Cascading bidirectional influences of digital media use and mental health in adolescence

Flannery, Jessica S.; Maza, Maria T.; Kilic, Zelal; Telzer, Eva H.

doi:10.1016/bs.acdb.2022.10.003

Cited by 23Impact of Technology on AdolescentsChild Development and Digital TechnologyChild and Adolescent Psychosocial and Emotional Development

Cascading bidirectional influences of digital media use and mental health in adolescence

Flannery, Jessica S., Maza, Maria T., Kilic, Zelal, Telzer, Eva H.·2023·Advances in Child Development and Behavior

DOI 10.1016/bs.acdb.2022.10.003

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Abstract

A substantial portion of critical adolescent development is occurring within digital environments. However, certain individual differences may lead adolescents to use digital media in diverse ways. In this chapter we suggest that the way teens use digital media influences how digital media affects their mental health. Further, we propose a model in which these influences, in the context of ongoing development, may have feedback effects on how digital media is subsequently used, thus resulting in a self-perpetuating cycle. Our model suggests that certain developmental risk/protective factors and maladaptive/adaptive digital media behaviors likely perpetuate each other in a cyclical manner each serving to maintain and/or escalate the other. We discuss existing evidence of these processes in psychosocial, identity, incentive processing, and physical health development. Future research focusing on individual differences and self-reinforcing digital media behaviors that manifest these feedback loops may portray a more complete picture of cascading digital media influences across adolescent development.

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Bidirectional associations between screen time and mental health could be supported by the self-perpetuating feedback loop model, whereby screen use leads to worsening mental health and poor mental health leads to increasing reliance on screens to cope.
“Bidirectional associations between screen time and mental health could be supported by the self-perpetuating feedback loop model [131], whereby screen use leads to worsening mental health and poor mental health leads to increasing reliance on screens to cope [132].”
From Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study (2024) · cites this paper as [131]

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#Grateful: Longitudinal Associations Between Adolescents’ Social Media Use and Gratitude During the COVID‐19 Pandemic
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Self-citation
Intersectionality and Identity Configurations: A Qualitative Study Exploring Sexual Identity Development Among Emerging Adults Within the United States
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Adolescents’ Social Media Experiences and Their Self-Esteem: A Person-Specific Susceptibility PerspectivePreprint
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The Effects of Digital Media and Media Multitasking on Attention Problems and Sleep
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Connective Action and Affective Language: Computational Text Analysis of Facebook Comments on Social Movements in South Korea
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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
“Bidirectional associations between screen time and mental health could be supported by the self-perpetuating feedback loop model [131], whereby screen use leads to worsening mental health and poor mental health leads to increasing reliance on screens to cope [132].”
Background
Social Media Use and Depressive Symptoms During Early Adolescence
Nagata, J. M., Otmar, C. D., Shim, J., Balasubramanian, P., Cheng, C. M., Li, E. J., Al-Shoaibi, A. A. A., Shao, I. Y., Ganson, K. T., Testa, A., et al. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.11704 · Cited by 71 · see citing works
Annual Research Review: Adolescent social media use is not a monolith: toward the study of specific social media components and individual differences
Maheux, A. J., Burnell, K., Maza, M. T., Fox, K. A., Telzer, E. H., & Prinstein, M. J. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14085 · Cited by 59 · see citing works
Self-citation
Variation in social media sensitivity across people and contexts
Vaid, S. S., Kroencke, L., Roshanaei, M., Talaifar, S., Hancock, J. T., Back, M. D., Gosling, S. D., Ram, N., & Harari, G. M. (2024) · Scientific Reports · doi:10.1038/s41598-024-55064-y · Cited by 29 · see citing works
Developmental changes in brain function linked with addiction-like social media use two years later
Flannery, J. S., Burnell, K., Kwon, S., Jorgensen, N. A., Prinstein, M. J., Lindquist, K. A., & Telzer, E. H. (2024) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsae008 · Cited by 24 · see citing works
“Social media serves many functions and is often a part of healthy adolescent development (Leung, 2011; Deters and Mehl, 2013; Ellis et al ., 2020; Flannery et al ., 2023).”
BackgroundSelf-citation
The effects of social media restriction: Meta-analytic evidence from randomized controlled trials
Burnell, K., Meter, D. J., Andrade, F. C., Slocum, A., & George, M. J. (2025) · SSM - Mental Health · doi:10.1016/j.ssmmh.2025.100459 · Cited by 23 · see citing works
Adolescents’ Social Comparison on Social Media: Links with Momentary Self-Evaluations
Burnell, K., Trekels, J., Prinstein, M. J., & Telzer, E. H. (2024) · Affective Science · doi:10.1007/s42761-024-00240-6 · Cited by 17 · see citing works
“Additionally, because the associations between social media interactions and outcomes are transactional (Flannery et al., 2023), risk factors of engaging in social comparisons should be tested.”
Self-citation
Longitudinal Change in Appearance-Related Social Media Consciousness and Depressive Symptoms: A Within-Person Analysis during Early-to-Middle Adolescence
Maheux, A. J., Laurenceau, J., Roberts, S. R., Nesi, J. L., Widman, L. M., & Choukas‐Bradley, S. (2024) · Journal of Youth and Adolescence · doi:10.1007/s10964-024-01998-5 · Cited by 21 · see citing works
“Although many of ﬂ ine and online experiences may be bidirectionally associated across cascading developmental systems (Flannery et al., 2023), and research indicates that adolescents with depression tend to use social media in distinct ways (Radovic et al., 2017), prior and current results provide…”
BackgroundResultInfluential
Media Use and Its Associations With Paranoia in Schizophrenia and Bipolar Disorder: Ecological Momentary Assessment
Paquin, V., Ackerman, R. A., Depp, C. A., Moore, R. C., Harvey, P. D., & Pinkham, A. E. (2024) · JMIR Mental Health · doi:10.2196/59198 · Cited by 14 · see citing works
Screen time and manic symptoms in early adolescents: prospective findings from the Adolescent Brain Cognitive Development Study
Nagata, J. M., Zamora, G., Al-Shoaibi, A. A. A., Lavender, J. M., Ganson, K. T., Testa, A. M., He, J., & Baker, F. C. (2025) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-025-02814-6 · Cited by 8 · see citing works
“It is also plausible that greater manic symptoms could lead to excessive screen use, and bidirectional relationships exist [20].”
Neurobiological sensitivity to popular peers moderates daily links between social media use and affect
Maza, M. T., Kwon, S., Jorgensen, N. A., Capella, J., Prinstein, M. J., Lindquist, K. A., & Telzer, E. H. (2023) · Developmental Cognitive Neuroscience · doi:10.1016/j.dcn.2023.101335 · Cited by 10 · see citing works
“Indeed, researchers have posited that adolescent mental health and affect may both impact and be impacted by social media use and have called for future work to examine the bidirectional relationship (Flannery et al., 2023; Luo and Hancock, 2020).”
Self-citation
Social media use
Magis‐Weinberg, L., & Davis, K. S. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-96023-6.00105-6 · Cited by 6 · see citing works
Child and adolescent psychiatry: challenges, solutions, opportunities, and future directions
Cortese, S., Arango, C., Aymerich, C., Catalan, A., Chetouani, M., Cohen, D., Coghill, D., Gabellone, A., Iniesta, R., Kadan, A., et al. (2026) · World Psychiatry · doi:10.1002/wps.70044 · Cited by 4 · see citing works
“Child and adolescent psychiatrists are seen as a costly resource in what is often a resource-poor environment 212 .”
Identifying relevant experiences to the measurement of social media experience via focus groups with young people: A registered reportPreprint
Dunne, J. H., Black, L., Nanda, P., Anderton, M., Banwell, E., Butters, L. C., Demkowicz, O., Davies, J., Davidson, B. I., Qualter, P., et al. (2023) · doi:10.31234/osf.io/erjvz · Cited by 3 · see citing works
Digital Sexual Communication Among Adolescents: Links with Sociosexual Health Outcomes and Psychosocial Distress
Maheux, A. J., Widman, L. M., McCrimmon, J., Lankster, A., & Medina, C. M. (2025) · Media Psychology · doi:10.1080/15213269.2025.2509507 · Cited by 1 · see citing works
“However, these processes are likely complicated, characterized by bidirectional effects (see Flannery et al., 2023) and third variables, such as characteristics of the adolescents’ social environment (e.g., parent support, peer or partner relationship quality) that were not measured in the current…”
Digital literacy as a predictor of mental health understanding among adolescent: Evidence from Yogyakarta, Indonesia
Setyaningrum, N., & Suud, F. M. (2025) · BIO Web of Conferences · doi:10.1051/bioconf/202520303026 · Cited by 1 · see citing works
Social Media and the Developing Brain
Telzer, E. H., & Maza, M. T. (2024) · Springer eBooks · doi:10.1007/978-3-031-56537-3_3 · Cited by 1 · see citing works
Self-citation
Social Media SensitivityPreprint
Vaid, S. S., Kroencke, L., Roshanaei, M., Talaifar, S., Hancock, J. T., Back, M. D., Gosling, S. D., Ram, N., & Harari, G. M. (2023) · doi:10.31234/osf.io/yfp45 · Cited by 1 · see citing works
Delineating temporal dynamics for the linkage between anxiety symptoms and problematic media use among Chinese adolescents
Cao, H., Wang, S., Zhou, N., & Zhang, M. (2025) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2025.101761
Digital cultures and the exposome of psychosis
Werst, M. J. A., Tiraboschi, G. A., & Paquin, V. (2026) · Schizophrenia Research · doi:10.1016/j.schres.2026.04.006
A Developmental Neuroscience Framework for Youth-Centered Digital Media and Implications for Policy
Telzer, E. H., Burnell, K., Maheux, A. J., Vaccaro, A. G., & Prinstein, M. J. (2026) · Policy Insights from the Behavioral and Brain Sciences · doi:10.1177/23727322261471447
“Adolescents, whose brains show heightened sensitivity to reward and novelty, are especially susceptible to these cues (Flannery et al., 2023).”
Self-citation
Adolescents’ Interactions with AI-Powered Chatbots: A Scoping Review of Psychosocial and Well-Being Research (2022–2025)
Bruno, G., Garofalo, C., Delvecchio, E., Buratta, L., Salmi, L. P., & Mazzeschi, C. (2026) · International Journal of Human-Computer Interaction · doi:10.1080/10447318.2026.2712659
Problematic Social Media Use and Depressive and Anxiety Symptoms in Adolescents
Nagata, J. M., Otmar, C. D., Li, E. J., Ganson, K. T., Lavender, J. M., Testa, A. M., He, J., Christakis, D., & Baker, F. C. (2026) · PEDIATRICS · doi:10.1542/peds.2025-075060

A REVIEW OF THE IMPACT OF DIGITAL MEDIA USAGE ON ADOLESCENT: MENTAL HEALTH AND BEHAVIOUR
DEEPIKA, D. J. G. (2025) · TPM Testing, psychometrics, methodology in applied psychology
Commentary: An updated agenda for the study of digital media use and adolescent development – future directions following Odgers & Jensen (2020)
Prinstein, M. J., Nesi, J. L., & Telzer, E. H. (2020) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13219 · Cited by 107 · see citing works
Self-citation
Trajectories of adolescent media use and their psychosocial correlates: A latent class growth and autoregressive latent trajectory panel analysis.
Chen, Y.-Y. (2025) · Applied Psychology: Health and Well-Being · doi:10.1111/aphw.70088 · Cited by 3 · see citing works
Youth in the Permanent Stream: Digital Media, Self-Regulation, and Societal ResponsibilityPreprint
Paulini, B. (2026) · SSRN Electronic Journal · doi:10.2139/ssrn.6274018
Connecting Online Behavior to Adolescent Development: A Theoretical Framework
Subrahmanyam, K., & Šmahel, D. (2010) · Advancing responsible adolescent development · doi:10.1007/978-1-4419-6278-2_2 · Cited by 35 · see citing works

Authors: Flannery, J. S., Maza, M. T., Kilic, Z., & Telzer, E. H.
Affiliations: University of North Carolina at Chapel Hill (US)
Corresponding author: Telzer, Eva H.
ORCID: Flannery, Jessica S.
Maza, Maria T.
Kilic, Zelal
Telzer, Eva H.
Venue: Advances in Child Development and Behavior
Publisher: Elsevier
Published: 2023
Volume: 64
Pages: 255-287
ISSN: 0065-2407 (ISSN-L)
DOI: 10.1016/bs.acdb.2022.10.003
OpenAlex: W4312798038
Cited by: 23
References: 143
Citations by year: 2026: 5 · 2025: 6 · 2024: 9 · 2023: 3
FWCI: 33.43
Type: book chapter
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Advances in child development and behavior (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: digital media use, adolescent mental health, bidirectional effects, feedback loops, individual differences, identity construction, incentive processing, physical health, psychosocial development
MeSH terms: Digital Technology, Adolescent, Adolescent Behavior, Female, Humans, Male, Mental Health, Models, Psychological, Adolescent Development, Social Media

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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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Cascading bidirectional influences of digital media use and mental health in adolescence

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