Association of screen time and depression in adolescence
Open accessAbstract
IMPORTANCE: Increases in screen time have been found to be associated with increases in depressive symptoms. However, longitudinal studies are lacking. OBJECTIVE: To repeatedly measure the association between screen time and depression to test 3 explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals. DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis used data from a randomized clinical trial assessing the 4-year efficacy of a personality-targeted drug and alcohol prevention intervention. This study assessed screen time and depression throughout 4 years, using an annual survey in a sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. Data were collected from September 2012 to September 2018. Analysis began and ended in December 2018. MAIN OUTCOMES AND MEASURES: Independent variables were social media, television, video gaming, and computer use. Symptoms of depression was the outcome, measured using the Brief Symptoms Inventory. Exercise and self-esteem were assessed to test displacement and upward social comparison hypothesis. RESULTS: A total of 3826 adolescents (1798 girls [47%]; mean [SD] age, 12.7 [0.5] years) were included. In general, depression symptoms increased yearly (year 1 mean [SD], 4.29 [5.10] points; year 4 mean [SD], 5.45 [5.93] points). Multilevel models, which included random intercepts at the school and individual level estimated between-person and within-person associations between screen time and depression. Significant between-person associations showed that for every increased hour spent using social media, adolescents showed a 0.64-unit increase in depressive symptoms (95% CI, 0.32-0.51). Similar between-level associations were reported for computer use (0.69; 95% CI, 0.47-0.91). Significant within-person associations revealed that a further 1-hour increase in social media use in a given year was associated with a further 0.41-unit increase in depressive symptoms in that same year. A similar within-person association was found for television (0.18; 95% CI, 0.09-0.27). Significant between-person and within-person associations between screen time and exercise and self-esteem supported upward social comparison and not displacement hypothesis. Furthermore, a significant interaction between the between-person and within-person associations concerning social media and self-esteem supported reinforcing spirals hypothesis. CONCLUSIONS AND RELEVANCE: Time-varying associations between social media, television, and depression were found, which appeared to be more explained by upward social comparison and reinforcing spirals hypotheses than by the displacement hypothesis. Both screen time modes should be taken into account when developing preventive measures and when advising parents.
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So far, only a few studies have applied the RI-CLPM method and found only minimal within-person associations between social media use and mental health, primarily measured as depressive symptoms.
“So far, only a few studies have applied this method and found only minimal within-person associations between social media use and mental health, primarily measured as depressive symptoms [7,20,21].”
From Social Media and Mental Health Among Early Adolescents in Sweden: A Longitudinal Study With 2-Year Follow-Up (KUPOL Study). (2021) · cites this paper as [7]
The Results report a within-person association between increased social media use and depressive symptoms. But the Measures section describes a multilevel model with person-mean-centred variables, not an RI-CLPM; the paper also does not characterize the association as minimal. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA systematic review showed a significant relationship between social media use and depression.
“For example, a systematic review showed that there was a significant relationship between social media use and depression (5).”
From Relationship of screen time with anxiety, depression, and sleep quality among adolescents: a cross-sectional study (2024) · cites this paper as [5]
The Key Points identify this paper as a cohort study of 3,826 adolescents, not a systematic review. The Results report a significant association between increased social media use and depressive symptoms, so the finding is supported but the description of the study is not. (LLM, conf=0.93)
Experimental — accuracy not yet measuredBoers and colleagues found a small within-person association between social media use and increased depressive symptoms.
“Boers and colleagues12 found a small within-person association between social media use and increased depressive symptoms.”
From The effect of social media on well-being differs from adolescent to adolescent (2020) · cites this paper as [12]
Previous within-person studies of social media use and adolescent well-being have reported mixed results.
“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 results6, 11–13.”
From The effect of social media on well-being differs from adolescent to adolescent (2020) · cites this paper as [12]
There is a lack of studies that focus on well-being as a momentary affective state.
“In addition, while earlier within-person studies have focused on associations with trait-like conceptualizations of well-being11–13, that is, adolescents’ average well-being across specific time periods18, there is a lack of studies that focus on well-being as a momentary affective state.”
From The effect of social media on well-being differs from adolescent to adolescent (2020) · cites this paper as [12]
Sex and sedentary screen time are associated with depression symptoms.
“Given the well-established associations of sex and sedentary screen time with depression symptoms, 43,44”
From Associations of time spent on homework or studying with nocturnal sleep behavior and depression symptoms in adolescents from Singapore (2020) · cites this paper as [43]
Upward social comparison suggests that the impact of screen time on mental health depends on the kind of content being viewed; for example, when individuals compare themselves with others who they consider are in more favorable positions.
“Upward social comparison suggests that the impact of screen time on mental health depends on the kind of content being viewed; for example, when individuals compare themselves with others who they consider are in more favorable positions (e.g., those with perfect bodies and lives) [17].”
Reinforcing spirals posits that screen time effects are mediated through content; individuals try to obtain and choose information consistent with their thoughts which may then become increasingly negative in nature.
“Reinforcing spirals also posits that screen time effects are mediated through content; however, reinforcing spirals adds that individuals try to obtain and choose information consistent with their thoughts which may then become increasingly negative in nature [17].”
The association between screen time and depression was proposed and tested with three explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals.
“Specifically, the association between screen time and depression was proposed and tested with three explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals [17].”
Upward social comparison and reinforcing spirals hypotheses explained associations between social media, television, and depression more than the displacement hypothesis.
“It was found that the upward social comparison and reinforcing spirals hypotheses explained associations between social media, television, and depression more than the displacement hypothesis [17].”
Of the four types of screen use assessed (social media, TV viewing, video gaming, and computer use), only greater levels of social media and computer use were associated with depression, but not TV viewing or video gaming.
“Of the four types of screen use assessed (i.e., social media, TV viewing, video gaming, and computer use), only greater levels of social media and computer use were associated with depression, but not TV viewing or video gaming [17].”
The displacement hypothesis suggests that all screen time adversely affects mental health because it displaces time one could be engaging in physical exercise and other healthy behaviours.
“The displacement hypothesis suggests that all screen time adversely affects mental health because it displaces time one could be engaging in physical exercise and other healthy behaviours [17].”
Since those on social media platforms share the most idealized versions of themselves, it becomes commonplace for individuals to compare their real-life experiences with those of others who highlight positive moments, causing deleterious effects on self-esteem and life satisfaction.
“Since those on social media platforms share the most idealized versions of themselves, it becomes commonplace for individuals to compare their real-life experiences with those of others who highlight positive moments, causing deleterious effects on self-esteem and life satisfaction [17].”
The findings may be explained in part by some combination of various media effects theories, including the displacement hypothesis.
“These findings may be explained, in part, by some combination of various media effects theories that have been proposed [115], including the displacement hypothesis [116, 117].”
From Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study (2024) · cites this paper as [115]
Higher levels of adolescent screen use are associated with depression.
“and depression [4,5]”
From Using Wearable Cameras to Categorize the Type and Context of Screen-Based Behaviors Among Adolescents: Observational Study (2022) · cites this paper as [4]
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- Authors
- Boers, E., Afzali, M. H., Newton, N., & Conrod, P.
- Affiliations
- Centre Hospitalier Universitaire Sainte-Justine (CA)
- UNSW Sydney (AU)
- Corresponding author
- Boers, Elroy
- Venue
- JAMA Pediatrics
- Publisher
- American Medical Association (AMA)
- Published
- 2019-09-01
- Volume
- 173
- Issue
- 9
- Pages
- 853
- ISSN
- 1072-4710 (ISSN-L)
- 2168-6203
- PMC
- PMC6632122
- OpenAlex
- W2957614298
- Cited by
- 481
- References
- 46
- Citations by year
- 2026: 76 · 2025: 66 · 2024: 56 · 2023: 74 · 2022: 89 · 2021: 68 · 2020: 40 · 2019: 12
- FWCI
- 104.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Pediatrics and Adolescent Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Social Sciences › Education › Child Development and Digital Technology
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Keywords
- adolescent depression, depressive symptoms, social media use, television viewing, video gaming, computer use, displacement theory, upward social comparison, self-esteem, physical activity, within-person associations, between-person associations, longitudinal change in depression, school-based adolescents, Brief Symptom Inventory, Greater Montreal
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