The Word “Mental” in Project 2025. (xii)
The twelfth (and thirteenth) instance of the word “mental” in Project 2025 is on page 876, still in the section about the Federal Trade Commission:
Other conservatives are more skeptical concerning the effect of online experience on the young, comparing the concern about social media to concern about video games, television, and bicycle safety. They point out, as does Cato fellow Jeffrey A. Singer, that the psychiatric profession has yet to designate “internet addiction” or “social media addiction” as a mental disorder in the authoritative Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). These conservatives also maintain that calling for regulation undermines conservatives’ calls for parental empowerment on education or vaccines as well as personal parenting responsibility.
Although Project 2025 already decries social media companies in at least two earlier sections in the text, here the authors equivocate: Maybe social media isn’t that harmful to young people. Or maybe it’s better if we leave the regulation of kids’ social media use to parents.
The topic here is about the internet, but they make a comparison to earlier forms of media, namely video games and television. There are, in fact, multiple studies that confirm a linkage between video games and television and violent behavior among children:
Among fifth graders, the association between physical aggression and media violence exposure is robust and persistent.
The more violent media adolescents and young adults watch, the more likely they exhibit seriously violent behavior.
Exposure to violent video games increases children’s dangerous behavior around real firearms.
Prior to the publication of DSM 5, the most recent edition of the text that lists all psychiatric diagnoses in use, some psychiatrists expressed concerns for a diagnosis that seemed like “internet addiction”:
the diagnosis is a compulsive-impulsive spectrum disorder that involves online and/or offline computer usage and consists of at least three subtypes: excessive gaming, sexual preoccupations, and e-mail/text messaging.
This came from growing concerns of youth spending a lot of time online in China and South Korea. That article was published in 2008, when social media, though common, had yet to hit its peak.
Some advocated more research into this possible condition because “it is not clear whether internet addiction usually represents a manifestation of an underlying disorder, or is truly a discrete disease“. For example, were people addicted to the internet because they actually had social phobia? Or did people actually have a gambling disorder, and gambling on the internet was easier to access?
From a paper entitled “Chaos and confusion in DSM-5 diagnosis of Internet Gaming Disorder: Issues, concerns, and recommendations for clarity in the field”:
The umbrella term “Internet addiction” has been criticized for its lack of specificity given the heterogeneity of potentially problematic behaviors that can be engaged in online as well as different underlying etiological mechanisms. This has led to the naming of specific online addictions, the most notable being Internet Gaming Disorder (IGD).
It’s true: People use the internet for a variety of reasons. Some people return to and seemingly cannot leave certain sites: Social media; porn; gambling; games. Would “internet addiction” include both an older person who spends eight hours a day checking their bank balance (because of anxiety? paranoia? dementia?) AND a young man who plays Fortnite for hours instead of sleeping?
“Internet gaming disorder” does appear as a “condition for further study” in DSM-5 (here’s a public-facing page with less detail):
The essential feature of Internet gaming disorder is a pattern of excessive and prolonged participation in Internet gaming that results in a cluster of cognitive and behavioral symptoms, including progressive loss of control over gaming, tolerance, and withdrawal symptoms, analogous to the symptoms of substance use disorders.
The diagnosis excludes social media. This suggests that there was already some question that social media overuse could be its own diagnostic entity:
Excessive use of the Internet not involving playing of online games (e.g., excessive use of social media, such as Facebook; viewing pornography online) is not considered analogous to Internet gaming disorder, and future research on other excessive uses of the Internet would need to follow similar guidelines as suggested herein. Excessive gambling online may qualify for a separate diagnosis of gambling disorder.
The only other place “social media” shows up in DSM 5 is under the proposed condition of “Nonsuicidal Self-Injury Disorder”:
The essential feature of nonsuicidal self-injury disorder is that the individual repeatedly inflicts minor-to-moderate, often painful injuries to the surface of his or her body without suicidal intent. Most commonly, the purpose is to reduce negative emotions, such as tension, anxiety, sadness, or self-reproach, or less often to resolve an interpersonal difficulty.
Additional prospective research is needed to outline the natural history of nonsuicidal self-injury disorder and the factors that promote or inhibit its course. Individuals often learn of the behavior on the recommendation or observation of another, through media outlets, and through social media.
Some literature describes the phenomena of “copycat suicides” and “suicide contagion”, which has prompted the American Foundation for Suicide Prevention to issue safe reporting guidelines for media. The goal is, in part, to help journalists reduce this contagion in their publications. It is unclear if such a contagion exists for nonsuicidal self-injury. It is indeed true that some young people learn about this destructive behavior through social media.
Do I appreciate the deference the authors of Project 2025 show here towards the profession of psychiatry and DSM-5? Not really. I find the overt deference jarring because, as we have seen, the authors of Project 2025 haven’t deferred to scientists and available data to inform other policy positions (e.g., abortion, gender-affirming care, homelessness).
As a reminder, the only reason why the subject of mental health even shows up in the FTC section is to insert parents into any contracts kids might make over the internet:
The FTC can and should institute unfair trade practices proceedings against entities that enter into contracts with children without parental consent.
But, again, the authors here seem to wobble about who is better poised to regulate the internet here: Parents? or the government?
And, like we’ve already seen in this document, the approach seems to be all or nothing. It’s either parents or the government, not both. (This sort of all-or-nothing, black-or-white thinking isn’t limited to people with conservative persuasions alone. Silence doesn’t always mean violence; defunding the police has increased problems for some of the most vulnerable populations; etc.)