MySpace Medical: How to Help At-Risk Teens Online

For adults, browsing MySpace.com can be a secret window onto how teenagers sculpt their public personas. Teens, one of the most wired groups in America, use the social-networking site to create profiles where they share clips of their favorite songs, post pictures or vent about a bad day.

But MySpace, which now boasts 200 million profiles, is not all fun and games. Findings from a new pair of studies by Megan Moreno, a physician specializing in adolescent medicine, and her colleagues at Seattle Children's Hospital reveal that more than half of the 500 teen profiles they looked at during two and a half months in 2007, read more like cautionary tales, chock full of high-risk behaviors from sexual conquests to binge drinking and drug use. While the prevalence of racy MySpace pages created by teens may not be news, Moreno's studies are the first to systematically catalog the sexual and substance-abuse content of teens' profiles, and to look at the results of an online health intervention. Her results, on a small scale, support the idea that these profiles are an untapped resource for physicians and mental-health professionals. By harnessing this technology as a monitoring tool, physicians, parents and counselors may effectively tag along with teens for some of their social interactions and when appropriate, contact teens at risk.

For the purposes of the study, published Monday in the Archives of Pediatric and Adolescent Medicine, researchers staged a sort of online intervention and looked at whether it had any impact on teens. Moreno created a MySpace listing for "Dr. Meg," listed her credentials as a medical professional, and contacted 190 of the teens with risqué profiles. She selected users registered as 18- to 20-year-olds (though many of them were clearly younger), and sent them all a basic message with information about the risky nature of online personal disclosures. She also directed teens to a Web site about sexual health and information on STD testing.

Three months later the researchers found more than a dozen of these teens had eliminated all sexual references on their profiles—more than double the number of sexual reference removals from a comparison group of teens who were not contacted. A handful of the contacted subjects e-mailed Moreno and told her they hadn't known what their "public" status had truly entailed and changed their status to "private." A couple of others told her to mind her own business. Most said nothing at all. Even if the wild behavior these teens are writing about is grounded more in fantasy than reality, law-enforcement and safety advocates have long warned that advertising these behaviors puts kids at risk from online predators looking for vulnerable youths. Parents also worry that some of the allusions to drug use and more compromising photos of teens with alcohol may hamper their teens' future efforts when they apply to college or a job.

To some extent, MySpace does limit public access to profiles of minors, but Moreno says that the site's safety features, like requiring users to have profiles set to private if they register as 14-or 15-year-olds can be easily circumvented. Out of 500 teens claiming to be 18 years old, Moreno found 50 who revealed that they were younger elsewhere on their sites, and many more had pictures or comments that suggested they were underage even if it wasn't explicitly stated. Moreno's team says that the goal of their work is not to monitor the hundreds of thousands of minors on social networks but rather to explore the feasibility of targeted outreach by professionals or parents to teens at risk.

For this particular study, the kids were chosen from Washington, D.C.'s Anacostia neighborhood, one of the poorest in the nation. "We wanted to reach a group that is difficult to contact by conventional public-health methods," Moreno explains. Coauthor Dimitri Christakis, a pediatrician at Seattle Children's Hospital, attributes much of the decrease in contacted teens' sexual references to the fact that the kids were embarrassed. Teens are used to positive reinforcement from their friends for this kind of behavior and the intervention e-mail was probably a rare moderating influence, he says.

The parent of two preteens himself, Christakis advises parents to follow his example—educate themselves about the Internet and create their own profiles even if they are daunted by the technology. He says he had trouble setting up his own profile initially, but it started a great conversation with his son. Any parent can do it, he says. Parents take it upon themselves to check out who their kids are friends with in the real world, so why not online? "The digital divide between the rich and poor is virtually gone, but now there is a new gap; parents are increasingly clueless about what kids do online," he says. Even though teens might not want their parents looking at their profiles, it is a parent's responsibility to check how their teen is representing him or herself, the researchers say, especially if the profile is public.

Adria Shipp, a counselor in North Carolina's Alamance-Burlington school system, echoes those sentiments and has written about sites like MySpace as tools for mental-health professionals' toolkits. Parents should ask their kids to go over their profiles with them, or if the profile is private, even insist they become "friends" online, she says. She advises counselors and parents to talk to teens about why they accept certain people as friends online" and question if their teens know them in real life. Christakis says the time to start these conversations and for parents to educate themselves about technology like MySpace is even before their kids are interested in it. Shipp advises adults to try to sit down with their kids even while their kids create their profiles to head off any risky disclosures.

But where does your teen's privacy come in? According to Shipp, it's best if you go over the site together, but if a profile is listed as public—it is just that. Christakis agrees that although your teen may not be excited about it, you're the parent and it's your responsibility to make sure your teens are safe and representing themselves in ways they won't regret later. "Most teens don't appreciate having a curfew or rules at home, but having rules is essential to healthy development," Moreno says. Shipp says if parents are anxious about respecting their teens' privacy then they can enlist an aunt or some other adult in their teen's life to serve as a bridge for discussing the issue.

Some studies say there is a risk that teens will just clean up their profiles to be parent-rated and then create an alternative one—with the objectionable material intact. But Moreno says that her current research suggests that it's too much trouble for most teens to maintain more than one profile.

Of course, there are a number of complications and concerns that can arise when teachers or counselors contact kids online. In Forsyth, N.C., being "friends" with a student on a social-networking site is grounds for dismissal, Shipp says. The policy is geared toward blocking inappropriate contact, she explains. But "how can we help them, if we can't keep all the lines of communication open?" she asks. Software that blocks school computers' access to social-networking sites also prevents staff from checking on concerns students have about online material in other students' profiles.

Although these health professionals see real promise in the opportunities to use MySpace and similar sites to reach youths, there may be other drawbacks to bringing more adults into this largely teen sphere. Although teens may see MySpace as their space for social voyeurism and an opportunity to explore aspects of their identity, some of the actions they claim to take—like smoking marijuana or drinking underage are illegal, and actionable. Campus police at Western Carolina University have been known to give out drinking citations to students if they have seen pictures of underage students with alcohol published online. And a party invite on Facebook promising lots of alcohol led to its breakup by police in Gaston County, N.C., earlier this month, after the invitation was passed on to them by a watchful adult. Moreno likens parental involvement online to telling teens how to dress: "You want to give leeway, but you don't want your teen walking out wearing a T shirt saying I LIKE DOING DRUGS. It's important for teens to know that even if you are not looking, over 200 million people are."

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