Greater time spent on social media was associated with an increased risk for mental health problems in adolescents, according to study data published in JAMA Psychiatry.

Kira E Riehm, MS, of the department of mental health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, and colleagues sought to identify the effects of social media use on adolescent mental health outcomes. Investigators abstracted 3 waves of data from the Population Assessment of Tobacco and Health study, focusing on a cohort of adolescents aged 12 to 15 years in the United States. Per PATH protocol, adolescents were assessed via household interviews using audio computer-assisted self-interviews.

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The primary exposure was self-reported time spent on social media on a typical day during wave 2 and participants categorized social media usage as up to 30 minutes, 30 minutes to 3 hours, 3 to 6 hours, and more than 6 hours. The primary outcome measure was internalizing and externalizing mental health problems reported through the Global Appraisal of Individual Needs Short Screener in wave 3. Covariates were captured in wave 1, including demographic characteristics, body mass index, self-reported substance use, and scale scores for lifetime internalizing and externalizing problems. Multinomial logistic regression was used to estimate the associations between time spent on social media and mental health outcomes.

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Data from 6595 adolescents (51.3% boys) were studied. Spending more than 30 minutes on social media per day was associated with an increased risk for internalizing problems alone and comorbid internalizing and externalizing problems compared with individuals reporting no use.

In analyses adjusting for demographics, past alcohol and marijuana use, and a history of mental health challenges, social media use for more than 3 hours per day compared with no use remained significantly associated with internalizing problems alone and comorbid internalizing and externalizing problems. In both unadjusted and adjusted analyses, relationships between social media use and externalizing problems were inconsistent. 

As study limitations, investigators noted that self-report data collection may not properly capture social media use or mental health problems. The investigators called for future studies to explore limits on daily social media use as a means of reducing mental health problems, as well as a balanced examination of the potential benefits and harms of social media use.

The investigators wrote, “Some researchers have raised concerns that studies on technology use and well-being are limited by publication bias. We believe that this is a legitimate concern given that many studies on this topic, including the present study, are secondary analyses of data not collected for the purpose of studying social media.”

Disclosure: One study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures


Riehm KE, Feder KA, Tormohlen KN, et al. Associations between time spent using social media and internalizing and externalizing problems among US youth [published online September 11, 2019]. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2019.2325