Social media use by adolescents linked to internalizing behaviors

September 11, 2019

A new study from researchers at the Johns Hopkins Bloomberg School of Public Health found that adolescents who spend more than three hours a day on social media are more likely to report high levels of internalizing behaviors compared to adolescents who do not use social media at all.

The study, published online September 11 in JAMA Psychiatry, examined the time adolescents reported spending on social media and two types of behaviors that can be indicators of mental health problems: internalizing and externalizing. Internalizing can involve social withdrawal, difficulty coping with anxiety or depression or directing feelings inward. Externalizing can include aggression, acting out, disobeying or other observable behaviors.

The study found the use of social media for any amount of time was associated with both a greater risk of reporting internalizing problems alone and concurrent symptoms of both internalizing and externalizing problems. The study found no significant association with social media use and externalizing problems alone. Teens who spent at least three hours on social media a day had the greatest risk for reporting internalizing problems alone.

"Many existing studies have found a link between digital or social media use and adolescent health, but few look at this association across time," says lead author Kira Riehm, MSc, a doctoral student in the Department of Mental Health at the Bloomberg School. "Our study shows that teens who report high levels of time spent on social media are more likely to report internalizing problems a year later. We cannot conclude that social media causes mental health problems, but we do think that less time on social media may be better for teens' health."

Social media use among teens is widespread. Recent polls have found that 95 percent of teens in the U.S. have access to a smartphone and close to 75 percent of teens have at least one social media account. The use of social media has both health risks and benefits. These platforms often provide ways to connect with peers and information and resources on causes important to them, but there are risks of cyberbullying and other digital aggressions.

For their study, the researchers used a nationally representative sample of U.S. adolescents ages 13 to 17 from the federally funded Population Assessment of Tobacco and Health Study (PATH) between 2013 and 2016. The study collected data over three years and the analysis involved 6,595 respondents. Each year, participants were asked how much time they spent on social media as well as questions pertaining to symptoms of internal and external mental health problems.

The study found that less than 17 percent of adolescents did not use social media. For those who did report using social media, 2,082 or 32 percent, reported spending less than 30 minutes; 2,000, or about 31 percent, reported spending 30 minutes to three hours; 817, or 12 percent, reported spending three to six hours; and 571, or 8 percent, reported spending more than six hours per day.

Researchers also found that 611 respondents, or about 9 percent, reported experiencing only internalizing problems, while 885, or 14 percent, reported experiencing externalizing problems only; 1,169, or about 18 percent, reported experiencing both internal and external problems; and 3,930, or about 59 percent, reported no/low problems. The study found no links between social media use and mental health problems and gender.

"Social media has the ability to connect adolescents who may be excluded in their daily life. We need to find a better way to balance the benefits of social media with possible negative health outcomes," says Riehm. "Setting reasonable boundaries, improving the design of social media platforms and focusing interventions on media literacy are all ways in which we can potentially find this equilibrium."
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The researchers were supported by training grants from the National Institute of Mental Health, National Institute on Drug Abuse, and Canadian Institutes of Health Research.

"Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among U.S. Youth" was written by Kira E. Riehm, Kenneth A. Feder, Kayla N. Tormohlen, Rosa M. Crum, Andrea S. Young, Kerry M. Green, Lauren R. Pacek, Lareina N. La Flair and Ramin Mojtabai.

Johns Hopkins University Bloomberg School of Public Health

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