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Abstract Studies investigating motives for social networking sites (SNS) use amongst people with eating disorder (ED) symptoms are scarce. The uses and gratifications theory states that people actively select media content to gratify their individual needs and this may help to explain why individuals with eating disorder symptoms choose to expose themselves to specific media content and how they choose to respond. Some evidence exists that readiness to change may be a factor related to SNS use patterns in this population. The aim of the present study was to investigate the potential relationship between readiness to change ED cognitions/behaviors and SNS use motives in individuals with current or past ED symptoms, employing a uses and gratifications theory perspective. Participants were recruited from ED recovery websites; 103 individuals (16–55 years old) provided complete data. As hypothesized, ED symptom severity was inversely associated with readiness to change and time spent on (specific) SNS was not associated with ED symptom severity. The results of hierarchical regression analyses further suggested that if individuals felt less capable of overcoming their dysfunctional cognitions/behaviors about their body/eating (i.e., were less ready to change), they were more likely to be motivated to use SNSs for the purpose of impressing others and reputation management. The clinical implication is that high amounts of SNS use may not necessarily be harmful for people with EDs or recovering from EDs, whereas using SNSs for the purposes of impression management could potentially be related to being less ready to recover.

BackgroundThe economic costs of mental disorders for society are huge. Internet-based interventions are often coined as cost-effective alternatives to usual care, but the evidence is mixed. ObjectiveThe aim was to review the literature on the cost-effectiveness of internet interventions for mental disorders compared with usual care and to provide an estimate of the monetary benefits of such interventions compared with usual care. MethodsA systematic review and meta-analysis of randomized controlled trials was conducted, which included participants with symptoms of mental disorders; investigated a telephone- or internet-based intervention; included a control condition in the form of treatment as usual, psychological placebo, waiting list control, or bibliotherapy; reported outcomes on both quality of life and costs; and included articles published in English. Electronic databases such as PubMed (including MEDLINE), Embase, Emcare, PsycINFO, Web of Science, and the Cochrane Library were used. Data on risk of bias, quality of the economic evaluation, quality-adjusted life years, and costs were extracted from the included studies, and the incremental net benefit was calculated and pooled. ResultsThe search yielded 6226 abstracts, and 37 studies with 14,946 participants were included. The quality of economic evaluations of the included studies was rated as moderate, and the risk of bias was high. A random-effects approach was maintained. Analyses suggested internet interventions were slightly more effective than usual care in terms of quality-adjusted life years gain (Hedges g=0.052, 95% CI 0.010-0.094; P=.02) and equally expensive (Hedges g=0.002, 95% CI −0.080 to 0.84; P=.96). The pooled incremental net benefit was US $255 (95% CI US $91 to US $419; P=.002), favoring internet interventions over usual care. The perspective of the economic evaluation and targeted mental disorder moderated the results. ConclusionsThe findings indicate that the cost-effectiveness of internet interventions for mental disorders compared with a care-as-usual approach is likely, but generalizability to new studies is poor given the substantial heterogeneity. This is the first study in the field of mental health to pool cost-effectiveness outcomes in an aggregate data meta-analysis. Trial RegistrationPROSPERO CRD42019141659; https://tinyurl.com/3cu99b34