approach also opens the door for other adults, such as resident advisers in dorms, to identify, report, and intervene in the lives of at-risk students.
“It allows those of us that care about adolescents to look more into their world and be available when they need it,” Christakis said.
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