Online-Offline: An Exploratory Study on the Relationship between Social Media Use and Positive Mental Health during the COVID-19 Pandemic

Most studies on the use of social media address the effects associated with excessive use, focusing on the length of time spent online. The motivations for using social media and the type of apps used are not always given due importance. This study focuses on the users’ emotional connections to social media and positive mental health. It investigates social media use as a normal behaviour used as part of a routine and also for social connectedness during the COVID-19 pandemic. These constructs are measured using two scales, the Social Media Use scale and the Positive Mental Health scale. Other questions on types of social media apps used and the reasons why they are used are also asked. Data from a volunteer sample (n = 631) of Maltese adults of ages between 16 and 65+, showed that while there is no association between routine use of social media and positive mental health, there is a significant negative correlation between emotional connectedness of social media use and positive mental health. The data also showed that the negative association varies across age cohorts with younger people having less positive mental health scores. This study suggests that the link between social media use and positive mental health is more complex than just measuring time spent online and effects on mental health outcomes.


Introduction
The internet has become part of our lives. Technological devices have become objects that we cannot live without, especially during the past 20 months of the pandemic when most work and education were shifted online. Our phones are with us everywhere, they are the first thing we use when we wake up and the last thing we use before we go to sleep. We touch our phones all the time. They have become extensions of us (Peper & Harvey, 2018). The experience of meeting people face-to-face and meeting them online has been blurred and the boundary of being online and offline is not so clear all the time. Sometimes a conversation which starts face-to-face, transitions into an online continuation seamlessly. The internet and social media come with their benefits when used well. They can be very helpful in many ways. They can be used to keep in contact with relatives and friends at all times. It is used to shop online for groceries, medicines, toys, appliances, furniture or clothes. Social media are part of our lives (Nabi et al., 2013;Whiting & Williams., 2013;Kim & Kim, 2017).
This study is based on the work by Bekalu et al. (2019). In their study these researchers distinguished between using social media integrated into a routine referred to as "routine use" as opposed to using social media as a means to make new friends, maintain friendships and receive emotional feedback and support. The latter is referred to as "social integration and emotional connectedness use" for short referred to "emotional connectedness use". Their study found that while routine social media use is linked to positive mental health outcomes, emotional connectedness use is linked to negative health outcomes. The Positive Mental Health Scale (Lukat et al., 2016) will be used to investigate whether social media use, be it routine use or used for emotional connectedness, has any association with positive mental health using a Maltese sample of participants.
The literature on the connection between the use of social media and mental health is broadly divided into at least two approaches. One focuses on the problematic use of social media and associated effects that come with it. The other considers the use of social media as a normal social behaviour with its negative and positive outcomes on our mental health (Bekalu et al., 2019). This study falls within the second approach.
The literature on problematic use is about how social media can sometimes be used in a bad way. Cyberbullying and creating fake news are two ways how such media can be used to harm people. When used positively, social media enables individuals to draw on information and other resources such as social support from other members of the network or group (Viswanathan et al., 2018). Social media can be used for a variety of reasons including online shopping, entertainment, education, work and maintaining interpersonal relationships (Ifinedo, 2016). Social networking allows users to communicate with thousands of people all over the world (Williams et al., 2012). This has been made easier through new technologies such as smartphones.
The smartphone has revolutionized the use of social media. A study by Winneck in 2016 showed that smartphones became so much a part of us that people touch their phones at least around 2617 times a day. When this study was later repeated in 2018, it was found that many people never stop touching their phones even when they are off (Schaposnik & Unwin, 2018). Smartphones have become extensions of our bodies (Peper & Harvey, 2018). They are with us whether we are online or offline, whether we are awake or asleep.
Social norms are strong determinants of human behaviour. This is true even in the online world (Masur et al., 2021). Many people are susceptible to social influence online just as they are influenced in their offline social world (Chung & Rimal, 2016, Dogruel & Schnauber-Stockmann, 2021. Social media are strong normative mechanism which can influence people positively or negatively in many ways (Rimal & Lapinski, 2015).

Uses and Gratifications Theory
Uses and Gratifications Theory, proposed by Blumler & McQuail in 1969 ex-plained that viewers and listeners made their own choices as to which media they chose to use, depending on which needs they needed gratified. This theory proposed that "the audience member makes a conscious and motivated choice among channels and content on offer" (McQuail, 1994: p. 318). The theory has been applied to the new media including social networking sites such as Facebook, YouTube, and TikTok. Sociological, psychological and environmental factors influence the type of media people choose to use. This applies to the new media as well (McQuail, 2005, Ruggiero, 2000. Several studies have been carried out on the uses and gratifications afforded by the new media (Dunne et al., 2010;Arnett, 2014). Whiting and Williams (2013)  Social Media Use and Wellbeing Different forms of social media have been associated positively with indices of psychological wellbeing, such as life satisfaction and self-esteem (Ellison et al., 2007;Nabi et al., 2013). Ellison et al., (2007) found that within a group, the members are able to stay in contact with one another even after disconnecting from one another physically. Interacting online is a continuation of meeting face-to-face. The online-offline boundary is not rigid. This is possible through online network tools. By the group staying in contact virtually after disconnecting physically they are benefiting from support from friends and a form of social capital (Ellison et al., 2007).
Several studies have found positive associations between social media use and positive mental health. Kim and Kim (2017) found that social media can have a positive association with the communication network of university students which, in succession, is also related positively to subjective wellbeing and social capital. Ostic et al., 2021 confirm that the overall impact of social media on wellbeing is positive, particularly because of the role of bonding and bridging social capital.
Although there are various studies supporting the evidence that social media and well-being are positively associated, there are several other studies that show the opposite. Findings from longitudinal studies (Coyne et al., 2020;Beeres et al., 2021) did not confirm associations between increased social media use and an increase in mental health issues in adolescents, disputing several findings that highlight this association. It seems that the relationship between mental health and social media can be complex. When social media is used well it can increase the positive mental health of users. When used excessively, on the other hand, it can create problems and therefore it affects the wellbeing of users negatively. One such study by Islam et al. (2020), discusses social media fatigue during COVID-19. Bailenson (2021) found similar results.

Positive Mental Health
Mental health is characterised by emotional wellbeing, freedom from anxiety and the ability to cope with the ordinary demands and stresses of life (APA, 2020). Over the past two decades, a greater emphasis has been placed on recognizing health and determining what makes people happy. Dolan et al., (2008) found that happiness and life satisfaction were the most popular indicators of personal health across nineteen vast datasets they examined. Studies and reports are broadening the concept of wellbeing. Subjective positive mental health, according to Diener (2006), is an umbrella term for people's various valuations of their lives, events that happen to them, the state of their minds and bodies and the conditions in which one is living. Bekalu et al. (2019) argued that irrespective of frequency and duration of media use, there could be an association between the reasons why persons use social media, and mental health depending on the motivations and gratifications. These two other variables have not been given due importance and there is insufficient research on how variables related to social media use may have an association with mental health. The aim of this research was to find out more about this association.
The main research question was "Is there an association between motivation for social media use and positive mental health"? Other questions investigated were: 1) Which are the most commonly used social media apps? 2) Why do participants use social media apps? 3) Is there an association between social media use and positive mental health?

Questionnaire Design
The Respondents were given a list of most commonly used apps and they had to choose the five apps they used most often and give reasons for why they use these apps.
A pilot study was conducted and feedback incorporated. Permission to carry out the survey was given by the Faculty Research Ethics Committee (FREC) of the University of Malta.

Recruitment of Participants
The questionnaire was shared on social media platforms to obtain data from participants with a wide age range and a diverse educational background. The questionnaire link was posted on the researchers' Facebook profiles. Respondents were encouraged to share the link on their own social media so that there was a snowball effect (Naderifar et al., 2017). The questionnaire was online between the 10 th of April 2021 and the 10 th of May 2021. A total of 631 participants answered the questionnaire. Table 1 describes the participants in terms of age, gender and education. This is a non-random sample and is not representative of the population. The sample is under represented in the 26 -35 age bracket and over represented in participants having a higher and tertiary education. Since this questionnaire was put on social media, the sample collected was a volunteer sample and therefore cannot be generalized to the population. It is also over represented in females. Studies repeatedly find that women use social media more than men (e.g. Krasnova et al., 2017;Anderson & Jiang, 2018). It could be that more women came across the questionnaire which was shared through social media platforms.

Use of Social Media Apps
Respondents were asked why they use social media apps and to mention the five social apps which they used most often. Table 2 gives, for each app, the number of participants who indicated that they were frequent users of the app. These numbers are broken down by gender and age group. The five most popular apps amongst the participants of this study were Facebook, Messenger, WhatsApp, YouTube and Instagram.

Reasons Why Participants Use Social Media
Participants were asked to give three reasons why they use social media apps. Responses were analysed using thematic analysis (Braun & Clark, 2006). The responses were read several times and given a code. Responses with similar codes were grouped into themes. These themes were then grouped into two categories basing this categorization on the work by Bekalu et al. (2019), "Routine Use" and "Emotional Connectedness". Table 3 gives the nine themes which emerged and the codes related to them. It also gives examples of quotes given by participants.
The themes emerging from this analysis replicate the findings of various researchers (e.g. Whiting & Williams, 2013;Sundar & Limperos, 2013) who used Uses and Gratifications Theory to analyse the motivations people have for using social media. Bekalu et al. (2019) found that "while routine use was found to be associated with positive health outcomes, emotional connection was associated with negative health outcomes" (p 795). Following Bekalu et al. (2019), three scores were computed from the data gathered. In this study the variables were called Emo-tionalConnectednessUse, RoutineUse, and PositiveMentalHealth, respectively.

Routine Use and Emotional Connectedness Use
The score for EmotionalConnectednessUse was calculated as the average of the responses from question 4 -9 of the questionnaire, while RoutineUse was computed as the average of the responses to questions 10 to 13. Question 11 was reverse coded. PositiveMentalHealth was computed as the average of the  "I use social app to buy groceries" "I am partially deaf. It helps me communicate" "I follow mass and prayer when church are closed" "To communicate with friends/family-find it useful e.g. I am studying for an exam and need some quick help/ask mum if food is done" "Get information on shopping offers etc" responses to questions 14 to 22 of the questionnaire. High values on these scales indicated higher emotional use and routine use of social media, and higher positive mental health.

Reliability and Validity
The validity of these scales has been tested extensively (Bekalu et al., 2019). These scales were also tested for their reliability on this sample. Cronbach's alpha was calculated for the RoutineUse subscale (alpha = 0.74), EmotionalCon-nectednessUse subscale (alpha = 0.82), and PositiveMentalHealth scale (alpha = 0.93). It is generally regarded that a Cronbach's alpha of 0.70 and above is acceptable, a value of 0.80 and above is good and a value of 0.90 and above is excellent (George & Mallery, 2002). In view of this the scales of reliability and validity used in the study are acceptable.

Test for normality
The scales were tested for normality. None of the three passed the test. The Shapiro-Wilks statistic had a significance of less than 0.0005 for all three scales, indicating that a normal distribution fit is very unlikely. It was therefore decided to use non-parametric tests where possible in all analysis involving these three scales.

Correlations between the scores
The two sub-scales, RoutineUse and EmotionalConnectednessUse were tested for correlations with Positive Mental Health using Spearman Correlation Coefficient. There was no significant correlation between RoutineUse and Positive-MentalHealth (r s = −0.05, p = 0.20) but there was a significant negative correlation between EmotionalConnectednessUse and PositiveMentalHealth (r s = −0.19, p < 0.0005). The negative correlation between emotional connection and positive mental health was also found in the study by Bekalu et al. (2019) however the positive association between routine use and positive mental health which they found in their study was not replicated here. Figure 1 shows a scatterplot of EmotionalConnectednessUse and Positive-MentalHealth with regression lines for the four age groups.
The figure shows that for the whole sample, there is a significant negative correlation between the scores on PositiveMentalHealth and EmotionalConnec-tednessUse, however the negative correlation is not uniform across the age groups with that for the 16 -25 group being the steepest.

Discussion
In this study, the three most popular apps used by the younger participants (16 -25 years) are Instagram, Messenger and Spotify (Table 2). Possibly the reason for this could be that Instagram gives the possibility to young people to capture every moment they choose to share with their friends without having to type a message. A picture is worth a thousand words and young people avoid writing a thousand words and instead post pictures to reach out to their friends and to feel connected to them. Even when sending messages on WhatsApp and Messenger, they use emojis and acronyms to type messages quickly. They use these social media apps to be constantly in touch with their friends. This is in line with the Social Enhancement Hypothesis which says that users make use of social networking sites to foster existing relationships and to find additional social interactions (Durbano & Marchesi, 2016). Being online and offline becomes an unconscious transition giving young people the feeling that they are constantly with their friends.
The answers to the question "why do you use social media apps?" were many and varied. They have been classified into various themes like "to look up information", "for work", "for educational purposes", "to express opinions on various issues" and "to relax" (Table 3). Many responses were about reaching out to family, chatting, and feeling connected. These support studies using Uses and Gratifications Theory which identified new uses and needs gratified by social media (Dunne et al., 2010;Sundar & Limperos, 2013;Whiting & Williams, 2013). According to these studies social media helped them live a better life and increased their overall wellbeing. Similar answers were given to the open ended question in this study. Social media were important to participants to keep in touch with their friends, more so during the pandemic. Social media gave them the possibility to chat with their friends, to study and to send messages. They could not imagine going through the pandemic and lock down without social media. It helped them survive and remain in touch with their friends and with was going on around them. One participant mentioned that it was her lifeline when she was studying abroad and away from friends and family. Another participant had a boyfriend who lived abroad and she could only communicate with him through social media because she could not travel. The responses to the question of why they used social media were positive uses which enhanced one's mental health. They helped participants relax, shop, listen to music they like, look up information about their hobbies and reach out to friends and family. Some participants mentioned wasting time and none mentioned negative uses. This could possibly be a response bias to appear in good light.
There is however a negative side to using social media for emotional connectedness. Young people, and possibly older ones, try to build friendships online however those who are marginalized or ignored or who are not so popular with their friends, could feel even more lonely. This could explain the negative correlation between emotional connectedness use of social media and positive mental health (Figure 1). If young people give social media extraordinary importance in their life and if face-to-face communication is replaced by online interaction than there is the risk of feeling anxious and depressed when they feel ignored. When these interactions are not forthcoming or are totally absent, there are negative mental health repercussions. Several studies have shown that social me-dia use is related to stress, anxiety and depression (Krasnova et al., 2013;Shakya & Christakis, 2017). In this study, the correlation between social media use for emotional connection and positive mental health in the younger cohort is more negative than for the other age groups (Figure 1). This implies that the younger age group, those between 16 and 24 could possibly be impacted more negatively by the use of social media than other cohorts. Possibly older age groups do not have the same needs for emotional connection as young people and the correlation between social media use for emotional connection and mental health is less negative.
Facebook seems to be more popular with older adults. WhatsApp and Messenger are also used by participants in the 46+ years cohort (Table 2). Participants mentioned that they use them to communicate with work colleagues as well as clients. They find it convenient and useful. Some participants said they use Pinterest, Facebook and YouTube to look up short video clips to learn how to do something related to a hobby or a pastime. Similar results were found by studies such as Krasnova et al., (2017). Finding recipes was mentioned often by older participants as was information related to gardening. Crochet, lacemaking, knitting, and looking up "how to videos" were mentioned by participants indicating that social media helped them keep themselves relaxed, entertained and happy.
Results from this study show that women are more avid users of social media than men (Table 1). Various studies have found that women use social media more than men. This gender difference has been found in other studies (e.g. Krasnova et al., 2017 andAnderson &Jiang, 2018). It seems that women use social networking sites more to explicitly foster social connections. Males seem to use social media more for looking for new relationships as opposed to maintaining relationships and to gain information of a general nature (Krasnova et al. 2017). Male participants mentioned using social media both for work as well as to relax. They also used Twitter and YouTube more frequently than other apps. This is in line with the studies by Anderson & Jiang (2018).

Routine Use of Social Media and Positive Mental Health
One key finding in this research was that no relationship was found between routine use of social media and positive mental health. The positive correlation found by Bekalu et al. (2019) is expected since routine use includes the use of social media apps such as Tik Tok, and Spotify for relaxation and entertainment.
Many participants said that they use these apps to while away the time, to relax, to chill and to listen to their favourite music. This type of media use, considered as routine use, should help foster positive mental health. Participants however also used social media for work, for school and education. The data for this research project was collected during the period when the pandemic had forced students to follow lectures online and when many workers had to work from home. This resulted in many people experiencing an increased workload and feeling more tired at the end of each day. The pandemic meant that there people were working online for long hours experiencing "zoom fatigue" (Bailenson, 2021). This could be a reason why the positive correlation found by Bekalu et al. (2019) between routine use and mental health was not found in this study.
Whereas under normal circumstances, social media were used to keep oneself entertained, during the pandemic social media were also used for long periods of time for work and education. Thus the results were confounded by many variables which were particular to the Covid-19 situation.

Emotional Connectedness Use of Social Media and Positive Mental Health
Following the arguments made above it might be expected that emotional and connectedness use of social media would have a positive correlation with positive mental health, but in fact, a negative correlation was found, as was also found by Bekalu et al. (2019). This seems to be counter intuitive. The fact that the respondents were a volunteer sample, and therefore not representative of the population must be taken into consideration. For this reason, the results of the tests carried out have to be interpreted with caution and certainly cannot be generalised to the general population. Moreover, since the measures used were collected through self-report scales there could be inaccuracies resulting from false perceptions or other biases inherent to such scales.

Concluding Note
Literature on the links between social media use and positive mental health is inconclusive. This study has contributed preliminary data that distinguishes between routine use of social media and emotional connectedness use, thus building on the work by Bekalu et al., (2019). By using a scale which captures two dimensions of media use, this study seems to be indicating that in the case of young people, using social media for social connectedness and maintaining relationships may have negative mental health outcomes. Since the data was collected during the pandemic, and since this was a volunteer sample, the results had to be interpreted with caution. However the fact that this result was also found by Bekalu et al., (2019) is of interest.