Abstract
IMPORTANCE: In response to widespread concerns about social media's influence on adolescent mental health, most research has studied adolescents from the general population, overlooking clinical groups.
OBJECTIVE: To synthesize, quantify, and compare evidence on the association between social media use and internalizing symptoms in adolescent clinical and community samples.
DATA SOURCES: Peer-reviewed publications from MEDLINE, Web of Science, PsycInfo, and Scopus (initially reviewed in May 2022 and updated in October 2023) and preprints from Europe PubMed Central (February 2023) published in English between 2007 and 2023.
STUDY SELECTION: Two blinded reviewers initially identified 14 211 cross-sectional and longitudinal studies quantifying the association between social media use and internalizing symptoms, excluding experimental studies and randomized clinical trials.
DATA EXTRACTION AND SYNTHESIS: PRISMA and MOOSE guidelines were followed, pooling data using a random-effects model and robust variance estimation. The quality of evidence was assessed using the Quality of Survey Studies in Psychology Checklist.
MAIN OUTCOMES AND MEASURES: Articles were included if they reported at least 1 quantitative measure of social media use (time spent, active vs passive use, activity, content, user perception, and other) and internalizing symptoms (anxiety, depression, or both).
RESULTS: The 143 studies reviewed included 1 094 890 adolescents and 886 effect sizes, 11% of which examined clinical samples. In these samples, a positive and significant meta-correlation was found between social media use and internalizing symptoms, both for time spent (n = 2893; r, 0.08; 95% CI, 0.01 to 0.15; P = .03; I2, 57.83) and user engagement (n = 859; r, 0.12; 95% CI, 0.09 to 0.15; P = .002; I2, 82.67). These associations mirrored those in community samples.
CONCLUSIONS AND RELEVANCE: The findings in this study highlight a lack of research on clinical populations, a critical gap considering public concerns about the increase in adolescent mental health symptoms at clinical levels. This paucity of evidence not only restricts the generalizability of existing research but also hinders our ability to evaluate and compare the link between social media use and mental health in clinical vs nonclinical populations.
| Original language | English |
|---|---|
| Pages (from-to) | 814-822 |
| Number of pages | 9 |
| Journal | JAMA Pediatrics |
| Volume | 178 |
| Issue number | 8 |
| Early online date | 24 Jun 2024 |
| DOIs | |
| Publication status | Published - Aug 2024 |
Funding
Conflict of Interest Disclosures: Dr Thomas reported grants from Wellcome Trust, Jacobs Foundation, UK Research and Innovation Economic and Social Research Council, and Gonville Studentship during the conduct of the study and from Wellcome Trust and Jacobs Foundation outside the submitted work. Dr Ford reported funding from Place2Be (research consultancy paid to research group) outside the submitted work. Dr Orben reported grants from UK Research and Innovation Medical Research Council, Jacobs Foundation, Emmanuel College, University of Cambridge, and UK Research and Innovation Future Leaders Fellowship during the conduct of the study as well as personal fees from Apple (honoraria for giving a talk at Apple University) outside the submitted work. No other disclosures were reported. Funding/Support: The study received funding support through the Medical Research Council (RG86932, Ms Fassi; MC_UU_00030/13, Dr Orben), Wellcome Trust (WT107496/Z/15/Z, Ms Thomas), Stellenbosch University (Dr Parry), Jacobs Foundation (Ms Leyland-Craggs and Dr Orben), National Institute for Health and Care (Dr Ford), Cambridge Biomedical Research (Dr Ford), National Institute for Health and Care Applied Research Centre (Dr Ford), Place2Be (Dr Ford), Emmanuel College (Dr Orben), and UK Research and Innovation (MR/X034925/1, Dr Orben).
| Funders | Funder number |
|---|---|
| UK Research and Innovation Economic and Social Research Council | |
| National Institute for Health and Care Applied Research Centre | |
| UK Research and Innovation Future Leaders Fellowship | |
| National Institute for Health and Care | |
| Jacobs Foundation | |
| Emmanuel College | |
| UK Research and Innovation Medical Research Council | |
| Universiteit Stellenbosch | |
| Emmanuel College, University of Cambridge | |
| Medical Research Council | RG86932, MC_UU_00030/13 |
| Wellcome Trust | WT107496/Z/15/Z |
| UK Research and Innovation | MR/X034925/1 |
Keywords
- Humans
- Social Media/statistics & numerical data
- Adolescent
- Depression/psychology
- Anxiety