Engagement with Algorithm-curated Short-form Video Content and Its Association with Non-suicidal Self-harm and Personality Traits

Summary

This cross-sectional study among Saudi adolescents and young adults found high rates of self-harm, anxious traits, and probable borderline personality traits disorder indicators, with significant associations observed for algorithm-curated short-form video use and psychological distress.

Abstract

The rapid expansion of algorithm-curated short-form video (ACSFV) platforms has raised concerns about their potential association with youth mental health, particularly through personalized content streams that may amplify psychological vulnerabilities and exposure to harmful material. This study examined the relationship between ACSFV use and self-harm behaviors, probable borderline personality disorder (BPD) traits indicators, and anxious personality traits among Saudi adolescents and young adults. It also examined associations with depression, anxiety, stress, and sociodemographic factors. A cross-sectional study was conducted among Saudi individuals aged 12–30 years, utilizing self-reported data on social media use. The Taylor Manifest Anxiety Scale-50 (TMAS-50) was used to assess anxious personality traits, and the Self-Harm Inventory (SHI) was used to screen for BPD traits indicators and evaluate the lifetime history of self-harm. The questionnaire also included the Depression, Anxiety, and Stress Scale-21 (DASS-21). Among the 566 participants (74% female, 51.8% aged 19–25 years), daily engagement with ACSFV content was frequent, with 22.5% using it for 3–4 h and 15.3% for more than 4 h per day. The most frequently used platforms were TikTok (84.2%), Snapchat (80.0%), and Instagram (70.0%). Self-harm behaviors (37.5%), BPD indicators (9.5%), and severe / very severe anxious traits (31.0%) were prevalent. Self-harm correlated with age category 15–25 years, depression, and stress. Anxious traits were associated with extensive engagement with ACSFV content in unadjusted analysis, while Facebook use and higher depression and anxiety scores remained significant in adjusted analysis. BPD indicators were independently associated with psychiatric consultations and stress levels. This study highlights high rates of self-harm, anxious traits, and BPD indicators among Saudi adolescents and young adults, emphasizing the complex associations between social media use and psychological distress and the need for culturally tailored interventions, school-based programs, and further research.

Introduction

Self-harm represents a significant public health concern among adolescents and young adults, with substantial variability across populations and settings. In community-based samples, the lifetime prevalence of self-harm behaviors has been estimated at approximately 15–20%, while higher rates are consistently reported in clinical populations, particularly among individuals with mood disorders, anxiety disorders, and personality pathology^1,2. Non-suicidal self-harm is especially prevalent during adolescence, a developmental period characterized by heightened emotional reactivity and vulnerability to psycho....

Protocol

Design and population

This cross-sectional study targeted Saudi children, adolescents, and young adults aged 10 to 30 years. Data collection was carried out between 01 April 2023 and 31 January 2024. With a population exceeding 33 million in 2023, an annual growth rate of 3.38%, and a median age of 26.6 years²⁶, Saudi Arabia is characterized by a significant youth population. The study was approved by the Taif University Institutional Review Board (Ref. No. HAO-02-T105) and conducted in full compliance with the ethical principles outlined in the Declaration of Helsinki, local institutional guidelines, ....

Results

Participants’ characteristics and levels of social media use
Among 601 individuals approached, 566 (94.2%) consented to participate in the study, while 35 (5.8%) declined. Most participants were female (74.0%), aged 19–25 years (52.1%), and held a Bachelor's degree (60.6%). Regarding psychiatric history, 19.3% had consulted a psychiatrist, 12.5% received psychotherapy, 12.4% were on psychiatric medication, and 9.2% had sought psychiatric care from a family doctor (Table 1).

Discussion

This study examined the associations between engagement with ACSFV content and self-harm behaviors, anxious traits, and borderline personality features among adolescents and young adults in Saudi Arabia. A high prevalence of self-harm behaviors was observed, and these behaviors were strongly associated with measures of psychological distress, particularly depression and stress. While higher levels of ACSFV engagement were associated with self-harm and anxious traits in unadjusted analyses, these relationships were attenu.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Questionnaire / Scale	Structured sociodemographic and psychiatric history questionnaire	Study investigators	Custom-designed
Questionnaire / Scale	Taylor Manifest Anxiety Scale-50 (TMAS-50)	Taylor JA	50-item version
Questionnaire / Scale	Self-Harm Inventory-22 (SHI-22)	Sansone et al.	22-item version
Questionnaire / Scale	Depression, Anxiety, and Stress Scale-21 (DASS-21)	Lovibond & Lovibond	21-item version
Data Collection Tool	Online self-administered questionnaire platform: SurveyMonkey	Not specified	Momentive
Recruitment Material	Barcode / QR code link	Study investigators	Not applicable
Equipment	Computers / mobile electronic devices	Not specified	Not specified
Statistical Software	SPSS for Windows	IBM Corp.	Version 21
Statistical Method	Cronbach’s alpha analysis	Implemented in SPSS	Version 21