Send Orders for Reprints to reprints@benthamscience.

net 11

Adolescent Psychiatry, 2022, 12, 11-22

SYSTEMATIC REVIEW ARTICLE
ISSN: 2210-6766
eISSN: 2210-6774

Trending: A Systematic Review of Social Media Use’s Influence

on Adolescent Anxiety and Depression

Sreedevi Damodar1,*, Cidney Lokemoen1, Vikram Gurusamy1, Manpreet Takhi1,

Daniel Bishev1, Allison Parrill1,2, Melissa Deviney1, Ulziibat Person3, Ijendu Korie4
and Romain Branch3
1
American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten; 2Lake Erie College of Osteopathic Medicine, 1858 W Grandview Blvd, Erie, PA 16509,
United States; 3Department of Behavioral Sciences and Psychiatry, Nassau University Medical
Center, 2201 Hempstead Turnpike, East Meadow, NY, 11554, United States; 4Department of
Psychiatry, Henry Mayo Newhall Hospital, 23845 McBean Pkwy, Valencia, CA, 91355, United States

Abstract: Background: With new technological advancements, adolescents can obtain
devices that give them virtually unlimited access to social media (SM) which may impact
adolescent mental health.
Objectives: This literature review aims to evaluate the influence of social media use on
adolescent anxiety and depression.
Methods: A literature search of PubMed from June 2010 through June 2020 was completed
for the following MeSH terms: social media, adolescent, anxiety, depression, and mental
health. English language articles that discussed adolescents aged 13 to 18 years, anxiety
and/or depression and SM were included. Extracted data included the SM platform, impact
ARTICLE HISTORY on anxiety and depression, interventions, temporal and dose-response relationships, and
observed versus self-reported usage.
Received: October 10, 2021
Revised: January 17, 2022 Results: The majority of articles positively associated depression (82.6%) and anxiety
Accepted: January 17, 2022
Adolescent Psychiatry

(78.3%) with SM use. depression corresponded with cyber-bullying (42.1%), negative

DOI: social perspective (21.0%), diminished self-esteem (15.8%), and sleep disturbance (10.5%).
10.2174/2210676612666220225122720
Anxiety corresponded with a negative social perspective (44.4%), diminished self-esteem
(33.3%), sleep disturbance (16.7%), and cyber-bullying (16.7%). Many studies suggested
the use of interventions to reduce depression (72.7%) and anxiety (72.7%), such as screen
time restrictions (n=6) and social support (n=4), but lacked evaluation of their
This is an Open Access article published implementation.
under CC BY 4.0
https://creativecommons.org/licenses/ Conclusion: Current literature suggests a positive association between adolescent SM use
by/4.0/legalcode with anxiety and depression. Our study highlights the need for further investigation of
temporal and dose-response associations between SM use and adolescent mental health, and
the potential benefits of SM-driven interventions.

Keywords: Adolescent, anxiety, depression, mental health, social media, sleep disturbance.

1. INTRODUCTION Mcinerney & Waters, 2014; Primack &

Escobar-Viera, 2017). SM has been defined as “a
Social media (SM) plays an integral role in the group of Internet-based applications that allow the
daily life of an adolescent (Allen, Ryan, Gray, creation and exchange of user-generated content”
(Kaplan & Haenlein, 2010; Primack & Escobar-
*Address correspondence to this author at the American
Viera, 2017). With new technological
University of the Caribbean School and Medicine, 1 advancements, adolescents can obtain devices that
University Drive, Cupecoy, Sint Maarten; Tel: 1-203-685- give them virtually unlimited access to SM. A
6182; E-mails: [email protected]; recent Pew Researchers survey found that 65% of
[email protected] parents surveyed admit they worry about their

2210-6774/22 © 2022 Bentham Science Publishers

12 Adolescent Psychiatry, 2022, Vol. 12, No. 1 Damodar et al.

kids spending too much time in front of screens Fritsch, 2018). Teens have significant worries of
(Pew Research Center, 2019). Furthermore, The missing out when not connected, leading to
Common Sense Census (2019), which evaluated anxiety, feelings of inadequacy, and impaired
SM use among teenagers reported that American social functioning (Glover & Fritsch, 2018; Royal
teens, ages 13 to 18 years, used entertainment Society for Public Health, 2012). This manifests
screen media outside of academics for an average in several domains including poor sleep and
of seven hours and twenty-two minutes each day eating, anxiety and depression, and weaker social
in 2019 (Common Sense Media, 2019). support systems (Primack & Escobar-Viera,
2017). Additionally, one study found that online
The advent of the Internet and SM has given outreach did not replace the benefits of face-to-
rise to a generation of teenagers who spend a face outreach, group, or community events
significant portion of their social lives and peer- (Richards et al. 2015). We aim to systematically
relationship-building online. The traditional evaluate and synthesize current literature
interaction of face-to-face communication is being analyzing the influence of SM use on adolescent
supplemented with indirect methods of anxiety and depression.
communication such as Facebook, Instagram,
Snapchat, and others. These platforms allow
2. METHODS
individuals to tightly control the parts of their
lives that are visible to others. Recent studies
A database search of PubMed was completed
showing positive correlations between SM peer-
for English, non-translated articles published from
support and adolescent well-being suggest SM
June 2010 through June 2020. The following
may play a supportive role in mood (Allen et al.
MeSH terms were searched: social media,
2014; Hur & Gupta, 2013; Manago, Taylor &
adolescent, anxiety, depression, and mental
Greenfield, 2012; Rajamohan, Bennett & Tedone,
health. Two researchers independently screened
2019). Positive effects of SM include increased
titles and abstracts, then four researchers screened
empathy and identity establishment by creating an
full-text articles for inclusion. Inclusion criteria
open platform for adolescents to share personal
were adolescents aged 13-18 years, mental health,
interests (Allen et al. 2014; Hur & Gupta, 2013;
depression, anxiety, or social media. Reference to
Manago et al. 2012; Rajamohan et al. 2019).
either anxiety and/or depression was required for
However, large-scale epidemiologic research inclusion. Extracted data included findings of
indicates a negative association between SM use SM's impact on SM platform(s) discussed, anxiety
and mental health (Barry, Sidoti, Briggs, Reiter & and/or depression, interventions to mitigate the
Lindsey, 2017; Primack & Escobar-Viera, 2017; effects of SM, temporal and dose-response
Rajamohan et al. 2019; Ralph, Berglas, Schwartz relationships between mental health and SM use,
& Brindis, 2011; Richards, Caldwell & Go, 2015). researcher tracked versus self-reported social
A recent study found that adolescents with high media usage, assessment of social media
overall SM use were more likely to experience advertisements, and the use of quantitative data.
depression symptoms, panic disorder symptoms, Included articles were additionally cross-
referenced to identify data points that may have
delinquent behaviors, family conflict, and poorer
been represented more than once due to having
social support than those with generally low social
been cited by multiple articles.
media use. SM use was categorized as frequency
scores of “0 = never; 1 = less than once a week;
3. RESULTS
2 = once a week; 3 = several times a week; 4 =
once a day; 5 = several times a day; 6 = once an
The literature search returned 9777 results with
hour; 7 = several times an hour; 8 = almost
23 articles meeting criteria including ten literature
constantly” (Vannucci & Ohannessian, 2019).
reviews, nine systematic reviews, two
The intense desire for SM engagement and observational studies, one experimental study, and
online profile perfectionism may lead to socially one meta-analysis (Fig. 1). Information on
anxious youth and poor mental health (Glover & databases, MeSH terms, and keywords employed
Social Media Use’s Influence on Adolescent Anxiety and Depression Adolescent Psychiatry, 2022, Vol. 12, No. 1 13

by the researchers of the included articles, when A dose-response relationship was noted by
provided, have been included in (Table 1). We 13.0% of articles, positively associating quantity
found that 73.9% of articles did not specify what of screen time to increased anxiety and depression
platform of SM was investigated and of those that symptoms (Table 4). Overall, only 34.8% of
did specify, 60.9% examined Facebook use. Twitter articles included quantitative data (Table 5).
and Instagram were examined by 26.1% articles, Quantitative data that directly tracked participants'
Myspace by 21.7% articles, and Snapchat by 17.4% use of social media was present in 26.1% of
articles. Many articles examined SM from articles, while 47.8% relied on self-reported use;
unspecified and/or multiple platforms (Table 2). however, many articles did not distinguish means
of data retrieval and analysis. Temporality
SM use was found to be associated with between SM use and the development of anxiety
depression in 82.6% of articles. Of the articles or depression, whether SM use led to mental
that reported this association, the most commonly health impacts or vice-versa, was not evaluated by
proposed mechanisms of depression were through any articles. No articles explored the influence of
cyber-bullying (42.1%), social perspective advertisements on social media platforms, on the
(21.0%), diminished self-esteem (15.8%), and development of anxiety and depression. Eight
sleep disturbance (10.5%) (Table 3). Social media
articles (34.8%) expressed the need for defining
use was found to be associated with anxiety in
problematic social media use and/or SM-
78.3% of articles. Of the articles that reported this
associated mental illness as a pathological
association, anxiety most commonly corresponded
diagnosis. Many studies suggested the use of
with proposed mechanisms of social perspective
interventions to reduce depression (72.7%) and
(44.4%), diminished self-esteem (33.3%), sleep
anxiety (72.7%), but none studied their
disturbance (16.7%), and cyber-bullying (16.7%)
implementation. These interventions included
(Table 3).
screen time restrictions (n=6), and social and
therapeutic support (n=4) (Table 5).

Fig. (1). PRISMA flow diagram of article selection.

14 Adolescent Psychiatry, 2022, Vol. 12, No. 1 Damodar et al.

Table 1. Databases, MeSH terms, and keywords searched by included articles.

- Databases MeSH Terms/Keywords

Bilgrami et al. Pubmed, Google Scholar N/A

Bry et al. Google Play store and IOS App store for N/A
apps related to anxiety/children

Desjarlais et al. Google Scholar, psychINFO Self disclosure, disclose, intimacy with computer-mediated
communication, instant messaging, computer, online, chat, internet

Hoare et al. CINAHL, Global Health, Medline, Mental health OR mental disorder OR depress* OR depress* mood or
psychARTICLES, psychINFO depress* symptom OR anxiety OR anxiety symptom OR psychiat*
OR psychol* OR self esteem OR stress* OR cognitive function*

Huang PsychINFO, communication and mass Facebook, twitter, instagram, myspace, social media, online social
media complete, ProQuest network, social network site and self concept, self esteem, self worth,
depress, loneliness, life satisfaction, well being

Rafla et al. Pubmed Internet, Internet addiction, problematic internet use, social media,
digital technology, mental health, adolescent

Richards et al. Medline, Embase, psychINFO Social media, facebook, twitter, youtube, myspace and mental health,
cyberbullying, self image, health, physical fitness

Ridout and PubMed, psychINFO N/A

Campbell

Sahu et al. Medline, Proquest, Pubmed, EBSCO Mobile phone, cellular phone, smartphone, addiction, overuse,
host, EMBASE, CINAHL, psychINFO, problematic use, among children, adolescents
OVID, Springer, Wiley Online Library,
Science Direct

Stiglic and Viner Medline, Embase, psychINFO, CINAHL (Child OR teenage OR adolescent OR youth) AND (screen time OR
television OR computer OR sedentary behavior OR sedentary activity)
AND health

Yonker et al. Medline/pubmed Social networking website, Web 2.0, facebook, twitter, myspace

Zink et al. Medline/PubMed, psycINFO, and Scopus (Sedentary OR sitting OR screen time OR media) AND (mental health
electronic databases OR anxiety OR anxious OR depress* OR emotional OR internalizing
OR social phobia OR panic disorder) AND (child* OR adolescents
OR adolescence OR youth)

Information provided by articles regarding databases, MeSH terms, and keywords searched by authors. Articles that did not include this information were not
included in this table.

The results of cross-referencing included associate SM use with depression and anxiety.
studies that yielded two overlapping data points. Second, the association with anxiety found by
First, both Hoare, Milton, Foster, and Allender Hoare, Milton, Foster, and Allender (2016) was
(2016) and Zink, Belcher, Imm, and Leventhal represented twice in our study due to also being
(2020) cited Ybarra, Alexander, and Mitchell cited by another included article (Stiglic & Viner,
(2005), an article not included in our study, to 2019). One included article (Primack & Escobar-
Social Media Use’s Influence on Adolescent Anxiety and Depression Adolescent Psychiatry, 2022, Vol. 12, No. 1 15

Viera, 2017) was cited by another, (Glover & adolescents throughout the current literature.
Fritsch, 2018) but the latter cites other studies that However, this association is not substantiated with
warrant unique data points to be awarded to both. quantitative, temporal, or dose-response
Table 2. General findings.
relationships, or defined criteria of problematic
social media use. Screen time restrictions and/or
online social therapy may be beneficial but are not
Variables Count % (n=23) thoroughly evaluated.

Study Type A past systematic review conducted by

Seabrook et al. (2016) included studies regarding
Literature Review 10 43.5 social networking platforms, anxiety, depression,
Systematic Review 9 39.1
and well-being, without exclusion criteria of age,
found mixed results. Overall, eight studies were
Observational Study 2 8.7 noted to show a direct positive relationship
between depression and social networking
Experimental 1 4.4
platforms, whereas 16 found non-significant
Meta-Analysis 1 4.4 associations. Three studies found a direct positive
relationship between anxiety and social
Social Media Platform* networking platforms, whereas seven found non-
Unspecified 17 73.9
significant associations (Seabrook, Kern &
Richard, 2016). In comparison, the current study
Facebook 14 60.9 found that 19 articles acknowledged a positive
association between SM use and depression and
Twitter 6 26.1
18 between SM use and anxiety. However, the
Instagram 6 26.1 significance of these associations has not been
established.
Myspace 5 21.7
A 2016 survey study of 1,787 adults, 19 to 32
Snapchat 4 17.4 years of age, found significant associations
Was SM use positively associated with anxiety/depression?**
between depressive symptoms among participants
in the highest quartile of time per day on SM
Depression 19 82.6 (AOR = 1.66, 95% CI = 1.14 - 2.42) compared to
those within the lowest quartile of time spent on
Anxiety 18 78.3
SM per day. The total median time spent on SM
Future Interventions *** 11 47.8 was 61 minutes/day with an interquartile range of
Legend: n= total number of studies reviewed. *Study investigated or made
30 to 135 minutes. Participants of younger age
statements regarding a specific SM platform or did not specify a platform. were more likely to visit more SM sites and spend
**Mechanism of positive association between SM use and more time online compared to older participants
anxiety/depression further explored in Table 3. ***Further explored in (Lin, Sidani, Shensa, Radovic, Miller & Colditz,
Table 4.
2016). This study assessed depression symptoms
using a standardized Patient-Reported Outcomes
4. DISCUSSION Measurement Information System (PROMIS)
Depression Scale Short Form but relied on self-
Evidence suggests that SM heavily impacts the reported usage data. Currently, no studies of this
mental health of adolescents, who have. a deep scale evaluate the pediatric or adolescent
emotional investment in SM and a strong desire population. Therefore, we recommend that a
for social connectedness and online presence similar study be performed in the 13- to 18-year-
(Barry et al. 2017; Rajamohan et al. 2019). We old age group to gain a deeper understanding of a
found a positive association between SM use and potential causal relationship between SM use and
the presence of anxiety and depression among
16 Adolescent Psychiatry, 2022, Vol. 12, No. 1 Damodar et al.

Table 3. Proposed mechanism through which SM use led to mental health pathology.

- Depression # (%) (n=19) Anxiety # (%) (n=18)

Via cyber-bullying 8 42.1 3 16.7

Via social perspective* 4 21.1 8 44.4

Via diminished self-esteem** 3 15.8 6 33.3

Via sleep disturbance*** 2 10.5 3 16.7

SM use was not positively associated with

pathology 4 21.1 5 27.8
Legend: n= number of studies that discussed anxiety or depression. *Social perspective is defined as feeling excluded or inferior to peers. **Diminished self-
esteem is defined as feeling insecure or having body-image issues. ***Sleep disturbance is defined as interfering with sleep quality or ability to fall asleep.

Table 4. Study content analysis.

Drew New Self- Reported Quantitative SM Diagnosis Dose-Response

Article Tracked Usage*
Conclusions Usage* Data** Clarification*** Established

Bilgrami et al. - - - - - -

Bry et al. X - X - X -

Carson et al. - - - - X -

Desjarlais et
X X - - - -
al.

Glover and
X - - - X -
Frisch

Hoare et al. - X X X - -

Huang - - - X - -

Li et al. X X - X - -

Lissak - - - - - X

Marino et al. - - X X X -

Mills et al. X - - X - -

Muzaffar et al. X X - X X -

Primack and
X X - X X -
Escobar-Viera

Rafla et al. X - - - - -

Rajamohan et
- - - - X -
al.

Richards et al. - - - - - -

(Table 4) contd….
Social Media Use’s Influence on Adolescent Anxiety and Depression Adolescent Psychiatry, 2022, Vol. 12, No. 1 17

Drew New Self- Reported Quantitative SM Diagnosis Dose-Response

Article Tracked Usage*
Conclusions Usage* Data** Clarification*** Established

Ridout and
X X X X - -
Campbell

Sahu et al. - X - - - -

Saunders and
X X - - - X
Vallance

Shah et al. - - - - - -

Stiglic and
- X X - X X
Viner

Yonker et al. - X X - - -

Zink et al. - X - - - -

Count 10 11 6 8 8 3

% (n=23) 43.5 47.8 26.1 34.8 34.8 13.0

Legend: n= total number of studies reviewed. If this information was discussed in the paper but was not used to directly describe SM use and development of
anxiety or depression, it was excluded from the count. Discussion of temporality, the influence of advertisements on development of anxiety/depression and
categorization of type of SM content (posts by friends, family, or influencers, etc.) was also examined, but not observed in any articles. Self-reported usage
and tracked usage refers to whether data collected on adolescent’s SM use was self-reported or directly tracked by the study. **Quantitative data is defined by
any article that supports its findings with quantitative data at any point. ***Recommended that pathological social media use has a standardized definition
and/or diagnostic criteria.

Table 5. Proposed future interventions.

Proposed Future Interventions # (%) (n=11)

To reduce depression 8 72.7

To reduce anxiety 8 72.7

Strategy

Screen time restrictions 6 54.5

Social and therapeutic support 4 36.4

Change in social media policies* 1 9.1

Legend: n = number of studies that discussed proposed future interventions to decrease the incidence of developing anxiety and depression. *Change in Social
Media Policies defined as reform of social media content, with app guidelines at a similar reading level of its intended users.

anxiety/depression. In addition, future studies In the face of one of our newest societal
should aim to identify the common factors shared problems, the coronavirus pandemic, and the
by adolescents with low SM use to establish associated increase in virtual communication,
possible protective factors that decrease SM use there is an urgency to develop a deeper
overall. It is important to establish whether SM understanding of how SM use may lead to mental
uses indirectly or directly impacts or increase the health pathology. In recent months, due to
risk of development of anxiety/depression. lockdown restrictions, adolescents are more
Perhaps, adolescents with lower SM use “replace” dependent on SM than ever before to
this time with sports, academics, work, family communicate with each other and learn life-long
obligations, and/or face-to-face social interactions.
18 Adolescent Psychiatry, 2022, Vol. 12, No. 1 Damodar et al.

social skills. While SM has aided in preventing relationships, risky behavior, peer-groups, and
feelings of isolation, the identification of specific emotional investment.
behaviors and risk factors linked to negative
Potential identification of SM history includes
mental health outcomes is imperative to promote
asking specific questions regarding SM and
and define safe usage (Guessoum et al. 2020).
internet use outlined in the internet assessment
The limitations of this study include the small listed by Carson, Gansner, and Khang (2018). An
quantity of applicable published articles on the in-depth discussion with children planning to be
topic of SM use affecting anxiety/depression in involved, or already participating in SM, may
adolescent populations. No cohort studies or guide better practices. We propose that
randomized control trials were found that implementing content restrictions, private
compared adolescents using SM versus those that profiles, daily-time limits, peer limits, age limits,
do not. Furthermore, limited data exist to prohibiting night-time use, and encouraging in-
differentiate between specific SM platform use. person friendships may curb possible negative
Though adolescents use multiple platforms to stay impacts of SM on adolescent anxiety and
in contact with friends, the majority of studies depression. Additionally, these restrictions should
published focused on platforms that have been be discussed with parents or guardians during
well-established over time, such as Facebook well-child visits to monitor their child’s SM use,
instead of new platforms such as Snapchat, contacts, and content.
Instagram, or TikTok. We excluded non-English
Healthcare practices change as society and
articles and those with participants aged below 13
technology evolve; we believe collecting a
and above 18 years; therefore, data regarding
thorough SM history by the provider will help
college students and problematic SM outside of
enhance the physician-client relationship and
this age range or in another language have been
guide therapeutic intervention related to
omitted. Finally, the search was limited to one
adolescent anxiety and depression. Moreover,
major database. Although the search yielded many
adolescents should be advised of warning signs
results, the inclusion of more databases may
that may indicate they are developing maladaptive
increase the pool of peer-reviewed articles.
or addictive behaviours regarding SM. These
We encourage clinicians to be aware of the problematic behaviours include the inability to put
impact SM has on adolescent mental health, their phone away, night-time use, replacement of
particularly anxiety and depression, and to in-person relationships for passive consumption of
examine these issues further. This review online media, or prioritizing their SM image over
acknowledges a positive correlation between SM academics, hobbies, or athletics.
use and anxiety/depression in adolescents. We
The goal of future research would be to
suggest the completion of a thorough history to
establish a detailed diagnostic criterion of anxiety
aid in deciphering the impact of SM use on an
and depression in adolescents in direct relation to
individual adolescent’s well-being and possibly
SM use. This should include determining the
allow caregivers to intervene with SM restrictions.
motivations behind adolescent SM use and
The impact of SM on sleep, anxiety/depression,
whether variations of these motivations, such as
and social perspective are apparent in the
passive entertainment (i.e., television, passive
literature (Table 4). Although SM has yet to
scrolling) versus virtual interaction, are associated
become a standard topic of discussion during
with the risk of anxiety/depression development.
clinic or office visits, we recommend that
Our study also highlights the need for further
clinicians ask about SM use when interviewing
investigation into temporal and dose-response
patients. We suggest clinicians include questions
associations of SM use, the influence of SM
related to SM, such as time spent, online-activity
advertisements, and the nuances of specific SM
content, cyberbullying experience, night-time use,
platforms. Currently, resources are limited for
self-esteem, motivation, relationships, sexual
medical professionals when assessing SM
Social Media Use’s Influence on Adolescent Anxiety and Depression Adolescent Psychiatry, 2022, Vol. 12, No. 1 19

addiction in adolescents. This includes how to depression disorders, healthcare professionals will
depict SM behavior that is considered to be be better equipped to overcome that barrier and
healthy versus unhealthy (Derevensky, Hayman & provide successful treatment. Future studies
Gilbeau, 2019). Defined criteria of problematic should focus on evidence-based screening,
social media use (PSMU) are scarce in current advertisements, specific SM platforms, and
literature, however, a recent study utilized potential interventions that capture the dynamic
modified ICD-11 criteria for gambling disorder to SM world of the adolescent population to prevent
create the Social Media Use Disorder Scale for a decline in mental health and promote safer
Adolescents (SOMEDIS-A). While not yet online practices.
clinically validated, this is the first instrument
assessing social media use disorder (SMUD) in CONSENT FOR PUBLICATION
adolescents that has shown good to excellent
internal consistency and criterion validity as well Not applicable.
as good to excellent discriminatory power
(Paschke, Austermann & Thomasius, 2021). Such
guidelines allow physicians and parents to better STANDARDS OF REPORTING
analyze adolescent SM behavior associated with
PRISMA guidelines and methodology were
negative mental health effects (Rajamohan et al. followed.
2019).
Caregivers and adolescents should agree as to FUNDING
the maximum number of hours per day and week
that social media may be used. Both caregivers None.
and adolescents should be educated on the
potential negative effects of social media use to CONFLICT OF INTEREST
continually monitor for deterioration in
adolescents' mood, sleep, and self-esteem. The authors declare no conflict of interest,
Caregivers should be educated in non- financial or otherwise.
judgemental and non-confrontational approaches
to conversing with children about their social
media use. Physicians should provide one-time ACKNOWLEDGEMENTS
screening with the SOMEDIS-A scale for
adolescents aged 13 and older who use social Declared none.
media. Patients screening positive warrant
comprehensive psychiatric evaluation with SUPPLEMENTARY MATERIAL
particular emphasis surrounding their social media
use and should be re-administered the SOMEDIS- Supplementary material is available on the
A at subsequent visits to better inform further publisher’s website along with the published
management. article.

CONCLUSION REFERENCES

This systematic review highlights a possible Allen, K.A., Ryan, T., Gray, D.L., Mcinerney, D.M.,
positive association between adolescent SM use Waters, L. (2014). Social media use and social
with anxiety and depression. The inability to connectedness in adolescents: The positives and the
understand adolescent experiences with SM may potential pitfalls. Aust. J. Educ. Dev. Psychol., 31(1),
18-31.
present a barrier to treatment. By identifying, http://dx.doi.org/10.1017/edp.2014.2
understanding, and clarifying the impact of SM on Angold, A., Costello, E.J., Erkanli, A. (1999). Comorbidity.
the incidence and exacerbation of anxiety and J. Child Psychol. Psychiatry, 40(1), 57-87.
20 Adolescent Psychiatry, 2022, Vol. 12, No. 1 Damodar et al.

http://dx.doi.org/10.1111/1469-7610.00424 PMID: Guessoum, S.B., Lachal, J., Radjack, R., Carretier, E.,
10102726 Minassian, S., Benoit, L., Moro, M.R. (2020).
Bailin, A., Milanaik, R., Adesman, A. (2014). Health Adolescent psychiatric disorders during the COVID-
implications of new age technologies for adolescents: 19 pandemic and lockdown. Psychiatry Res., 291,
A review of the research. Curr. Opin. Pediatr., 26(5), 113264.
605-619. http://dx.doi.org/10.1016/j.psychres.2020.113264
http://dx.doi.org/10.1097/MOP.0000000000000140 PMID: 32622172
PMID: 25160783 Hoare, E., Milton, K., Foster, C., Allender, S. (2016). The
Barry, C.T., Sidoti, C.L., Briggs, S.M., Reiter, S.R., associations between sedentary behaviour and mental
Lindsey, R.A. (2017). Adolescent social media use health among adolescents: A systematic review. Int.
and mental health from adolescent and parent J. Behav. Nutr. Phys. Act., 13(1), 108.
perspectives. J. Adolesc., 61, 1-11. http://dx.doi.org/10.1186/s12966-016-0432-4 PMID:
http://dx.doi.org/10.1016/j.adolescence.2017.08.005 27717387
PMID: 28886571 Hoge, E., Bickham, D., Cantor, J. (2017). Digital media,
Bry, L.J., Chou, T., Miguel, E., Comer, J.S. (2018). anxiety, and depression in children. Pediatrics, 140
Consumer smartphone apps marketed for child and (Suppl. 2), S76-S80.
adolescent anxiety: A systematic review and content http://dx.doi.org/10.1542/peds.2016-1758G PMID:
analysis. Behav. Ther., 49(2), 249-261. 29093037
http://dx.doi.org/10.1016/j.beth.2017.07.008 PMID: Huang, C. (2017). Time spent on social network sites and
29530263 psychological well-being: A meta-analysis.
Byron, P., Albury, K., Evers, C. (2013). It would be weird Cyberpsychol. Behav. Soc. Netw., 20(6), 346-354.
to have that on Facebook: Young people’s use of http://dx.doi.org/10.1089/cyber.2016.0758 PMID:
social media and the risk of sharing sexual health 28622031
information. Reprod. Health Matters, 21(41), 35-44. Hur, J., Gupta, M. (2013). Growing up in the web of social
http://dx.doi.org/10.1016/S0968-8080(13)41686-5 networking: Adolescent development and social
PMID: 23684185 media. Adolesc. Psychiatry (Hilversum), 3(3), 233-
Carson, N.J., Gansner, M., Khang, J. (2018). Assessment of 244.
digital media use in the adolescent psychiatric http://dx.doi.org/10.2174/2210676611303030004
evaluation. Child Adolesc. Psychiatr. Clin. N. Am., Jiang, J. (2018). How teens and parents navigate screen time
27(2), 133-143. and device distractions. Available from:
http://dx.doi.org/10.1016/j.chc.2017.11.003 PMID: https://www.pewresearch.org/internet/2018/08/22/ho
29502741 w-teens-and-parents-navigate-screen-time-and-
Common Sense Media. (2019). The common sense census: device-distractions/ (Accessed on: August 22, 2018).
Media use by tweens and teens Available from: Jorgenson, A.G., Hsiao, R.C., Yen, C.F. (2016). Internet
https://www.commonsensemedia.org/research/the- addiction and other behavioral addictions. Child
common-sense-census-media-use-by-tweens-and- Adolesc. Psychiatr. Clin. N. Am., 25(3), 509-520.
teens-2019 http://dx.doi.org/10.1016/j.chc.2016.03.004 PMID:
Derevensky, J.L., Hayman, V., Lynette Gilbeau, (2019). 27338971
Behavioral addictions: Excessive gambling, gaming, Kaplan, A.M., Haenlein, M. (2010). Users of the world,
internet, and smartphone use among children and unite! The challenges and opportunities of social
adolescents. Pediatr. Clin. North Am., 66(6), 1163- media. Bus. Horiz., 53(1), 59-68.
1182. http://dx.doi.org/10.1016/j.bushor.2009.09.003
http://dx.doi.org/10.1016/j.pcl.2019.08.008 PMID: Kessler, R.C., Berglund, P., Demler, O., Jin, R.,
31679605 Merikangas, K.R., Walters, E.E. (2005). Lifetime
Desjarlais, M., Gilmour, J., Sinclair, J., Howell, K.B., West, prevalence and age-of-onset distributions of DSM-IV
A. (2015). Predictors and social consequences of disorders in the National Comorbidity Survey
online interactive SELF-DISCLOSURE: A literature Replication. Arch. Gen. Psychiatry, 62(6), 593-602.
review from 2002 to 2014. Cyberpsychol. Behav. http://dx.doi.org/10.1001/archpsyc.62.6.593 PMID:
Soc. Netw., 18(12), 718-725. 15939837
http://dx.doi.org/10.1089/cyber.2015.0109 PMID: Li, M., Jiang, X., Ren, Y. (2017). Mediator effects of
26652672 positive emotions on social support and depression
Glover, J., Fritsch, S.L. (2018). #Kidsanxiety and social among adolescents suffering from mobile phone
media. Child Adolesc. Psychiatr. Clin. N. Am., 27(2), addiction. Psychiatr. Danub., 29(2), 207-213.
171-182. http://dx.doi.org/10.24869/psyd.2017.207 PMID:
http://dx.doi.org/10.1016/j.chc.2017.11.005 PMID: 28636580
29502744 Lin, L.Y., Sidani, J.E., Shensa, A., Radovic, A., Miller, E.,
Colditz, J.B., Hoffman, B.L., Giles, L.M., Primack,
Social Media Use’s Influence on Adolescent Anxiety and Depression Adolescent Psychiatry, 2022, Vol. 12, No. 1 21

B.A. (2016). Association between social media use Primack, B.A., Escobar-Viera, C.G. (2017). Social media as
and depression among U.S. young adults. Depress. it interfaces with psychosocial development and
Anxiety, 33(4), 323-331. mental illness in transitional age youth. Child
http://dx.doi.org/10.1002/da.22466 PMID: 26783723 Adolesc. Psychiatr. Clin. N. Am., 26(2), 217-233.
Lissak, G. (2018). Adverse physiological and psychological http://dx.doi.org/10.1016/j.chc.2016.12.007 PMID:
effects of screen time on children and adolescents: 28314452
Literature review and case study. Environ. Res., 164, Rafla, M., Carson, N.J., DeJong, S.M. (2014). Adolescents
149-157. and the internet: What mental health clinicians need
http://dx.doi.org/10.1016/j.envres.2018.01.015 to know. Curr. Psychiatry Rep., 16(9), 472.
PMID: 29499467 http://dx.doi.org/10.1007/s11920-014-0472-x PMID:
Morin-Major, J.K., Marin, M.F., Durand, N., Wan, N., 25070673
Juster, R.P., Lupien, S.J. (2016). Facebook behaviors Rajamohan, S., Bennett, E., Tedone, D. (2019). The hazards
associated with diurnal cortisol in adolescents: Is and benefits of social media use in adolescents.
befriending stressful? Psychoneuroendocrinology, Nursing, 49(11), 52-56.
63, 238-246. http://dx.doi.org/10.1097/01.NURSE.0000585908.13
http://dx.doi.org/10.1016/j.psyneuen.2015.10.005 109.24 PMID: 31651777
PMID: 26519778 Ralph, L.J., Berglas, N.F., Schwartz, S.L., Brindis, C.D.
Manago, A.M., Taylor, T., Greenfield, P.M. (2012). Me and (2011). Finding teens in their space: Using social
my 400 friends: The anatomy of college students’ networking sites to connect youth to sexual health
Facebook networks, their communication patterns, services. Sex. Res. Soc. Policy, 8(1), 38-49.
and well-being. Dev. Psychol., 48(2), 369-380. http://dx.doi.org/10.1007/s13178-011-0043-4
http://dx.doi.org/10.1037/a0026338 PMID: Richards, D., Caldwell, P.H., Go, H. (2015). Impact of
22288367 social media on the health of children and young
Marino, C., Gini, G., Vieno, A., Spada, M.M. (2018). The people. J. Paediatr. Child Health, 51(12), 1152-
associations between problematic Facebook use, 1157.
psychological distress and well-being among http://dx.doi.org/10.1111/jpc.13023 PMID:
adolescents and young adults: A systematic review 26607861
and meta-analysis. J. Affect. Disord., 226, 274-281. Ridout, B., Campbell, A. (2018). The use of social
http://dx.doi.org/10.1016/j.jad.2017.10.007 PMID: networking sites in mental health interventions for
29024900 young people: Systematic review. J. Med. Internet
Mills, J.S., Musto, S., Williams, L., Tiggemann, M. (2018). Res., 20(12), e12244.
“Selfie” harm: Effects on mood and body image in http://dx.doi.org/10.2196/12244 PMID: 30563811
young women. Body Image, 27, 86-92. Royal Society for Public Health. (2012). #StatusOfMind:
http://dx.doi.org/10.1016/j.bodyim.2018.08.007 Social media and young people's mental health and
PMID: 30149282 wellbeing. Available from:
Muzzafar, N., Briceno Brito, E., Fogel, J., Fagan, D., https://www.rsph.org.uk/uploads/assets/uploaded/d12
Kumar, K., Verma, R. (2018). The association of 5b27c-0b62-41c5-a2c0155a8887cd01.pdf
adolescent facebook behaviours with symptoms of Sahu, M., Gandhi, S., Sharma, M.K. (2019). Mobile phone
social anxiety, generalized anxiety, and depression. addiction among children and adolescents. J. Addict.
J. Can. Acad. Child Adolescent Psychol., 27(4), 252- Nurs., 30(4), 261-268.
260. http://dx.doi.org/10.1097/JAN.0000000000000309
National Institute of Mental Health. (2017). Any anxiety PMID: 31800517
disorder. Any anxiety disorder. Available from: Saunders, T.J., Vallance, J.K. (2017). Screen time and
https://www.nimh.nih.gov/health/statistics/any- health Indicators among children and YOUTH:
anxiety-disorder.shtml Current evidence, limitations and future directions.
Paschke, K., Austermann, M.I., Thomasius, R. (2021). ICD- Appl. Health Econ. Health Policy, 15(3), 323-331.
11-based assessment of social media use disorder in http://dx.doi.org/10.1007/s40258-016-0289-3 PMID:
adolescents: Development and validation of the 27798796
social media use disorder scale for adolescents. Seabrook, E.M., Kern, M.L., Rickard, N.S. (2016). Social
Front. Psychiatry, 12, 661483. networking sites, depression, and anxiety: A
http://dx.doi.org/10.3389/fpsyt.2021.661483 PMID: systematic review. JMIR Ment. Health, 3(4), e50.
33967862 http://dx.doi.org/10.2196/mental.5842 PMID:
Pew Research Center: Internet, Science & Tech. (2019). 27881357
Available from: Shah, J., Das, P., Muthiah, N., Milanaik, R. (2019). New
https://www.pewresearch.org/internet/fact- age technology and social media: Adolescent
sheet/social-media/ psychosocial implications and the need for protective
measures. Curr. Opin. Pediatr., 31(1), 148-156.
22 Adolescent Psychiatry, 2022, Vol. 12, No. 1 Damodar et al.

http://dx.doi.org/10.1097/MOP.0000000000000714 online interactions: A national survey. J. Adolesc.

PMID: 30507648 Health, 36(1), 9-18.
Stiglic, N., Viner, R.M. (2019). Effects of screentime on the http://dx.doi.org/10.1016/j.jadohealth.2003.10.012
health and well-being of children and adolescents: A PMID: 15661591
systematic review of reviews. BMJ Open, 9(1), Yonker, L.M., Zan, S., Scirica, C.V., Jethwani, K., Kinane,
e023191. T.B. (2015). “Friending” teens: Systematic review of
http://dx.doi.org/10.1136/bmjopen-2018-023191 social media in adolescent and young adult health
PMID: 30606703 care. J. Med. Internet Res., 17(1), e4.
Vannucci, A., McCauley Ohannessian, C. (2019). Social http://dx.doi.org/10.2196/jmir.3692 PMID:
media use subgroups differentially predict 25560751
psychosocial well-being during early adolescence. J. Zink, J., Belcher, B.R., Imm, K., Leventhal, A.M. (2020).
Youth Adolesc., 48(8), 1469-1493. The relationship between screen-based sedentary
http://dx.doi.org/10.1007/s10964-019-01060-9 behaviors and symptoms of depression and anxiety in
PMID: 31256313 youth: A systematic review of moderating variables.
Ybarra, M.L., Alexander, C., Mitchell, K.J. (2005). BMC Public Health, 20(1), 472.
Depressive symptomatology, youth Internet use, and http://dx.doi.org/10.1186/s12889-020-08572-1
PMID: 32272906