Cassey Muir

Background: Adolescents' experiences of social media are increasingly shaped by algorithmic recommendation systems that structure repeated exposure to diverse content types. However, research has focused predominantly on screen time, with limited attention to the diverse types of content encountered within curated feeds or how these experiences intersect with developmental processes such as identity formation, social evaluation, and emotional regulation. Methods: Semi‐structured photo‐elicitation interviews were conducted in 2025 with 27 adolescents aged 14–19 years in the United Kingdom (mean age = 17.15 years, SD = 1.49; 70% self‐described female). Participants shared screenshots from their TikTok For You or Instagram Explore pages to support discussion of algorithmically recommended content. Data were analysed using reflexive thematic analysis. Results: Seven content types were identified: entertainment, consumerism, identity‐related, mental health, news and activism, body image, and AI‐generated content. All were experienced as double‐edged, with perceived benefits and risks shaped by repeated algorithmic exposure, developmental stage, emotional state, and individual context. Participants frequently reflected retrospectively on earlier social media experiences, identifying younger adolescence as a period of particular vulnerability. Perceived impacts were closely connected to developmental processes including identity formation, social evaluation, and emotional regulation, with younger adolescents perceived as less equipped to critically evaluate content or manage algorithmic exposure. Conclusions: Adolescents' wellbeing in relation to social media appears shaped by the types of content repeatedly encountered and the developmental context in which exposure occurs. Research, education, and platform design should address the quality, recurrence, and emotional consequences of algorithmically curated content exposure across adolescence.

Background: Research on social media and adolescent mental health has often focused on screen time or discrete harmful content, with less attention to how algorithmic recommendation shapes cumulative exposure in everyday use. We aimed to develop a grounded theory of how adolescents experience algorithmically curated feeds and how these experiences relate to mental health and wellbeing.Methods: We conducted semi-structured, photo-elicitation interviews with 27 UK young people aged 14-19 years. Participants shared screenshots from their TikTok ‘For You’ and Instagram ‘Explore’ pages to support discussion of algorithmically recommended content. Data were analysed using constructivist grounded theory, with iterative coding, memo-writing, and theoretical sampling.Findings: We identify algorithmically structured exposure as a central mechanism through which engagement-driven recommendation systems shape young people’s digital mental health. Algorithms organised what content participants encountered, how frequently, and with what emotional intensity, within broader socioecological contexts. Three interlocking processes sustained exposure; algorithmic reinforcement of engagement, emotional feedback loops between mood and recommendations, and a persistent sense of limited control despite high awareness. Although participants developed adaptive strategies and algorithmic literacy, these were unevenly distributed and often insufficient within engagement-driven, profit-oriented systems.Interpretation: Digital mental health is produced through interactions between individual capacities, social environments, and commercially driven platform design. Protecting population mental health therefore requires multi-level action, including developmentally appropriate social media and algorithmic literacy education alongside structural reforms to recommendation systems, transparency, and platform governance.

Background: Clustering and co-occurring of family adversities, including mental health problems, substance use, domestic violence and abuse, as well as poverty can increase health and behavioural risks for children, which persist throughout the life course. Yet, interventions that acknowledge and account for the complex interactive nature of such risks are limited. This study aimed to develop intervention principles based on reflections from mothers, fathers, and young people who experience multiple and interacting adversities. These principles will show how family members perceive an intervention may bring about positive change and highlight key insights into design and delivery. Methods: A series of six co-design workshops with mothers, fathers, and young people who experienced multiple and interacting adversities (n = 41) were iteratively conducted across two regions in England (London and North-East) by four researchers. Workshop content and co-design activities were informed by advisory groups. Data from facilitator notes and activities were analysed thematically, resulting in a set of intervention principles. Results: The intervention principles highlighted that: (1) to reduce isolation and loneliness parents and young people wanted to be connected to services, resources, and peer support networks within their local community, particularly by a knowledgeable and friendly community worker; (2) to address feelings of being misunderstood, parents and young people wanted the development of specialised trauma informed training for practitioners and to have the space to build trusting, gradual, and non-stigmatising relationships with practitioners; and (3) to address the needs and strengths of individual family members, mothers, fathers, and young people wanted separate, tailored, and confidential support. Conclusions: The current study has important implications for practice in supporting families that experience multiple and interacting adversities. The intervention principles from this study share common characteristics with other intervention models currently on offer in the United Kingdom, including social prescribing, but go beyond these to holistically consider the whole families’ needs, environments, and circumstances. There should be particular focus on the child’s as well as the mothers’ and fathers’ needs, independently of the family unit. Further refinement and piloting of the developing intervention are needed.

Emotional support from family members may have an important effect on adolescent health outcomes, and has been identified as a target for policy to protect against the impacts of poverty and other early life adversities. However, few studies have assessed the extent to which poverty and adversity themselves influence the nature of emotional support that parents can provide to adolescents. We, therefore, aimed to investigate the impact of trajectories of income poverty and family adversities, including parental mental ill health, alcohol misuse and domestic violence across childhood developmental stages on young people’s relationships with their families and perceived emotional support received. We analysed longitudinal data on 10,976 children from the nationally representative UK Millennium Cohort study. Exposure trajectories of poverty and family adversities were characterised using group-based multi-trajectory models (age 9 months–14 years). The outcomes were perceived emotional support and quality of family relationships, measured by the three-item Short Social Provisions Scale (SPS-3) and levels of parent–adolescent closeness and conflict, measured at age 14. ORs and 95% CIs were estimated using multivariable logistic regression models, adjusting for potential confounding factors. At age 14, the overall prevalence of low perceived emotional support was 13% (95% CI: 12, 14). Children of mothers with lower socioeconomic status (SES) were more likely to report low emotional support, with a clear social gradient (education—degree plus: 10.3% vs. no qualifications: 15.4%). Compared with children exposed to low levels of poverty and adversity, children in the persistent adversity trajectory groups experienced higher odds of low emotional support and low-quality parent–adolescent relationship; those exposed to both persistent poverty and poor parental mental health were particularly at increased risk of experiencing poor family relationships and low perceived emotional support (adjusted odds ratio 2·2; 95% CI 1·7–2·9). Low perceived emotional support and poor family relationships in adolescence are more prevalent among socially disadvantaged children and adolescents and those experiencing social adversity. Policies to improve levels of family support for UK adolescents should focus on improving modifiable determinants such as child poverty and family mental health.

Background Clustering and co-occurring of family adversities, including mental health problems, substance use, domestic violence and abuse, as well as poverty can increase health and behavioural risks for children, which persist throughout the life course. Yet, interventions that acknowledge and account for the complex interactive nature of such risks are limited. This study aimed to develop intervention principles through exploring insights into the ways in which mothers, fathers, and young people who experience multiple and interacting adversities perceived an intervention may bring about positive change. Methods A series of six co-production workshops with mothers, fathers, and young people who experienced multiple and interacting adversities (n = 41) were iteratively conducted across two regions in England (London and North-East) by four researchers. Workshop content and co-production activities were informed by advisory groups. Data from facilitator notes and activities were analysed thematically, resulting in a set of intervention principles. Results The intervention principles highlighted that: (1) to reduce isolation and loneliness parents and young people wanted to be connected to services, resources, and peer support networks within their local community, particularly by a knowledgeable and friendly community worker; (2) to address feelings of being misunderstood, parents and young people wanted the development of specialised trauma informed training for practitioners and to have the space to build trusting, gradual, and non-stigmatising relationships with practitioners; and (3) to address the needs and strengths of individual family members, mothers, fathers, and young people wanted separate, tailored, and confidential support. Conclusions The current study has important implications for practice in supporting families that experience multiple and interacting adversities. The intervention principles from this study share common characteristics with other intervention models currently on offer in the United Kingdom, including social prescribing, but go beyond these to holistically consider the whole families’ needs, environments, and circumstances. There should be particular focus on the child’s as well as the mothers' and fathers' needs, independently of the family unit. Further refinement and piloting of the developing intervention are needed.

Introduction: Children exposed to parental intimate partner violence and abuse, mental illness, and substance use experience a range of problems which may persist into adulthood. These risks often co-occur and interact with structural factors such as poverty. Despite increasing evidence, it remains unclear how best to improve outcomes for children and families experiencing these adversities and address the complex issues they face. Aims and Methods: Systematic review of systematic reviews. We searched international literature databases for systematic reviews, from inception to 2021, to provide an evidence overview of the range and effectiveness of interventions to support children and families where these parental risk factors had been identified. Results: Sixty-two systematic reviews were included. The majority ( n = 59) focused on interventions designed to address single risk factors. Reviews mostly focused on parental mental health ( n = 38) and included psychological interventions or parenting-training for mothers. Only two reviews assessed interventions to address all three risk factors in combination and assessed structural interventions. Evidence indicates that families affected by parental mental health problems may be best served by integrated interventions combining therapeutic interventions for parents with parent skills training. Upstream interventions such as income supplementation and welfare reform were demonstrated to reduce the impacts of family adversity. Conclusion: Most intervention approaches focus on mitigating individual psychological harms and seek to address risk factors in isolation, which presents potentially significant gaps in intervention evidence. These interventions may not address the cumulative impacts of co-occurring risks, or social factors that may compound adversities.

This qualitative evidence synthesis informs intervention development by systematically searching, evaluating and synthesizing qualitative studies on fatherhood in the context of heavy drinking and other substance use. We searched seven databases, grey literature and reference lists to identify eligible studies. Our international sample includes 156 fathers of different ages, cultural backgrounds and family living arrangements across 14 unique studies. The lead author applied thematic synthesis to develop the themes, in an ongoing dialogue with team members. Our understanding of fatherhood in the context of heavy drinking and other substance use is communicated through six themes. Fathers’ heavy drinking and other substance use can be understood as a method of emotional coping. Fathers’ substance use choices are intertwined with their social contexts from childhood to adulthood. Being a safe presence in children’s lives is a potentially overlooked aspect of fathers’ substance use interventions. In our qualitative evidence synthesis, we observed the pivotal role of supportive relationships in fathers’ substance use trajectories. We recommend co-produced intervention development that considers both fathers as individuals and as members of social networks. This is relevant across statutory, community and voluntary sector settings.

Parental substance use is highly prevalent worldwide, presenting major child safeguarding and public health concerns. Qualitative research enables in-depth understanding of how young people experience parental substance use and helps inform practice and policy through illustrative cases of experiences. This review aimed to synthesize published qualitative evidence exploring the lived experiences, perceived impact, and coping strategies of children and young people whose parents use substances. International literature databases including Medline, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, International Bibliography of the Social Sciences, Social Science Database, Sociology Collection, and Scopus were searched from inception to 2022, alongside grey literature searching and relevant websites. Qualitative accounts were included, provided by participants aged below 25 years. No language, date, or geographical limits were applied. A thematic synthesis of 35 studies, across 49 papers, covering over 700 children and young people’s voices, identified five overarching themes. These themes included, (a) living with the unpredictable: insecurity within the family; (b) social and emotional impact of parental substance use; (c) controlling the uncontrollable: creating safety within the family; (d) coping with and resisting the emotional and social impacts; and (e) formal and informal support. The findings emphasize that children and young people who experience parental substance use are trying to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, and often stigmatizing experiences, usually without formal support in place. Further research is needed to coproduce child-centered interventions that promote children and young people’s social and emotional resilience.

Within child welfare systems, the issue of parental alcohol misuse (PAM) and the responsibility for supporting children affected by PAM impacts on multiple health and social care services. An innovation pilot project (IPP) was set up to reduce the fragmentation between services and to help identify children affected by PAM. The current study presents findings regarding the IPP, examining its implementation, the service delivery, and the perceived impact for family members. Qualitative data were collected from 41 participants. This included interviews with alcohol-misusing parents (n = 13), affected adult family members (n = 5), and children affected by PAM (n = 9). Two focus groups and three one-to-one interviews were conducted with project workers (n = 7) and multi-agency service managers (n = 7). Data were analysed thematically relating to three main themes: (1) innovation in team composition and multi-disciplinary team working, (2) innovative ways of working, and (3) the benefits of a whole-family approach. The findings highlighted the importance of time for the team to ‘bed in’ and come together under one structure, a focus and oversight on whole-family care, and the importance of offering early, targeted, and flexible interventions to prevent crisis points and manage the consequences of PAM. Consideration will need to be given to joint commissioning to strengthen family-focused support.