Cited by 158Impact of Technology on AdolescentsChild Development and Digital TechnologyChild and Adolescent Psychosocial and Emotional Development

There Is No Evidence That Associations Between Adolescents’ Digital Technology Engagement and Mental Health Problems Have Increased

Open access
Vuorre, Matti, Orben, Amy, Przybylski, Andrew K.·2021·Clinical Psychological Science

Published version of a preprint

Abstract

Digital technology is ubiquitous in modern adolescence, and researchers are concerned that it has negative impacts on mental health that, furthermore, increase over time. To investigate whether technology is becoming more harmful, we examined changes in associations between technology engagement and mental health in three nationally representative samples. Results were mixed across types of technology and mental health outcomes: Technology engagement had become less strongly associated with depression in the past decade, but social-media use had become more strongly associated with emotional problems. We detected no changes in five other associations or differential associations by sex. There is therefore little evidence for increases in the associations between adolescents’ technology engagement and mental health. Information about new digital media has been collected for a relatively short time; drawing firm conclusions about changes in their associations with mental health may be premature. We urge transparent and credible collaborations between scientists and technology companies.

AI snapshot

Written from the paper’s full text.

TL;DR

Across three large nationally representative samples, the paper finds little evidence that associations between adolescents’ technology engagement and mental health problems have increased over time. Results were mixed by technology and outcome, with some associations decreasing and one increasing, but changes were very small.

Key findings

  • In 2017, technology–mental health associations were generally weak, ranging from zero to about 0.15 SD; in YRBS, males at average device use reported suicide planning with 9% probability versus 11% at 1 SD above the mean (difference 2%, 95% CI [1.6%, 2.7%]).
  • No consistent increase over time: social media use became more strongly associated with emotional problems, but depression’s association with social media and TV decreased; no credible changes were detected in five other associations, and no changes differed by gender.
  • Where credible changes occurred, they were smaller than 0.01 SD per year; GAMs explained less than 3% of variance and indicated only two nonlinear changes: social media–emotional problems and TV–depression.

Methods

  • Analyzed three nationally representative datasets—Monitoring the Future, Understanding Society, and Youth Risk Behavior Surveillance System—with a combined 430,561 participants, restricting to ages 10–15 where possible.
  • Outcomes included depression, conduct problems, emotional problems, and suicidal ideation/behaviour; predictors included TV viewing, social media use, and digital device use.
  • Estimated Bayesian models with year (centered at 2017), technology use, and their interaction, plus sex interactions; US models included random intercepts, YRBS used Bernoulli/probit models with random item parameters, and sensitivity analyses used generalized additive models.

Limitations

  • The paper states that between-person associations cannot support causal claims, that no covariates were included due to lack of strong theory and cross-dataset heterogeneity, and that self-report technology use is biased and noisy.
  • The paper states that newer technologies have a shorter observation window, making firm conclusions premature, and that the work may conflate between- and within-person associations or different levels of analysis.
  • Evident from the text: most analyses are cross-sectional except Understanding Society, and the study relies on self-reported mental health and technology use rather than objective usage data.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/2167702621994549

Cites

48 of 48 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 38 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    No credible changes were detected in the relationship between suicidal ideation and behaviour and either social media or television.

    “Interestingly, no credible changes were detected in the relationship between suicidal ideation and behaviour and either social media or television.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: Any change over time in the technology–mental health association was linear over the study period.
  • Findingown data

    Emotional problems were related to both TV and social media.

    “Emotional problems were also related to both technologies, but suicidal ideation and behaviour was reliably associated only with social media.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The relationship between social media and TV, and conduct problems remained stable, with parameters narrowly centered on zero.

    “The relationship between social media and TV, and conduct problems had remained stable, as indicated by the estimated parameters narrowly centered on zero.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: Any change over time in the technology–mental health association was linear over the study period.
  • Findingown data

    Most GAM models showed that the nonlinear technology-mental health relationships did not change over time.

    “Critically, most models indicated that the (nonlinear) technology-mental health relationships had not changed over time as suggested by model comparison using AIC (Figure 3, bottom right)”
    Quote in the paperSubstantial claim
  • Findingown data

    The GAMs with year and technology use but no interaction explained under 3% of variance in the mental health outcomes.

    “However, in line with the previous linear models, the GAMs that included year and technology use, but not their interaction, still only explained less than 3% of variance in the outcomes (Figure 3, bottom left).”
    Quote in the paperNot a substantial claim
  • May combine two claims. 24
  • Classified as probably not a substantial claim. 20
  • The quote only partly states this claim. 1
  • May combine two claims.

    Findingown data

    Changes in technology-mental health relations were not moderated by sex; none of the estimates credibly differed from zero.

    “We also investigated whether changes in technology’s relations with mental health described in the bottom panel of Figure 2 were moderated by sex, but none of the estimates were credibly different from zero, suggesting that any changes—or lack thereof—over time were not different between boys and girls.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: Any change over time in the technology–mental health association was linear over the study period.
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The association between emotional problems and social media increased over time.

    “The association between emotional problems and social media had increased, but their association with TV had remained stable.”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: Any change over time in the technology–mental health association was linear over the study period.
  • May combine two claims.

    Findingown data

    Cross-sectional correlations suggested that changes in the technology-mental health relationship over time were plausible but likely differed by outcome and technology.

    “These cross-sectional between-person relationships are shown in Figure 1, which suggested that changes in the relationship over time were plausible, but likely to differ between outcomes and technologies.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Structural equation models replicated the main results, except that the 2017 TV-suicide association's 95% CI just excluded zero ([0.001, 0.026]).

    “Those analyses replicated the above results, with the only exception that the 2017 TV – suicide association’s 95% CI just excluded zero ([0.001, 0.026]; see online analysis supplement).”
    Quote in the paperNot a substantial claim
    • The authors state this as an assumption: Any change over time in the technology–mental health association was linear over the study period.
    • The authors state this as an assumption: Relations between technology use and mental health were linear, and any changes in those relations were linear.
  • May combine two claims.

    Findingown data

    The relationships between technology use and mental health in the GAM analysis were complex and mostly curvilinear.

    “As can be seen in Figure 3 (top panel), the technology use-mental health relations were complex and generally curvilinear.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Depression links declined for both social media and television.

    “Unexpectedly, both social media’s and television’s associations with depression, on the other hand, had decreased.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    The study's observed patterns conflicted with one another and lacked conceptual replication in related outcomes.

    “because the observed patterns in the current study were contradictory to each other, and not conceptually replicated across the other related outcomes”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Observed associations usually come from between-person correlations, which make causal direction hard to determine and are vulnerable to confounding.

    “the observed associations are typically based on between-persons correlations, which make determining causality and directionality difficult, and are susceptible to the influence of confounding observed or unobserved variables (Ophir et al., 2020).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Ophir et al., 2020

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  • May combine two claims.

    Premisecitation

    The literature on a negative link between digital technology engagement and mental health is mixed and rests on weak methods and data.

    “Currently, the literature suggesting a negative link between digital technology engagement and mental health is decidedly mixed and grounded on suboptimal methodologies and data (Dickson et al., 2019; Odgers & Jensen, 2020).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Dickson et al., 2019

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    • cites Odgers & Jensen, 2020

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  • May combine two claims.

    Premisecitation

    Studies using more systematic methods have found that well-being-technology relations depend on gender, arbitrary analytic choices, and the exact variables included.

    “Studies that have adopted more systematic approaches to estimating associations between well-being and technology engagement have shown that the resulting relations depend on gender, arbitrary analytic choices, and the exact variables included in the analyses (Bjerre-Nielsen et al., 2020; Jensen et al., 2019; Kreski et al., 2020; Orben et al., 2019).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Bjerre-Nielsen et al., 2020

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    • cites Jensen et al., 2019

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    • cites Kreski et al., 2020

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  • May combine two claims.

    Premisereasoning

    Researchers have treated technology effects as fixed, so at least two time-dependent changes have not been systematically tested.

    “because researchers have assumed that technology effects are fixed, at least two time-dependent changes have evaded systematic testing.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Premisenone given

    Little research attention has been given to how a technology's effects may change as its affordances expand or as business models alter how adolescents use it.

    “Yet little attention is paid to how a given technology’s effects might shift over time, as affordances expand, or the underlying business models drive designers to change how adolescents use them.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The claim that video games created a generation of violent criminals has been refuted.

    “but this argument has since been refuted (Drummond et al., 2020; Ferguson et al., 2020).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Drummond et al., 2020

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    • cites Ferguson et al., 2020

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Comic books and television were blamed for predisposing adolescents to maladjustment and antisocial behaviour.

    “the visually stimulating characteristics of comic books and television were implicated as factors predisposing adolescents to maladjustment and antisocial behaviour (Wertham, 1954).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Wertham, 1954

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  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Reviews by academic, medical, and policy groups have pointed to low-quality evidence and the need for longitudinal research.

    “Literature reviews by academic, medical, and policy collaborations have highlighted both the low-quality evidence in this space and the need for a longitudinal perspective (Appel et al., 2020; Hawkes, 2019; Viner et al., 2019).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Appel et al., 2020

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    • cites Hawkes, 2019

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    • cites Viner et al., 2019

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  • May combine two claims.

    Premisecitation

    Most of this literature relies on self-reported technology use, which is biased and noisy and leads to inaccurate estimates of health and well-being relations.

    “most of this literature is limited by its use of self-reports of technology use, which are known to be biased and noisy indicators of true amounts of engagement, and lead to inaccurate estimated relations between health and well-being (Johannes et al., 2020; Parry et al., 2020; Scharkow, 2016; Shaw et al., 2020).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Johannes et al., 2020

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    • cites Parry et al., 2020

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    • cites Scharkow, 2016

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the early 1900s, dime novels were accused of causing mania and risk-taking.

    “the early twentieth century saw dime novels blamed for eliciting mania and risk taking (Furedi, 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Furedi, 2015

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Radio dramas were believed to make young listeners susceptible to poor health, sleep loss, and anxiety.

    “the immersive nature of radio dramas was thought to make young listeners vulnerable to ill health, sleep loss, and anxiety (Preston, 1941).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Preston, 1941

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Technologies are often treated as unitary causes of social change through technological determinism, and academics seldom treat them as dynamic when studying effects on young people.

    “Technologies are often considered as unitary causes of change in society, through a process called technological determinism, and academics therefore rarely treat them as dynamic when trying to understand their effects on young and vulnerable people (Grimes et al., 2008; Orben, 2020).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Grimes et al., 2008

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    • cites Orben, 2020

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The US conduct and emotional problems subscales had moderate reliabilities (alphas .62 and .69).

    “19,190 (con-duct) and 19,184 (emotional problems) 10 to 15-year olds rated their agreement on a three-point scale from “Not true” to “Certainly true” to at least one of these items, which indicated moderate reliabilities (alphas .62 and .69, respectively).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    The magnitudes of these relations were within the ranges of previous findings and are generally considered very small.

    “The magnitudes of these relations were within the ranges of previous findings (that have mainly ignored differences between years), and are generally considered to be very small.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Recent analyses and reviews show that people who report more technology engagement also tend to report more mental health problems, but the reasons for these cross-sectional links are poorly understood.

    “recent analyses and reviews have shown a trend whereby individuals who report greater technology engagement tend to also report higher levels of mental health problems, but the factors underlying these cross-sectional relationships still remain poorly understood (Appel et al., 2020).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Appel et al., 2020

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Because information about new digital media has been collected for only a relatively short time, firm conclusions about changes in their mental health associations may be premature.

    “Information about new digital media has been collected for a relatively short time; drawing firm conclusions about changes in their associations with mental health may be premature.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    MTF and US outcomes had low item-level missingness (complete responses: MTF = 95%, US = 96%).

    “Outcomes in the MTF and US datasets showed low item-level missingness (complete responses: MTF = 95%, US = 96%); missing item values were ignored in computing the scale means.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Rows with missing sex were excluded (MTF: 4%, US: 0.02%, YRBS: 0.3%).

    “Rows of data where the sex variable was missing were excluded (MTF: 4%, US: 0.02%, YRBS: 0.3%) to allow using sex as a moderator in our analyses below.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    These shifts can shape changes over time in user motivations and in technology-mental health associations, and may cause some technologies' effects to rise or fall over long periods.

    “These shifts have the potential to shape differences over time in user motivations and the associations between technology engagement and mental health, and could therefore cause certain technologies’ effects on mental health to increase or decrease over long periods of time.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The MTF depression scale had good reliability (alpha = .85).

    “380,924 8th and 10th graders responded to at least one item on the scale, whose items provided good reliability (alpha = .85).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Premisecitation

    Dark patterns and attention-demanding features could amplify social media's negative effects, while tools that empower or connect users could improve health and well-being.

    “the addition of so called dark patterns—features that are designed to manipulate users to e.g. purchase items (Singer, 2016)—and attention demanding features that undermine users’ psychological autonomy could serve to magnify negative impacts of social media, whereas tools that empower or connect users in new ways could do the opposite and promote health and well-being (Lewis, 2017; Solon, 2017;”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Lewis, 2017

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    • cites Solon, 2017

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    • cites Verduyn et al., 2017

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  • May combine two claims.

    Interpretationown data

    Overall, there was very little evidence that negative associations between technology and mental health increased over time, and some evidence pointed the other way.

    “Overall, there was very little evidence for an increase in the negative associations between technology and mental health over time, and some evidence to the contrary.”
    Quote in the paperSubstantial claim
    • The authors state this as an assumption: Any change over time in the technology–mental health association was linear over the study period.
    • The authors state this as an assumption: Relations between technology use and mental health were linear, and any changes in those relations were linear.
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

    Interpretationreasoning

    Material changes in how technologies affect people and societies may not appear as an obvious stepwise shift between successive technologies; subtle advances within one technological environment may produce large changes.

    “material changes in how technologies affect individuals and societies may therefore not be marked by an obvious stepwise shift between two successive forms of technology, say from radio to television. Instead, more subtle advances within a single technological milieu might drive profound changes.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Study design and conductown data

    The study used three large nationally representative datasets from the US and UK, with a combined 430,561 participants.

    “We focused on three large nationally representative datasets, from the United States and United Kingdom, with pertinent variables on adolescent mental health and technology engagement, and a combined total of 430,561 participants.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The study's models did not include covariates.

    “We also did not include covariates in our models for two reasons.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Study design and conductreasoning

    The study, as with earlier literature, may blur distinctions between between-person and within-person associations and causal mechanisms.

    “In addition, it is important to note that this work, along with previous literature on this topic, to some extent risks conflating between- and within-person associations and causal mechanisms.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationown data

    The observed shifts-more social media-emotional problems and less technology-depression-suggest emerging technologies' roles are changing and justify a more dynamic view of these links.

    “Nevertheless, the observed patterns of change — the increased association between social media use and emotional problems, and decreased association between technology engagement and depression — hint at the changing roles of emerging technologies in young people’s lives and underlines the scientific value of considering a more dynamic picture of their associations with mental health.”
    Quote in the paperNot a substantial claim
  • The quote only partly states this claim.

    Interpretationown data

    Any temporal change in effects is better seen as gradual drift, not a rapid shift.

    “showing that if effects are changing over time, this change is better characterized as a slow drift rather than a rapid shift.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Longitudinal work has sometimes shown mental health problems predicting smartphone use instead of the reverse, or bidirectional links.

    “some longitudinal studies have found the opposite, whereby mental health problems predict smartphone use, rather than phone use predicting mental health problems (Bado et al., 2020), or found bidirectional relationships (Orben et al., 2019).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Bado et al., 2020

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    • cites Orben et al., 2019

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  • May combine two claims.

    Premisecitation

    Research on this topic shows self-reported technology use is systematically biased and weakly related to objective measures.

    “In studies of this topic, self-report measures of technology use are consistently biased and are not highly correlated with objective use (Johannes et al., 2020; Parry et al., 2020; Scharkow, 2016).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Johannes et al., 2020

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    • cites Parry et al., 2020

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    • cites Scharkow, 2016

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  • May combine two claims.

    Interpretationown data

    The data did not support either the notion that older, less-worried-about technologies are becoming less harmful or that currently worrisome technologies are becoming more harmful.

    “Overall, the ideas that technologies we no longer worry about are becoming less harmful or that technologies we worry the most about now are becoming more harmful were not supported in the data we analysed.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisecitation

    Choosing covariates ought to follow a strong theory that lays out causal links among variables.

    “First, the selection of covariates should be guided by a strong theory that specifies the causal relations between variables (Rohrer, 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Rohrer, 2018

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39 of 39
  • The authors state this as an assumption.

    Any change over time in the technology–mental health association was linear over the study period.

    “We adopted the simplifying assumption that any change to that relationship had been linear over the time frame studied.”
  • The authors state this as an assumption.

    Relations between technology use and mental health were linear, and any changes in those relations were linear.

    “In our focal analyses we assumed linear relations between technology use and mental health and assumed that any changes to those relations would be linear.”
  • The authors state this as an assumption.

    Social media and similar digital technologies could have increasingly negative mental health effects over time because of their dynamic nature.

    “Therefore, it remains a reasonable, yet untested, assumption that their possible negative influence on mental health could be magnified over time by virtue of their dynamic nature.”
  • The paper relies on this without support.

    No suitable theory specifying causal relations between variables currently exists.

    “Currently, no good candidates for such a theory exist, and it was not our purpose here to offer one.”
  • The paper relies on this without support.

    Large samples probably cause even tiny associations to have confidence intervals that exclude zero.

    “because the large sample sizes are likely to make even small relations’ confidence intervals exclude zero”
  • The paper relies on this without support.

    Understanding of social media and digital devices is constrained by how recently they appeared.

    “In the context of older technologies, such as TV, our knowledge of social media and digital device use is necessarily limited by their comparatively brief existence.”
6 of 6

Claims other papers make about this one

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Cites

Flagged first, then by citations

1 of the 49 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Furedi F., 2015, History Today, 65, 46
  2. Viner R., 2019, The health impacts of screen time: A guide for clinicians and parents
  3. Wertham F., 1954, Seduction of the innocent

Cited by

Sorted by citations

Authors
Vuorre, M., Orben, A., & Przybylski, A. K.
Affiliations
  • University of Oxford (GB)
  • MRC Cognition and Brain Sciences Unit (GB)
Corresponding author
Przybylski, Andrew K.
Venue
Clinical Psychological Science
Published
2021-05-03
Volume
9
Issue
5
Pages
823-835
ISSN
  • 2167-7026 (ISSN-L)
  • 2167-7034
OpenAlex
W3136028244
Cited by
158
References
49
Citations by year
2026: 26 · 2025: 30 · 2024: 32 · 2023: 39 · 2022: 21 · 2021: 9 · 2020: 1
FWCI
34.99
Type
journal article
Language
en
Open access
Locations
  • Clinical Psychological Science (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
  • PsyArXiv (OSF Preprints) (submittedVersion)
  • Apollo (University of Cambridge) (submittedVersion)
  • Apollo
Funders
  • Economic and Social Research Council (ES/T008709/1)
  • Hou Family Foundation
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 mental health, social media use, depression, emotional problems, temporal trends, gender differences

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