negative impact of social media on youth research paper

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• Published: 01 July 2020

The effect of social media on well-being differs from adolescent to adolescent

• Ine Beyens   ORCID: orcid.org/0000-0001-7023-867X 1 ,
• J. Loes Pouwels   ORCID: orcid.org/0000-0002-9586-392X 1 ,
• Irene I. van Driel   ORCID: orcid.org/0000-0002-7810-9677 1 ,
• Loes Keijsers   ORCID: orcid.org/0000-0001-8580-6000 2 &
• Patti M. Valkenburg   ORCID: orcid.org/0000-0003-0477-8429 1  

Scientific Reports volume  10 , Article number:  10763 ( 2020 ) Cite this article

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The question whether social media use benefits or undermines adolescents’ well-being is an important societal concern. Previous empirical studies have mostly established across-the-board effects among (sub)populations of adolescents. As a result, it is still an open question whether the effects are unique for each individual adolescent. We sampled adolescents’ experiences six times per day for one week to quantify differences in their susceptibility to the effects of social media on their momentary affective well-being. Rigorous analyses of 2,155 real-time assessments showed that the association between social media use and affective well-being differs strongly across adolescents: While 44% did not feel better or worse after passive social media use, 46% felt better, and 10% felt worse. Our results imply that person-specific effects can no longer be ignored in research, as well as in prevention and intervention programs.

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Introduction.

Ever since the introduction of social media, such as Facebook and Instagram, researchers have been studying whether the use of such media may affect adolescents’ well-being. These studies have typically reported mixed findings, yielding either small negative, small positive, or no effects of the time spent using social media on different indicators of well-being, such as life satisfaction and depressive symptoms (for recent reviews, see for example 1 , 2 , 3 , 4 , 5 ). Most of these studies have focused on between-person associations, examining whether adolescents who use social media more (or less) often than their peers experience lower (or higher) levels of well-being than these peers. While such between-person studies are valuable in their own right, several scholars 6 , 7 have recently called for studies that investigate within-person associations to understand whether an increase in an adolescent’s social media use is associated with an increase or decrease in that adolescent’s well-being. The current study aims to respond to this call by investigating associations between social media use and well-being within single adolescents across multiple points in time 8 , 9 , 10 .

Person-specific effects

To our knowledge, four recent studies have investigated within-person associations of social media use with different indicators of adolescent well-being (i.e., life satisfaction, depression), again with mixed results 6 , 11 , 12 , 13 . Orben and colleagues 6 found a small negative reciprocal within-person association between the time spent using social media and life satisfaction. Likewise, Boers and colleagues 12 found a small within-person association between social media use and increased depressive symptoms. Finally, Coyne and colleagues 11 and Jensen and colleagues 13 did not find any evidence for within-person associations between social media use and depression.

Earlier studies that investigated within-person associations of social media use with indicators of well-being have all only reported average effect sizes. However, it is possible, or even plausible, that these average within-person effects may have been small and nonsignificant because they result from sizeable heterogeneity in adolescents’ susceptibility to the effects of social media use on well-being (see 14 , 15 ). After all, an average within-person effect size can be considered an aggregate of numerous individual within-person effect sizes that range from highly positive to highly negative.

Some within-person studies have sought to understand adolescents’ differential susceptibility to the effects of social media by investigating differences between subgroups. For instance, they have investigated the moderating role of sex to compare the effects of social media on boys versus girls 6 , 11 . However, such a group-differential approach, in which potential differences in susceptibility are conceptualized by group-level moderators (e.g., gender, age) does not provide insights into more fine-grained differences at the level of the single individual 16 . After all, while girls and boys each represent a homogenous group in terms of sex, they may each differ on a wide array of other factors.

As such, although worthwhile, the average within-person effects of social media on well-being obtained in previous studies may have been small or non-significant because they are diluted across a highly heterogeneous population (or sub-population) of adolescents 14 , 15 . In line with the proposition of media effects theories that each adolescent may have a unique susceptibility to the effects of social media 17 , a viable explanation for the small and inconsistent findings in earlier studies may be that the effect of social media differs from adolescent to adolescent. The aim of the current study is to investigate this hypothesis and to obtain a better understanding of adolescents’ unique susceptibility to the effects of social media on their affective well-being.

Social media and affective well-being

Within-person studies have provided important insights into the associations of social media use with cognitive well-being (e.g., life satisfaction 6 ), which refers to adolescents’ cognitive judgment of how satisfied they are with their life 18 . However, the associations of social media use with adolescents’ affective well-being (i.e., adolescents’ affective evaluations of their moods and emotions 18 ) are still unknown. In addition, while earlier within-person studies have focused on associations with trait-like conceptualizations of well-being 11 , 12 , 13 , that is, adolescents’ average well-being across specific time periods 18 , there is a lack of studies that focus on well-being as a momentary affective state. Therefore, we extend previous research by examining the association between adolescents’ social media use and their momentary affective well-being. Like earlier experience sampling (ESM) studies among adults 19 , 20 , we measured adolescents’ momentary affective well-being with a single item. Adolescents’ momentary affective well-being was defined as their current feelings of happiness, a commonly used question to measure well-being 21 , 22 , which has high convergent validity, as evidenced by the strong correlations with the presence of positive affect and absence of negative affect.

To assess adolescents’ momentary affective well-being (henceforth referred to as well-being), we conducted a week-long ESM study among 63 middle adolescents ages 14 and 15. Six times a day, adolescents were asked to complete a survey using their own mobile phone, covering 42 assessments per adolescent, assessing their affective well-being and social media use. In total, adolescents completed 2,155 assessments (83.2% average compliance).

We focused on middle adolescence, since this is the period in life characterized by most significant fluctuations in well-being 23 , 24 . Also, in comparison to early and late adolescents, middle adolescents are more sensitive to reactions from peers and have a strong tendency to compare themselves with others on social media and beyond. Because middle adolescents typically use different social media platforms, in a complementary way 25 , 26 , 27 , each adolescent reported on his/her use of the three social media platforms that s/he used most frequently out of the five most popular social media platforms among adolescents: WhatsApp, followed by Instagram, Snapchat, YouTube, and, finally, the chat function of games 28 . In addition to investigating the association between overall social media use and well-being (i.e., the summed use of adolescents’ three most frequently used platforms), we examined the unique associations of the two most popular platforms, WhatsApp and Instagram 28 .

Like previous studies on social media use and well-being, we distinguished between active social media use (i.e., “activities that facilitate direct exchanges with others” 29 ) and passive social media use (i.e., “consuming information without direct exchanges” 29 ). Within-person studies among young adults have shown that passive but not active social media use predicts decreases in well-being 29 . Therefore, we examined the unique associations of adolescents’ overall active and passive social media use with their well-being, as well as active and passive use of Instagram and WhatsApp, specifically. We investigated categorical associations, that is, whether adolescents would feel better or worse if they had actively or passively used social media. And we investigated dose–response associations to understand whether adolescents’ well-being would change as a function of the time they had spent actively or passively using social media.

The hypotheses and the design, sampling and analysis plan were preregistered prior to data collection and are available on the Open Science Framework, along with the code used in the analyses ( https://osf.io/nhks2 ). For details about the design of the study and analysis approach, see Methods.

In more than half of all assessments (68.17%), adolescents had used social media (i.e., one or more of their three favorite social media platforms), either in an active or passive way. Instagram (50.90%) and WhatsApp (53.52%) were used in half of all assessments. Passive use of social media (66.21% of all assessments) was more common than active use (50.86%), both on Instagram (48.48% vs. 20.79%) and WhatsApp (51.25% vs. 40.07%).

Strong positive between-person correlations were found between the duration of active and passive social media use (overall: r  = 0.69, p  < 0.001; Instagram: r  = 0.38, p  < 0.01; WhatsApp: r  = 0.85, p  < 0.001): Adolescents who had spent more time actively using social media than their peers, had also spent more time passively using social media than their peers. Likewise, strong positive within-person correlations were found between the duration of active and passive social media use (overall: r  = 0.63, p  < 0.001; Instagram: r  = 0.37, p  < 0.001; WhatsApp: r  = 0.57, p  < 0.001): The more time an adolescent had spent actively using social media at a certain moment, the more time s/he had also spent passively using social media at that moment.

Table 1 displays the average number of minutes that adolescents had spent using social media in the past hour at each assessment, and the zero-order between- and within-person correlations between the duration of social media use and well-being. At the between-person level, the duration of active and passive social media use was not associated with well-being: Adolescents who had spent more time actively or passively using social media than their peers did not report significantly higher or lower levels of well-being than their peers. At the within-person level, significant but weak positive correlations were found between the duration of active and passive overall social media use and well-being. This indicates that adolescents felt somewhat better at moments when they had spent more time actively or passively using social media (overall), compared to moments when they had spent less time actively or passively using social media. When looking at specific platforms, a positive correlation was only found for passive WhatsApp use, but not for active WhatsApp use, and not for active and passive Instagram use.

Average and person-specific effects

The within-person associations of social media use with well-being and differences in these associations were tested in a series of multilevel models. We ran separate models for overall social media use (i.e., active use and passive use of adolescents’ three favorite social media platforms, see Table 2 ), Instagram use (see Table 3 ), and WhatsApp use (see Table 4 ). In a first step we examined the average categorical associations for each of these three social media uses using fixed effects models (Models 1A, 3A, and 5A) to investigate whether, on average, adolescents would feel better or worse at moments when they had used social media compared to moments when they had not (i.e., categorical predictors: active use versus no active use, and passive use versus no passive use). In a second step, we examined heterogeneity in the within-person categorical associations by adding random slopes to the fixed effects models (Models 1B, 3B, and 5B). Next, we examined the average dose–response associations using fixed effects models (Models 2A, 4A, and 6A), to investigate whether, on average, adolescents would feel better or worse when they had spent more time using social media (i.e., continuous predictors: duration of active use and duration of passive use). Finally, we examined heterogeneity in the within-person dose–response associations by adding random slopes to the fixed effects models (Models 2B, 4B, and 6B).

Overall social media use.

The model with the categorical predictors (see Table 2 ; Model 1A) showed that, on average, there was no association between overall use and well-being: Adolescents’ well-being did not increase or decrease at moments when they had used social media, either in a passive or active way. However, evidence was found that the association of passive (but not active) social media use with well-being differed from adolescent to adolescent (Model 1B), with effect sizes ranging from − 0.24 to 0.68. For 44.26% of the adolescents the association was non-existent to small (− 0.10 <  r  < 0.10). However, for 45.90% of the adolescents there was a weak (0.10 <  r  < 0.20; 8.20%), moderate (0.20 <  r  < 0.30; 22.95%) or even strong positive ( r  ≥ 0.30; 14.75%) association between overall passive social media use and well-being, and for almost one in ten (9.84%) adolescents there was a weak (− 0.20 <  r  < − 0.10; 6.56%) or moderate negative (− 0.30 <  r  < − 0.20; 3.28%) association.

The model with continuous predictors (Model 2A) showed that, on average, there was a significant dose–response association for active use. At moments when adolescents had used social media, the time they spent actively (but not passively) using social media was positively associated with well-being: Adolescents felt better at moments when they had spent more time sending messages, posting, or sharing something on social media. The associations of the time spent actively and passively using social media with well-being did not differ across adolescents (Model 2B).

Instagram use

As shown in Model 3A in Table 3 , on average, there was a significant categorical association between passive (but not active) Instagram use and well-being: Adolescents experienced an increase in well-being at moments when they had passively used Instagram (i.e., viewing posts/stories of others). Adolescents did not experience an increase or decrease in well-being when they had actively used Instagram. The associations of passive and active Instagram use with well-being did not differ across adolescents (Model 3B).

On average, no significant dose–response association was found for Instagram use (Model 4A): At moments when adolescents had used Instagram, the time adolescents spent using Instagram (either actively or passively) was not associated with their well-being. However, evidence was found that the association of the time spent passively using Instagram differed from adolescent to adolescent (Model 4B), with effect sizes ranging from − 0.48 to 0.27. For most adolescents (73.91%) the association was non-existent to small (− 0.10 <  r  < 0.10), but for almost one in five adolescents (17.39%) there was a weak (0.10 <  r  < 0.20; 10.87%) or moderate (0.20 <  r  < 0.30; 6.52%) positive association, and for almost one in ten adolescents (8.70%) there was a weak (− 0.20 <  r  < − 0.10; 2.17%), moderate (− 0.30 <  r  < − 0.20; 4.35%), or strong ( r  ≤ − 0.30; 2.17%) negative association. Figure  1 illustrates these differences in the dose–response associations.

The dose–response association between passive Instagram use (in minutes per hour) and affective well-being for each individual adolescent (n = 46). Red lines represent significant negative within-person associations, green lines represent significant positive within-person associations, and gray lines represent non-significant within-person associations. A graph was created for each participant who had completed at least 10 assessments. A total of 13 participants were excluded because they had completed less than 10 assessments of passive Instagram use. In addition, one participant was excluded because no graph could be computed, since this participant's passive Instagram use was constant across assessments.

WhatsApp use

As shown in Model 5A in Table 4 , just as for Instagram, we found that, on average, there was a significant categorical association between passive (but not active) WhatsApp use and well-being: Adolescents reported that they felt better at moments when they had passively used WhatsApp (i.e., read WhatsApp messages). For active WhatsApp use, no significant association was found. Also, in line with the results for Instagram use, no differences were found regarding the associations of active and passive WhatsApp use (Model 5B).

In addition, a significant dose–response association was found for passive (but not active) use (Model 6A). At moments when adolescents had used WhatsApp, we found that, on average, the time adolescents spent passively using WhatsApp was positively associated with well-being: Adolescents felt better at moments when they had spent more time reading WhatsApp messages. The time spent actively using WhatsApp was not associated with well-being. No differences were found in the dose–response associations of active and passive WhatsApp use (Model 6B).

This preregistered study investigated adolescents’ unique susceptibility to the effects of social media. We found that the associations of passive (but not active) social media use with well-being differed substantially from adolescent to adolescent, with effect sizes ranging from moderately negative (− 0.24) to strongly positive (0.68). While 44.26% of adolescents did not feel better or worse if they had passively used social media, 45.90% felt better, and a small group felt worse (9.84%). In addition, for Instagram the majority of adolescents (73.91%) did not feel better or worse when they had spent more time viewing post or stories of others, whereas some felt better (17.39%), and others (8.70%) felt worse.

These findings have important implications for social media effects research, and media effects research more generally. For decades, researchers have argued that people differ in their susceptibility to the effects of media 17 , leading to numerous investigations of such differential susceptibility. These investigations have typically focused on moderators, based on variables such as sex, age, or personality. Yet, over the years, studies have shown that such moderators appear to have little power to explain how individuals differ in their susceptibility to media effects, probably because a group-differential approach does not account for the possibility that media users may differ across a range of factors, that are not captured by only one (or a few) investigated moderator variables.

By providing insights into each individual’s unique susceptibility, the findings of this study provide an explanation as to why, up until now, most media effects research has only found small effects. We found that the majority of adolescents do not experience any short-term changes in well-being related to their social media use. And if they do experience any changes, these are more often positive than negative. Because only small subsets of adolescents experience small to moderate changes in well-being, the true effects of social media reported in previous studies have probably been diluted across heterogeneous samples of individuals that differ in their susceptibility to media effects (also see 30 ). Several scholars have noted that overall effect sizes may mask more subtle individual differences 14 , 15 , which may explain why previous studies have typically reported small or no effects of social media on well-being or indicators of well-being 6 , 11 , 12 , 13 . The current study seems to confirm this assumption, by showing that while the overall effect sizes are small at best, the person-specific effect sizes vary considerably, from tiny and small to moderate and strong.

As called upon by other scholars 5 , 31 , we disentangled the associations of active and passive use of social media. Research among young adults found that passive (but not active) social media use is associated with lower levels of affective well-being 29 . In line with these findings, the current study shows that active and passive use yielded different associations with adolescents’ affective well-being. Interestingly though, in contrast to previous findings among adults, our study showed that, on average, passive use of Instagram and WhatsApp seemed to enhance rather than decrease adolescents’ well-being. This discrepancy in findings may be attributed to the fact that different mechanisms might be involved. Verduyn and colleagues 29 found that passive use of Facebook undermines adults’ well-being by enhancing envy, which may also explain the decreases in well-being found in our study among a small group of adolescents. Yet, adolescents who felt better by passively using Instagram and WhatsApp, might have felt so because they experienced enjoyment. After all, adolescents often seek positive content on social media, such as humorous posts or memes 32 . Also, research has shown that adolescents mainly receive positive feedback on social media 33 . Hence, their passive Instagram and WhatsApp use may involve the reading of positive feedback, which may explain the increases in well-being.

Overall, the time spent passively using WhatsApp improved adolescents’ well-being. This did not differ from adolescent to adolescent. However, the associations of the time spent passively using Instagram with well-being did differ from adolescent to adolescent. This discrepancy suggests that not all social media uses yield person-specific effects on well-being. A possible explanation may be that adolescents’ responses to WhatsApp are more homogenous than those to Instagram. WhatsApp is a more private platform, which is mostly used for one-to-one communication with friends and acquaintances 26 . Instagram, in contrast, is a more public platform, which allows its users to follow a diverse set of people, ranging from best friends to singers, actors, and influencers 28 , and to engage in intimate communication as well as self-presentation and social comparison. Such diverse uses could lead to more varied, or even opposing responses, such as envy versus inspiration.

Limitations and directions for future research

The current study extends our understanding of differential susceptibility to media effects, by revealing that the effect of social media use on well-being differs from adolescent to adolescent. The findings confirm our assumption that among the great majority of adolescents, social media use is unrelated to well-being, but that among a small subset, social media use is either related to decreases or increases in well-being. It must be noted, however, that participants in this study felt relatively happy, overall. Studies with more vulnerable samples, consisting of clinical samples or youth with lower social-emotional well-being may elicit different patterns of effects 27 . Also, the current study focused on affective well-being, operationalized as happiness. It is plausible that social media use relates differently with other types of well-being, such as cognitive well-being. An important next step is to identify which adolescents are particularly susceptible to experience declines in well-being. It is conceivable, for instance, that the few adolescents who feel worse when they use social media are the ones who receive negative feedback on social media 33 .

In addition, future ESM studies into the effects of social media should attempt to include one or more follow-up measures to improve our knowledge of the longer-term influence of social media use on affective well-being. While a week-long ESM is very common and applied in most earlier ESM studies 34 , a week is only a snapshot of adolescent development. Research is needed that investigates whether the associations of social media use with adolescents’ momentary affective well-being may cumulate into long-lasting consequences. Such investigations could help clarify whether adolescents who feel bad in the short term would experience more negative consequences in the long term, and whether adolescents who feel better would be more resistant to developing long-term negative consequences. And while most adolescents do not seem to experience any short-term increases or decreases in well-being, more research is needed to investigate whether these adolescents may experience a longer-term impact of social media.

While the use of different platforms may be differently associated with well-being, different types of use may also yield different effects. Although the current study distinguished between active and passive use of social media, future research should further differentiate between different activities. For instance, because passive use entails many different activities, from reading private messages (e.g., WhatsApp messages, direct messages on Instagram) to browsing a public feed (e.g., scrolling through posts on Instagram), research is needed that explores the unique effects of passive public use and passive private use. Research that seeks to explore the nuances in adolescents’ susceptibility as well as the nuances in their social media use may truly improve our understanding of the effects of social media use.

Participants

Participants were recruited via a secondary school in the south of the Netherlands. Our preregistered sampling plan set a target sample size of 100 adolescents. We invited adolescents from six classrooms to participate in the study. The final sample consisted of 63 adolescents (i.e., 42% consent rate, which is comparable to other ESM studies among adolescents; see, for instance 35 , 36 ). Informed consent was obtained from all participants and their parents. On average, participants were 15 years old ( M  = 15.12 years, SD  = 0.51) and 54% were girls. All participants self-identified as Dutch, and 41.3% were enrolled in the prevocational secondary education track, 25.4% in the intermediate general secondary education track, and 33.3% in the academic preparatory education track.

The study was approved by the Ethics Review Board of the Faculty of Social and Behavioral Sciences at the University of Amsterdam and was performed in accordance with the guidelines formulated by the Ethics Review Board. The study consisted of two phases: A baseline survey and a personalized week-long experience sampling (ESM) study. In phase 1, researchers visited the school during school hours. Researchers informed the participants of the objective and procedure of the study and assured them that their responses would be treated confidentially. Participants were asked to sign the consent form. Next, participants completed a 15-min baseline survey. The baseline survey included questions about demographics and assessed which social media each adolescent used most frequently, allowing to personalize the social media questions presented during the ESM study in phase 2. After completing the baseline survey, participants were provided detailed instructions about phase 2.

In phase 2, which took place two and a half weeks after the baseline survey, a 7-day ESM study was conducted, following the guidelines for ESM studies provided by van Roekel and colleagues 34 . Aiming for at least 30 assessments per participant and based on an average compliance rate of 70 to 80% reported in earlier ESM studies among adolescents 34 , we asked each participant to complete a total of 42 ESM surveys (i.e., six 2-min surveys per day). Participants completed the surveys using their own mobile phone, on which the ESM software application Ethica Data was installed during the instruction session with the researchers (phase 1). Each 2-min survey consisted of 22 questions, which assessed adolescents’ well-being and social media use. Two open-ended questions were added to the final survey of the day, which asked about adolescents’ most pleasant and most unpleasant events of the day.

The ESM sampling scheme was semi-random, to allow for randomization and avoid structural patterns in well-being, while taking into account that adolescents were not allowed to use their phone during school time. The Ethica Data app was programmed to generate six beep notifications per day at random time points within a fixed time interval that was tailored to the school’s schedule: before school time (1 beep), during school breaks (2 beeps), and after school time (3 beeps). During the weekend, the beeps were generated during the morning (1 beep), afternoon (3 beeps), and evening (2 beeps). To maximize compliance, a 30-min time window was provided to complete each survey. This time window was extended to one hour for the first survey (morning) and two hours for the final survey (evening) to account for travel time to school and time spent on evening activities. The average compliance rate was 83.2%. A total of 2,155 ESM assessments were collected: Participants completed an average of 34.83 surveys ( SD  = 4.91) on a total of 42 surveys, which is high compared to previous ESM studies among adolescents 34 .

The questions of the ESM study were personalized based on the responses to the baseline survey. During the ESM study, each participant reported on his/her use of three different social media platforms: WhatsApp and either Instagram, Snapchat, YouTube, and/or the chat function of games (i.e., the most popular social media platforms among adolescents 28 ). Questions about Instagram and WhatsApp use were only included if the participant had indicated in the baseline survey that s/he used these platforms at least once a week. If a participant had indicated that s/he used Instagram or WhatsApp (or both) less than once a week, s/he was asked to report on the use of Snapchat, YouTube, or the chat function of games, depending on what platform s/he used at least once a week. In addition to Instagram and WhatsApp, questions were asked about a third platform, that was selected based on how frequently the participant used Snapchat, YouTube, or the chat function of games (i.e., at least once a week). This resulted in five different combinations of three platforms: Instagram, WhatsApp, and Snapchat (47 participants); Instagram, WhatsApp, and YouTube (11 participants); Instagram, WhatsApp, and chatting via games (2 participants); WhatsApp, Snapchat, and YouTube (1 participant); and WhatsApp, YouTube, and chatting via games (2 participants).

Frequency of social media use

In the baseline survey, participants were asked to indicate how often they used and checked Instagram, WhatsApp, Snapchat, YouTube, and the chat function of games, using response options ranging from 1 ( never ) to 7 ( more than 12 times per day ). These platforms are the five most popular platforms among Dutch 14- and 15-year-olds 28 . Participants’ responses were used to select the three social media platforms that were assessed in the personalized ESM study.

Duration of social media use

In the ESM study, duration of active and passive social media use was measured by asking participants how much time in the past hour they had spent actively and passively using each of the three platforms that were included in the personalized ESM surveys. Response options ranged from 0 to 60 min , with 5-min intervals. To measure active Instagram use, participants indicated how much time in the past hour they had spent (a) “posting on your feed or sharing something in your story on Instagram” and (b) “sending direct messages/chatting on Instagram.” These two items were summed to create the variable duration of active Instagram use. Sum scores exceeding 60 min (only 0.52% of all assessments) were recoded to 60 min. To measure duration of passive Instagram use, participants indicated how much time in the past hour they had spent “viewing posts/stories of others on Instagram.” To measure the use of WhatsApp, Snapchat, YouTube and game-based chatting, we asked participants how much time they had spent “sending WhatsApp messages” (active use) and “reading WhatsApp messages” (passive use); “sending snaps/messages or sharing something in your story on Snapchat” (active use) and “viewing snaps/stories/messages from others on Snapchat” (passive use); “posting YouTube clips” (active use) and “watching YouTube clips” (passive use); “sending messages via the chat function of a game/games” (active use) and “reading messages via the chat function of a game/games” (passive use). Duration of active and passive overall social media use were created by summing the responses across the three social media platforms for active and passive use, respectively. Sum scores exceeding 60 min (2.13% of all assessments for active overall use; 2.90% for passive overall use) were recoded to 60 min. The duration variables were used to investigate whether the time spent actively or passively using social media was associated with well-being (dose–response associations).

Use/no use of social media

Based on the duration variables, we created six dummy variables, one for active and one for passive overall social media use, one for active and one for passive Instagram use, and one for active and one for passive WhatsApp use (0 =  no active use and 1 =  active use , and 0 =  no passive use and 1 =  passive use , respectively). These dummy variables were used to investigate whether the use of social media, irrespective of the duration of use, was associated with well-being (categorical associations).

Consistent with previous ESM studies 19 , 20 , we measured affective well-being using one item, asking “How happy do you feel right now?” at each assessment. Adolescents indicated their response to the question using a 7-point scale ranging from 1 ( not at all ) to 7 ( completely ), with 4 ( a little ) as the midpoint. Convergent validity of this item was established in a separate pilot ESM study among 30 adolescents conducted by the research team of the fourth author: The affective well-being item was strongly correlated with the presence of positive affect and absence of negative affect (assessed by a 10-item positive and negative affect schedule for children; PANAS-C) at both the between-person (positive affect: r  = 0.88, p < 0.001; negative affect: r  = − 0.62, p < 0.001) and within-person level (positive affect: r  = 0.74, p < 0.001; negative affect: r  = − 0.58, p < 0.001).

Statistical analyses

Before conducting the analyses, several validation checks were performed (see 34 ). First, we aimed to only include participants in the analyses who had completed more than 33% of all ESM assessments (i.e., at least 14 assessments). Next, we screened participants’ responses to the open questions for unserious responses (e.g., gross comments, jokes). And finally, we inspected time series plots for patterns in answering tendencies. Since all participants completed more than 33% of all ESM assessments, and no inappropriate responses or low-quality data patterns were detected, all participants were included in the analyses.

Following our preregistered analysis plan, we tested the proposed associations in a series of multilevel models. Before doing so, we tested the homoscedasticity and linearity assumptions for multilevel analyses 37 . Inspection of standardized residual plots indicated that the data met these assumptions (plots are available on OSF at  https://osf.io/nhks2 ). We specified separate models for overall social media use, use of Instagram, and use of WhatsApp. To investigate to what extent adolescents’ well-being would vary depending on whether they had actively or passively used social media/Instagram/WhatsApp or not during the past hour (categorical associations), we tested models including the dummy variables as predictors (active use versus no active use, and passive use versus no passive use; models 1, 3, and 5). To investigate whether, at moments when adolescents had used social media/Instagram/WhatsApp during the past hour, their well-being would vary depending on the duration of social media/Instagram/WhatsApp use (dose–response associations), we tested models including the duration variables as predictors (duration of active use and duration of passive use; models 2, 4, and 6). In order to avoid negative skew in the duration variables, we only included assessments during which adolescents had used social media in the past hour (overall, Instagram, or WhatsApp, respectively), either actively or passively. All models included well-being as outcome variable. Since multilevel analyses allow to include all available data for each individual, no missing data were imputed and no data points were excluded.

We used a model building approach that involved three steps. In the first step, we estimated an intercept-only model to assess the relative amount of between- and within-person variance in affective well-being. We estimated a three-level model in which repeated momentary assessments (level 1) were nested within adolescents (level 2), who, in turn, were nested within classrooms (level 3). However, because the between-classroom variance in affective well-being was small (i.e., 0.4% of the variance was explained by differences between classes), we proceeded with estimating two-level (instead of three-level) models, with repeated momentary assessments (level 1) nested within adolescents (level 2).

In the second step, we assessed the within-person associations of well-being with (a) overall active and passive social media use (i.e., the total of the three platforms), (b) active and passive use of Instagram, and (c) active and passive use of WhatsApp, by adding fixed effects to the model (Models 1A-6A). To facilitate the interpretation of the associations and control for the effects of time, a covariate was added that controlled for the n th assessment of the study week (instead of the n th assessment of the day, as preregistered). This so-called detrending is helpful to interpret within-person associations as correlated fluctuations beyond other changes in social media use and well-being 38 . In order to obtain within-person estimates, we person-mean centered all predictors 38 . Significance of the fixed effects was determined using the Wald test.

In the third and final step, we assessed heterogeneity in the within-person associations by adding random slopes to the models (Models 1B-6B). Significance of the random slopes was determined by comparing the fit of the fixed effects model with the fit of the random effects model, by performing the Satorra-Bentler scaled chi-square test 39 and by comparing the Bayesian information criterion (BIC 40 ) and Akaike information criterion (AIC 41 ) of the models. When the random effects model had a significantly better fit than the fixed effects model (i.e., pointing at significant heterogeneity), variance components were inspected to investigate whether heterogeneity existed in the association of either active or passive use. Next, when evidence was found for significant heterogeneity, we computed person-specific effect sizes, based on the random effect models, to investigate what percentages of adolescents experienced better well-being, worse well-being, and no changes in well-being. In line with Keijsers and colleagues 42 we only included participants who had completed at least 10 assessments. In addition, for the dose–response associations, we constructed graphical representations of the person-specific slopes, based on the person-specific effect sizes, using the xyplot function from the lattice package in R 43 .

Three improvements were made to our original preregistered plan. First, rather than estimating the models with multilevel modelling in R 43 , we ran the preregistered models in Mplus 44 . Mplus provides standardized estimates for the fixed effects models, which offers insight into the effect sizes. This allowed us to compare the relative strength of the associations of passive versus active use with well-being. Second, instead of using the maximum likelihood estimator, we used the maximum likelihood estimator with robust standard errors (MLR), which are robust to non-normality. Sensitivity tests, uploaded on OSF ( https://osf.io/nhks2 ), indicated that the results were almost identical across the two software packages and estimation approaches. Third, to improve the interpretation of the results and make the scales of the duration measures of social media use and well-being more comparable, we transformed the social media duration scores (0 to 60 min) into scales running from 0 to 6, so that an increase of 1 unit reflects 10 min of social media use. The model estimates were unaffected by this transformation.

Reporting summary

Further information on the research design is available in the Nature Research Reporting Summary linked to this article.

Data availability

The dataset generated and analysed during the current study is available in Figshare 45 . The preregistration of the design, sampling and analysis plan, and the analysis scripts used to analyse the data for this paper are available online on the Open Science Framework website ( https://osf.io/nhks2 ).

Best, P., Manktelow, R. & Taylor, B. Online communication, social media and adolescent wellbeing: A systematic narrative review. Child Youth Serv. Rev. 41 , 27–36. https://doi.org/10.1016/j.childyouth.2014.03.001 (2014).

Article   Google Scholar  

James, C. et al. Digital life and youth well-being, social connectedness, empathy, and narcissism. Pediatrics 140 , S71–S75. https://doi.org/10.1542/peds.2016-1758F (2017).

Article   PubMed   Google Scholar  

McCrae, N., Gettings, S. & Purssell, E. Social media and depressive symptoms in childhood and adolescence: A systematic review. Adolesc. Res. Rev. 2 , 315–330. https://doi.org/10.1007/s40894-017-0053-4 (2017).

Sarmiento, I. G. et al. How does social media use relate to adolescents’ internalizing symptoms? Conclusions from a systematic narrative review. Adolesc Res Rev , 1–24, doi:10.1007/s40894-018-0095-2 (2018).

Orben, A. Teenagers, screens and social media: A narrative review of reviews and key studies. Soc. Psychiatry Psychiatr. Epidemiol. https://doi.org/10.1007/s00127-019-01825-4 (2020).

Orben, A., Dienlin, T. & Przybylski, A. K. Social media’s enduring effect on adolescent life satisfaction. Proc. Natl. Acad. Sci. USA 116 , 10226–10228. https://doi.org/10.1073/pnas.1902058116 (2019).

Article   CAS   PubMed   Google Scholar  

Whitlock, J. & Masur, P. K. Disentangling the association of screen time with developmental outcomes and well-being: Problems, challenges, and opportunities. JAMA https://doi.org/10.1001/jamapediatrics.2019.3191 (2019).

Hamaker, E. L. In Handbook of Research Methods for Studying Daily Life (eds Mehl, M. R. & Conner, T. S.) 43–61 (Guilford Press, New York, 2012).

Schmiedek, F. & Dirk, J. In The Encyclopedia of Adulthood and Aging (ed. Krauss Whitbourne, S.) 1–6 (Wiley, 2015).

Keijsers, L. & van Roekel, E. In Reframing Adolescent Research (eds Hendry, L. B. & Kloep, M.) (Routledge, 2018).

Coyne, S. M., Rogers, A. A., Zurcher, J. D., Stockdale, L. & Booth, M. Does time spent using social media impact mental health? An eight year longitudinal study. Comput. Hum. Behav. 104 , 106160. https://doi.org/10.1016/j.chb.2019.106160 (2020).

Boers, E., Afzali, M. H., Newton, N. & Conrod, P. Association of screen time and depression in adolescence. JAMA 173 , 853–859. https://doi.org/10.1001/jamapediatrics.2019.1759 (2019).

Jensen, M., George, M. J., Russell, M. R. & Odgers, C. L. Young adolescents’ digital technology use and mental health symptoms: Little evidence of longitudinal or daily linkages. Clin. Psychol. Sci. https://doi.org/10.1177/2167702619859336 (2019).

Valkenburg, P. M. The limited informativeness of meta-analyses of media effects. Perspect. Psychol. Sci. 10 , 680–682. https://doi.org/10.1177/1745691615592237 (2015).

Pearce, L. J. & Field, A. P. The impact of “scary” TV and film on children’s internalizing emotions: A meta-analysis. Hum. Commun.. Res. 42 , 98–121. https://doi.org/10.1111/hcre.12069 (2016).

Howard, M. C. & Hoffman, M. E. Variable-centered, person-centered, and person-specific approaches. Organ. Res. Methods 21 , 846–876. https://doi.org/10.1177/1094428117744021 (2017).

Valkenburg, P. M. & Peter, J. The differential susceptibility to media effects model. J. Commun. 63 , 221–243. https://doi.org/10.1111/jcom.12024 (2013).

Eid, M. & Diener, E. Global judgments of subjective well-being: Situational variability and long-term stability. Soc. Indic. Res. 65 , 245–277. https://doi.org/10.1023/B:SOCI.0000003801.89195.bc (2004).

Kross, E. et al. Facebook use predicts declines in subjective well-being in young adults. PLoS ONE 8 , e69841. https://doi.org/10.1371/journal.pone.0069841 (2013).

Article   ADS   CAS   PubMed   PubMed Central   Google Scholar  

Reissmann, A., Hauser, J., Stollberg, E., Kaunzinger, I. & Lange, K. W. The role of loneliness in emerging adults’ everyday use of facebook—An experience sampling approach. Comput. Hum. Behav. 88 , 47–60. https://doi.org/10.1016/j.chb.2018.06.011 (2018).

Rutledge, R. B., Skandali, N., Dayan, P. & Dolan, R. J. A computational and neural model of momentary subjective well-being. Proc. Natl. Acad. Sci. USA 111 , 12252–12257. https://doi.org/10.1073/pnas.1407535111 (2014).

Article   ADS   CAS   PubMed   Google Scholar  

Tov, W. In Handbook of Well-being (eds Diener, E.D. et al. ) (DEF Publishers, 2018).

Harter, S. The Construction of the Self: Developmental and Sociocultural Foundations (Guilford Press, New York, 2012).

Steinberg, L. Adolescence . Vol. 9 (McGraw-Hill, 2011).

Rideout, V. & Fox, S. Digital Health Practices, Social Media Use, and Mental Well-being Among Teens and Young Adults in the US (HopeLab, San Francisco, 2018).

Google Scholar  

Waterloo, S. F., Baumgartner, S. E., Peter, J. & Valkenburg, P. M. Norms of online expressions of emotion: Comparing Facebook, Twitter, Instagram, and WhatsApp. New Media Soc. 20 , 1813–1831. https://doi.org/10.1177/1461444817707349 (2017).

Article   PubMed   PubMed Central   Google Scholar  

Rideout, V. & Robb, M. B. Social Media, Social Life: Teens Reveal their Experiences (Common Sense Media, San Fransico, 2018).

van Driel, I. I., Pouwels, J. L., Beyens, I., Keijsers, L. & Valkenburg, P. M. 'Posting, Scrolling, Chatting & Snapping': Youth (14–15) and Social Media in 2019 (Center for Research on Children, Adolescents, and the Media (CcaM), Universiteit van Amsterdam, 2019).

Verduyn, P. et al. Passive Facebook usage undermines affective well-being: Experimental and longitudinal evidence. J. Exp. Psychol. 144 , 480–488. https://doi.org/10.1037/xge0000057 (2015).

Valkenburg, P. M. & Peter, J. Five challenges for the future of media-effects research. Int. J. Commun. 7 , 197–215 (2013).

Verduyn, P., Ybarra, O., Résibois, M., Jonides, J. & Kross, E. Do social network sites enhance or undermine subjective well-being? A critical review. Soc. Issues Policy Rev. 11 , 274–302. https://doi.org/10.1111/sipr.12033 (2017).

Radovic, A., Gmelin, T., Stein, B. D. & Miller, E. Depressed adolescents’ positive and negative use of social media. J. Adolesc. 55 , 5–15. https://doi.org/10.1016/j.adolescence.2016.12.002 (2017).

Valkenburg, P. M., Peter, J. & Schouten, A. P. Friend networking sites and their relationship to adolescents’ well-being and social self-esteem. Cyberpsychol. Behav. 9 , 584–590. https://doi.org/10.1089/cpb.2006.9.584 (2006).

van Roekel, E., Keijsers, L. & Chung, J. M. A review of current ambulatory assessment studies in adolescent samples and practical recommendations. J. Res. Adolesc. 29 , 560–577. https://doi.org/10.1111/jora.12471 (2019).

van Roekel, E., Scholte, R. H. J., Engels, R. C. M. E., Goossens, L. & Verhagen, M. Loneliness in the daily lives of adolescents: An experience sampling study examining the effects of social contexts. J. Early Adolesc. 35 , 905–930. https://doi.org/10.1177/0272431614547049 (2015).

Neumann, A., van Lier, P. A. C., Frijns, T., Meeus, W. & Koot, H. M. Emotional dynamics in the development of early adolescent psychopathology: A one-year longitudinal Study. J. Abnorm. Child Psychol. 39 , 657–669. https://doi.org/10.1007/s10802-011-9509-3 (2011).

Hox, J., Moerbeek, M. & van de Schoot, R. Multilevel Analysis: Techniques and Applications 3rd edn. (Routledge, London, 2018).

Wang, L. P. & Maxwell, S. E. On disaggregating between-person and within-person effects with longitudinal data using multilevel models. Psychol. Methods 20 , 63–83. https://doi.org/10.1037/met0000030 (2015).

Satorra, A. & Bentler, P. M. Ensuring positiveness of the scaled difference chi-square test statistic. Psychometrika 75 , 243–248. https://doi.org/10.1007/s11336-009-9135-y (2010).

Article   MathSciNet   PubMed   PubMed Central   MATH   Google Scholar  

Schwarz, G. Estimating the dimension of a model. Ann. Stat. 6 , 461–464. https://doi.org/10.1214/aos/1176344136 (1978).

Article   MathSciNet   MATH   Google Scholar  

Akaike, H. A new look at the statistical model identification. IEEE Trans. Autom. Control 19 , 716–723. https://doi.org/10.1109/TAC.1974.1100705 (1974).

Article   ADS   MathSciNet   MATH   Google Scholar  

Keijsers, L. et al. What drives developmental change in adolescent disclosure and maternal knowledge? Heterogeneity in within-family processes. Dev. Psychol. 52 , 2057–2070. https://doi.org/10.1037/dev0000220 (2016).

R Core Team R: A Language and Environment for Statistical Computing. (R Foundation for Statistical Computing, Vienna, 2017).

Muthén, L. K. & Muthén, B. O. Mplus User’s Guide 8th edn. (Muthén & Muthén, Los Angeles, 2017).

Beyens, I., Pouwels, J. L., van Driel, I. I., Keijsers, L. & Valkenburg, P. M. Dataset belonging to Beyens et al. (2020). The effect of social media on well-being differs from adolescent to adolescent. https://doi.org/10.21942/uva.12497990 (2020).

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Acknowledgements

This study was funded by the NWO Spinoza Prize and the Gravitation grant (NWO Grant 024.001.003; Consortium on Individual Development) awarded to P.M.V. by the Dutch Research Council (NWO). Additional funding was received from the VIDI grant (NWO VIDI Grant 452.17.011) awarded to L.K. by the Dutch Research Council (NWO). The authors would like to thank Savannah Boele (Tilburg University) for providing her pilot ESM results.

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I.B., J.L.P., I.I.v.D., L.K., and P.M.V. designed the study; I.B., J.L.P., and I.I.v.D. collected the data; I.B., J.L.P., and L.K. analyzed the data; and I.B., J.L.P., I.I.v.D., L.K., and P.M.V. contributed to writing and reviewing the manuscript.

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Beyens, I., Pouwels, J.L., van Driel, I.I. et al. The effect of social media on well-being differs from adolescent to adolescent. Sci Rep 10 , 10763 (2020). https://doi.org/10.1038/s41598-020-67727-7

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Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice

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Introduction

Social media has become a prominent fixture in the lives of many individuals facing the challenges of mental illness. Social media refers broadly to web and mobile platforms that allow individuals to connect with others within a virtual network (such as Facebook, Twitter, Instagram, Snapchat, or LinkedIn), where they can share, co-create, or exchange various forms of digital content, including information, messages, photos, or videos (Ahmed et al. 2019 ). Studies have reported that individuals living with a range of mental disorders, including depression, psychotic disorders, or other severe mental illnesses, use social media platforms at comparable rates as the general population, with use ranging from about 70% among middle-age and older individuals to upwards of 97% among younger individuals (Aschbrenner et al. 2018b ; Birnbaum et al. 2017b ; Brunette et al. 2019 ; Naslund et al. 2016 ). Other exploratory studies have found that many of these individuals with mental illness appear to turn to social media to share their personal experiences, seek information about their mental health and treatment options, and give and receive support from others facing similar mental health challenges (Bucci et al. 2019 ; Naslund et al. 2016b ).

Across the USA and globally, very few people living with mental illness have access to adequate mental health services (Patel et al. 2018 ). The wide reach and near ubiquitous use of social media platforms may afford novel opportunities to address these shortfalls in existing mental health care, by enhancing the quality, availability, and reach of services. Recent studies have explored patterns of social media use, impact of social media use on mental health and wellbeing, and the potential to leverage the popularity and interactive features of social media to enhance the delivery of interventions. However, there remains uncertainty regarding the risks and potential harms of social media for mental health (Orben and Przybylski 2019 ) and how best to weigh these concerns against potential benefits.

In this commentary, we summarized current research on the use of social media among individuals with mental illness, with consideration of the impact of social media on mental wellbeing, as well as early efforts using social media for delivery of evidence-based programs for addressing mental health problems. We searched for recent peer reviewed publications in Medline and Google Scholar using the search terms “mental health” or “mental illness” and “social media,” and searched the reference lists of recent reviews and other relevant studies. We reviewed the risks, potential harms, and necessary safety precautions with using social media for mental health. Overall, our goal was to consider the role of social media as a potentially viable intervention platform for offering support to persons with mental disorders, promoting engagement and retention in care, and enhancing existing mental health services, while balancing the need for safety. Given this broad objective, we did not perform a systematic search of the literature and we did not apply specific inclusion criteria based on study design or type of mental disorder.

Social Media Use and Mental Health

In 2020, there are an estimated 3.8 billion social media users worldwide, representing half the global population (We Are Social 2020 ). Recent studies have shown that individuals with mental disorders are increasingly gaining access to and using mobile devices, such as smartphones (Firth et al. 2015 ; Glick et al. 2016 ; Torous et al. 2014a , b ). Similarly, there is mounting evidence showing high rates of social media use among individuals with mental disorders, including studies looking at engagement with these popular platforms across diverse settings and disorder types. Initial studies from 2015 found that nearly half of a sample of psychiatric patients were social media users, with greater use among younger individuals (Trefflich et al. 2015 ), while 47% of inpatients and outpatients with schizophrenia reported using social media, of which 79% reported at least once-a-week usage of social media websites (Miller et al. 2015 ). Rates of social media use among psychiatric populations have increased in recent years, as reflected in a study with data from 2017 showing comparable rates of social media use (approximately 70%) among individuals with serious mental illness in treatment as compared with low-income groups from the general population (Brunette et al. 2019 ).

Similarly, among individuals with serious mental illness receiving community-based mental health services, a recent study found equivalent rates of social media use as the general population, even exceeding 70% of participants (Naslund et al. 2016 ). Comparable findings were demonstrated among middle-age and older individuals with mental illness accessing services at peer support agencies, where 72% of respondents reported using social media (Aschbrenner et al. 2018b ). Similar results, with 68% of those with first episode psychosis using social media daily were reported in another study (Abdel-Baki et al. 2017 ).

Individuals who self-identified as having a schizophrenia spectrum disorder responded to a survey shared through the National Alliance of Mental Illness (NAMI) and reported that visiting social media sites was one of their most common activities when using digital devices, taking up roughly 2 h each day (Gay et al. 2016 ). For adolescents and young adults ages 12 to 21 with psychotic disorders and mood disorders, over 97% reported using social media, with average use exceeding 2.5 h per day (Birnbaum et al. 2017b ). Similarly, in a sample of adolescents ages 13–18 recruited from community mental health centers, 98% reported using social media, with YouTube as the most popular platform, followed by Instagram and Snapchat (Aschbrenner et al. 2019 ).

Research has also explored the motivations for using social media as well as the perceived benefits of interacting on these platforms among individuals with mental illness. In the sections that follow (see Table 1 for a summary), we consider three potentially unique features of interacting and connecting with others on social media that may offer benefits for individuals living with mental illness. These include: (1) Facilitate social interaction; (2) Access to a peer support network; and (3) Promote engagement and retention in services.

Facilitate Social Interaction

Social media platforms offer near continuous opportunities to connect and interact with others, regardless of time of day or geographic location. This on demand ease of communication may be especially important for facilitating social interaction among individuals with mental disorders experiencing difficulties interacting in face-to-face settings. For example, impaired social functioning is a common deficit in schizophrenia spectrum disorders, and social media may facilitate communication and interacting with others for these individuals (Torous and Keshavan 2016 ). This was suggested in one study where participants with schizophrenia indicated that social media helped them to interact and socialize more easily (Miller et al. 2015 ). Like other online communication, the ability to connect with others anonymously may be an important feature of social media, especially for individuals living with highly stigmatizing health conditions (Berger et al. 2005 ), such as serious mental disorders (Highton-Williamson et al. 2015 ).

Studies have found that individuals with serious mental disorders (Spinzy et al. 2012 ) as well as young adults with mental illness (Gowen et al. 2012 ) appear to form online relationships and connect with others on social media as often as social media users from the general population. This is an important observation because individuals living with serious mental disorders typically have few social contacts in the offline world and also experience high rates of loneliness (Badcock et al. 2015 ; Giacco et al. 2016 ). Among individuals receiving publicly funded mental health services who use social media, nearly half (47%) reported using these platforms at least weekly to feel less alone (Brusilovskiy et al. 2016 ). In another study of young adults with serious mental illness, most indicated that they used social media to help feel less isolated (Gowen et al. 2012 ). Interestingly, more frequent use of social media among a sample of individuals with serious mental illness was associated with greater community participation, measured as participation in shopping, work, religious activities, or visiting friends and family, as well as greater civic engagement, reflected as voting in local elections (Brusilovskiy et al. 2016 ).

Emerging research also shows that young people with moderate to severe depressive symptoms appear to prefer communicating on social media rather than in-person (Rideout and Fox 2018 ), while other studies have found that some individuals may prefer to seek help for mental health concerns online rather than through in-person encounters (Batterham and Calear 2017 ). In a qualitative study, participants with schizophrenia described greater anonymity, the ability to discover that other people have experienced similar health challenges and reducing fears through greater access to information as important motivations for using the Internet to seek mental health information (Schrank et al. 2010 ). Because social media does not require the immediate responses necessary in face-to-face communication, it may overcome deficits with social interaction due to psychotic symptoms that typically adversely affect face-to-face conversations (Docherty et al. 1996 ). Online social interactions may not require the use of non-verbal cues, particularly in the initial stages of interaction (Kiesler et al. 1984 ), with interactions being more fluid and within the control of users, thereby overcoming possible social anxieties linked to in-person interaction (Indian and Grieve 2014 ). Furthermore, many individuals with serious mental disorders can experience symptoms including passive social withdrawal, blunted affect, and attentional impairment, as well as active social avoidance due to hallucinations or other concerns (Hansen et al. 2009 ), thus potentially reinforcing the relative advantage, as perceived by users, of using social media over in person conversations.

Access to a Peer Support Network

There is growing recognition about the role that social media channels could play in enabling peer support (Bucci et al. 2019 ; Naslund et al. 2016b ), referred to as a system of mutual giving and receiving where individuals who have endured the difficulties of mental illness can offer hope, friendship, and support to others facing similar challenges (Davidson et al. 2006 ; Mead et al. 2001 ). Initial studies exploring use of online self-help forums among individuals with serious mental illnesses have found that individuals with schizophrenia appeared to use these forums for self-disclosure and sharing personal experiences, in addition to providing or requesting information, describing symptoms, or discussing medication (Haker et al. 2005 ), while users with bipolar disorder reported using these forums to ask for help from others about their illness (Vayreda and Antaki 2009 ). More recently, in a review of online social networking in people with psychosis, Highton-Williamson et al. ( 2015 ) highlight that an important purpose of such online connections was to establish new friendships, pursue romantic relationships, maintain existing relationships or reconnect with people, and seek online peer support from others with lived experience (Highton-Williamson et al. 2015 ).

Online peer support among individuals with mental illness has been further elaborated in various studies. In a content analysis of comments posted to YouTube by individuals who self-identified as having a serious mental illness, there appeared to be opportunities to feel less alone, provide hope, find support and learn through mutual reciprocity, and share coping strategies for day-to-day challenges of living with a mental illness (Naslund et al. 2014 ). In another study, Chang ( 2009 ) delineated various communication patterns in an online psychosis peer-support group (Chang 2009 ). Specifically, different forms of support emerged, including “informational support” about medication use or contacting mental health providers, “esteem support” involving positive comments for encouragement, “network support” for sharing similar experiences, and “emotional support” to express understanding of a peer’s situation and offer hope or confidence (Chang 2009 ). Bauer et al. ( 2013 ) reported that the main interest in online self-help forums for patients with bipolar disorder was to share emotions with others, allow exchange of information, and benefit by being part of an online social group (Bauer et al. 2013 ).

For individuals who openly discuss mental health problems on Twitter, a study by Berry et al. ( 2017 ) found that this served as an important opportunity to seek support and to hear about the experiences of others (Berry et al. 2017 ). In a survey of social media users with mental illness, respondents reported that sharing personal experiences about living with mental illness and opportunities to learn about strategies for coping with mental illness from others were important reasons for using social media (Naslund et al. 2017 ). A computational study of mental health awareness campaigns on Twitter provides further support with inspirational posts and tips being the most shared (Saha et al. 2019 ). Taken together, these studies offer insights about the potential for social media to facilitate access to an informal peer support network, though more research is necessary to examine how these online interactions may impact intentions to seek care, illness self-management, and clinically meaningful outcomes in offline contexts.

Promote Engagement and Retention in Services

Many individuals living with mental disorders have expressed interest in using social media platforms for seeking mental health information (Lal et al. 2018 ), connecting with mental health providers (Birnbaum et al. 2017b ), and accessing evidence-based mental health services delivered over social media specifically for coping with mental health symptoms or for promoting overall health and wellbeing (Naslund et al. 2017 ). With the widespread use of social media among individuals living with mental illness combined with the potential to facilitate social interaction and connect with supportive peers, as summarized above, it may be possible to leverage the popular features of social media to enhance existing mental health programs and services. A recent review by Biagianti et al. ( 2018 ) found that peer-to-peer support appeared to offer feasible and acceptable ways to augment digital mental health interventions for individuals with psychotic disorders by specifically improving engagement, compliance, and adherence to the interventions and may also improve perceived social support (Biagianti et al. 2018 ).

Among digital programs that have incorporated peer-to-peer social networking consistent with popular features on social media platforms, a pilot study of the HORYZONS online psychosocial intervention demonstrated significant reductions in depression among patients with first episode psychosis (Alvarez-Jimenez et al. 2013 ). Importantly, the majority of participants (95%) in this study engaged with the peer-to-peer networking feature of the program, with many reporting increases in perceived social connectedness and empowerment in their recovery process (Alvarez-Jimenez et al. 2013 ). This moderated online social therapy program is now being evaluated as part of a large randomized controlled trial for maintaining treatment effects from first episode psychosis services (Alvarez-Jimenez et al. 2019 ).

Other early efforts have demonstrated that use of digital environments with the interactive peer-to-peer features of social media can enhance social functioning and wellbeing in young people at high risk of psychosis (Alvarez-Jimenez et al. 2018 ). There has also been a recent emergence of several mobile apps to support symptom monitoring and relapse prevention in psychotic disorders. Among these apps, the development of PRIME (Personalized Real-time Intervention for Motivational Enhancement) has involved working closely with young people with schizophrenia to ensure that the design of the app has the look and feel of mainstream social media platforms, as opposed to existing clinical tools (Schlosser et al. 2016 ). This unique approach to the design of the app is aimed at promoting engagement and ensuring that the app can effectively improve motivation and functioning through goal setting and promoting better quality of life of users with schizophrenia (Schlosser et al. 2018 ).

Social media platforms could also be used to promote engagement and participation in in-person services delivered through community mental health settings. For example, the peer-based lifestyle intervention called PeerFIT targets weight loss and improved fitness among individuals living with serious mental illness through a combination of in-person lifestyle classes, exercise groups, and use of digital technologies (Aschbrenner et al. 2016b , c ). The intervention holds tremendous promise as lack of support is one of the largest barriers towards exercise in patients with serious mental illness (Firth et al. 2016 ), and it is now possible to use social media to counter such. Specifically, in PeerFIT, a private Facebook group is closely integrated into the program to offer a closed platform where participants can connect with the lifestyle coaches, access intervention content, and support or encourage each other as they work towards their lifestyle goals (Aschbrenner et al. 2016a ; Naslund et al. 2016a ). To date, this program has demonstrated preliminary effectiveness for meaningfully reducing cardiovascular risk factors that contribute to early mortality in this patient group (Aschbrenner, Naslund, Shevenell, Kinney, et al., 2016), while the Facebook component appears to have increased engagement in the program, while allowing participants who were unable to attend in-person sessions due to other health concerns or competing demands to remain connected with the program (Naslund et al. 2018 ). This lifestyle intervention is currently being evaluated in a randomized controlled trial enrolling young adults with serious mental illness from real world community mental health services settings (Aschbrenner et al. 2018a ).

These examples highlight the promise of incorporating the features of popular social media into existing programs, which may offer opportunities to safely promote engagement and program retention, while achieving improved clinical outcomes. This is an emerging area of research, as evidenced by several important effectiveness trials underway (Alvarez-Jimenez et al. 2019 ; Aschbrenner et al. 2018a ), including efforts to leverage online social networking to support family caregivers of individuals receiving first episode psychosis services (Gleeson et al. 2017 ).

Challenges with Social Media for Mental Health

The science on the role of social media for engaging persons with mental disorders needs a cautionary note on the effects of social media usage on mental health and wellbeing, particularly in adolescents and young adults. While the risks and harms of social media are frequently covered in the popular press and mainstream news reports, careful consideration of the research in this area is necessary. In a review of 43 studies in young people, many benefits of social media were cited, including increased self-esteem and opportunities for self-disclosure (Best et al. 2014 ). Yet, reported negative effects were an increased exposure to harm, social isolation, depressive symptoms, and bullying (Best et al. 2014 ). In the sections that follow (see Table 1 for a summary), we consider three major categories of risk related to use of social media and mental health. These include: (1) Impact on symptoms; (2) Facing hostile interactions; and (3) Consequences for daily life.

Impact on Symptoms

Studies consistently highlight that use of social media, especially heavy use and prolonged time spent on social media platforms, appears to contribute to increased risk for a variety of mental health symptoms and poor wellbeing, especially among young people (Andreassen et al. 2016 ; Kross et al. 2013 ; Woods and Scott 2016 ). This may partly be driven by the detrimental effects of screen time on mental health, including increased severity of anxiety and depressive symptoms, which have been well documented (Stiglic and Viner 2019 ). Recent studies have reported negative effects of social media use on mental health of young people, including social comparison pressure with others and greater feeling of social isolation after being rejected by others on social media (Rideout and Fox 2018 ). In a study of young adults, it was found that negative comparisons with others on Facebook contributed to risk of rumination and subsequent increases in depression symptoms (Feinstein et al. 2013 ). Still, the cross-sectional nature of many screen time and mental health studies makes it challenging to reach causal inferences (Orben and Przybylski 2019 ).

Quantity of social media use is also an important factor, as highlighted in a survey of young adults ages 19 to 32, where more frequent visits to social media platforms each week were correlated with greater depressive symptoms (Lin et al. 2016 ). More time spent using social media is also associated with greater symptoms of anxiety (Vannucci et al. 2017 ). The actual number of platforms accessed also appears to contribute to risk as reflected in another national survey of young adults where use of a large number of social media platforms was associated with negative impact on mental health (Primack et al. 2017 ). Among survey respondents using between 7 and 11 different social media platforms compared with respondents using only 2 or fewer platforms, there were 3 times greater odds of having high levels of depressive symptoms and a 3.2 times greater odds of having high levels of anxiety symptoms (Primack et al. 2017 ).

Many researchers have postulated that worsening mental health attributed to social media use may be because social media replaces face-to-face interactions for young people (Twenge and Campbell 2018 ) and may contribute to greater loneliness (Bucci et al. 2019 ) and negative effects on other aspects of health and wellbeing (Woods and Scott 2016 ). One nationally representative survey of US adolescents found that among respondents who reported more time accessing media such as social media platforms or smartphone devices, there were significantly greater depressive symptoms and increased risk of suicide when compared with adolescents who reported spending more time on non-screen activities, such as in-person social interaction or sports and recreation activities (Twenge et al. 2018 ). For individuals living with more severe mental illnesses, the effects of social media on psychiatric symptoms have received less attention. One study found that participation in chat rooms may contribute to worsening symptoms in young people with psychotic disorders (Mittal et al. 2007 ), while another study of patients with psychosis found that social media use appeared to predict low mood (Berry et al. 2018 ). These studies highlight a clear relationship between social media use and mental health that may not be present in general population studies (Orben and Przybylski 2019 ) and emphasize the need to explore how social media may contribute to symptom severity and whether protective factors may be identified to mitigate these risks.

Facing Hostile Interactions

Popular social media platforms can create potential situations where individuals may be victimized by negative comments or posts. Cyberbullying represents a form of online aggression directed towards specific individuals, such as peers or acquaintances, which is perceived to be most harmful when compared with random hostile comments posted online (Hamm et al. 2015 ). Importantly, cyberbullying on social media consistently shows harmful impact on mental health in the form of increased depressive symptoms as well as worsening of anxiety symptoms, as evidenced in a review of 36 studies among children and young people (Hamm et al. 2015 ). Furthermore, cyberbullying disproportionately impacts females as reflected in a national survey of adolescents in the USA, where females were twice as likely to be victims of cyberbullying compared with males (Alhajji et al. 2019 ). Most studies report cross-sectional associations between cyberbullying and symptoms of depression or anxiety (Hamm et al. 2015 ), though one longitudinal study in Switzerland found that cyberbullying contributed to significantly greater depression over time (Machmutow et al. 2012 ).

For youth ages 10 to 17 who reported major depressive symptomatology, there were over 3 times greater odds of facing online harassment in the last year compared with youth who reported mild or no depressive symptoms (Ybarra 2004 ). Similarly, in a 2018 national survey of young people, respondents ages 14 to 22 with moderate to severe depressive symptoms were more likely to have had negative experiences when using social media and, in particular, were more likely to report having faced hostile comments or being “trolled” from others when compared with respondents without depressive symptoms (31% vs. 14%) (Rideout and Fox 2018 ). As these studies depict risks for victimization on social media and the correlation with poor mental health, it is possible that individuals living with mental illness may also experience greater hostility online compared to individuals without mental illness. This would be consistent with research showing greater risk of hostility, including increased violence and discrimination, directed towards individuals living with mental illness in in-person contexts, especially targeted at those with severe mental illnesses (Goodman et al. 1999 ).

A computational study of mental health awareness campaigns on Twitter reported that while stigmatizing content was rare, it was actually the most spread (re-tweeted) demonstrating that harmful content can travel quickly on social media (Saha et al. 2019 ). Another study was able to map the spread of social media posts about the Blue Whale Challenge, an alleged game promoting suicide, over Twitter, YouTube, Reddit, Tumblr, and other forums across 127 countries (Sumner et al. 2019 ). These findings show that it is critical to monitor the actual content of social media posts, such as determining whether content is hostile or promotes harm to self or others. This is pertinent because existing research looking at duration of exposure cannot account for the impact of specific types of content on mental health and is insufficient to fully understand the effects of using these platforms on mental health.

Consequences for Daily Life

The ways in which individuals use social media can also impact their offline relationships and everyday activities. To date, reports have described risks of social media use pertaining to privacy, confidentiality, and unintended consequences of disclosing personal health information online (Torous and Keshavan 2016 ). Additionally, concerns have been raised about poor quality or misleading health information shared on social media and that social media users may not be aware of misleading information or conflicts of interest especially when the platforms promote popular content regardless of whether it is from a trustworthy source (Moorhead et al. 2013 ; Ventola 2014 ). For persons living with mental illness, there may be additional risks from using social media. A recent study that specifically explored the perspectives of social media users with serious mental illnesses, including participants with schizophrenia spectrum disorders, bipolar disorder, or major depression, found that over one third of participants expressed concerns about privacy when using social media (Naslund and Aschbrenner 2019 ). The reported risks of social media use were directly related to many aspects of everyday life, including concerns about threats to employment, fear of stigma and being judged, impact on personal relationships, and facing hostility or being hurt (Naslund and Aschbrenner 2019 ). While few studies have specifically explored the dangers of social media use from the perspectives of individuals living with mental illness, it is important to recognize that use of these platforms may contribute to risks that extend beyond worsening symptoms and that can affect different aspects of daily life.

In this commentary, we considered ways in which social media may yield benefits for individuals living with mental illness, while contrasting these with the possible harms. Studies reporting on the threats of social media for individuals with mental illness are mostly cross-sectional, making it difficult to draw conclusions about direction of causation. However, the risks are potentially serious. These risks should be carefully considered in discussions pertaining to use of social media and the broader use of digital mental health technologies, as avenues for mental health promotion or for supporting access to evidence-based programs or mental health services. At this point, it would be premature to view the benefits of social media as outweighing the possible harms, when it is clear from the studies summarized here that social media use can have negative effects on mental health symptoms, can potentially expose individuals to hurtful content and hostile interactions, and can result in serious consequences for daily life, including threats to employment and personal relationships. Despite these risks, it is also necessary to recognize that individuals with mental illness will continue to use social media given the ease of accessing these platforms and the immense popularity of online social networking. With this in mind, it may be ideal to raise awareness about these possible risks so that individuals can implement necessary safeguards, while highlighting that there could also be benefits. Being aware of the risks is an essential first step, before then recognizing that use of these popular platforms could contribute to some benefits like finding meaningful interactions with others, engaging with peer support networks, and accessing information and services.

To capitalize on the widespread use of social media and to achieve the promise that these platforms may hold for supporting the delivery of targeted mental health interventions, there is need for continued research to better understand how individuals living with mental illness use social media. Such efforts could inform safety measures and also encourage use of social media in ways that maximize potential benefits while minimizing risk of harm. It will be important to recognize how gender and race contribute to differences in use of social media for seeking mental health information or accessing interventions, as well as differences in how social media might impact mental wellbeing. For example, a national survey of 14- to 22-year olds in the USA found that female respondents were more likely to search online for information about depression or anxiety and to try to connect with other people online who share similar mental health concerns when compared with male respondents (Rideout and Fox 2018 ). In the same survey, there did not appear to be any differences between racial or ethnic groups in social media use for seeking mental health information (Rideout and Fox 2018 ). Social media use also appears to have a differential impact on mental health and emotional wellbeing between females and males (Booker et al. 2018 ), highlighting the need to explore unique experiences between gender groups to inform tailored programs and services. Research shows that lesbian, gay, bisexual, or transgender individuals frequently use social media for searching for health information and may be more likely compared with heterosexual individuals to share their own personal health experiences with others online (Rideout and Fox 2018 ). Less is known about use of social media for seeking support for mental health concerns among gender minorities, though this is an important area for further investigation as these individuals are more likely to experience mental health problems and online victimization when compared with heterosexual individuals (Mereish et al. 2019 ).

Similarly, efforts are needed to explore the relationship between social media use and mental health among ethnic and racial minorities. A recent study found that exposure to traumatic online content on social media showing violence or hateful posts directed at racial minorities contributed to increases in psychological distress, PTSD symptoms, and depression among African American and Latinx adolescents in the USA (Tynes et al. 2019 ). These concerns are contrasted by growing interest in the potential for new technologies including social media to expand the reach of services to underrepresented minority groups (Schueller et al. 2019 ). Therefore, greater attention is needed to understanding the perspectives of ethnic and racial minorities to inform effective and safe use of social media for mental health promotion efforts.

Research has found that individuals living with mental illness have expressed interest in accessing mental health services through social media platforms. A survey of social media users with mental illness found that most respondents were interested in accessing programs for mental health on social media targeting symptom management, health promotion, and support for communicating with health care providers and interacting with the health system (Naslund et al. 2017 ). Importantly, individuals with serious mental illness have also emphasized that any mental health intervention on social media would need to be moderated by someone with adequate training and credentials, would need to have ground rules and ways to promote safety and minimize risks, and importantly, would need to be free and easy to access.

An important strength with this commentary is that it combines a range of studies broadly covering the topic of social media and mental health. We have provided a summary of recent evidence in a rapidly advancing field with the goal of presenting unique ways that social media could offer benefits for individuals with mental illness, while also acknowledging the potentially serious risks and the need for further investigation. There are also several limitations with this commentary that warrant consideration. Importantly, as we aimed to address this broad objective, we did not conduct a systematic review of the literature. Therefore, the studies reported here are not exhaustive, and there may be additional relevant studies that were not included. Additionally, we only summarized published studies, and as a result, any reports from the private sector or websites from different organizations using social media or other apps containing social media–like features would have been omitted. Although, it is difficult to rigorously summarize work from the private sector, sometimes referred to as “gray literature,” because many of these projects are unpublished and are likely selective in their reporting of findings given the target audience may be shareholders or consumers.

Another notable limitation is that we did not assess risk of bias in the studies summarized in this commentary. We found many studies that highlighted risks associated with social media use for individuals living with mental illness; however, few studies of programs or interventions reported negative findings, suggesting the possibility that negative findings may go unpublished. This concern highlights the need for a future more rigorous review of the literature with careful consideration of bias and an accompanying quality assessment. Most of the studies that we described were from the USA, as well as from other higher income settings such as Australia or the UK. Despite the global reach of social media platforms, there is a dearth of research on the impact of these platforms on the mental health of individuals in diverse settings, as well as the ways in which social media could support mental health services in lower income countries where there is virtually no access to mental health providers. Future research is necessary to explore the opportunities and risks for social media to support mental health promotion in low-income and middle-income countries, especially as these countries face a disproportionate share of the global burden of mental disorders, yet account for the majority of social media users worldwide (Naslund et al. 2019 ).

Future Directions for Social Media and Mental Health

As we consider future research directions, the near ubiquitous social media use also yields new opportunities to study the onset and manifestation of mental health symptoms and illness severity earlier than traditional clinical assessments. There is an emerging field of research referred to as “digital phenotyping” aimed at capturing how individuals interact with their digital devices, including social media platforms, in order to study patterns of illness and identify optimal time points for intervention (Jain et al. 2015 ; Onnela and Rauch 2016 ). Given that most people access social media via mobile devices, digital phenotyping and social media are closely related (Torous et al. 2019 ). To date, the emergence of machine learning, a powerful computational method involving statistical and mathematical algorithms (Shatte et al. 2019 ), has made it possible to study large quantities of data captured from popular social media platforms such as Twitter or Instagram to illuminate various features of mental health (Manikonda and De Choudhury 2017 ; Reece et al. 2017 ). Specifically, conversations on Twitter have been analyzed to characterize the onset of depression (De Choudhury et al. 2013 ) as well as detecting users’ mood and affective states (De Choudhury et al. 2012 ), while photos posted to Instagram can yield insights for predicting depression (Reece and Danforth 2017 ). The intersection of social media and digital phenotyping will likely add new levels of context to social media use in the near future.

Several studies have also demonstrated that when compared with a control group, Twitter users with a self-disclosed diagnosis of schizophrenia show unique online communication patterns (Birnbaum et al. 2017a ), including more frequent discussion of tobacco use (Hswen et al. 2017 ), symptoms of depression and anxiety (Hswen et al. 2018b ), and suicide (Hswen et al. 2018a ). Another study found that online disclosures about mental illness appeared beneficial as reflected by fewer posts about symptoms following self-disclosure (Ernala et al. 2017 ). Each of these examples offers early insights into the potential to leverage widely available online data for better understanding the onset and course of mental illness. It is possible that social media data could be used to supplement additional digital data, such as continuous monitoring using smartphone apps or smart watches, to generate a more comprehensive “digital phenotype” to predict relapse and identify high-risk health behaviors among individuals living with mental illness (Torous et al. 2019 ).

With research increasingly showing the valuable insights that social media data can yield about mental health states, greater attention to the ethical concerns with using individual data in this way is necessary (Chancellor et al. 2019 ). For instance, data is typically captured from social media platforms without the consent or awareness of users (Bidargaddi et al. 2017 ), which is especially crucial when the data relates to a socially stigmatizing health condition such as mental illness (Guntuku et al. 2017 ). Precautions are needed to ensure that data is not made identifiable in ways that were not originally intended by the user who posted the content as this could place an individual at risk of harm or divulge sensitive health information (Webb et al. 2017 ; Williams et al. 2017 ). Promising approaches for minimizing these risks include supporting the participation of individuals with expertise in privacy, clinicians, and the target individuals with mental illness throughout the collection of data, development of predictive algorithms, and interpretation of findings (Chancellor et al. 2019 ).

In recognizing that many individuals living with mental illness use social media to search for information about their mental health, it is possible that they may also want to ask their clinicians about what they find online to check if the information is reliable and trustworthy. Alternatively, many individuals may feel embarrassed or reluctant to talk to their clinicians about using social media to find mental health information out of concerns of being judged or dismissed. Therefore, mental health clinicians may be ideally positioned to talk with their patients about using social media and offer recommendations to promote safe use of these sites while also respecting their patients’ autonomy and personal motivations for using these popular platforms. Given the gap in clinical knowledge about the impact of social media on mental health, clinicians should be aware of the many potential risks so that they can inform their patients while remaining open to the possibility that their patients may also experience benefits through use of these platforms. As awareness of these risks grows, it may be possible that new protections will be put in place by industry or through new policies that will make the social media environment safer. It is hard to estimate a number needed to treat or harm today given the nascent state of research, which means the patient and clinician need to weigh the choice on a personal level. Thus, offering education and information is an important first step in that process. As patients increasingly show interest in accessing mental health information or services through social media, it will be necessary for health systems to recognize social media as a potential avenue for reaching or offering support to patients. This aligns with growing emphasis on the need for greater integration of digital psychiatry, including apps, smartphones, or wearable devices, into patient care and clinical services through institution-wide initiatives and training clinical providers (Hilty et al. 2019 ). Within a learning healthcare environment where research and care are tightly intertwined and feedback between both is rapid, the integration of digital technologies into services may create new opportunities for advancing use of social media for mental health.

As highlighted in this commentary, social media has become an important part of the lives of many individuals living with mental disorders. Many of these individuals use social media to share their lived experiences with mental illness, to seek support from others, and to search for information about treatment recommendations, accessing mental health services and coping with symptoms (Bucci et al. 2019 ; Highton-Williamson et al. 2015 ; Naslund et al. 2016b ). As the field of digital mental health advances, the wide reach, ease of access, and popularity of social media platforms could be used to allow individuals in need of mental health services or facing challenges of mental illness to access evidence-based treatment and support. To achieve this end and to explore whether social media platforms can advance efforts to close the gap in available mental health services in the USA and globally, it will be essential for researchers to work closely with clinicians and with those affected by mental illness to ensure that possible benefits of using social media are carefully weighed against anticipated risks.

Abdel-Baki, A., Lal, S., Charron, D.-C., Stip, E., & Kara, N. (2017). Understanding access and use of technology among youth with first-episode psychosis to inform the development of technology-enabled therapeutic interventions. Early Intervention in Psychiatry, 11 (1), 72–76.

PubMed   Google Scholar  

Ahmed, Y. A., Ahmad, M. N., Ahmad, N., & Zakaria, N. H. (2019). Social media for knowledge-sharing: a systematic literature review. Telematics and Informatics, 37 , 72–112.

Google Scholar  

Alhajji, M., Bass, S., & Dai, T. (2019). Cyberbullying, mental health, and violence in adolescents and associations with sex and race: data from the 2015 youth risk behavior survey. Global Pediatric Health, 6 , 2333794X19868887.

PubMed   PubMed Central   Google Scholar  

Alvarez-Jimenez, M., Bendall, S., Lederman, R., Wadley, G., Chinnery, G., Vargas, S., Larkin, M., Killackey, E., McGorry, P., & Gleeson, J. F. (2013). On the HORYZON: moderated online social therapy for long-term recovery in first episode psychosis. Schizophrenia Research, 143 (1), 143–149.

Alvarez-Jimenez, M., Gleeson, J., Bendall, S., Penn, D., Yung, A., Ryan, R., et al. (2018). Enhancing social functioning in young people at ultra high risk (UHR) for psychosis: a pilot study of a novel strengths and mindfulness-based online social therapy. Schizophrenia Research, 202 , 369–377.

Alvarez-Jimenez, M., Bendall, S., Koval, P., Rice, S., Cagliarini, D., Valentine, L., et al. (2019). HORYZONS trial: protocol for a randomised controlled trial of a moderated online social therapy to maintain treatment effects from first-episode psychosis services. BMJ Open, 9 (2), e024104.

Andreassen, C. S., Billieux, J., Griffiths, M. D., Kuss, D. J., Demetrovics, Z., Mazzoni, E., & Pallesen, S. (2016). The relationship between addictive use of social media and video games and symptoms of psychiatric disorders: a large-scale cross-sectional study. Psychology of Addictive Behaviors, 30 (2), 252.

Aschbrenner, K. A., Naslund, J. A., & Bartels, S. J. (2016a). A mixed methods study of peer-to-peer support in a group-based lifestyle intervention for adults with serious mental illness. Psychiatric Rehabilitation Journal, 39 (4), 328–334.

Aschbrenner, K. A., Naslund, J. A., Shevenell, M., Kinney, E., & Bartels, S. J. (2016b). A pilot study of a peer-group lifestyle intervention enhanced with mHealth technology and social media for adults with serious mental illness. The Journal of Nervous and Mental Disease, 204 (6), 483–486.

Aschbrenner, K. A., Naslund, J. A., Shevenell, M., Mueser, K. T., & Bartels, S. J. (2016c). Feasibility of behavioral weight loss treatment enhanced with peer support and mobile health technology for individuals with serious mental illness. Psychiatric Quarterly, 87 (3), 401–415.

Aschbrenner, K. A., Naslund, J. A., Gorin, A. A., Mueser, K. T., Scherer, E. A., Viron, M., et al. (2018a). Peer support and mobile health technology targeting obesity-related cardiovascular risk in young adults with serious mental illness: protocol for a randomized controlled trial. Contemporary Clinical Trials, 74 , 97–106.

Aschbrenner, K. A., Naslund, J. A., Grinley, T., Bienvenida, J. C. M., Bartels, S. J., & Brunette, M. (2018b). A survey of online and mobile technology use at peer support agencies. Psychiatric Quarterly , 1–10.

Aschbrenner, K. A., Naslund, J. A., Tomlinson, E. F., Kinney, A., Pratt, S. I., & Brunette, M. F. (2019). Adolescents’ use of digital technologies and preferences for mobile health coaching in mental health settings. Frontiers in Public Health. 7 , 178.

Badcock, J. C., Shah, S., Mackinnon, A., Stain, H. J., Galletly, C., Jablensky, A., & Morgan, V. A. (2015). Loneliness in psychotic disorders and its association with cognitive function and symptom profile. Schizophrenia Research, 169 (1–3), 268–273.

Batterham, P. J., & Calear, A. J. (2017). Preferences for internet-based mental health interventions in an adult online sample: findings from ann online community survey. JMIR Mental Health, 4 (2), e26.

Bauer, R., Bauer, M., Spiessl, H., & Kagerbauer, T. (2013). Cyber-support: an analysis of online self-help forums (online self-help forums in bipolar disorder). Nordic Journal of Psychiatry, 67 (3), 185–190.

Berger, M., Wagner, T. H., & Baker, L. C. (2005). Internet use and stigmatized illness. Social Science & Medicine, 61 (8), 1821–1827.

Berry, N., Lobban, F., Belousov, M., Emsley, R., Nenadic, G., & Bucci, S. (2017). # WhyWeTweetMH: understanding why people use Twitter to discuss mental health problems. Journal of Medical Internet Research, 19 (4), e107.

Berry, N., Emsley, R., Lobban, F., & Bucci, S. (2018). Social media and its relationship with mood, self-esteem and paranoia in psychosis. Acta Psychiatrica Scandinavica, 138 , 558–570.

Best, P., Manktelow, R., & Taylor, B. (2014). Online communication, social media and adolescent wellbeing: a systematic narrative review. Children and Youth Services Review, 41 , 27–36.

Biagianti, B., Quraishi, S. H., & Schlosser, D. A. (2018). Potential benefits of incorporating peer-to-peer interactions into digital interventions for psychotic disorders: a systematic review. Psychiatric Services, 69 (4), 377–388.

Bidargaddi, N., Musiat, P., Makinen, V.-P., Ermes, M., Schrader, G., & Licinio, J. (2017). Digital footprints: facilitating large-scale environmental psychiatric research in naturalistic settings through data from everyday technologies. Molecular Psychiatry, 22 (2), 164.

Birnbaum, M. L., Ernala, S. K., Rizvi, A. F., De Choudhury, M., & Kane, J. M. (2017a). A collaborative approach to identifying social media markers of schizophrenia by employing machine learning and clinical appraisals. Journal of Medical Internet Research, 19 (8), e289.

Birnbaum, M. L., Rizvi, A. F., Correll, C. U., Kane, J. M., & Confino, J. (2017b). Role of social media and the Internet in pathways to care for adolescents and young adults with psychotic disorders and non-psychotic mood disorders. Early Intervention in Psychiatry, 11 (4), 290–295.

Booker, C. L., Kelly, Y. J., & Sacker, A. (2018). Gender differences in the associations between age trends of social media interaction and well-being among 10-15 year olds in the UK. BMC Public Health, 18 (1), 321.

Brunette, M., Achtyes, E., Pratt, S., Stilwell, K., Opperman, M., Guarino, S., & Kay-Lambkin, F. (2019). Use of smartphones, computers and social media among people with SMI: opportunity for intervention. Community Mental Health Journal , 1–6.

Brusilovskiy, E., Townley, G., Snethen, G., & Salzer, M. S. (2016). Social media use, community participation and psychological well-being among individuals with serious mental illnesses. Computers in Human Behavior, 65 , 232–240.

Bucci, S., Schwannauer, M., & Berry, N. (2019). The digital revolution and its impact on mental health care. Psychology and Psychotherapy: Theory, Research and Practice, 92 (2), 277–297.

Chancellor, S., Birnbaum, M. L., Caine, E. D., Silenzio, V. M., & De Choudhury, M. (2019). A taxonomy of ethical tensions in inferring mental health states from social media. In Proceedings of the Conference on Fairness, Accountability, and Transparency, 79–88.

Chang, H. J. (2009). Online supportive interactions: using a network approach to examine communication patterns within a psychosis social support group in Taiwan. Journal of the American Society for Information Science and Technology, 60 (7), 1504–1517.

Davidson, L., Chinman, M., Sells, D., & Rowe, M. (2006). Peer support among adults with serious mental illness: a report from the field. Schizophrenia Bulletin, 32 (3), 443–450.

De Choudhury, M., Gamon, M., & Counts, S. (2012). Happy, nervous or surprised? classification of human affective states in social media. Paper presented at the sixth international Association for Advancement of Artificial Intelligence (AAAI) Conference on Weblogs and Social Meedia, 435–438.

De Choudhury, M., Gamon, M., Counts, S., & Horvitz, E. (2013). Predicting depression via social media. Paper presented at the seventh international Association for Advancement of Artificial Intelligence (AAAI) Conference on Weblogs and Social Media, 128–137.

Docherty, N. M., Hawkins, K. A., Hoffman, R. E., Quinlan, D. M., Rakfeldt, J., & Sledge, W. H. (1996). Working memory, attention, and communication disturbances in schizophrenia. Journal of Abnormal Psychology, 105 (2), 212–219.

Ernala, S. K., Rizvi, A. F., Birnbaum, M. L., Kane, J. M., & De Choudhury, M. (2017). Linguistic markers indicating therapeutic outcomes of social media disclosures of schizophrenia. Proceedings of the ACM on Human-Computer Interaction, 1 (1), 43.

Feinstein, B. A., Hershenberg, R., Bhatia, V., Latack, J. A., Meuwly, N., & Davila, J. (2013). Negative social comparison on Facebook and depressive symptoms: rumination as a mechanism. Psychology of Popular Media Culture, 2 (3), 161.

Firth, J., Cotter, J., Torous, J., Bucci, S., Firth, J. A., & Yung, A. R. (2015). Mobile phone ownership and endorsement of “mHealth” among people with psychosis: a meta-analysis of cross-sectional studies. Schizophrenia Bulletin, 42 (2), 448–455.

Firth, J., Rosenbaum, S., Stubbs, B., Gorczynski, P., Yung, A. R., & Vancampfort, D. (2016). Motivating factors and barriers towards exercise in severe mental illness: a systematic review and meta-analysis. Psychological Medicine, 46 (14), 2869–2881.

Gay, K., Torous, J., Joseph, A., Pandya, A., & Duckworth, K. (2016). Digital technology use among individuals with schizophrenia: results of an online survey. JMIR Mental Health, 3 (2), e15.

Giacco, D., Palumbo, C., Strappelli, N., Catapano, F., & Priebe, S. (2016). Social contacts and loneliness in people with psychotic and mood disorders. Comprehensive Psychiatry, 66 , 59–66.

Gleeson, J., Lederman, R., Herrman, H., Koval, P., Eleftheriadis, D., Bendall, S., Cotton, S. M., & Alvarez-Jimenez, M. (2017). Moderated online social therapy for carers of young people recovering from first-episode psychosis: study protocol for a randomised controlled trial. Trials, 18 (1), 27.

Glick, G., Druss, B., Pina, J., Lally, C., & Conde, M. (2016). Use of mobile technology in a community mental health setting. Journal of Telemedicine and Telecare, 22 (7), 430–435.

Goodman, L. A., Thompson, K. M., Weinfurt, K., Corl, S., Acker, P., Mueser, K. T., & Rosenberg, S. D. (1999). Reliability of reports of violent victimization and posttraumatic stress disorder among men and women with serious mental illness. Journal of Traumatic Stress: Official Publication of the International Society for Traumatic Stress Studies, 12 (4), 587–599.

Gowen, K., Deschaine, M., Gruttadara, D., & Markey, D. (2012). Young adults with mental health conditions and social networking websites: seeking tools to build community. Psychiatric Rehabilitation Journal, 35 (3), 245–250.

Guntuku, S. C., Yaden, D. B., Kern, M. L., Ungar, L. H., & Eichstaedt, J. C. (2017). Detecting depression and mental illness on social media: an integrative review. Current Opinion in Behavioral Sciences, 18 , 43–49.

Haker, H., Lauber, C., & Rössler, W. (2005). Internet forums: a self-help approach for individuals with schizophrenia? Acta Psychiatrica Scandinavica, 112 (6), 474–477.

Hamm, M. P., Newton, A. S., Chisholm, A., Shulhan, J., Milne, A., Sundar, P., Ennis, H., Scott, S. D., & Hartling, L. (2015). Prevalence and effect of cyberbullying on children and young people: a scoping review of social media studies. JAMA Pediatrics, 169 (8), 770–777.

Hansen, C. F., Torgalsbøen, A.-K., Melle, I., & Bell, M. D. (2009). Passive/apathetic social withdrawal and active social avoidance in schizophrenia: difference in underlying psychological processes. The Journal of Nervous and Mental Disease, 197 (4), 274–277.

Highton-Williamson, E., Priebe, S., & Giacco, D. (2015). Online social networking in people with psychosis: a systematic review. International Journal of Social Psychiatry, 61 (1), 92–101.

Hilty, D. M., Chan, S., Torous, J., Luo, J., & Boland, R. J. (2019). Mobile health, smartphone/device, and apps for psychiatry and medicine: competencies, training, and faculty development issues. Psychiatric Clinics, 42 (3), 513–534.

Hswen, Y., Naslund, J. A., Chandrashekar, P., Siegel, R., Brownstein, J. S., & Hawkins, J. B. (2017). Exploring online communication about cigarette smoking among Twitter users who self-identify as having schizophrenia. Psychiatry Research, 257 , 479–484.

Hswen, Y., Naslund, J. A., Brownstein, J. S., & Hawkins, J. B. (2018a). Monitoring online discussions about suicide among Twitter users with schizophrenia: exploratory study. JMIR Mental Health, 5 (4), e11483.

Hswen, Y., Naslund, J. A., Brownstein, J. S., & Hawkins, J. B. (2018b). Online communication about depression and anxiety among twitter users with schizophrenia: preliminary findings to inform a digital phenotype using social media. Psychiatric Quarterly, 89 (3), 569–580.

Indian, M., & Grieve, R. (2014). When Facebook is easier than face-to-face: social support derived from Facebook in socially anxious individuals. Personality and Individual Differences, 59 , 102–106.

Jain, S. H., Powers, B. W., Hawkins, J. B., & Brownstein, J. S. (2015). The digital phenotype. Nature Biotechnology, 33 (5), 462–463.

Kiesler, S., Siegel, J., & McGuire, T. W. (1984). Social psychological aspects of computer-mediated communication. American Psychologist, 39 , 1123–1134.

Kross, E., Verduyn, P., Demiralp, E., Park, J., Lee, D. S., Lin, N., Shablack, H., Jonides, J., & Ybarra, O. (2013). Facebook use predicts declines in subjective well-being in young adults. PLoS One, 8 (8), e69841.

Lal, S., Nguyen, V., & Theriault, J. (2018). Seeking mental health information and support online: experiences and perspectives of young people receiving treatment for first-episode psychosis. Early Intervention in Psychiatry, 12 (3), 324–330.

Lin, L. Y., Sidani, J. E., Shensa, A., Radovic, A., Miller, E., Colditz, J. B., Hoffman, B. L., Giles, L. M., & Primack, B. A. (2016). Association between social media use and depression among US young adults. Depression and Anxiety, 33 (4), 323–331.

Machmutow, K., Perren, S., Sticca, F., & Alsaker, F. D. (2012). Peer victimisation and depressive symptoms: can specific coping strategies buffer the negative impact of cybervictimisation? Emotional and Behavioural Difficulties, 17 (3–4), 403–420.

Manikonda, L., & De Choudhury, M. (2017). Modeling and understanding visual attributes of mental health disclosures in social media. In Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems, 170–181.

Mead, S., Hilton, D., & Curtis, L. (2001). Peer support: a theoretical perspective. Psychiatric Rehabilitation Journal, 25 (2), 134–141.

Mereish, E. H., Sheskier, M., Hawthorne, D. J., & Goldbach, J. T. (2019). Sexual orientation disparities in mental health and substance use among Black American young people in the USA: effects of cyber and bias-based victimisation. Culture, Health & Sexuality, 21 (9), 985–998.

Miller, B. J., Stewart, A., Schrimsher, J., Peeples, D., & Buckley, P. F. (2015). How connected are people with schizophrenia? Cell phone, computer, email, and social media use. Psychiatry Research, 225 (3), 458–463.

Mittal, V. A., Tessner, K. D., & Walker, E. F. (2007). Elevated social Internet use and schizotypal personality disorder in adolescents. Schizophrenia Research, 94 (1–3), 50–57.

Moorhead, S. A., Hazlett, D. E., Harrison, L., Carroll, J. K., Irwin, A., & Hoving, C. (2013). A new dimension of health care: systematic review of the uses, benefits, and limitations of social media for health communication. Journal of Medical Internet Research, 15 (4), e85.

Naslund, J. A., & Aschbrenner, K. A. (2019). Risks to privacy with use of social media: understanding the views of social media users with serious mental illness. Psychiatric Services, 70 (7), 561–568.

Naslund, J. A., Grande, S. W., Aschbrenner, K. A., & Elwyn, G. (2014). Naturally occurring peer support through social media: the experiences of individuals with severe mental illness using YouTube. PLoS One, 9 (10), e110171.

Naslund, J. A., Aschbrenner, K. A., & Bartels, S. J. (2016). How people living with serious mental illness use smartphones, mobile apps, and social media. Psychiatric Rehabilitation Journal, 39 (4), 364–367.

Naslund, J. A., Aschbrenner, K. A., Marsch, L. A., & Bartels, S. J. (2016a). Feasibility and acceptability of Facebook for health promotion among people with serious mental illness. Digital Health, 2 , 2055207616654822.

PubMed Central   Google Scholar  

Naslund, J. A., Aschbrenner, K. A., Marsch, L. A., & Bartels, S. J. (2016b). The future of mental health care: peer-to-peer support and social media. Epidemiology and Psychiatric Sciences, 25 (2), 113–122.

Naslund, J. A., Aschbrenner, K. A., McHugo, G. J., Unützer, J., Marsch, L. A., & Bartels, S. J. (2019). Exploring opportunities to support mental health care using social media: A survey of social media users with mental illness. Early Intervention in Psychiatry, 13 (3), 405–413.

Naslund, J. A., Aschbrenner, K. A., Marsch, L. A., McHugo, G. J., & Bartels, S. J. (2018). Facebook for supporting a lifestyle intervention for people with major depressive disorder, bipolar disorder, and schizophrenia: an exploratory study. Psychiatric Quarterly, 89 (1), 81–94.

Naslund, J. A., Gonsalves, P. P., Gruebner, O., Pendse, S. R., Smith, S. L., Sharma, A., & Raviola, G. (2019). Digital innovations for global mental health: opportunities for data science, task sharing, and early intervention. Current Treatment Options in Psychiatry , 1–15.

Onnela, J.-P., & Rauch, S. L. (2016). Harnessing smartphone-based digital phenotyping to enhance behavioral and mental health. Neuropsychopharmacology, 41 (7), 1691–1696.

Orben, A., & Przybylski, A. K. (2019). The association between adolescent well-being and digital technology use. Nature Human Behaviour, 3 (2), 173–182.

Patel, V., Saxena, S., Lund, C., Thornicroft, G., Baingana, F., Bolton, P., et al. (2018). The Lancet Commission on global mental health and sustainable development. The Lancet, 392 (10157), 1553–1598.

Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., & James, A. E. (2017). Use of multiple social media platforms and symptoms of depression and anxiety: a nationally-representative study among US young adults. Computers in Human Behavior, 69 , 1–9.

Reece, A. G., & Danforth, C. M. (2017). Instagram photos reveal predictive markers of depression. EPJ Data Science, 6 (1), 15.

Reece, A. G., Reagan, A. J., Lix, K. L., Dodds, P. S., Danforth, C. M., & Langer, E. J. (2017). Forecasting the onset and course of mental illness with Twitter data. Scientific Reports, 7 (1), 13006.

Rideout, V., & Fox, S. (2018). Digital health practices, social media use, and mental well-being among teens and young adults in the U.S. Retrieved from San Francisco, CA: https://www.hopelab.org/reports/pdf/a-national-survey-by-hopelab-and-well-being-trust-2018.pdf . Accessed 10 Jan 2020.

Saha, K., Torous, J., Ernala, S. K., Rizuto, C., Stafford, A., & De Choudhury, M. (2019). A computational study of mental health awareness campaigns on social media. Translational behavioral medicine, 9 (6), 1197–1207.

Schlosser, D. A., Campellone, T., Kim, D., Truong, B., Vergani, S., Ward, C., & Vinogradov, S. (2016). Feasibility of PRIME: a cognitive neuroscience-informed mobile app intervention to enhance motivated behavior and improve quality of life in recent onset schizophrenia. JMIR Research Protocols, 5 (2).

Schlosser, D. A., Campellone, T. R., Truong, B., Etter, K., Vergani, S., Komaiko, K., & Vinogradov, S. (2018). Efficacy of PRIME, a mobile app intervention designed to improve motivation in young people with schizophrenia. Schizophrenia Bulletin, 44 (5), 1010–1020.

Schrank, B., Sibitz, I., Unger, A., & Amering, M. (2010). How patients with schizophrenia use the internet: qualitative study. Journal of Medical Internet Research, 12 (5), e70.

Schueller, S. M., Hunter, J. F., Figueroa, C., & Aguilera, A. (2019). Use of digital mental health for marginalized and underserved populations. Current Treatment Options in Psychiatry, 6 (3), 243–255.

Shatte, A. B., Hutchinson, D. M., & Teague, S. J. (2019). Machine learning in mental health: a scoping review of methods and applications. Psychological Medicine, 49 (9), 1426–1448.

Spinzy, Y., Nitzan, U., Becker, G., Bloch, Y., & Fennig, S. (2012). Does the Internet offer social opportunities for individuals with schizophrenia? A cross-sectional pilot study. Psychiatry Research, 198 (2), 319–320.

Stiglic, N., & Viner, R. M. (2019). Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews. BMJ Open, 9 (1), e023191.

Sumner, S. A., Galik, S., Mathieu, J., Ward, M., Kiley, T., Bartholow, B., et al. (2019). Temporal and geographic patterns of social media posts about an emerging suicide game. Journal of Adolescent Health, 65 (1), 94–100.

Torous, J., & Keshavan, M. (2016). The role of social media in schizophrenia: evaluating risks, benefits, and potential. Current Opinion in Psychiatry, 29 (3), 190–195.

Torous, J., Chan, S. R., Tan, S. Y.-M., Behrens, J., Mathew, I., Conrad, E. J., et al. (2014a). Patient smartphone ownership and interest in mobile apps to monitor symptoms of mental health conditions: a survey in four geographically distinct psychiatric clinics. JMIR Mental Health, 1 (1), e5.

Torous, J., Friedman, R., & Keshavan, M. (2014b). Smartphone ownership and interest in mobile applications to monitor symptoms of mental health conditions. JMIR mHealth and uHealth, 2 (1), e2.

Torous, J., Wisniewski, H., Bird, B., Carpenter, E., David, G., Elejalde, E., et al. (2019). Creating a digital health smartphone app and digital phenotyping platform for mental health and diverse healthcare needs: an interdisciplinary and collaborative approach. Journal of Technology in Behavioral Science, 4 (2), 73–85.

Trefflich, F., Kalckreuth, S., Mergl, R., & Rummel-Kluge, C. (2015). Psychiatric patients' internet use corresponds to the internet use of the general public. Psychiatry Research, 226 , 136–141.

Twenge, J. M., & Campbell, W. K. (2018). Associations between screen time and lower psychological well-being among children and adolescents: evidence from a population-based study. Preventive Medicine Reports, 12 , 271–283.

Twenge, J. M., Joiner, T. E., Rogers, M. L., & Martin, G. N. (2018). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 6 (1), 3–17.

Tynes, B. M., Willis, H. A., Stewart, A. M., & Hamilton, M. W. (2019). Race-related traumatic events online and mental health among adolescents of color. Journal of Adolescent Health, 65 (3), 371–377.

Vannucci, A., Flannery, K. M., & Ohannessian, C. M. (2017). Social media use and anxiety in emerging adults. Journal of Affective Disorders, 207 , 163–166.

Vayreda, A., & Antaki, C. (2009). Social support and unsolicited advice in a bipolar disorder online forum. Qualitative Health Research, 19 (7), 931–942.

Ventola, C. L. (2014). Social media and health care professionals: benefits, risks, and best practices. Pharmacy and Therapeutics, 39 (7), 491–520.

We Are Social. (2020). Digital in 2020. Retrieved from https://wearesocial.com/global-digital-report-2019 . Accessed 10 Jan 2020.

Webb, H., Jirotka, M., Stahl, B. C., Housley, W., Edwards, A., Williams, M., ... & Burnap, P. (2017). The ethical challenges of publishing Twitter data for research dissemination . Paper presented at the proceedings of the 2017 ACM on Web Science Conference, 339–348.

Williams, M. L., Burnap, P., & Sloan, L. (2017). Towards an ethical framework for publishing twitter data in social research: taking into account users’ views, online context and algorithmic estimation. Sociology, 51 (6), 1149–1168.

Woods, H. C., & Scott, H. (2016). # Sleepyteens: social media use in adolescence is associated with poor sleep quality, anxiety, depression and low self-esteem. Journal of Adolescence, 51 , 41–49.

Ybarra, M. L. (2004). Linkages between depressive symptomatology and internet harassment among young regular Internet users. Cyberpsychology & Behavior, 7 (2), 247–257.

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Dr. Naslund is supported by a grant from the National Institute of Mental Health (U19MH113211). Dr. Aschbrenner is supported by a grant from the National Institute of Mental Health (1R01MH110965-01).

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Naslund, J.A., Bondre, A., Torous, J. et al. Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice. J. technol. behav. sci. 5 , 245–257 (2020). https://doi.org/10.1007/s41347-020-00134-x

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Received : 19 October 2019

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Issue Date : September 2020

DOI : https://doi.org/10.1007/s41347-020-00134-x

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Potential risks of content, features, and functions: The science of how social media affects youth

Almost a year after APA issued its health advisory on social media use in adolescence , society continues to wrestle with ways to maximize the benefits of these platforms while protecting youth from the potential harms associated with them. 1

By early 2024, few meaningful changes to social media platforms had been enacted by industry, and no federal policies had been adopted. There remains a need for social media companies to make fundamental changes to their platforms.

Psychological science continues to reveal benefits from social media use , as well as risks and opportunities that certain content, features, and functions present to young social media users. The science discussed below highlights the need to enact new, responsible safety standards to mitigate harm. 2

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Related content

• APA report calls on social media companies to take responsibility to protect youth
• How much is too much social media use?

Elaboration of science on social media content, features, and functions

Platforms built for adults are not inherently suitable for youth. i Youth require special protection due to areas of competence or vulnerability as they progress through the childhood, teenage, and late adolescent years. ii This is especially true for youth experiencing psychological, physical, intellectual, mental health, or other developmental challenges; chronological age is not directly associated with social media readiness . iii

Hypersensitivity to social feedback

Brain development starting at ages 10–13 (i.e., the outset of puberty) until approximately the mid-twenties is linked with hypersensitivity to social feedback/stimuli. iv In other words, youth become especially invested in behaviors that will help them get personalized feedback, praise, or attention from peers.

• AI-recommended content has the potential to be especially influential and hard to resist within this age range. v It is critical that AI-recommended content be designed to prioritize youth safety and welfare over engagement. This suggests potentially restricting the use of personalized recommendations using youth data, design features that may prioritize content evoking extreme emotions, or content that may depict illegal or harmful behavior.
• Likes and follower counts activate neural regions that trigger repetitive behavior, and thus may exert greater influence on youths’ attitudes and behavior than among adults. vi Youth are especially sensitive to both positive social feedback and rejection from others. Using these metrics to maintain platform engagement capitalizes on youths’ vulnerabilities and likely leads to problematic use.
• The use of youth data for tailored ad content similarly is influential for youth who are biologically predisposed toward peer influence at this stage and sensitive to personalized content. vii

Need for relationship skill building

Adolescence is a critical period for the development of more complex relationship skills, characterized by the ability to form emotionally intimate relationships. viii The adolescent years should provide opportunities to practice these skills through one-on-one or small group interactions.

• The focus on metrics of followers, likes, and views focuses adolescents’ attention on unilateral, depersonalized interactions and may discourage them from building healthier and psychologically beneficial relationship skills. ix

Susceptibility to harmful content

Adolescence is a period of heightened susceptibility to peer influence, impressionability, and sensitivity to social rejection. x Harmful content, including cyberhate, the depiction of illegal behavior, and encouragement to engage in self-harm (e.g., cutting or eating-disordered behavior) is associated with increased mental health difficulties among both the targets and witnesses of such content. xi

• The absence of clear and transparent processes for addressing reports of harmful content makes it harder for youth to feel protected or able to get help in the face of harmful content.

Underdeveloped impulse control

Youths’ developing cortical system (particularly in the brain’s inhibitory control network) makes them less capable of resisting impulses or stopping themselves from behavior that may lead to temporary benefit despite negative longer-term consequences. xii This can lead to adolescents making decisions based on short-term gain, lower appreciation of long-term risks, and interference with focus on tasks that require concentration.

• Infinite scroll is particularly risky for youth since their ability to monitor and stop engagement on social media is more limited than among adults. xiii This contributes to youths’ difficulty disengaging from social media and may contribute to high rates of youth reporting symptoms of clinical dependency on social media. xiv
• The lack of time limits on social media use similarly is challenging for youth, particularly during the school day or at times when they should be doing homework. xv
• Push notifications capitalize on youths’ sensitivity to distraction. Task-shifting is a higher order cognitive ability not fully developed until early adulthood and may interfere with youths’ focus during class time and when they should be doing homework. xvi
• The use and retention of youths’ data without appropriate parental consent, and/or child assent in developmentally appropriate language, capitalizes on youths’ relatively poor appreciation for long-term consequences of their actions, permanence of online content, or their ability to weigh the risks of their engagement on social media. xvii

Reliance on sleep for healthy brain development

Other than the first year of life, puberty is the most important period of brain growth and reorganization in our lifetimes. xviii Sleep is essential for healthy brain development and mental health in adolescence. xix Sleep delay or disruptions have significant negative effects on youths’ attention, behavior, mood, safety, and academic performance.

• A lack of limits on the time of day when youth can use social media has been cited as the predominant reason why adolescents are getting less than the recommended amount of sleep, with significant implications for brain and mental health. xx

Vulnerability to malicious actors

Youth are easily deceived by predators and other malicious actors who may attempt to interact with them on social media channels. xxi

• Connection and direct messaging with adult strangers places youth at risk of identity theft and potentially dangerous interactions, including sexploitation.

Need for parental/caregiver partnership

Research indicates that youth benefit from parental support to guide them toward safe decisions and to help them understand and appropriately respond to complex social interactions. xxii Granting parents oversight of youths’ accounts should be offered in balance with adolescents’ needs for autonomy, privacy, and independence. However, it should be easier for parents to partner with youth online in a manner that fits their family’s needs.

• The absence of transparent and easy-to-use parental/caregiver tools increases parents’ or guardians’ difficulty in supporting youths’ experience on social media. xxiii

Health advisory on social media use in adolescence

Related topics

• Social media and the internet
• Mental health

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A path forward based on science

Change is needed soon. Solutions should reflect a greater understanding of the science in at least three ways.

First, youth vary considerably in how they use social media. Some uses may promote healthy development and others may create harm. As noted in the APA health advisory , using social media is not inherently beneficial or harmful to young people. The effects of social media depend not only on what teens can do and see online, but teens’ pre-existing strengths or vulnerabilities, and the contexts in which they grow up.

Second, science has highlighted biological and psychological abilities/vulnerabilities that interact with the content, functions, and features built into social media platforms, and it is these aspects of youths’ social media experience that must be addressed to attenuate risks. xxiv Social media use, functionality, and permissions/consenting should be tailored to youths’ developmental capabilities. Design features created for adults may not be appropriate for children.

Third, youth are adept at working around age restrictions. Substantial data reveal a remarkable number of children aged 12 years and younger routinely using social media, indicating that current policies and practices to restrict use to older youth are not working. xxv

Policies will not protect youth unless technology companies are required to reduce the risks embedded within the platforms themselves.

As policymakers at every level assess their approach to this complex issue, it is important to note the limitations of frequently proposed policies, which are often misreported and fall far short of comprehensive safety solutions that will achieve meaningful change.

Restricting downloads

Restricting application downloads at the device level does not fully restrict youths’ access and will not meaningfully improve the safety of social media platforms. Allowing platforms to delegate responsibility to app stores does not address the vulnerabilities and harms built into the platforms.

Requiring age restrictions

Focusing only on age restrictions does not improve the platforms or address the biological and psychological vulnerabilities that persist past age 18. While age restriction proposals could offer some benefits if effectively and equitably implemented, they do not represent comprehensive improvements to social media platforms, for at least four reasons:

• Creating a bright line age limit ignores individual differences in adolescents’ maturity and competency
• These proposals fail to mitigate the harms for those above the age limit and can lead to a perception that social media is safe for adolescents above the threshold age, though neurological changes continue until age 25
• Completely limiting access to social media may disadvantage those who are experiencing psychological benefits from social media platforms, such as community support and access to science-based resources, which particularly impact those in marginalized populations
• The process of age-verification requires more thoughtful consideration to ensure that the storage of official identification documents does not systematically exclude subsets of youth, create risks for leaks, or circumvent the ability of young people to maintain anonymity on social platforms.

Use of parental controls

Granting parents and caregivers greater access to their children’s social media accounts will not address risks embedded within platforms themselves. More robust and easy-to-use parental controls would help some younger age groups, but as a sole strategy, this approach ignores the complexities of adolescent development, the importance of childhood autonomy and privacy, and disparities in time or resources available for monitoring across communities. xxvi

[Related: Keeping teens safe on social media: What parents should know to protect their kids ]

Some parents might be technologically ill-equipped, lack the time or documentation to complete requirements, or simply be unavailable to complete these requirements. Disenfranchising some young people from these platforms creates inequities. xxvii

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1 These recommendations enact policies and resolutions approved by the APA Council of Representatives including the APA Resolution on Child and Adolescent Mental and Behavioral Health and the APA Resolution on Dismantling Systemic Racism in contexts including social media. These are not professional practice guidelines but are intended to provide information based on psychological science.

2 This report seeks to elaborate on extant psychological science findings, which may be particularly relevant in the creation of policy solutions that protect young people, and to inform the development of social media safety standards.

Recommendations from APA’s health advisory on social media use in adolescence

• Youth using social media should be encouraged to use functions that create opportunities for social support, online companionship, and emotional intimacy that can promote healthy socialization.
• Social media use, functionality, and permissions/consenting should be tailored to youths’ developmental capabilities; designs created for adults may not be appropriate for children.
• In early adolescence (i.e., typically 10–14 years), adult monitoring (i.e., ongoing review, discussion, and coaching around social media content) is advised for most youths’ social media use; autonomy may increase gradually as kids age and if they gain digital literacy skills. However, monitoring should be balanced with youths’ appropriate needs for privacy.
• To reduce the risks of psychological harm, adolescents’ exposure to content on social media that depicts illegal or psychologically maladaptive behavior, including content that instructs or encourages youth to engage in health-risk behaviors, such as self-harm (e.g., cutting, suicide), harm to others, or those that encourage eating-disordered behavior (e.g., restrictive eating, purging, excessive exercise) should be minimized, reported, and removed; moreover, technology should not drive users to this content.
• To minimize psychological harm, adolescents’ exposure to “cyberhate” including online discrimination, prejudice, hate, or cyberbullying especially directed toward a marginalized group (e.g., racial, ethnic, gender, sexual, religious, ability status), or toward an individual because of their identity or allyship with a marginalized group should be minimized.
• Adolescents should be routinely screened for signs of “problematic social media use” that can impair their ability to engage in daily roles and routines, and may present risk for more serious psychological harms over time.
• The use of social media should be limited so as to not interfere with adolescents’ sleep and physical activity.
• Adolescents should limit use of social media for social comparison, particularly around beauty- or appearance-related content.
• Adolescents’ social media use should be preceded by training in social media literacy to ensure that users have developed psychologically-informed competencies and skills that will maximize the chances for balanced, safe, and meaningful social media use.
• Substantial resources should be provided for continued scientific examination of the positive and negative effects of social media on adolescent development.

Acknowledgments

We wish to acknowledge the outstanding contributions to this report made by the following individuals:

Expert advisory panel

Mary Ann McCabe, PhD, ABPP, member-at-large, Board of Directors, American Psychological Association; associate clinical professor of pediatrics, The George Washington University School of Medicine and Health Sciences

Mitchell J. Prinstein, PhD, ABPP, chief science officer, American Psychological Association; John Van Seters Distinguished Professor of Psychology and Neuroscience, University of North Carolina at Chapel Hill

Mary K. Alvord, PhD, founder, Alvord, Baker & Associates; board president, Resilience Across Borders; adjunct associate professor of psychiatry and behavioral sciences, The George Washington University School of Medicine and Health Sciences

Dawn T. Bounds, PhD, PMHNP-BC, FAAN, assistant professor, Sue & Bill Gross School of Nursing, University of California, Irvine

Linda Charmaraman, PhD, senior research scientist, Wellesley Centers for Women, Wellesley College

Sophia Choukas-Bradley, PhD, assistant professor, Department of Psychology, University of Pittsburgh

Dorothy L. Espelage, PhD, William C. Friday Distinguished Professor of Education, University of North Carolina at Chapel Hill

Joshua A. Goodman, PhD, assistant professor, Department of Psychology, Southern Oregon University

Jessica L. Hamilton, PhD, assistant professor, Department of Psychology, Rutgers University

Brendesha M. Tynes, PhD, Dean’s Professor of Educational Equity, University of Southern California

L. Monique Ward, PhD, professor, Department of Psychology (Developmental), University of Michigan

Lucía Magis-Weinberg, MD, PhD, assistant professor, Department of Psychology, University of Washington

We also wish to acknowledge the contributions to this report made by Katherine B. McGuire, chief advocacy officer, and Corbin Evans, JD, senior director of congressional and federal relations, American Psychological Association.

Selected references

i Maza, M. T., Fox, K. A., Kwon, S. J., Flannery, J. E., Lindquist, K. A., Prinstein, M. J., & Telzer, E. H. (2023). Association of habitual checking behaviors on social media with longitudinal functional brain development. JAMA Pediatrics , 177 (2), 160–167; Prinstein, M. J., Nesi, J., & Telzer, E. H. (2020). Commentary: An updated agenda for the study of digital media use and adolescent development—Future directions following Odgers & Jensen (2020). Journal of Child Psychology and Psychiatry , 61 (3), 349–352. https://doi.org/10.1111/jcpp.13219

ii Nesi, J., Choukas-Bradley, S., & Prinstein, M. J. (2018). Transformation of adolescent peer relations in the social media context: Part 1—A theoretical framework and application to dyadic peer relationships. Clinical Child and Family Psychology Review , 21 (3), 267–294. https://doi.org/10.1007/s10567-018-0261-x

iii Valkenburg, P. M., & Peter, J. (2013). The differential susceptibility to media effects model. Journal of Communication , 63 (2), 221–243. https://doi.org/10.1111/jcom.12024

iv Fareri, D. S., Martin, L. N., & Delgado, M. R. (2008). Reward-related processing in the human brain: Developmental considerations. Development and Psychopathology , 20 (4), 1191–1211; Somerville, L. H., & Casey, B. J. (2010). Developmental neurobiology of cognitive control and motivational systems. Current Opinion in Neurobiology , 20 (2), 236–241. https://doi.org/10.1016/j.conb.2010.01.006

v Shin, D. (2020). How do users interact with algorithm recommender systems? The interaction of users, algorithms, and performance. Computers in Human Behavior , 109 , 106344. https://doi.org/10.1016/j.chb.2020.106344

vi Sherman, L. E., Payton, A. A., Hernandez, L. M., Greenfield, P. M., & Dapretto, M. (2016). The power of the Like in adolescence: Effects of peer influence on neural and behavioral responses to social media. Psychological Science , 27 (7), 1027–1035. https://doi.org/10.1177/0956797616645673

vii Albert, D., Chein, J., & Steinberg, L. (2013). The teenage brain: Peer influences on adolescent decision making. Current Directions in Psychological Science , 22 (2), 114–120. https://doi.org/10.1177/0963721412471347

viii Armstrong-Carter, E., & Telzer, E. H. (2021). Advancing measurement and research on youths’ prosocial behavior in the digital age. Child Development Perspectives , 15 (1), 31–36. https://doi.org/10.1111/cdep.12396 ; Newcomb, A. F., & Bagwell, C. L. (1995). Children’s friendship relations: A meta-analytic review. Psychological Bulletin , 117 (2), 306.

ix Nesi, J., & Prinstein, M. J. (2019). In search of likes: Longitudinal associations between adolescents’ digital status seeking and health-risk behaviors. Journal of Clinical Child & Adolescent Psychology , 48 (5), 740–748. https://doi.org/10.1080/15374416.2018.1437733 ; Rotondi, V., Stanca, L., & Tomasuolo, M. (2017). Connecting alone: Smartphone use, quality of social interactions and well-being. Journal of Economic Psychology , 63 , 17–26. https://doi.org/10.1016/j.joep.2017.09.001

x Sherman, L. E., Payton, A. A., Hernandez, L. M., Greenfield, P. M., & Dapretto, M. (2016). The power of the Like in adolescence: Effects of peer influence on neural and behavioral responses to social media. Psychological Science , 27 (7), 1027–1035. https://doi.org/10.1177/0956797616645673

xi Susi, K., Glover-Ford, F., Stewart, A., Knowles Bevis, R., & Hawton, K. (2023). Research review: Viewing self-harm images on the internet and social media platforms: Systematic review of the impact and associated psychological mechanisms. Journal of Child Psychology and Psychiatry , 64 (8), 1115–1139.

xii Hartley, C. A., & Somerville, L. H. (2015). The neuroscience of adolescent decision-making. Current Opinion in Behavioral Sciences , 5 , 108–115. https://doi.org/10.1016/j.cobeha.2015.09.004

xiii Atherton, O. E., Lawson, K. M., & Robins, R. W. (2020). The development of effortful control from late childhood to young adulthood. Journal of Personality and Social Psychology , 119 (2), 417–456. https://doi.org/10.1037/pspp0000283

xiv Boer, M., Stevens, G. W., Finkenauer, C., & Van den Eijnden, R. J. (2022). The course of problematic social media use in young adolescents: A latent class growth analysis. Child Development , 93 (2), e168–e187.

xv Hall, A. C. G., Lineweaver, T. T., Hogan, E. E., & O’Brien, S. W. (2020). On or off task: The negative influence of laptops on neighboring students’ learning depends on how they are used. Computers & Education , 153 , 103901. https://doi.org/10.1016/j.compedu.2020.103901 ; Sana, F., Weston, T., & Cepeda, N. J. (2013). Laptop multitasking hinders classroom learning for both users and nearby peers. Computers & Education , 62 , 24–31. https://doi.org/10.1016/j.compedu.2012.10.003

xvi von Bastian, C. C., & Druey, M. D. (2017). Shifting between mental sets: An individual differences approach to commonalities and differences of task switching components. Journal of Experimental Psychology: General , 146 (9), 1266–1285. https://doi.org/10.1037/xge0000333

xvii Andrews, J. C., Walker, K. L., & Kees, J. (2020). Children and online privacy protection: Empowerment from cognitive defense strategies. Journal of Public Policy & Marketing , 39 (2), 205–219. https://doi.org/10.1177/0743915619883638 ; Romer D. (2010). Adolescent risk taking, impulsivity, and brain development: Implications for prevention. Developmental Psychobiology , 52 (3), 263–276. https://doi.org/10.1002/dev.20442

xviii Orben, A., Przybylski, A. K., Blakemore, S.-J., Kievit, R. A. (2022). Windows of developmental sensitivity to social media. Nature Communications , 13 (1649). https://doi.org/10.1038/s41467-022-29296-3

xix Paruthi, S., Brooks, L. J., D’Ambrosio, C., Hall, W. A., Kotagal, S., Lloyd, R. M., Malow, B. A., Maski, K., Nichols, C., Quan, S. F., Rosen, C. L., Troester, M. M., & Wise, M. S. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine , 12 (6), 785–786. https://doi.org/10.5664/jcsm.5866

xx Perrault, A. A., Bayer, L., Peuvrier, M., Afyouni, A., Ghisletta, P., Brockmann, C., Spiridon, M., Hulo Vesely, S., Haller, D. M., Pichon, S., Perrig, S., Schwartz, S., & Sterpenich, V. (2019). Reducing the use of screen electronic devices in the evening is associated with improved sleep and daytime vigilance in adolescents. Sleep , 42 (9), zsz125. https://doi.org/10.1093/sleep/zsz125 ; Telzer, E. H., Goldenberg, D., Fuligni, A. J., Lieberman, M. D., & Gálvan, A. (2015). Sleep variability in adolescence is associated with altered brain development. Developmental Cognitive Neuroscience , 14, 16–22. https://doi.org/10.1016/j.dcn.2015.05.007

xxi Livingstone, S., & Smith, P. K. (2014). Annual research review: Harms experienced by child users of online and mobile technologies: The nature, prevalence and management of sexual and aggressive risks in the digital age. Journal of Child Psychology and Psychiatry , 55 (6), 635–654. https://doi.org/10.1111/jcpp.12197 ; Wolak, J., Finkelhor, D., Mitchell, K. J., & Ybarra, M. L. (2008). Online “predators” and their victims: Myths, realities, and implications for prevention and treatment. American Psychologist , 63 (2), 111–128. https://doi.org/10.1037/0003-066X.63.2.111

xxii Wachs, S., Costello, M., Wright, M. F., Flora, K., Daskalou, V., Maziridou, E., Kwon, Y., Na, E.-Y., Sittichai, R., Biswal, R., Singh, R., Almendros, C., Gámez-Guadix, M., Görzig, A., & Hong, J. S. (2021). “DNT LET ’EM H8 U!”: Applying the routine activity framework to understand cyberhate victimization among adolescents across eight countries. Computers & Education , 160 , Article 104026. https://doi.org/10.1016/j.compedu.2020.104026 ; Padilla-Walker, L. M., Stockdale, L. A., & McLean, R. D. (2020). Associations between parental media monitoring, media use, and internalizing symptoms during adolescence. Psychology of Popular Media , 9 (4), 481. https://doi.org/10.1037/ppm0000256

xxiii Dietvorst, E., Hiemstra, M., Hillegers, M. H. J., & Keijsers, L. (2018). Adolescent perceptions of parental privacy invasion and adolescent secrecy: An illustration of Simpson’s paradox. Child Development , 89 (6), 2081–2090. https://doi.org/10.1111/cdev.13002 ; Auxier, B. (2020, July 28). Parenting Children in the Age of Screens. Pew Research Center: Internet, Science & Tech; Pew Research Center. https://www.pewresearch.org/internet/2020/07/28/parenting-children-in-the-age-of-screens/

xxiv National Academies of Sciences, Engineering, and Medicine. (2024). Social media and adolescent health . The National Academies Press. https://doi.org/10.17226/27396

xxv Charmaraman, L., Lynch, A. D., Richer, A. M., & Zhai, E. (2022). Examining early adolescent positive and negative social technology behaviors and well-being during the Covid -19 pandemic. Technology, Mind, and Behavior , 3 (1), Feb 17 2022. https://doi.org/10.1037/tmb0000062

xxvi Dietvorst, E., Hiemstra, M., Hillegers, M.H.J., & Keijsers, L. (2018). Adolescent perceptions of parental privacy invasion and adolescent secrecy: An illustration of Simpson’s paradox. Child Development , 89 (6), 2081–2090. https://doi.org/10.1111/cdev.13002

xxvii Charmaraman, L., Lynch, A. D., Richer, A. M., & Zhai, E. (2022). Examining early adolescent positive and negative social technology behaviors and well-being during the Covid -19 pandemic. Technology, Mind, and Behavior , 3 (1), Feb 17 2022. https://doi.org/10.1037/tmb0000062

Negative impact of social media affects girls and boys at different ages – study

• Girls may experience a negative link at 11-13, boys when they are 14-15,
• Increased social media use might also affect life satisfaction at aged 19, but
• Adolescents with lower life satisfaction consistently use social media more.

Girls and boys might be more vulnerable to the negative effects of social media use at different times during their adolescence, according to research published today by an international team of scientists, including experts from the Oxford Internet Institute .

In a study published in Nature Communications , UK data shows, girls experience a negative link between social media use and life satisfaction when they are 11-13 years old and boys when they are 14-15 years old. Increased social media use also predicts lower life satisfaction at age 19 years.

Sensitivity to social media use might be linked to developmental changes, possibly changes in the structure of the brain, or to puberty, which occurs later in boys than in girls

This suggests sensitivity to social media use might be linked to developmental changes, possibly changes in the structure of the brain, or to puberty, which occurs later in boys than in girls. But, for both, social media use at the age of 19 years was again associated with a decrease in life satisfaction. At this age, say the researchers, it is possible social changes – such as leaving home or starting work – may make us vulnerable.

Social media has fundamentally changed how young people spend time, share information and talk to others. This has led to widespread concern about its potential negative impact. Yet, even after years of research, there is still considerable uncertainty about how social media relates to wellbeing. The team looked for a connection between estimated social media use and reported life satisfaction and found key periods of adolescence where social media use was associated with a subsequent decrease in life satisfaction. The researchers also found teens who have lower than average life satisfaction later use more social media.

The researchers also found teens who have lower than average life satisfaction later use more social media

Dr Amy Orben, from the University of Cambridge, who led the study, said, ‘The link between social media use and mental wellbeing is clearly very complex. Changes within our bodies, such as brain development and puberty, and in our social circumstances appear to make us vulnerable at particular times of our lives.’

She maintained, ‘I wouldn’t say that there is a specific age group we should all be worried about. We should all be reflecting on our social media use and encouraging those conversations but we need to understand what is driving these changes across the age groups and between genders. There are very large individual differences, so there may be certain teenagers that benefit from their use of social media whilst at the same time, someone else is harmed.'

We should all be reflecting on our social media use and encouraging those conversations but we need to understand what is driving these changes across the age groups and between genders

Professor Andrew Przybylski , Director of Research at the Oxford Internet Institute said, 'Currently the amount of time young people spend on social media is a “black box” to scientists and parents alike. To improve our science we need better data and to improve parenting around tech we need to start a new conversation. It’s not about social media being good or bad, it’s about what young people are up to, why they are using it, and how they feel about it fits into the greater picture of family life.'

Dr Orben added, ‘With our findings, rather than debating whether or not the link exists, we can now focus on the periods of our adolescence where we now know we might be most at risk and use this as a springboard to explore some of the really interesting questions.’

It’s not about social media being good or bad, it’s about what young people are up to, why they are using it, and how they feel about it fits into the greater picture of family life

Professor Przybylski agreed and said, 'To pinpoint which individuals might be influenced by social media, more research is needed that combines objective behavioural data with biological and cognitive measurements of development. We therefore call on social media companies and other online platforms to do more to share their data with independent scientists, and, if they are unwilling, for governments to show they are serious about tackling online harms by introducing legislation to compel these companies to be more open.'

The team, including psychologists, neuroscientists and modellers, analysed two UK datasets comprising some 84,000 individuals between the ages of 10 and 80 years old. These included longitudinal data – that is, data that tracks individuals over a period of time – on 17,400 young people aged 10-21 years old. The researchers are from the Universities of Cambridge and Oxford, and the Donders Institute for Brain, Cognition and Behaviour.

The researchers are keen to point out that, while their findings show at a population level that there is a link between social media use and poorer wellbeing, it is not yet possible to predict which individuals are most at risk.

Orben, A et al. Windows of developmental sensitivity to social media. Nat Comms; 28 March 2022; DOI: 10.1038/s41467-022-29296-3

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Social Media Use and Its Connection to Mental Health: A Systematic Review

Fazida karim.

1 Psychology, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

2 Business & Management, University Sultan Zainal Abidin, Terengganu, MYS

Azeezat A Oyewande

3 Family Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

4 Family Medicine, Lagos State Health Service Commission/Alimosho General Hospital, Lagos, NGA

Lamis F Abdalla

5 Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA

Reem Chaudhry Ehsanullah

Safeera khan.

Social media are responsible for aggravating mental health problems. This systematic study summarizes the effects of social network usage on mental health. Fifty papers were shortlisted from google scholar databases, and after the application of various inclusion and exclusion criteria, 16 papers were chosen and all papers were evaluated for quality. Eight papers were cross-sectional studies, three were longitudinal studies, two were qualitative studies, and others were systematic reviews. Findings were classified into two outcomes of mental health: anxiety and depression. Social media activity such as time spent to have a positive effect on the mental health domain. However, due to the cross-sectional design and methodological limitations of sampling, there are considerable differences. The structure of social media influences on mental health needs to be further analyzed through qualitative research and vertical cohort studies.

Introduction and background

Human beings are social creatures that require the companionship of others to make progress in life. Thus, being socially connected with other people can relieve stress, anxiety, and sadness, but lack of social connection can pose serious risks to mental health [ 1 ].

Social media

Social media has recently become part of people's daily activities; many of them spend hours each day on Messenger, Instagram, Facebook, and other popular social media. Thus, many researchers and scholars study the impact of social media and applications on various aspects of people’s lives [ 2 ]. Moreover, the number of social media users worldwide in 2019 is 3.484 billion, up 9% year-on-year [ 3 - 5 ]. A statistic in Figure  1  shows the gender distribution of social media audiences worldwide as of January 2020, sorted by platform. It was found that only 38% of Twitter users were male but 61% were using Snapchat. In contrast, females were more likely to use LinkedIn and Facebook. There is no denying that social media has now become an important part of many people's lives. Social media has many positive and enjoyable benefits, but it can also lead to mental health problems. Previous research found that age did not have an effect but gender did; females were much more likely to experience mental health than males [ 6 , 7 ].

Impact on mental health

Mental health is defined as a state of well-being in which people understand their abilities, solve everyday life problems, work well, and make a significant contribution to the lives of their communities [ 8 ]. There is debated presently going on regarding the benefits and negative impacts of social media on mental health [ 9 , 10 ]. Social networking is a crucial element in protecting our mental health. Both the quantity and quality of social relationships affect mental health, health behavior, physical health, and mortality risk [ 9 ]. The Displaced Behavior Theory may help explain why social media shows a connection with mental health. According to the theory, people who spend more time in sedentary behaviors such as social media use have less time for face-to-face social interaction, both of which have been proven to be protective against mental disorders [ 11 , 12 ]. On the other hand, social theories found how social media use affects mental health by influencing how people view, maintain, and interact with their social network [ 13 ]. A number of studies have been conducted on the impacts of social media, and it has been indicated that the prolonged use of social media platforms such as Facebook may be related to negative signs and symptoms of depression, anxiety, and stress [ 10 - 15 ]. Furthermore, social media can create a lot of pressure to create the stereotype that others want to see and also being as popular as others.

The need for a systematic review

Systematic studies can quantitatively and qualitatively identify, aggregate, and evaluate all accessible data to generate a warm and accurate response to the research questions involved [ 4 ]. In addition, many existing systematic studies related to mental health studies have been conducted worldwide. However, only a limited number of studies are integrated with social media and conducted in the context of social science because the available literature heavily focused on medical science [ 6 ]. Because social media is a relatively new phenomenon, the potential links between their use and mental health have not been widely investigated.

This paper attempt to systematically review all the relevant literature with the aim of filling the gap by examining social media impact on mental health, which is sedentary behavior, which, if in excess, raises the risk of health problems [ 7 , 9 , 12 ]. This study is important because it provides information on the extent of the focus of peer review literature, which can assist the researchers in delivering a prospect with the aim of understanding the future attention related to climate change strategies that require scholarly attention. This study is very useful because it provides information on the extent to which peer review literature can assist researchers in presenting prospects with a view to understanding future concerns related to mental health strategies that require scientific attention. The development of the current systematic review is based on the main research question: how does social media affect mental health?

Research strategy

The research was conducted to identify studies analyzing the role of social media on mental health. Google Scholar was used as our main database to find the relevant articles. Keywords that were used for the search were: (1) “social media”, (2) “mental health”, (3) “social media” AND “mental health”, (4) “social networking” AND “mental health”, and (5) “social networking” OR “social media” AND “mental health” (Table  1 ).

Out of the results in Table  1 , a total of 50 articles relevant to the research question were selected. After applying the inclusion and exclusion criteria, duplicate papers were removed, and, finally, a total of 28 articles were selected for review (Figure  2 ).

PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses

Inclusion and exclusion criteria

Peer-reviewed, full-text research papers from the past five years were included in the review. All selected articles were in English language and any non-peer-reviewed and duplicate papers were excluded from finally selected articles.

Of the 16 selected research papers, there were a research focus on adults, gender, and preadolescents [ 10 - 19 ]. In the design, there were qualitative and quantitative studies [ 15 , 16 ]. There were three systematic reviews and one thematic analysis that explored the better or worse of using social media among adolescents [ 20 - 23 ]. In addition, eight were cross-sectional studies and only three were longitudinal studies [ 24 - 29 ].The meta-analyses included studies published beyond the last five years in this population. Table  2  presents a selection of studies from the review.

IGU, internet gaming disorder; PSMU, problematic social media use

This study has attempted to systematically analyze the existing literature on the effect of social media use on mental health. Although the results of the study were not completely consistent, this review found a general association between social media use and mental health issues. Although there is positive evidence for a link between social media and mental health, the opposite has been reported.

For example, a previous study found no relationship between the amount of time spent on social media and depression or between social media-related activities, such as the number of online friends and the number of “selfies”, and depression [ 29 ]. Similarly, Neira and Barber found that while higher investment in social media (e.g. active social media use) predicted adolescents’ depressive symptoms, no relationship was found between the frequency of social media use and depressed mood [ 28 ].

In the 16 studies, anxiety and depression were the most commonly measured outcome. The prominent risk factors for anxiety and depression emerging from this study comprised time spent, activity, and addiction to social media. In today's world, anxiety is one of the basic mental health problems. People liked and commented on their uploaded photos and videos. In today's age, everyone is immune to the social media context. Some teens experience anxiety from social media related to fear of loss, which causes teens to try to respond and check all their friends' messages and messages on a regular basis.

On the contrary, depression is one of the unintended significances of unnecessary use of social media. In detail, depression is limited not only to Facebooks but also to other social networking sites, which causes psychological problems. A new study found that individuals who are involved in social media, games, texts, mobile phones, etc. are more likely to experience depression.

The previous study found a 70% increase in self-reported depressive symptoms among the group using social media. The other social media influence that causes depression is sexual fun [ 12 ]. The intimacy fun happens when social media promotes putting on a facade that highlights the fun and excitement but does not tell us much about where we are struggling in our daily lives at a deeper level [ 28 ]. Another study revealed that depression and time spent on Facebook by adolescents are positively correlated [ 22 ]. More importantly, symptoms of major depression have been found among the individuals who spent most of their time in online activities and performing image management on social networking sites [ 14 ].

Another study assessed gender differences in associations between social media use and mental health. Females were found to be more addicted to social media as compared with males [ 26 ]. Passive activity in social media use such as reading posts is more strongly associated with depression than doing active use like making posts [ 23 ]. Other important findings of this review suggest that other factors such as interpersonal trust and family functioning may have a greater influence on the symptoms of depression than the frequency of social media use [ 28 , 29 ].

Limitation and suggestion

The limitations and suggestions were identified by the evidence involved in the study and review process. Previously, 7 of the 16 studies were cross-sectional and slightly failed to determine the causal relationship between the variables of interest. Given the evidence from cross-sectional studies, it is not possible to conclude that the use of social networks causes mental health problems. Only three longitudinal studies examined the causal relationship between social media and mental health, which is hard to examine if the mental health problem appeared more pronounced in those who use social media more compared with those who use it less or do not use at all [ 19 , 20 , 24 ]. Next, despite the fact that the proposed relationship between social media and mental health is complex, a few studies investigated mediating factors that may contribute or exacerbate this relationship. Further investigations are required to clarify the underlying factors that help examine why social media has a negative impact on some peoples’ mental health, whereas it has no or positive effect on others’ mental health.

Conclusions

Social media is a new study that is rapidly growing and gaining popularity. Thus, there are many unexplored and unexpected constructive answers associated with it. Lately, studies have found that using social media platforms can have a detrimental effect on the psychological health of its users. However, the extent to which the use of social media impacts the public is yet to be determined. This systematic review has found that social media envy can affect the level of anxiety and depression in individuals. In addition, other potential causes of anxiety and depression have been identified, which require further exploration.

The importance of such findings is to facilitate further research on social media and mental health. In addition, the information obtained from this study can be helpful not only to medical professionals but also to social science research. The findings of this study suggest that potential causal factors from social media can be considered when cooperating with patients who have been diagnosed with anxiety or depression. Also, if the results from this study were used to explore more relationships with another construct, this could potentially enhance the findings to reduce anxiety and depression rates and prevent suicide rates from occurring.

The content published in Cureus is the result of clinical experience and/or research by independent individuals or organizations. Cureus is not responsible for the scientific accuracy or reliability of data or conclusions published herein. All content published within Cureus is intended only for educational, research and reference purposes. Additionally, articles published within Cureus should not be deemed a suitable substitute for the advice of a qualified health care professional. Do not disregard or avoid professional medical advice due to content published within Cureus.

The authors have declared that no competing interests exist.

THE NEGATIVE IMPACT OF SOCIAL MEDIA ON YOUTH

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