"Facebook 'Addiction'- What the media says - What the research says - Where we go from here"

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Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 1 of 45 AMENDED Exhibit 359 PLAINTIFFS' OMNIBUS OPPOSITION TO DEFENDANTS' MOTIONS FOR SUMMARY JUDGMENT Case No.: 4:22-md-03047-YGR MDL No. 3047 In Re: Social Media Adolescent Addiction/Personal Injury Products Liability Litigation + Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 2 of 45 Facebook "Addiction" - - What the media says What the research says Where we go from here f - Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 3 of 45 What is the issue? There is growing concern in the public that technology companies are deliberately manipulating users by designing addictive products that can harm our well-being and subvert our efforts at self-control. 2 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 4 of 45 ↑› Technology Addicted to posting on Facebook? Blame your brain Live Science > Culture Social media is as harmful as alcohol and drugs for millennials FACEBOOK, TWITTER, COCAINE: DOES SOCIAL MEDIA REALLY HAVE SIMILAR EFFECT ON US AS ADDICTIVE DRUGS? Facebook Addiction' Activates Same Brain Areas As Drugs; How Social Media Sites Hook You In What Facebook Addiction Looks Like in the Brain Headlines frequently reference the concept of addiction with respect to Facebook and social media 3 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 5 of 45 The media narrative likens Facebook to a drug of abuse, implying that it is similarly addictive. There are also claims that Facebook is like a drug dealer, where the goal is to get people "hooked." "Social media triggers a dopamine high" "Facebook is a drug dealer... the drug in question is dopamine" 4 1. 2. 3. Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 6 of 45 Let's cut through some of the noise Obviously Facebook isn't a drug. There is no medically established diagnosis of Facebook addiction. But – is there some truth here? 5 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 7 of 45 To understand and respond to these claims, we first need to understand: WHAT IS ADDICTION? WHAT IS DOPAMINE? WHAT IS OUR ROLE? HO NH2 1 HO f 6 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 8 of 45 How can we understand clinical addiction in the context of Facebook use? 7 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 9 of 45 Clinical addiction defined + • • Addiction is a primary, chronic disease where a substance or behavior is pursued pathologically. It is life-impairing and causes significant psychological distress. Current medical diagnoses apply only to substances or gambling. There are 9 defined categories of abusable substances (e.g., stimulants). Gambling is a recently defined behavioral addiction, as of 2013. Addiction involves a broad set of changes to brain circuitry underlying reward, stress, and self-control. The major brain change is that the dopamine system becomes less sensitive. 8 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 10 of 45 What might a "Facebook addiction" look like? Note there is NO approved clinical definition PREOCCUPYING THOUGHTS Thoughts about FB use are excessive, absorbing, and irresistible. OVERWHELMING BEHAVIOR Drive to use FB is extremely strong, despite desire and/ or attempts to stop. Other interests are neglected in favor of FB use. LIFE IMPAIRMENT *as a direct result FB use has caused significant negative impacts on important areas of life functioning, e.g., loss of job or relationships. Use continues despite these problems. 9 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 11 of 45 "Facebook addiction" related concepts Note there is NO approved clinical definition "TOLERANCE" "WITHDRAWAL" MOOD ESCAPE Need to use FB for longer (higher "dose") to get same feelings of excitement Negative feelings like irritability, anxiety, sadness, or anger result from not using FB. FB is used to relieve certain moods, like depression or anxiety (that are unrelated to withdrawal feelings) 10 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 12 of 45 What would NOT constitute "Facebook addiction" Based on proposed clinical criteria for Internet Gaming Disorder Excessive use Excessive use may be a necessary, but not sufficient, criterion A proposed threshold of >3 months of >6 hours per day of non work-related internet use would still not be diagnostic on its own Using more that you like/ feeling guilty about use This is a personal judgment call and not a sign of a disorder, unless the negative feelings are causing significant distress Feeling "out of control" Unless these are persistent feelings plus having failed attempts to stop 11 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 13 of 45 Since Facebook addiction isn't a medical diagnosis (yet), does this mean there isn't a problem? Within certain populations (e.g., U.S. college students), up to 30% of people report "problematic" FB use behaviors. International prevalence estimates of internet addiction range from 0.3-25%. However, prevalence estimates of Facebook problems or addiction symptoms are hard to interpret because of the varying definitions and measurement methods used. Clearly more consensus around the clinical definitions/ cut-offs is needed. 12 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 14 of 45 Even if most people's behavior isn't at the level of clinical concern, many people may have subthreshold symptoms and could benefit from support to regulate their Facebook use There may also be some people with a real, impairing, and distressing problem with their Facebook use that could constitute a psychiatric disorder. We just haven't talked to them yet. 13 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 15 of 45 Doesn't Facebook activate dopamine? That sounds like a powerful chemical, like a drug 14 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 16 of 45 $ Dopamine has been linked to technology "high," "addiction," "getting hooked," and "wanting more" But of course it's much more complicated $ 15 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 17 of 45 A fair headline from The Guardian: The unsexy truth about dopamine Dopamine might be the media's neurotransmitter of choice for scare stories about addiction, but the reality is rather more nuanced What is dopamine? How is it related to addiction? What does this mean for Facebook? 16 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 18 of 45 Movement Learning Salience Dopamine is a major chemical in the brain that is related to several important functions. Control Focus But why isn't reward depicted here? 17 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 19 of 45 Reward-related processes involve a specific dopamine pathway (the mesolimbic pathway) Movement Control Focus Learning Salience A reward is something that results in motivated behavior to seek it out. You learn that it is important or salient, and you control your behavior to go get it (or not get it). Dopamine is just one player in a complex reward system 18 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 20 of 45 In general, mesolimbic dopamine signaling tracks with higher reward magnitude and uncertain reward probability. • This is results in greater motivation to pursue large rewards, and more potential for learning when rewards are unpredictable. • Signals for natural rewards trigger the release of dopamine, including food, sex, and social approval. Humans have also learned that other things can be rewarding by association, like money. 19 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 21 of 45 DOPAMINE: FACT VS. FICTION The claim Dopamine gives you pleasure Dopamine gets you high Dopamine is elevated in addiction The truth Dopamine is not responsible for feelings of pleasure or "liking" an experience. Instead it is related to learning that an experience is desirable and "wanting" it, i.e. being motivated to seek it. Excessive dopamine that is released in response to a drug that directly acts on the brain (e.g., cocaine) is associated with other brain changes that do produce a high. The amount of dopamine released by natural behaviors is not intoxicating. Dopamine is blunted in addiction because the system works to get back into balance after excessive triggering by a drug. 20 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 22 of 45 Dopamine does play an important role in addiction 4 • • All drugs of abuse increase dopamine in the brain, with a specific pattern. Dopamine increases are exaggerated compared to natural rewards, they are brief, and they are tightly linked in time to the action of taking the drug. This produces activation in the reward system, motivating us to to pursue those drugs. Because of the pattern and magnitude of the dopamine response, the brain quickly learns that the drug is important and wanted. The dopamine system compensates for this excessive activation. The reward system becomes blunted (so more drug is needed) and the control system gets weaker (so it is harder to inhibit drug-seeking behavior). 21 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 23 of 45 How is dopamine related to Facebook use? 22 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 24 of 45 Several aspects of Facebook are consistent with things that research has shown trigger dopamine release and reward- related brain activation (e.g., in the ventral striatum, or VS) .10 Social approval Unpredictable rewards 23 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 25 of 45 Example neuroscience findings: Facebook and reward 1. Instagram pictures with more vs. fewer "Likes" activate the ventral striatum (VS) This means Like counts provide meaningful information for whether something is important and potentially rewarding. 2. Facebook symbols activate the VS more if you are a frequent user If you use FB often, presumably you find it rewarding, and also those images will be more familiar to you and therefore more salient. 3. People who have stronger VS responses to reputation gains as compared to monetary gains are also more likely to use FB more People who are particularly sensitive to social rewards might find FB use more rewarding and therefore use it more. 1. Sherman et al., 2016, 2017 2. Turel et al., 2014 3. Meshi et al., 2013 24 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 26 of 45 So, we know that FB behaviors or cues can activate reward-related brain regions and, most likely - though not directly proven - trigger dopamine release. Importantly, this is not tantamount to "addiction" and instead underlies normal learning about things that are positive, salient, and wanted. 25 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 27 of 45 So if Facebook is just like any other reward that isn't a drug of abuse, what's the problem? 26 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 28 of 45 Potential problem #1: People keep using Facebook because design elements have made it reinforcing, but the reward value is lacking. • • e.g., notification alerts for content of little or no interest e.g., unexpected stories in News Feed that aren't interesting, but are unpredictable e.g., other use of unpredictable or variable rewards, 27 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 29 of 45 Potential problem #2: Facebook's rewards are easily accessible, available all the time, limitless, and hard to regulate. • e.g., continuous content without breaks • e.g., expectation of quick responses and availability • e.g., updates/counts of Likes • e.g., lack of feedback about use 28 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 30 of 45 Q: Are there such things as "dopamine feedback loops" that keep people addicted? 29 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 31 of 45 A: Dopamine circuit "loops" do exist. They are subject to multiple inputs and therefore many sources of control. There is no evidence that control resources are ineffective in the case of social media use. 30 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 32 of 45 There are several dopamine "loops" that allow for behavior to occur efficiently These operate on the order of seconds, after dopamine signaling occurs on the order of milliseconds Movement Control Focus Learning Salience One loop underlies the execution of coordinated behavior (e.g., movement to get a reward) as well as monitoring or control of that behavior (is it effective? is it planned? is the specific reward wanted?) 31 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 33 of 45 If and when control is ineffective, behavior to get a reward may go unchecked. These loops are difficult to regulate in certain circumstances ADDICTION Deficient dopamine systems due to brain changes associated with clinical addiction HABITS Strong links between a cue and an automatic behavior, when awareness is low 32 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 34 of 45 Let's talk about habits Related to the addiction narrative are accusations that Facebook is deliberately habit- forming, reducing people's agency in controlling their behavior 33 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 35 of 45 Habits are automatic behavioral tendencies Situation -> behavior Situation -> behavior Cue Response Situation -> behavior Cue Response Situation -> behavior Situation -> behavior + EFFORT Situation -> behavior Repeated behaviors in the same situation can lead to habit formation especially if rewarded The situation serves as a cue for an automatic behavioral response Exerting control over automaticity is effortful; habits are hard to break 34 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 36 of 45 There are many Facebook cues that signal particular behaviors Facebook Cue Notification pops up See News Feed tab App icon with a red badge Response Read it Click on it Open it People engage in these behaviors repeatedly, sometimes without thinking 35 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 37 of 45 There are also cues in life outside of Facebook that can signal Facebook-related behaviors Non-Facebook Cue Wake up in morning Finish checking email Feel bored Response Reach for phone Open FB Check for any notifications People engage in these behaviors repeatedly, sometimes without thinking 36 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 38 of 45 So people use Facebook a lot, and it becomes a habit. There must be enough reward, at least initially, for people to use it often. What is the problem here? 37 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 39 of 45 Potential problem: Facebook provides cues for use that may draw people in when they don't want to • • • e.g., unwanted push notifications and badges, especially ones that are on by default e.g., pressure of social reciprocity when receiving tags or comments e.g., stories or videos that autoplay 38 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 40 of 45 Habits can be changed by behavior regulation, but several aspects of Facebook can make regulation difficult From Vishwanath, 2015 Low awareness ★ Increase awareness by getting feedback on behavior, receiving alerts, and tracking behavior over time Low intentionality Increase intentionality by prompting more choices, reconsidering defaults, and providing support for setting and pursuing goals Low attentiveness ★ Increase attentiveness by adding new salient stimuli or "speed bumps" to add friction to automatic behaviors Low control Increase control over behavior with tools to set limits, prompts for alternative behaviors, and reduced barriers for exercising control (e.g., make it easy to flexibly change settings) 39 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 41 of 45 Is the "addiction" narrative really about people having a habit of using Facebook? If people find Facebook somewhat rewarding and indulgent, they may feel guilty. If their motivation to change their habit is low, they probably will be unsuccessful. 40 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 42 of 45 We need to find out if "real" Facebook addiction exists. Is there such thing as compulsive Facebook use that persists even when it is causing harm and distress? VERY HARD TO RESIST Even when exercising efforts at self-control STRONGER THAN OPPOSING FORCES Behavior persists even when it causes harm and distress 41 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 43 of 45 Who is vulnerable? People with deficient self-regulation more generally (e.g., people with bipolar mania, ADHD, depression, anxiety, other addictions...) People whose primary way of coping with difficult emotional experiences is to go on Facebook, so they may become dependent on Facebook People with broader dependence on the internet or phone, especially those who are driven to "escape" their real life Adolescents, whose self-regulation abilities are still developing Facebook "addiction" may be a symptom of other problems, instead of the primary problem itself. However, Facebook can still be part of the solution. 42 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 44 of 45 Topics for Future Research I Can we identify behavioral patterns that are consistent with addiction? Tolerance concept: Do people progressively increase length of time spent per session (with or without changing # of sessions), similar to needing an increased "dose" of a drug? Do they do this prior to a deactivation? New user behaviors: Classic addictive substances have a relatively short time frame from first use to addiction. What is the length of time or "ramp up" pattern from first use to some definition of problematic use? 43 Case 4:22-md-03047-YGR Document 2887-27 Filed 03/27/26 Page 45 of 45 Topics for Future Research II How can we understand problematic use (a symptom) as well as pathological use (a disorder resembling addiction)? What are examples of negative impacts from using Facebook? (interviews; survey) Prevalence of self-reported addiction symptoms (survey). Important to distinguish Facebook vs. phone/internet broadly In-person assessment with people reporting problems to understand Facebook contributing factors (interviews) 44