Q&A with Dr. Coury

By Nathan Poling

Daniel L. Coury, MD, is Chief of the Section of Developmental and Behavioral Pediatrics at Nationwide Children’s Hospital and a Professor of Clinical Pediatrics and Psychiatry at The Ohio State University College of Medicine. Dr. Coury received his medical degree from the University of Tennessee Center for Health Sciences, followed by an internship and residency in pediatrics at the University of Tennessee Center for Health Sciences. He was a fellow in ambulatory pediatrics at Brown University. Activities over the past two decades include federally funded projects in the areas of drug exposed infants, training in developmental and behavioral pediatrics, pediatric residency curriculum guidelines, pediatric psychopharmacology, training professionals in dual diagnosis and the establishment of a web site for developmental and behavioral pediatrics. He also is active in conducting pediatric psychopharmacology clinical trials. Dr. Coury’s research interests include developmental and behavioral pediatrics, medical education, attention deficit hyperactivity disorder and autism. In addition to his duties as Section Chief, he is the Administrative Medical Director for Nationwide Children’s Hospital Behavioral Health Services and is Medical Director of The Autism Treatment Network of Autism Speaks.

What effect do you feel social media has on teens mentally?

The positive aspect is how it connects teens, how it makes them feel part of a group. In the 1950’s through the 1970’s, it was the phone. In the 80’s and 90’s it was instant messaging and email. Most of these were more 1:1 connecting, in other words one person was talking to one other person. Social media permits an entire group to be interacting even though very physically distant from each other in either a positive or negative way. The negative aspect is when negative statements are made in front of this group, or when several people send negative statements to an individual and bullying occurs. In the past you could hang up the phone. With email you can choose not to open that message. With social media, it can be hard to overlook such comments. Even if you personally do not read them, chances are that someone else will and tell you or make more comments about it in that comment.

Are you seeing differences between patients that have brought up social media versus those who do not and what differences, if any are you seeing?

As I mentioned before, in the past a teen knew what one or a few friends were doing. Now a teen can know what ALL their friends are doing. With smartphones and tablet devices, this information can be with the teen every moment of the day, compared to old technologies that were only accessible at certain times or in certain places. Now, some teens can feel that they don’t have a lot of privacy in their day to day lives or that there is pressure to post, like or comment the right things.

Do you find that social media can contribute to conditions such as depression and how does it impact those conditions?

Yes, it can just like the things that a person says or does in person can. When everyone else does something and don’t invite you, or even worse, when others say hurtful statements it can be very discouraging and cause depression. This can be especially difficult for patients who only have one or two close friends that are also friends with other, more popular individuals who they see having fun with their friend.

How do the things that are said to or about people on social media impact the response that people have to them as opposed to if they had been said in person?

I think the bullies feel more comfortable saying things when they don’t have to see the person who is hurt by their words or actions. They don’t know when to quit since they can’t see the victim and how they are reacting to it. Teens who would normally never say mean things to others face to face have the confidence to do it online. There are teens who jump in after one person starts the bullying who would not otherwise have started the bullying if they were face to face with the person. There is more of a snowball effect that spreads the effect ever further.

Are you treating or advising patients that experience difficulty with the things said on social media differently than those who do not feel that social media is a factor?

I spend more time with those who are already experiencing difficulty, doing damage control. For those who don’t feel this is a factor, I point out how others have been hurt and the negative consequences that have been seen.

To what extent do you feel that social media has on high profile cases, such as a suicide that makes a point to focus on a single tweet for example? Are there typically bigger issues at play?

Again, that single tweet is seen / heard by many many people. The impact is much greater than saying it one time face to face. It is the group who jump on the wagon and also start saying hurtful things, some by people who may not even know the victim, that make this such a concern. Even if the message was not directed at a single person, such as “I just wish you would go away” can be picked up by a random person who takes it to heart.

What do you think people who post mean things on social media hope to gain from doing so, is it an insecurity for them or are they just trying to gain social status?

Yes, both of those. A lot of bullying stems from insecurity and / or jealousy; by trying to place themselves in a position of power by bullying, they gain some social status. However, that position of power / leadership isn’t always seen as a positive – think of dictators, etc.

Coury, Daniel. E-mail interview. 28 Apr. 2014.