Suffering can strike not only in expected places, such as amid South Africa’s AIDS pandemic, but also after a raucous college party or even on Facebook. Brown University Public Health Ph.D. graduate Samantha Rosenthal has dedicated her research to mitigating a diverse array of saddening situations.
Rosenthal decided that this would be her direction at a time when she was not headed that way at all. An engineering graduate of Carnegie Mellon University, she took a job at a large consumer products company, working on beauty products.
“I basically came home from work everyday feeling as though I was working very hard but I wasn’t convinced that I was improving people’s lives,” she said.
“I’m generally interested in relieving distress of whatever type,” she said. “I’m very aware that I was born into a privileged country and a privileged family and home and that many people are not. It’s therefore a responsibility.”
This calling brought her to the School of Public Health at Brown, first as a master’s degree student working on factors affecting the spread of HIV in South Africa, and then in the doctoral program, where she has studied social factors associated with depression in young adulthood (her dissertation: Social and Behavioral Risk During the Transition to Adulthood). Now that she’s completed her Ph.D., she’s continuing to work on each of these themes as a research associate. She also pays forward what she’s learned by teaching epidemiology and biostatistics at Rhode Island College and Wheaton College in Massachusetts.
The sad face of Facebook
In the first two chapters of her doctoral thesis, Rosenthal breaks new ground in studying the links between social networking and depression. Situations such as cyberbullying and the regrettable misunderstandings that come from posting the wrong picture at the wrong time are common, but their impact has barely been studied, especially in young adults who are moving from college into adulthood and often use Facebook as a cornerstone of their social lives.
“To me there was just a huge, obvious gap that needed to be addressed,” Rosenthal said.
Researchers who have tackled social media and mental health — mostly in teens — have relied on coarse measures of overall social media use, such as frequency. Rosenthal, however, accounted for tone. She convened focus groups of young adult Facebook users to learn what constitutes a consequential negative Facebook experience (NFE) and then recruited a large sample (264 people) to query about their experiences and mood.
Her research shows that young adults don’t just brush off the difficult moments in their online social lives. Instead, people who had experienced bullying, meanness, misunderstandings, or unwanted contact on Facebook were more likely to be depressed, as measured by a reliable, standardized questionnaire, than those who had no NFEs. Rosenthal asked her volunteers to recall how frequent, recent, and severe the incidents were. In all these different ways, NFEs correlated with a greater likelihood of being depressed. The significance remained after controlling for factors such as gender, race, income, social support, and prior or family depression.
Incidents were not rare. More than four in five people had at least one negative experience on Facebook, more than half had one in the last year, and 63 percent reported four or more lifetime negative experiences.
In chapter two, Rosenthal examined the data to discern who became most upset by NFEs. Women and those with current depression were more likely to take negative experiences to heart. People who had bouts of depression during adolescence — before social media became prominent — were also more affected by incidents of bullying or meanness.
These data are not just descriptions, Rosenthal said, they can be prescriptions.
“It is important to educate parents and young adults that young people with a history of adolescent depressive episodes may be more upset by NFEs,” she wrote in her dissertation. “More work should be done to understand how NFEs can be avoided and how upset from NFEs can be reduced.”
That is not to say Rosenthal’s research proves that a rough time on Facebook causes depression. Depressed people may regard their Facebook experience more negatively. What the research shows is that while the online world may seem virtual, the clinically measurable connections with mood are very real.
Drinking and depression
Equally real are the connections between the negative consequences of drinking and depression that Rosenthal examined in her dissertation’s last chapter. More than 400 first-year women at a university in New York answered monthly surveys on a wide variety of health-related issues, including their drinking habits and mood. Focusing on the subset who did not have a pre-college history of depression, Rosenthal examined whether the amount of drinking or its negative consequences could result in depression.
Contrary to other studies, the amount of drinking did not predict the development of depression, Rosenthal found. But negative outcomes, such as relationship problems, declining grades, or campus discipline significantly predicted whether the women would go on to report a depressive episode.
These findings, too, point to ways to help. Her dissertation suggests that interventions to address alcohol-related problems could reduce depression.
“It may be worthwhile to assess alcohol consequences as a screening tool for depression risk among women,” she added. “By identifying students who begin to miss class, have dropping grades, get into fights, or are cited for drinking, school administrators and health care providers can not only introduce alcohol use/misuse education but also targeted mental health care.”
Local and global
Rosenthal has begun similar work as a research associate. Part of her time is spent helping Stephen Buka, professor of epidemiology, develop statewide and community-specific profiles for underage substance use for Rhode Island. Her other project is in global health, working with Katherine Smith, professor of biology, to analyze global infectious disease outbreaks.
In 2014, Smith, Rosenthal and colleagues at Brown published a sweeping analysis that revealed which diseases were waning thanks to improvements in health care and which were rising nonetheless.
Online or offline, locally and globally, Rosenthal seeks to understand how people end up in harm’s way so that she can help them steer clear.