Longitudinal associations between digital media use and ADHD symptoms in children and adolescents: a systematic literature review

Thorell, Lisa B.; Burén, Jonas; Ström Wiman, Johanna; Sandberg, David; Nutley, Sissela B.

doi:10.1007/s00787-022-02130-3

Cited by 132Attention Deficit Hyperactivity DisorderChild Development and Digital TechnologyImpact of Technology on Adolescents

Longitudinal associations between digital media use and ADHD symptoms in children and adolescents: a systematic literature review

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Thorell, Lisa B., Burén, Jonas, Ström Wiman, Johanna, Sandberg, David, Nutley, Sissela B.·2024·European Child & Adolescent Psychiatry

DOI 10.1007/s00787-022-02130-3PMC PMC11272698

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Abstract

Previous reviews have often shown a link between digital media ADHD symptom levels. However, longitudinal studies are needed to find stronger evidence of a causal effect as well as to determine the direction of effects. The aim of the present review (PROSPERO CRD42021262695) was therefore to provide a systematic review of studies meeting the following inclusion criteria: (1) include longitudinal data investigating associations between digital media (i.e., gaming and social media) and later ADHD symptoms or vice versa, (2) be published within the past 10 years (i.e., 2011 until June 2021), (3) be published in a peer-reviewed journal in English, and (4) include children or adolescents (age 0-17 years). After a systematic search in the Web of Science and PsycInfo databases, we included 28 studies, all with adequate or high quality. Results showed support for reciprocal associations between digital media and ADHD symptoms, with associations being more consistent for problematic use of digital media than for screen time. Thus, children with ADHD symptoms appear more vulnerable to developing high or problematic use of digital media (i.e., selection effects), and digital media also have effects on later ADHD symptom levels, either because of specific characteristics of digital media or because of indirect effects on, for example, sleep and social relations (i.e., media effects). However, it should be emphasized that further studies investigating potential moderators and mediators are needed if we are to better understand the complex associations between digital media and ADHD symptom levels.

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A more recent review found reciprocal associations between digital media use and ADHD symptoms.
“A more recent review evaluating the longitudinal associations between digital media use and ADHD symptoms found reciprocal associations between digital media use and ADHD symptoms [57].”
From Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study (2024) · cites this paper as [57]

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Background
Sleep as a Mediator of Screen Time Effects on US Children's Health Outcomes
Barlett, N. D., Gentile, D. A., Barlett, C. P., Eisenmann, J. C., & Walsh, D. A. (2011) · Journal of Children and Media · doi:10.1080/17482798.2011.633404 · Cited by 80 · cited 2× · see citing works
“Regarding mediators and covariates, there are studies showing that only the effects of school performance and peer problems [63] or sleep problems [53] remained significant when investigating the association between digital media use and later ADHD symptoms.”
Background
Screen-based sedentary behaviour and psychosocial well-being in childhood: Cross-sectional and longitudinal associations
Allen, M. S., & Vella, S. A. (2015) · Mental Health and Physical Activity · doi:10.1016/j.mhpa.2015.10.002 · Cited by 75 · cited 3× · see citing works
“…measure of use of computers, game consoles, mobile phones, and TV), the results of the current review show that eight studies found significant positive associations with later ADHD symptom levels or with symptoms of inattention when controlling for baseline levels of screen time [44, 47, 52–57].”
BackgroundResult
ICD-11-Based Assessment of Social Media Use Disorder in Adolescents: Development and Validation of the Social Media Use Disorder Scale for Adolescents
Paschke, K., Austermann, M. I., & Thomasius, R. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.661483 · Cited by 74 · see citing works
Comorbidity between Behavioral Addictions and Attention Deficit/Hyperactivity Disorder: a Systematic Review
Karaca, S., Saleh, A., Canan, F., & Potenza, M. N. (2016) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-016-9660-8 · Cited by 73 · cited 1× · see citing works
“More specifically, several reviews [8, 9, 36, 37] have shown that there is an overrepresentation of ADHD among children/adolescents with problematic use of digital media (often defined as symptoms of IGD or Internet addiction).”
Background
The Association of Lifestyle Factors and ADHD in Children
Holton, K. F., & Nigg, J. T. (2016) · Journal of Attention Disorders · doi:10.1177/1087054716646452 · Cited by 70 · cited 1× · see citing works
“These health-promoting activities are also linked to ADHD symptoms [35], and excessive use of digital media might therefore amplify pre-existing difficulties with maintaining unhealthy behaviors that children and adolescents with ADHD may already display due to the nature of their diagnosis.”
Background
Emotion Regulation and Desire Thinking as Predictors of Problematic Facebook Use
Marino, C., Caselli, G., Lenzi, M., Monaci, M. G., Vieno, A., Nikčević, A. V., & Spada, M. M. (2019) · Psychiatric Quarterly · doi:10.1007/s11126-019-09628-1 · Cited by 65 · cited 1× · see citing works
“…such as executive functions (i.e., working memory, inhibitory con-trol, and planning), delay aversion and emotion regulation, given that these functions have been linked to digital media use [81–83], other types of additions such as alcohol/drug addiction or gambling [84, 85], and ADHD [86].”
Background
The co‐occurrence between symptoms of internet gaming disorder and psychiatric disorders in childhood and adolescence: prospective relations or common causes?
Hygen, B. W., Skalická, V., Stenseng, F., Belsky, J., Steinsbekk, S., & Wichstrøm, L. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13289 · Cited by 65 · cited 7× · see citing works
“Hygen et al. [42] found that symptoms of IGD at age 10 years were related to ADHD symptom levels both 2 and 4 years later, although these associations were only found in the between-subject (with and without control for baseline levels) and not in the within-subject analyses.”
BackgroundResultInfluential
Is excessive use of social media an addiction?
Zendle, D., & Bowden-Jones, H. (2019) · BMJ · doi:10.1136/bmj.l2171 · Cited by 64 · cited 1× · see citing works
“It has also been suggested that a Social Media Disorder (SMD) should be included as a psychiatric disorder in the next version of the DSM, the argument being that social media use can be just as addictive and have just as serious effects on mental health as excessive gaming [16–19].”
Background
Social Media Use and Emotional and Behavioural Outcomes in Adolescence: Evidence from British Longitudinal Data
McNamee, P., Mendolia, S., & Yerokhin, O. (2021) · Economics & Human Biology · doi:10.1016/j.ehb.2021.100992 · Cited by 62 · cited 4× · see citing works
“With regard to more specific measures of screen time, McNamee et al. [45] found a significant relation between screen time for social media and later ADHD symptom levels in within-subject analyses, whereas Boer et al. [46] only found a significant association when not controlling for base-line…”
BackgroundMethodInfluential
Screen-exposure and altered brain activation related to attention in preschool children: An EEG study
Zivan, M., Bar, S., Xiang, J., Hutton, J., Farah, R., & Horowitz‐Kraus, T. (2019) · Trends in Neuroscience and Education · doi:10.1016/j.tine.2019.100117 · Cited by 59 · cited 1× · see citing works
“…greatest in preschool children, owing to the rapid cognitive and socioemotional development that takes place during this period in life, and research has shown that early screen time does have effects on cognition [e.g., 75], externalizing behaviors [76] and attentional networks in the brain [77].”
Background
Relationship Between Family Technoference and Behavior Problems in Children Aged 4–5 Years
Sundqvist, A., Heimann, M., & Koch, F. (2020) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2019.0512 · Cited by 59 · cited 1× · see citing works
“Interestingly, previous research has found associations even when infants are only exposed to a TV in the background [e.g., 78] or when parents are disrupted by their digital media devices when interacting with their preschool child [e.g., 79].”
Background
Attention Problems and Pathological Gaming: Resolving the ‘Chicken and Egg’ in a Prospective Analysis
Ferguson, C. J., & Ceranoglu, T. A. (2013) · Psychiatric Quarterly · doi:10.1007/s11126-013-9276-0 · Cited by 53 · cited 2× · see citing works
“…[44, 54, 61], four studies found unidirectional associations between digital media use and later ADHD symptoms [42, 46, 47, 56], two studies found unidirectional associations between ADHD symptoms and later digital media use [40, 62], and one study did not find any significant associations [59].”
BackgroundResult
Gaming Disorder in Children and Adolescents: Risk Factors and Preventive Approaches
Bender, P. K., Kim, E., & Gentile, D. A. (2020) · Current Addiction Reports · doi:10.1007/s40429-020-00337-5 · Cited by 51 · cited 1× · see citing works
“However, we believe that parents need to monitor their child’s digital media use carefully as early prevention is important and parents play a vital role in teaching children how to use digital media in a balanced way [69, 70].”
Background
Low self-control and aggression exert serial mediation between inattention/hyperactivity problems and severity of internet gaming disorder features longitudinally among adolescents
Jeong, H., Yim, H. W., Lee, S., Lee, H. K., Potenza, M. N., Jo, S., Son, H. J., & Kim, G. (2020) · Journal of Behavioral Addictions · doi:10.1556/2006.2020.00039 · Cited by 49 · cited 2× · see citing works
“Regarding studies examining associations between ADHD symptoms and later gaming addiction, all studies except three [41, 42, 46] found significant relations [61–63, 65– 67 ], when controlling for baseline levels.”
Background
Reciprocal Longitudinal Associations Between Adolescents’ Media Consumption and Psychological Health
Poulain, T., Vogel, M., Ludwig, J., Grafe, N., Körner, A., & Kiess, W. (2019) · Academic Pediatrics · doi:10.1016/j.acap.2018.08.009 · Cited by 45 · cited 2× · see citing works
“…[44, 54, 61], four studies found unidirectional associations between digital media use and later ADHD symptoms [42, 46, 47, 56], two studies found unidirectional associations between ADHD symptoms and later digital media use [40, 62], and one study did not find any significant associations [59].”
Background
High-dose electronic media use in five-year-olds and its association with their psychosocial symptoms: a cohort study
Niiranen, J., Kiviruusu, O. H., Vornanen, R., Saarenpää‐Heikkilä, O., & Paavonen, E. J. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-040848 · Cited by 44 · cited 2× · see citing works
“Significant associations were found in some studies of younger children [48, 49], but not in other studies looking at children of a similar age [58].”
BackgroundResult
An Empirical Exploration of Longitudinal Predictors for Problematic Internet Use and Problematic Gaming Behavior
Wartberg, L., Zieglmeier, M., & Kammerl, R. (2020) · Psychological Reports · doi:10.1177/0033294120913488 · Cited by 43 · cited 1× · see citing works
“Regarding studies examining associations between ADHD symptoms and later gaming addiction, all studies except three [41, 42, 46] found significant relations [61–63, 65– 67 ], when controlling for baseline levels.”
Background
The Relationship Between Media Multitasking and Attention Problems in Adolescents: Results of Two Longitudinal Studies
Baumgartner, S. E., van der Schuur, W. A., Lemmens, J. S., & Poel, F. T. (2017) · Human Communication Research · doi:10.1111/hcre.12111 · Cited by 37 · see citing works
Gaming and Social Media Addiction in University Students: Sex Differences, Suitability of Symptoms, and Association With Psychosocial Difficulties
Burén, J., Nutley, S. B., Sandberg, D., Wiman, J. S., & Thorell, L. B. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.740867 · Cited by 34 · cited 2× · see citing works
“It has also been suggested that a Social Media Disorder (SMD) should be included as a psychiatric disorder in the next version of the DSM, the argument being that social media use can be just as addictive and have just as serious effects on mental health as excessive gaming [16–19].”
BackgroundSelf-citation
Preschool children’s context-specific sedentary behaviours and parental socioeconomic status in Finland: a cross-sectional study
Määttä, S., Konttinen, H. M., Haukkala, A., Erkkola, M., & Roos, E. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016690 · Cited by 33 · cited 1× · see citing works
“Importantly, previous research [e.g., 89, 90] has shown that, in many countries, the average screen time for children greatly exceeds these limits, with averages continuously increasing and families with low SES being less likely to follow recommendations.”
Background
Time spent gaming and psychiatric symptoms in childhood: cross-sectional associations and longitudinal effects
Stenseng, F., Hygen, B. W., & Wichstrøm, L. (2019) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-019-01398-2 · Cited by 31 · cited 7× · see citing works
“Only three reports included in the present review [40–42] used interviews to assess digital media addiction and/or ADHD symptom levels, and this should clearly be considered an important strength of these studies.”
BackgroundResultInfluential
Prevalence and correlates of problematic internet experiences and computer-using time: A two-year longitudinal study in Korean school children
Yang, S.-J., Stewart, R., Lee, J.-Y., Kim, J.-M., Kim, S.-W., Shin, I.-S., & Yoon, J.-S. (2014) · Psychiatry Investigation · doi:10.4306/pi.2014.11.1.24 · Cited by 27 · cited 1× · see citing works
“…to find associations when controlling for ADHD symptom levels at baseline (or failed to control for baseline levels altogether) investigated screen time in general [51, 63, 64], screen time for multitasking [47], social media [46], violent games [50], and Internet bullying/sexual harassment [64].”
Background
Aggressive Video Games Are Not a Risk Factor for Mental Health Problems in Youth: A Longitudinal Study
Ferguson, C. J., & Wang, J. (2020) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2020.0027 · Cited by 22 · cited 1× · see citing works
“…screen time for violent media (usually violent computer games) and later ADHD symptom levels, one study failed to find a significant association [60], while another study [54] found a significant association, although it did not remain significant when controlling for ADHD symptom levels at…”
Result
Which came first? Assessing transactional relationships between children’s violent media use and ADHD-related behaviors
Beyens, I., Piotrowski, J. T., & Valkenburg, P. M. (2020) · Communication Research · doi:10.1177/0093650218782300 · Cited by 21 · cited 6× · see citing works
“A third study [44] found that screen time for violent media at Time 1 was not related to ADHD symptoms at Time 2.”
BackgroundResultInfluential
The Many Channels of Screen Media Technology in ADHD: a Paradigm for Quantifying Distinct Risks and Potential Benefits
Engelhard, M., & Kollins, S. H. (2019) · Current Psychiatry Reports · doi:10.1007/s11920-019-1077-1 · Cited by 20 · cited 3× · see citing works
“With regard to ADHD, it has been suggested that individuals with this disorder are more attracted than others to fast-paced activities, creating high arousal and delivering immediate rewards [5, 25].”
Background
Longitudinal Predictors of Self-Regulation at School Entry: Findings from the All Our Families Cohort
Hetherington, E., McDonald, S., Racine, N. M., & Tough, S. (2020) · Children · doi:10.3390/children7100186 · Cited by 20 · cited 4× · see citing works
“In addition, three studies [40, 48, 49] only found relations when not controlling for baseline levels.”
BackgroundResultInfluential
Neurodevelopmental Traits and Longitudinal Transition Patterns in Internet Addiction: A 2-year Prospective Study
Hirota, T., Takahashi, M., Adachi, M., Sakamoto, Y., & Nakamura, K. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04620-2 · Cited by 17 · see citing works
Associations between Childhood and Adolescent Emotional and Behavioral Characteristics and Screen Time of Adolescents
Männikkö, N., Ruotsalainen, H., Miettunen, J., & Kääriäinen, M. (2020) · Issues in Mental Health Nursing · doi:10.1080/01612840.2020.1725195 · Cited by 12 · cited 2× · see citing works
“However, four studies [48–51] failed to control for baseline levels altogether.”
BackgroundResult
ADHD symptoms and callous‐unemotional traits as predictors of violent media use in adolescence
Rydell, A., & Brocki, K. C. (2020) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12693 · Cited by 5 · cited 4× · see citing works
“However, one study found support for a stronger association between violent media and ADHD symptoms among boys [50], and another study found some support for a stronger association between media multitasking and ADHD symptoms among girls [47].”
BackgroundResultInfluential
Revision process for the International statistical classification of diseases and related health problems
White, J. M. L., Kita, M., Krpelanová, E., et al. (2026) · Bulletin of the World Health Organization · doi:10.2471/blt.25.294650

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[88]World Health Organization (2019). Guidelines on Physical Activity, Sedentary Behaviour and Sleep for Children under 5 Years of Age 31091057

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Problematic social media use in childhood and adolescence
Montag, C., Demetrovics, Z., Elhai, J. D., Grant, D., Koning, I. M., Rumpf, H., Spada, M. M., Throuvala, M. A., & van den Eijnden, R. J. J. M. (2024) · Addictive Behaviors · doi:10.1016/j.addbeh.2024.107980 · Cited by 207 · see citing works
Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study
Nagata, J. M., Al-Shoaibi, A. A. A., Leong, A. W., Zamora, G., Testa, A., Ganson, K. T., & Baker, F. C. (2024) · BMC Public Health · doi:10.1186/s12889-024-20102-x · Cited by 103 · see citing works
“…longitudinal data and larger cohorts other than the ABCD Study cohort, we found weak but significant correlations between screen time and adolescents’ internalizing and externalizing behavior symptoms, including depression, anxiety, ADHD, somatic, ODD, and conduct symptoms [12, 57, 84, 110, 111].”
Background
Effects of Social Media Use on Youth and Adolescent Mental Health: A Scoping Review of Reviews
Agyapong-Opoku, N., Agyapong-Opoku, F., & Greenshaw, A. J. (2025) · Behavioral Sciences · doi:10.3390/bs15050574 · Cited by 77 · see citing works
“Passive social media use is defined as observing content, nighttime social media consumption, and engaging in appearance-based activities, while active social media use is associated with cyberbullying or sexting (Prasad et al., 2023).”
Loot box purchases and their relationship with internet gaming disorder and online gambling disorder in adolescents: A prospective study
González‐Cabrera, J. M., Basterra-González, A., Ortega-Barón, J., Caba‐Machado, V., Díaz‐López, A., Pontes, H. M., & Machimbarrena, J. M. (2023) · Computers in Human Behavior · doi:10.1016/j.chb.2023.107685 · Cited by 67 · see citing works
“…to online gambling, minors (who cannot legally gamble) constitute a population that requires additional safeguards (Gibson et al., 2022) as children appear to be more vulnerable to developing problematic use of digital media, particularly when they present other comorbities (Thorell et al., 2022).”
Long-term impact of digital media on brain development in children
Nivins, S., Sauce, B., Liebherr, M., Judd, N., & Klingberg, T. (2024) · Scientific Reports · doi:10.1038/s41598-024-63566-y · Cited by 47 · see citing works
Problematic Use of Internet Associates with Poor Quality of Life via Psychological Distress in Invididuals with ADHD
Chen, C., Lee, K.-Y., Fung, X. C. C., Chen, J., Lai, Y.-C., Potenza, M. N., Chang, K., Fang, C., Pakpour, A. H., & Lin, C. (2024) · Psychology Research and Behavior Management · doi:10.2147/prbm.s449369 · Cited by 28 · see citing works
Digital screen exposure in infants, children and adolescents: a systematic review of existing recommendations
Nuvoli, V., Camanni, M., Mariani, I., Ponte, S., Black, M., & Lazzerini, M. (2025) · Public Health in Practice · doi:10.1016/j.puhip.2025.100653 · Cited by 20 · see citing works
Screen Time and Autism Spectrum Disorder: A Comprehensive Systematic Review of Risk, Usage, and Addiction
Yuan, G., Zhu, Z., Guo, H., Yang, H., Zhang, J., Zhang, K., Zhang, X., Lu, X., Du, J., Shi, H., et al. (2026) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06665-z · Cited by 20 · see citing works
Trajectory of internet gaming disorder among Chinese adolescents: Course, predictors, and long-term mental health outcomes
Peng, P., Chen, Z., Ren, S., Hé, Y., Li, J., Liao, A., Zhao, L., Shao, X., Chen, S., He, R., et al. (2025) · Journal of Behavioral Addictions · doi:10.1556/2006.2025.00054 · Cited by 21 · see citing works
“Hyperactivity/inattention traits increase vulnerability by seeking immediate stimulation and rewards provided by gaming (Thorell, Burén, Ström Wiman, Sandberg, & Nutley, 2022).”
Bidirectional associations of problematic social media use and problematic gaming with mental health difficulties and strengths in adolescents: Sex and social support as potential moderators
Todorovic, L., Bozhar, H., de Rooij, S. R., Bogaerts, A., Boyer, B. E., & Larsen, H. (2025) · Journal of Research on Adolescence · doi:10.1111/jora.70076 · Cited by 16 · see citing works
“A literature review of longitudinal studies investigating the relationship between PSMU and ADHD in adolescents suggested a bidirectional relationship (Thorell et al., 2022).”
Toddler Screen Time: Longitudinal Associations with Autism and ADHD Symptoms and Developmental Outcomes
Hill, M. M., Gangi, D. N., & Miller, M. R. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01785-0 · Cited by 15 · see citing works
Navigating the Digital Maze: A Review of AI Bias, Social Media, and Mental Health in Generation Z
Chang, J. P., Cheng, S., Chang, S. M.-J., & Su, K. (2025) · AI · doi:10.3390/ai6060118 · Cited by 17 · see citing works
“Longitudinal studies suggest that adolescents with problematic social media use are more likely to experience attention and impulsivity issues [30,31], depressive feelings [32], and lower academic achievement and life satisfaction [33].”
Short‐Form Video Media Use Is Associated With Greater Inattentive Symptoms in Thai School‐Age Children: Insights From a Cross‐Sectional Survey
Chiencharoenthanakij, R., Yothamart, K., Chantathamma, N., Sukhumdecha, W., Charoensri, S., Thanyakulsajja, B., & Anuroj, K. (2025) · Brain and Behavior · doi:10.1002/brb3.70656 · Cited by 17 · see citing works
“…factors could strengthenthebrain’sbottom–up,stimulus-drivencircuitrywhile weakening prefrontal networks essential for executive function (Baumgartner et al. 2024; Marino et al. 2019; Ra et al. 2018; Thorell et al. 2022; Zhao et al. 2022; Zhao et al. 2023; He et al. 2023; Supanitayanon et al. 2020).”
The associations between levels of inattention/hyperactivity and social media addiction among young adults: The mediating role of emotional regulation strategies in self-blame and blaming others
Liu, T.-Y., Ko, W.-T., Griffiths, M. D., Pakpour, A. H., Üztemur, S., Ahorsu, D. K., Huang, P., & Lin, C. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104338 · Cited by 17 · see citing works
Associations between screen use, learning and concentration among children and young people in western countries: a scoping review
Leonhardt, C., Danielsen, D., & Andersen, S. (2025) · Children and Youth Services Review · doi:10.1016/j.childyouth.2025.108508 · Cited by 12 · see citing works
Sleep Quality as a Mediator of Internet Gaming Disorder and Executive Dysfunction in Adolescents: Cross-Sectional Questionnaire Study
Moshel, M. L., Warburton, W., Thomasius, R., & Paschke, K. (2025) · Journal of Medical Internet Research · doi:10.2196/68571 · Cited by 12 · see citing works
“Whereas previous studies investigating IGD are often hindered by small and heterogeneous samples with a lack of focus on possible mediation [26,48], the large sample size in this study is representative of the general population of children and adolescents.”
Online risks and parental mediation in social media usage among kids: a quantitative study in Rawalpindi City
Youssef, E., Ali, S., Malek, M. A., & Riaz, S. (2025) · Frontiers in Communication · doi:10.3389/fcomm.2024.1521814 · Cited by 11 · see citing works
Beyond screen time: The core influences of problematic screen use on adolescent development networks
Xu, L., Song, K., Deng, H.-Y., Geng, X., Zhang, J., Fang, X., Potenza, M. N., & Zhang, J. (2025) · Journal of Behavioral Addictions · doi:10.1556/2006.2025.00035 · Cited by 16 · see citing works
“For instance, empirical studies have highlighted the predictive role of social media use in attention deficits, with impulsivity identified as a potential risk factor for symptoms of attention-deficit hyperactivity disorder (Thorell, Burén, Ström Wiman, Sandberg, & Nutley, 2024).”
Settling a distracted globe: An overview of psychosocial and psychotherapeutic treatment of attention-deficit/hyperactivity disorder
Gonda, X., Bálint, S., Réthelyi, J., & Döme, P. (2024) · European Neuropsychopharmacology · doi:10.1016/j.euroneuro.2024.03.002 · Cited by 11 · see citing works
“Prevailing societal and technology changes certainly do not benefit brains prone to distraction and struggling with maintenance of focus (Thorell et al., 2022), triggering symptoms in those on the sub-clinical sides of the spectrum and driving them to get evaluated, diagnosed, and helped.”
Background
Online harms: Problematic technology use is a public health concern and requires a multistakeholder approach
Kuss, D. J. (2025) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2025.100602 · Cited by 10 · see citing works
“In a longitudinal study (Jeong et al., 2020), it was also found that ADHD and playing online games for over four hours daily was associated with Gaming Disorder.”
Problematic social Internet use and associations with ADHD symptoms in girls: a longitudinal observational study
Halkett, A. E., & Hinshaw, S. P. (2024) · BMC Public Health · doi:10.1186/s12889-024-20381-4 · Cited by 11 · see citing works
“In their systematic review of ADHD and digital media use, Thorell et al. (2022) explicitly call for more longitudinal studies focused on social Internet use, noting that they had identified only two longitudinal studies addressing social media specifically [31].”
Background
Digital Media Use and Screen Time Exposure Among Youths: A Lifestyle-Based Public Health Concern
Khanani, M. I., Khan, M. R., Farooqi, M. F., Fazal, J., Aabideen, Z., & Kuwaiti, N. A. (2025) · Cureus · doi:10.7759/cureus.88373 · Cited by 19 · see citing works
“For instance, two independent systematic reviews of eight articles and 28 longitudinal studies, respectively found evidence of reciprocal associations between problematic digital media use and ADHD symptoms in children and adolescents by impacting sleep cycles and social relationships [86,87].”
Online social activity time predicts ADHD problems in youth from late childhood to early adolescence in the ABCD study
Deng, H., Song, K., Geng, X., Xu, L., Zhang, J., Li, X., He, J., Potenza, M. N., & Zhang, J. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02620-6 · Cited by 8 · see citing works
Longitudinal relationship between gaming disorder symptoms, hyperactivity/inattention symptoms and aggression among Chinese adolescents: Within-person and between-person effects
Chen, S., Liao, J., Wang, X., Li, J., Liu, Y., & Zhang, W. (2025) · Computers in Human Behavior · doi:10.1016/j.chb.2025.108608 · Cited by 8 · see citing works
Incidence of ADHD medication use among Finnish children and adolescents in 2008–2019: a need for practice changes?
Kolari, T. A., Vuori, M. A., Rättö, H., Varimo, E. A., Aronen, E. T., Saastamoinen, L., & Ruokoniemi, P. T. (2024) · Scandinavian Journal of Public Health · doi:10.1177/14034948231219826 · Cited by 8 · see citing works
Young adults’ risk profiles and predictive factors of Problematic Social Media Use (PSMU): a cross-sectional study
Hylkilä, K., Kääriäinen, M., Peltonen, A., Castrén, S., Mustonen, T., Konttila, J., & Männikkö, N. (2025) · Current Psychology · doi:10.1007/s12144-025-07662-w · Cited by 10 · see citing works
“Similar symptoms may also be involved in other problematic behaviours (e.g., PSMU) (El Archi et al., 2022 ) and links between PSMU and ADHD are mainly studied in adolescent populations (e.g., Akbari et al., 2023a ; Thorell et al., 2024 ).”
Screen Time Among and Youth Children With Disabilities: A Systematic Review and Meta‐Analysis
Vanderloo, L. M., Bourke, M., Taylor, L. G., Phillips, S. M., Loh, A., Disimino, K., Bassett-Gunter, R. L., Koo, T., Thompson‐Hill, M., & Tucker, P. (2025) · Child Care Health and Development · doi:10.1111/cch.70136 · Cited by 7 · see citing works
“…time, followed by children and youth with ADHD. researchers have found similar trends of high screen time in children and youth with these specific disabilities, making these populations a priority for intervention and support around reduced screen time (Slobodin et al. 2019; Thorell et al. 2022).”
The phenotypic and genetic relationship between adolescent mental health and time spent on social media, gaming, and TV
Frei, E., Frei, O., Jaholkowski, P. P., Parker, N., Parekh, P., Shadrin, A. A., Hagen, E., Bakken, N. R., Birkenæs, V., Ask, H., et al. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116761 · Cited by 7 · see citing works
The effect of digital parental awareness and somatic symptoms on problematic media use in children with attention-deficit/hyperactivity disorder
Güzel, Y., & Öztürk, M. (2024) · Journal of Pediatric Nursing · doi:10.1016/j.pedn.2024.12.019 · Cited by 7 · see citing works
Exploring the potential of a game-based preschool assessment of mathematical competencies
Chatzaki, M.-A., Skillen, J., Ricken, G., & Seitz-Stein, K. (2024) · Frontiers in Education · doi:10.3389/feduc.2024.1337716 · Cited by 11 · see citing works
US State Policies Regarding Social Media: Do Policies Match the Evidence?
Thimm-Kaiser, M., & Keyes, K. M. (2025) · Milbank Quarterly · doi:10.1111/1468-0009.70021 · Cited by 6 · see citing works
Attention deficit/Hyperactivity disorder
Antshel, K. M., & McBride, H. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-96023-6.00056-7 · Cited by 6 · see citing works
Modernizing behavioral parent training program for ADHD with mHealth strategies, telehealth groups, and health behavior curriculum: a randomized pilot trial
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“…the severity of PUSM may be greater in adolescents with attention-deficit/hyperactivity disorder and internalizing psychopathology, such as depression and anxiety (Boer et al., 2020; Dekkers and van Hoorn, 2022; Settanni et al., 2018; Shuai et al., 2021; Thorell et al., 2024; Wang et al., 2017).”
Did screen reading steal children's focus? Longitudinal associations between reading habits, selective attention and text comprehension
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On the Interplay of Epigenetics, ADHD and Digital Media Usage: An Adaptive Dynamical System Modelling Approach
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The indirect role of children’s screen time and the moderating role of problematic parental screen use on the relationships between different parental mediation strategies and preschoolers’ developmental outcomes
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Digital Media, Genetics, and Risk for ADHD Symptoms in Children: A Longitudinal Study
Nivins, S., Mooney, M. A., Nigg, J. T., & Klingberg, T. (2025) · Pediatrics Open Science · doi:10.1542/pedsos.2025-000922 · Cited by 4 · see citing works
Changes in prefrontal hemodynamics and mood states during screen use: a functional near-infrared spectroscopy study
Fehring, D. J., Gaillard, A., Mazzoli, E., Rossell, S. L., Dempsey, P. C., Wheeler, M. J., Owen, N. G., Dunstan, D. W., & Hallgren, M. Å. (2025) · Scientific Reports · doi:10.1038/s41598-025-09360-w · Cited by 5 · see citing works
“The impact of social media, the most prevalent form of screen use, on young people’s mental health has received considerable public and research attention, with some studies linking its use to poor educational outcomes and to attention-related disorders 51–53 .”
Genome-wide analysis of screen behaviors among adolescents identifies novel loci and overlap with educational attainment and mental disorders
Frei, E., Filiz, T. T., Frei, O., Loughnan, R. J., Jaholkowski, P. P., Parker, N., Bakken, N. R., Birkenæs, V., Shadrin, A. A., Ask, H., et al. (2025) · Scientific Reports · doi:10.1038/s41598-025-17450-y · Cited by 5 · see citing works
“Although many studies have linked ADHD and problematic screen usage on a phenotypic level 53,54 , genetic studies on the topic are scarce.”
The SASOP/PsychMg child and adolescent attention-deficit/hyperactivity disorder guidelines
Belsham, B., Kelly, L., & Schoeman, R. (2025) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v31i0.2357 · Cited by 3 · see citing works
“62 A recent study showed that 44 % of children and adolescents with ADHD met the criteria for internet gaming disorder (IGD), compared to 9.5 % of controls.”
Influential
Verification of the Effectiveness of a Token Economy Method Through Digital Intervention Content for Children with Attention-Deficit/Hyperactivity Disorder
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“Recently, digital therapeutics (DTx) have emerged as a nonpharmacological intervention, offering diverse digital content designed to support treatment [7–9].”
Longitudinal Mediated Relations Between Screen Time and School Adjustment Through Executive Function Difficulties
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“…learning disability, or attention-deficit hyperactivity disorder, is also warranted as research on these neurodiverse groups suggests that they may be more susceptible to the negative effects of excessive ST (Nikkelen et al., 2014; Qu et al., 2023; Slobodin et al., 2019; Thorell et al., 2022).”
Duration of ADHD medication treatment among Finnish children and adolescents ‒ a nationwide register study
Kolari, T. A., Vuori, M. A., Rättö, H., Varimo, E. A., Aronen, E. T., Auranen, K. J., Saastamoinen, L., & Ruokoniemi, P. T. (2025) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-025-02735-4 · Cited by 4 · see citing works
The role of technology and screen media use in treatment outcomes of children participating in a digital mental health intervention: a retrospective analysis of Bend Health
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Media consumption by preschool children: The risk of autism and developmental disorders
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Balancing speed and experience: the cognitive and affective impacts of playback acceleration in digital media consumption
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Problematic Social Media use in Individuals with ADHD: Associations with Screen Time, Motives, Content, and Psychosocial Functioning
Thorell, L. B., Dorrestein, M., Wurth, P., Burger, M., Properzi, L., & Nutley, S. B. (2025) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-025-01582-3 · Cited by 2 · see citing works
“Both cross-sectional (Lissak, 2018) and longitudinal (Thorell et al., 2024b) studies have shown that ADHD symptom levels are associated with screen time and addictive social media use.”
Self-citation
Have we found directionality? Longitudinal associations between screen use and executive function in children. A scoping review
Reid, C. A., Dhamankar, M., Marsh, S., Peterson, E. R., Erb, C. D., & Waldie, K. E. (2026) · Developmental Review · doi:10.1016/j.dr.2026.101266 · Cited by 2 · see citing works
Taming the endless scroll? Short-form videos, digital routines and neurocognitive outcomes in youth
Ebster, M., Lauerer, M., Nagel, E., & Schmidt, S. (2026) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-026-03083-7 · Cited by 3 · see citing works
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“Impor-tantly, addictive media use and ADHD symptoms may have a transactional relationship, since bidirectional associations over time were seen in longitudinal studies among adolescents [27, 28].”
Understanding health behaviors that modify the risk for obesity in ADHD
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The indirect effect of attention-deficit/hyperactivity disorder between problematic media use and aggression among a sample of Lebanese children - a cross-sectional study
Geagea, A., Gerbaka, L., Hallit, R. R., Malaeb, D. N., El-Khatib, S., Sakr, F., Dabbous, M., Hallit, S. R., Fekih‐Romdhane, F., & Obeïd, S. (2025) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2025.2517098 · Cited by 1 · see citing works
“While increasing access to fast-paced, highly stimulating digital media has been suggested as a contributing factor in the growing number of ADHD diagnoses (Beyens et al., 2018; Haddad et al., 2021; Thorell et al., 2024).”
Scrolling Through ADHD: College Students’ Engagement with ADHD Digital Media
Schiros, A., & Antshel, K. M. (2025) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-025-00538-7 · Cited by 1 · see citing works
“…the lack of known directionality in the current study due to its cross-sectional design, it is likely that a similar bidirectional relationship between ADHD-specific digital media use and ADHD symptoms is present given this relationship is well-established in the literature (Thorell et al., 2022).”
The Effect of Parenting Education to Mothers on the Amount of Screen Use in Children and Adolescents with Attention Deficit/Hyperactivity Disorder
Jafari, S. F., Mousavi, M. Z., Kousha, M., Isanazar, A., & Leili, E. K. (2025) · Journal of Comprehensive Pediatrics · doi:10.5812/jcp-160297 · Cited by 1 · see citing works
The effects of tv/video viewing hours on later ADHD symptoms: a counterfactual analysis in longitudinal population-representative data
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Digital media balance and mental health: effects of a school-based program
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“Finally, some children, such as those with Attention-Deficit/Hyperactivity Disorder (ADHD; [29, 30]), Autism Spectrum Disorder (ASD; [31]), and youth with pre-existing mental health problems [32], are particularly vulnerable to developing problematic digital media use or experiencing more severe…”
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The impact of electronic product use on children with tic disorders and ADHD, and management strategies: a review
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“I’ve Become More Myself”: Challenges and Benefits of Engaging with ADHD Short-Form Video Content and Communities
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Screen time in preschool-aged children and attention deficit hyperactivity disorder-related behaviors: A literature review
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Gaming Disorder in Adults: Associations With Physical Health, Mental Health, and Addictive Health Behaviors in the Czech Population
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Social Media and Social (Dis)Connectedness in Autism and Attention-Deficit/Hyperactivity Disorder: A Systematic Review
Potter, A. L., O’Leary, A., Incecik, E., Rose, K., Pavlopoulou, G., & Tibber, M. S. (2026) · Autism in Adulthood · doi:10.1177/25739581261435559 · Cited by 2 · see citing works
Electronic media use, sleep behavior, and internalizing problems in adolescent with ADHD
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Problematic Social Media Use and Attention-Deficit/Hyperactivity Disorder Symptoms in Adolescents
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Social Media Interventions for Individuals with ADHD: A Scoping Review
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Reconceptualizing the Interaction Between ADHD Symptoms and Environmental Context
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11. Leseprøve på papir og digitalt: Hva viser PIRLS 2021?
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“But, on the ﬂ ip side, scholars and health professionals are also focusing on the opposite direction of this association — that is, whether some of these children with ADHD (32) or ASD like symptoms might be more likely to use digital media later on.”
Fathers’ and Mothers’ Support Needs and Support Experiences after Rapid Genome SequencingPreprint
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“There is a need for more longitudinal studies that track children's development over time about their digital media consumption [10].”
Response Surface Analysis of Problematic Social Media Use and Suicidal Behavior in Early AdolescencePreprint
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Testing Bidirectional Associations Between Screen Time and Inattention/Hyperactivity Symptoms From Childhood to Adulthood in a Brazilian CohortPreprint
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CAN DIGITAL MEDIA AND SCREEN TIME INFLUENCE ON CHILDREN’S AND ADOLESCENTS’ BRAIN DEVELOPMENT? – AN ARTICLE REVIEW
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Authors: Thorell, L. B., Burén, J., Ström Wiman, J., Sandberg, D., & Nutley, S. B.
Affiliations: Karolinska Institutet (SE)
Corresponding author: Thorell, Lisa B.
ORCID: Thorell, Lisa B.
Burén, Jonas
Nutley, Sissela B.
Venue: European Child & Adolescent Psychiatry
Publisher: Springer Science and Business Media LLC
Published: 2022-12-23
Volume: 33
Issue: 8
Pages: 2503-2526
ISSN: 1018-8827 (ISSN-L)
1435-165X
DOI: 10.1007/s00787-022-02130-3
PMC: PMC11272698
OpenAlex: W4312115048
Cited by: 132
References: 88
Citations by year: 2026: 55 · 2025: 55 · 2024: 19 · 2023: 3
FWCI: 3.31
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by
creativecommons.org/licenses/by/4.0 (tdm)
creativecommons.org/licenses/by/4.0 (vor)
Locations: European Child & Adolescent Psychiatry (publishedVersion, cc-by)
PubMed Central (publishedVersion, cc-by)
PubMed (publishedVersion)
Funders: Forskningsrådet om Hälsa, Arbetsliv och Välfärd (2020-00630)
Karolinska Institute
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Social Sciences › Education › Child Development and Digital Technology
Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
Keywords: ADHD symptoms, digital media use, video gaming, social media, problematic media use, screen time, children, adolescents, bidirectional relationship, selection effects, sleep, interpersonal relationships, causal effects
MeSH terms: Screen Time, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Humans, Longitudinal Studies, Video Games, Social Media

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Longitudinal associations between digital media use and ADHD symptoms in children and adolescents: a systematic literature review

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