The Longitudinal Impact of Social Media Use on UK Adolescents' Mental Health: Longitudinal Observational Study

Abstract

Background Cross-sectional studies have found a relationship between social media use and depression and anxiety in young people. However, few longitudinal studies using representative data and mediation analysis have been conducted to understand the causal pathways of this relationship. Objective This study aims to examine the longitudinal relationship between social media use and young people’s mental health and the role of self-esteem and social connectedness as potential mediators. Methods The sample included 3228 participants who were 10- to 15-year-olds from Understanding Society (2009-2019), a UK longitudinal household survey. The number of hours spent on social media was measured on a 5-point scale from “none” to “7 or more hours” at the ages of 12-13 years. Self-esteem and social connectedness (number of friends and happiness with friendships) were measured at the ages of 13-14 years. Mental health problems measured by the Strengths and Difficulties Questionnaire were assessed at the ages of 14-15 years. Covariates included demographic and household variables. Unadjusted and adjusted multilevel linear regression models were used to estimate the association between social media use and mental health. We used path analysis with structural equation modeling to investigate the mediation pathways. Results In adjusted analysis, there was a nonsignificant linear trend showing that more time spent on social media was related to poorer mental health 2 years later (n=2603, β=.21, 95% CI 0.43 to 0.84; P=.52). In an unadjusted path analysis, 68% of the effect of social media use on mental health was mediated by self-esteem (indirect effect, n=2569, β=.70, 95% CI 0.15-1.30; P=.02). This effect was attenuated in the adjusted analysis, and it was found that self-esteem was no longer a significant mediator (indirect effect, n=2316, β=.24, 95% CI 0.12 to 0.66; P=.22). We did not find evidence that the association between social media and mental health was mediated by social connectedness. Similar results were found in imputed data. Conclusions There was little evidence to suggest that more time spent on social media was associated with later mental health problems in UK adolescents. This study shows the importance of longitudinal studies to examine this relationship and suggests that prevention strategies and interventions to improve mental health associated with social media use could consider the role of factors like self-esteem.

Smartphones, social Media and Adolescent mental well-being: the impact of school policies Restricting dayTime use—protocol for a natural experimental observational study using mixed methods at secondary schools in England (SMART Schools Study)

“…In the UK, most adolescents (98%) own a smartphone, and are reported to be active users of social media (93%),14 with comparable trends reported in other Western populations 15. Samples in the USA and the UK (2021–2022) estimate that the time adolescents spend on smartphones and social media ranges between one and a half hours and eight and a half hours per day,12–14 16 17 with most adolescents spending between 1 and 3 hours per day 14 16 17. Problematic social media use is also prevalent, with 12% of adolescents in England reported to exhibit addictive use behaviours 18…”

“…In moderation, smartphone and social media use (eg, <2 hours per day) can be advantageous for mental well-being and mental health,19–24 as well as other associated health and behavioural outcomes (eg, sleep, physical activity, classroom behaviour and attainment). However, at higher levels of use, the reverse effect tends to be seen, with increasing time spent on smartphones and social media associated with decreasing levels of mental well-being and higher levels of anxiety and depression 17 19–21 23 25 26. Poor academic performance, disruptive classroom behaviour and less time spent in physical activity and sleep are also more likely in adolescents who spend a greater proportion of time on smartphones and/or social media 19–23 25 26.…”

The Impact of Social Media Use on Sleep and Mental Health in Youth: a Scoping Review

“…A total of 33 studies were included in this scoping review, with 26 of them were cross-sectional in nature, indicating a snapshot overview of the relationship between SMU, sleep, and mental health. Moreover, only a few studies utilized representative samples [ 35 , 36 , 40 , 41 ], as outlined in Table 1 . It is also worth noting that the sample sizes varied significantly across studies, ranging from 54 to 195,668 participants.…”

“…Four longitudinal cohort studies reported mixed findings between SMU and mental health [ 41 , 63 , 64 •, 65 ]. Two cohort studies conducted in the USA and China reported that frequent and problematic SMU were significantly associated subsequent mental health issues [ 64 •, 65 ].…”

Cohort profile: The Social media, smartphone use and Self-harm in Young People (3S-YP) study–A prospective, observational cohort study of young people in contact with mental health services

“…Most existing data on social media or smartphone use and mental health problems in young people, including self-harm, are from cross-sectional studies, some of which have repeated waves [ 12 , 13 ]. Most studies have considered self-reported time spent on social media, rather than the nature or quality of activity, or objective measures of online activity.…”