Association of digital media use with subsequent symptoms of attention-deficit/hyperactivity disorder among adolescents
Open accessAbstract
Importance: Modern digital platforms are easily accessible and intensely stimulating; it is unknown whether frequent use of digital media may be associated with symptoms of attention-deficit/hyperactivity disorder (ADHD). Objective: To determine whether the frequency of using digital media among 15- and 16-year-olds without significant ADHD symptoms is associated with subsequent occurrence of ADHD symptoms during a 24-month follow-up. Design, Setting, and Participants: Longitudinal cohort of students in 10 Los Angeles County, California, high schools recruited through convenience sampling. Baseline and 6-, 12-, 18-, and 24-month follow-up surveys were administered from September 2014 (10th grade) to December 2016 (12th grade). Of 4100 eligible students, 3051 10th-graders (74%) were surveyed at the baseline assessment. Exposures: Self-reported use of 14 different modern digital media activities at a high-frequency rate over the preceding week was defined as many times a day (yes/no) and was summed in a cumulative index (range, 0-14). Main Outcomes and Measures: Self-rated frequency of 18 ADHD symptoms (never/rare, sometimes, often, very often) in the 6 months preceding the survey. The total numbers of 9 inattentive symptoms (range, 0-9) and 9 hyperactive-impulsive symptoms (range, 0-9) that students rated as experiencing often or very often were calculated. Students who had reported experiencing often or very often 6 or more symptoms in either category were classified as being ADHD symptom-positive. Results: Among the 2587 adolescents (63% eligible students; 54.4% girls; mean [SD] age 15.5 years [0.5 years]) who did not have significant symptoms of ADHD at baseline, the median follow-up was 22.6 months (interquartile range [IQR], 21.8-23.0, months). The mean (SD) number of baseline digital media activities used at a high-frequency rate was 3.62 (3.30); 1398 students (54.1%) indicated high frequency of checking social media (95% CI, 52.1%-56.0%), which was the most common media activity. High-frequency engagement in each additional digital media activity at baseline was associated with a significantly higher odds of having symptoms of ADHD across follow-ups (OR, 1.11; 95% CI, 1.06-1.16). This association persisted after covariate adjustment (OR, 1.10; 95% CI, 1.05-1.15). The 495 students who reported no high-frequency media use at baseline had a 4.6% mean rate of having ADHD symptoms across follow-ups vs 9.5% among the 114 who reported 7 high-frequency activities (difference; 4.9%; 95% CI, 2.5%-7.3%) and vs 10.5% among the 51 students who reported 14 high-frequency activities (difference, 5.9%; 95% CI, 2.6%-9.2%). Conclusions and Relevance: Among adolescents followed up over 2 years, there was a statistically significant but modest association between higher frequency of digital media use and subsequent symptoms of ADHD. Further research is needed to determine whether this association is causal.
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Greater duration of digital media use is associated with greater ADHD symptoms.
“Greater duration of digital media use is associated with greater ADHD symptoms138”
From Digital Ecosystems, Children, and Adolescents: Technical Report (2026) · cites this paper as [138]
The Primary Analysis and Secondary Analyses report that greater high-frequency digital media use was associated with subsequent ADHD symptoms among adolescents. But the study measured how often activities were used, not the duration of use, so it does not establish the claim as phrased. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn adolescents without ADHD at baseline, more frequent digital media use is significantly associated with ADHD symptoms after 24 months of follow-up.
“A recent survey of adolescents without symptoms of ADHD at the start of the study indicated a significant association between more frequent use of digital media and symptoms of ADHD after 24 months of follow-up.6”
From Brain health consequences of digital technology use (2020) · cites this paper as [6]
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- Authors
- Ra, C. K., Cho, J., Stone, M. D., De La Cerda, J., Goldenson, N. I., Moroney, E., Tung, I., Lee, S. S., & Leventhal, A. M.
- Affiliations
- University of Southern California (US)
- University of California San Diego (US)
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles
- University of California, Los Angeles (US)
- Corresponding author
- Leventhal, Adam M.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2018-07-17
- Volume
- 320
- Issue
- 3
- Pages
- 255
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC6553065
- OpenAlex
- W2884483214
- Cited by
- 360
- References
- 35
- Citations by year
- 2026: 46 · 2025: 61 · 2024: 35 · 2023: 39 · 2022: 41 · 2021: 66 · 2020: 42 · 2019: 22 · 2018: 7 · 2015: 1
- FWCI
- 26.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute on Drug Abuse (R01DA033296)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Education › Child Development and Digital Technology
- Keywords
- attention deficit hyperactivity disorder, ADHD symptoms, digital media use, adolescents, social media use, inattentive symptoms, hyperactive-impulsive symptoms, screen time, high school students, ADHD risk factors, inattention, impulsivity, anxiety, substance use
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Female, Humans, Longitudinal Studies, Male, Prevalence, Logistic Models, Video Games, Internet, Self Report, Social Media
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