Social Media Use is Linked to Internalizing Problems in Adolescents

Post by Shireen Parimoo

What's the science?

The growing prevalence of social media has sparked an interest in the effects of social media use on mental health. Studies have shown that more frequent use of social media is related to lower self-esteem and self-evaluation. Adolescents use social media at high rates and therefore may be particularly at risk for experiencing its negative effects. Childhood psychopathology can be broadly divided into internalizing and externalizing sub-types, which means that the symptoms are either experienced internally (e.g. sadness) or directed externally (e.g. aggressive behavior), respectively. Little research is available on the long-term effects of social media use, particularly on the development of internalizing and externalizing symptoms. This week in JAMA Psychiatry, Riehm and colleagues conducted a longitudinal study to investigate the relationship between time spent on social media and mental health outcomes in adolescents.

How did they do it?

Publicly available longitudinal data for 6595 adolescents were obtained from the Population Assessment of Tobacco and Health Study. In the study, nationally representative data were collected at three time points, each one year apart. The adolescents were aged 12 – 15 years old at the first time point, and 14 – 17 years old at the final time point. At the first time point, participants provided demographic data and at the second time point, they provided information on daily exposure to social media based on frequency and duration of use. Time spent on social media per day was divided into four groups: up to 30 minutes, 30 minutes to three hours, three to six hours, and more than six hours. Participants also completed the Global Appraisal of Individual Needs – Short Screener at the first (baseline) and third time points, which measures self-reports of mental health-related problems and severity categorized as either internalizing or externalizing problems. The authors examined the link between social media use and internalizing and externalizing problems in adolescents. They further estimated the population attributable fraction (PAF) to determine how reducing the amount of social media use might mitigate mental health problems. They did this by creating counterfactual population data for various scenarios in which adolescents from each social media use category would use it less frequently, and then examining the association between social media use and mental health problems.

What did they find?

Most adolescents reported no or low internalizing and externalizing problems (59.3%), whereas 9.1% reported internalizing problems only, 14% reported externalizing problems only, and 17.7% reported experiencing both internalizing and externalizing problems (i.e. comorbid). For social media exposure, most adolescents reported using social media for up to three hours (62.5%), with 12.3% using social media for 3-6 hours and 8.4% reporting more than six hours of daily use. Greater use of social media was associated with a higher risk of experiencing internalizing problems as well as comorbid (internal & external) mental health problems. This association persisted even after baseline mental health was taken into account. The association between social media use and externalizing problems was not as clear; using social media for 30 minutes to 3 hours or for more than 6 hours was associated with more externalizing problems, but not after controlling for the baseline measure of externalizing problems. Finally, according to the PAF estimates, lowering daily social media use to 30 minutes or less per day would result in up to a 9.4% reduction in internalizing problems and up to 7.3% reduction in externalizing problems. 

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What's the impact?

This study demonstrates the extent to which internalizing and externalizing mental health problems in adolescents can be attributed to social media use. The finding that using social media less often might reduce mental health problems in adolescents has implications for developing general guidelines on frequency of social media use, and further highlights the importance of understanding the link between social media use and mental health in other populations (e.g. young adults).


Riehm et al. Associations between time spent using social media and internalizing and externalizing problems among US youth. JAMA Psychiatry (2019). Access the original scientific publication here.