The Impact of YouTube on Loneliness and Mental Health

Round 1

Reviewer 1 Report

This is a review work on the relationships between YouTube use and mental health. The authors have done a thorough job to review the studies on this topic in the year range of 2005-2023. I think this work is important and useful for future researchers who want to study the impact of YouTube (or other related platforms) on mental health and therefore I recommend its publication. 

I take the perspective as a reader, and provide some comments for the authors for further amendments.

1. Page 15, line 279: what are affordances approaches and elements-based approaches? Actually this particular paragraph reads a bit obscure to me.

2. Page 17, line 373: What are active and passive social media use? 

Author Response

Thank you for your support for our paper including some useful comments which we integrated into the revised version.

Point 1: Page 15, line 279: what are affordances approaches and elements-based approaches? Actually this particular paragraph reads a bit obscure to me.

Response 1: This was earlier explained in Section 2.1. We looked more closely at page 15 as suggested although decided to remove this part due to repetition. Please see our revisions marked up in red. We instead  used examples from Table 2 to cluster some findings in terms of the positive and negative impact of YouTube use. Overview of studies on the use of YouTube and mental health issues. "For example, YouTube may be positively useful for information seeking/sharing and mental health support [57-58,77,82]. However, there are indications that different types of YouTube use may be associated with negative mental health symptoms [31,39,73,80] although it is unclear how self-management counters this". This paragraph was edited to also highlight the problem/solution of the Review i.e., An automated detection and moderation AI system is needed for detecting and moderating detrimental YouTube content.

Point 2. Page 17, line 373: What are active and passive social media use? 

Response 2: Marked up in red: "ASMU focuses on one-on-one exchanges between users in posts or private messaging whereas PSMU involves monitoring of others’ online presence through scrolling or looking at profiles, essentially not engaging with other users [94]". 

Reviewer 2 Report

The question raised has interest, it could be relevant for those working in clinical practice or research related to mental health. The references are exhaustive and the authors carefully show the results achieved in the reviewed articles, warning that the topic is controversial and there are no unique responses to the use of YouTube and its effects on audiences. The main problem with the article is that the structure is not clear. The information is confusing for the reader. Attached is a document in which bookmarks have been added to see the structure clearly, which is complicated and unclear. For example, the distinction between Introduction and background is not clear. When read in depth, many ideas could be clustered so that they are not repeated. The methods section could be expanded. The summary is a collection of data, a list. It is not justified to include two summaries (points 5 and 6). The conclusions help to understand the results.

In the paper that I uploaded some ideas appear marked in yellow that helped me to understand the information, they have no other meaning.

The article should be rewritten and re-edited.

Comments for author File: Comments.pdf

Author Response

Thanks for your interest and concerns about the structure as well as methods and presentation in general.

Point 1: The main problem with the article is that the structure is not clear. The information is confusing for the reader. Attached is a document in which bookmarks have been added to see the structure clearly, which is complicated and unclear. For example, the distinction between Introduction and background is not clear. When read in depth, many ideas could be clustered so that they are not repeated.

Response 1: About the Structure being unclear, Section 2 was changed from “Background” to “Overview of existing work”.  In Section 1.3, we included a revision to explain the “Overview of existing work” is included “to help provide context to the research issues underlining the rationale for the study”.  Please note that these issues are not the goals of the study. The aim and rationale were revised and unnecessary parts in terms of the intent or “goals” were removed to improve the clarity. The flow of the paper has been improved and repetition was removed (see marked up in red version for deletions). The results in Section 4 detail the outcomes of theoretical and empirical literature on “loneliness and mental health issues from the use of YouTube”. The results for findings on “Human-computer interaction in the use of YouTube” is presented in section 5.  A section with existing work to-date on human-computer interaction was added (2.4). Efforts were made to improve readability and clarity – we considered the ideas that could be clustered although the heterogeneity of the topic meant this was always possible. For example, we greatly improved the first paragraph of Section 5. We also clustered together some findings in terms of the positive and negative impact of YouTube.

Point 2: The methods section could be expanded. The summary is a collection of data, a list. It is not justified to include two summaries (points 5 and 6). The conclusions help to understand the results.

Response 2: We expanded the Methods section to explain the 5-step integrative literature review method in more detail. However, a small part was removed due to repetition (see marked up in red deletion). To save confusion about summaries in Sections 5 and 6 (if this is what is meant by points 5 and 6), the word “summary” was deleted in Section 5 which focuses on “HCI issues”. The findings on loneliness/mental health were different from HCI therefore we presented these sections separately. We revised Section 1.3 to introduce the HCI part of the Review. Table 2 is a “list” of results because there were comprehensive findings on loneliness/mental health issues. However, Section 5 does not need a “list” or Table because it is reviewed only several and has been clarified as being a secondary investigation of the paper. We moved most of HCI material to Section 6.3 as it was more relevant to future research. Better findings/conclusions based on positive/negative mental health impact findings were included.

Point 3: The article should be rewritten and re-edited.

Response 3: There is a significant rewriting effort in the revised version. Thank you for pointing out where some improvements could be generally made. We carefully considered the need for Section 2 and although it may lengthen the paper by including it, we believe this is necessary because of the lack of previous synthesis and complications of the topic. Rather than add to these complications we believe that the paper has carefully dissected the issues to understand what the problem is and demonstrated the findings of the review to highlight the potential of the recommended solution. We have taken extra effort to emphasize the problem of establishing evidence in the digital mental health domain in combination with eminent digital mental health platforms/interventions. Although we covered some different topics around the potential YouTube recommending algorithms, we have provided the necessary synthesis of information to provide Informatics professionals with justification to design and develop a protocol for mental health intervention/promotion applied on YouTube. We have established a novel idea for a complex genre so we needed a depth of details to show why it is necessary, what involves and how it could be designed/developed.

Round 2

Reviewer 2 Report

I appreciate your efforts for improving the paper. Any problem from my part to be published. Congratulations