**4. DoD through a theoretical lens**

DoD can be investigated through a theoretical lens and there are several theories, including cognitive behavior models, Precarious Manhood Theory, and the Interpersonal-Psychological Theory of Suicide, which paints a comprehensive layout to conceptualize psychopathology associated with DoD [28]. The Beck's cognitive model [29] states that the engagement in the self-destructive behaviors occur subsequent to the distortion of the beliefs following trauma. There are two maladaptive cognitions, namely assimilated and overaccommodated cognitions [28, 29], which can easily be described in the context of COVID-19. Assimilated cognitions are related to the feeling of self-blame, for instance self-doubt or regret for not getting the employment. On the other hand, overaccommodated cognitions is linking multiple events to question self-worth [29]. For instance, previous rejections by the employers made one believe that he/she will never find a job [29]. These experiences may trigger the feelings of low self-efficacy and hopelessness leading to the depressive symptoms as explained through the Learned Helplessness Theory of Depression [29, 30]. Hopelessness is a well-established risk factor of "Deaths of Despair," and COVID-19 has created a conducive environment for the hopelessness among college students with regards to the financial hardships and limited job opportunities [29, 30]. Another framework is Precarious Manhood Theory, which is important dimension with regards to DoD. Men feel distressed if asked to engage in "feminine" activities [29, 30] and attempt to engaging in stereotypic masculine coping behaviors to restore their gender-role [29, 30]. All these models explain the potential mechanisms of hopelessness, which drive up the diseases of despair.

#### **4.1 Psychological capital and social media**

The levels of hopelessness during COVID-19 pandemic were investigated among students. Students reported worries associated with far-ranging impacts of COVID-19 on their academic goals, job security and fear of contagion, which may result in undesirable outcomes, such as DoD [31, 32]. The anxiety and hopelessness were greater among students spending more time on social media [31, 32]. Excessive use of social media predisposes students to the negative coping mechanisms of escapism, thereby reducing their psychological capital [31, 32]. Students with the less psychological capital tend to use self-destructive measures to cope with the negative events, such as COVID-19 pandemic [31, 32]. According to the collective evidence, psychological capital acts as a mediator in the association between excessive use of media (problematic social media use) and mental health issues among college students [31–33].

*"Deaths of Despair" among College Students Amidst COVID-19 Pandemic: A Call for Action DOI: http://dx.doi.org/10.5772/intechopen.102961*

### **4.2 Social media and suicide**

Social media increases the risk of suicidal behavior through cyberbullying [32, 33]. Previous research indicate that victims of cyberbullying were more likely to commit suicides than those who were not victims [32, 33]. Cyberbullying is not a sole predictor of suicidal behaviors among young adults, however, the risk can be increased by preponderance of other psychological and environmental stressors described elsewhere in this chapter [11–15, 19, 32, 33]. Another emerging concern is the media contagion effect [34–36]. Evidence suggested suicidal behavior as a contagion, can be impacted directly or indirectly through media reporting, suicide clusters, and through an exposure to a suicidal peer [37]. These effects are more pronounced among college students due to the social-influence effect on the risk perception of this group [36, 37]. Several reports confirmed that self-harming young adults are more active in social media than those who do not engage in such behaviors [35–38]. Researchers have suggested a U-shaped relationship between social media use and mental health, meaning poor mental being at lower and higher ends of internet use [37, 38]. Social media advertisements expose adolescents to other risky behaviors, which can have a negative influence on their psychological well-being [37, 38].

#### **4.3 Social media and risky behaviors**

Social marketing may have negative influence on mental health and behaviors among young adults, for instance, alcohol brand promotion advertisements on social media platforms [37, 38]. Alcohol brands are strongly presented over the social media channels, including Facebook, YouTube, and Twitter these days and expose young adults to underage drinking [38, 39]. Unrestricted advertisements are responsible for the mass persuasion and viewers (especially young adults) perceive such behaviors as normative and desirable and are at greater risk of adopting maladaptive behaviors. Another emerging issue, which has a strong association with mental health, substance abuse, and suicidality is sexting and digital abuse [38–41]. Sexting is sharing the sexually explicit messages through messages, emails, and/or internet, and this acts as a moderator of age-inappropriate sexual behavior [40, 41]. Young adults who sexted had higher odds of being engaged in substance abuse, which is one of the diseases of despair [41, 42]. Young adults are highly predisposed to these behaviors due to their propensity towards peer pressure, lack of self-regulation, and technophilic nature [41–43]. The content presented in this chapter point to developing effective mental health and suicide prevention programs to address the unmet needs of the adolescents.
