Addictive use of social media, not total time, associated with youth mental health
Columbia University Irving Medical Center
NEW YORK, NY (June 18, 2025)--Addictive use of social media, video games, or mobile phones—but not total screen time—is associated with worse mental health among preteens, a new study by researchers at Columbia and Cornell universities has found.
The study, published June 18 in JAMA, examined the social media use of nearly 4,300 children, starting at age 8, and how use changed over the next four years.
Addictive use of screens—excessive use that interfered with schoolwork, home responsibilities, or other activities—was common, and use patterns varied by screen type and over time. For mobile phones, about half of the children reported high addictive use from the start of the study that remained high through early adolescence, and about 25% developed increasingly addictive use as they aged. For social media, approximately 40% of children had high or increasingly addictive use. Unlike social media and mobile phones, video game use followed only two trajectories—high and low—without a distinct “increasing” group over time.
Both high and increasingly addictive screen use were associated with worse mental health (e.g. anxiety, depression, or aggression) and suicidal behaviors and thoughts.
“These kids experience a craving for such use that they find it hard to curtail. Parents who notice these problems should have their kids evaluated for this addictive use and then seek professional help for kids with an addiction,” says psychiatrist J. John Mann, the Paul Janssen Professor of Translational Neuroscience in Psychiatry and Radiology at Columbia University Vagelos College of Physicians and Surgeons and the New York State Psychiatric Institute and one of the study’s senior leaders.
“While national surveys and previous studies have documented rising screen use, our study is the first to map longitudinal trajectories of addictive use specifically, offering new insights into when and for whom risks emerge. Policy efforts should move away from generic limits on screen time and instead focus on identifying and addressing addictive patterns of screen use,” says Yunyu Xiao, PhD, the first and lead author, assistant professor of population health science and psychiatry at Weill Cornell Medicine.
Children entering adolescence also should be assessed repeatedly for addictive use. “If you do not follow kids over time, you would miss this substantial group that shifts from low risk to higher risk,” Mann says.
Background
Increasing use of social media, video games, and mobile phones among children and teenagers has raised concerns that excessive use may be contributing to a rise in mental health problems among young people.
Most research has focused on total screen time, rather than the nature of screen time or how that use may change over time.
Study details
The new study—the first to characterize addictive use trajectories for social media, mobile phones, and video games among children—looked at children in the Adolescent Brain Cognitive Development Study.
The researchers analyzed data collected over four years on the youths’ mental health; use of social media, mobile phones, and video games; and their agreement with various statements about screen use (e.g. “I play video games so I can forget about my problems,” and “I feel the need to use social media apps more and more.”)
Based on the participants’ agreement with such statements, the researchers identified several addictive use patterns and examined the relationship between these addictive patterns and mental health.
Screen use and mental health
Overall, about 5% of the nearly 4,300 study participants exhibited suicidal behaviors (from preparatory actions to suicide attempts) during the study’s fourth year, and this was the outcome used to evaluate the impact of addictive screen use or the total time of screen use.
For social media and mobile phones, children with high or increasingly addictive use patterns had a two to three times greater risk of suicidal behaviors and suicidal ideation compared to children with a low addictive use pattern.
Total screen time was not associated with suicide-related or mental health outcomes.
Next steps
This study indicates that interventions that focus on addictive screen use may hold more promise as a prevention approach and do not support prevention focusing on total screen time.
“Now that we know that an addictive use pattern is so important, we need to develop intervention strategies and test them in controlled clinical trials,” says Mann, who adds that it’s not known if screen access needs to be eliminated or just restricted. “We know from studies of addiction management that partial access can quickly reinforce the addiction.”
More information
The study, “Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths,” was published June 18 in JAMA.
J. John Mann, MD, PhD, is also director of the Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons and co-director of the Columbia Center for Prevention and Treatment of Depression.
All authors: Yunyu Xiao (Weill Cornell Medicine), Yuan Meng (Weill Cornell Medicine), Timothy T. Brown (University of California, Berkeley), Katherine M. Keyes (Columbia), and J. John Mann (Columbia).
This study was supported by funding from the National Institutes of Health (RF1MH134649), American Foundation for Suicide Prevention (YIG-2-133-22), Google, and the Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity (AIM-AHEAD), a program of the National Institutes of Health (1OT2OD032581-02-259).
J. John Mann reports receipt of royalties for commercial use of the Columbia-Suicide Severity Rating Scale from the Research Foundation for Mental Hygiene and the Columbia Pathways App from Columbia University.
Journal
JAMA
Article Title
Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths
Article Publication Date
18-Jun-2025
COI Statement
J. John Mann reports receipt of royalties for commercial use of the Columbia-Suicide Severity Rating Scale from the Research Foundation for Mental Hygiene and the Columbia Pathways App from Columbia University.
Study finds addictive screen use, not total screen time, linked to youth suicide risk
New research found that youth who become increasingly addicted to social media, mobile phones or video games are at greater risk of suicidal thoughts, suicide attempts and emotional or behavioral issues. The study, published June 18 in JAMA, was led by researchers at Weill Cornell Medicine, Columbia University and University of California, Berkeley.
Unlike previous studies that focused on total screen time at one point in a child’s life, this study looked at how young people’s patterns of compulsive or “addictive” use changed over time. These patterns included feeling unable to stop using a device, experiencing distress when not using it or using it to escape from problems. In contrast, simply spending more time on screens at 10 years old wasn’t associated with worse suicide-related and mental health outcomes.
“For parents and educators, the discussion around mobile phones and social media has focused on limiting or banning use, but our results indicate more complex factors are involved,” said first author Dr. Yunyu Xiao, assistant professor of population health sciences at Weill Cornell Medicine. “Clinical trials have shown that limiting cell phone use, for instance during school hours, was not effective in reducing the risk of suicidal behavior or improving other aspects of mental health.”
This study could signal a paradigm shift in how the impact of screen time on youth mental health is addressed. “Testing interventions that work against other types of addiction may be one way to approach this type of social media and mobile phone use,” Dr. Xiao said.
Dr. John Mann, the Paul Janssen Professor of Translational Neuroscience in Psychiatry and Radiology at Columbia University and the New York State Psychiatric Institute, is senior author on this study.
Quantity Versus Quality
Over four years, the researchers tracked nearly 4,300 youths aged nine to ten when they first started the study. Participants identified themselves as Asian, Black, Hispanic, white or multiracial. Using machine learning and data from participant interviews, the researchers characterized three addictive use trajectories for social media and mobile phone usage and two for addictive use with video games. When graphed, these trajectories depicted relative levels of addictive behaviors.
By age 14, almost one in three participants had a high addictive use trajectory for social media and one in four for mobile phones. More than 40 percent of the youths had a high addictive use trajectory for video games. These adolescents were significantly more likely to report suicidal thoughts or behaviors, as well as symptoms of anxiety, depression, aggression or rule-breaking.
The researchers also found that each type of digital activity showed unique patterns of association with suicide-related behaviors and mental health symptoms. For social media and mobile phones, the high and increasing addictive use trajectories were associated with a two to three times greater risk of suicidal behaviors and suicidal ideation compared with the low addictive use trajectory. The higher use trajectories were also associated with either internalizing symptoms such as anxiousness and depression, or externalizing symptoms, including aggressiveness or inattentiveness.
“Parents may want to pay more attention to how their kids are using their digital devices and consider having them evaluated for signs of addictive use, said co-first author Dr. Yuan Meng, postdoctoral associate in population health sciences at Weill Cornell. “If an addiction is identified, limiting use of mobile phones and social media for part of the day, may potentially reinforce addictive behaviors, so seeking professional advice is essential.”
Paradigm Shift
This study demonstrated that the total amount of time spent on social media, mobile phones and video games was not associated with future suicide-related or mental health outcomes. What mattered most was how youth were engaging with screens—especially whether their use showed signs of compulsion, distress or loss of control.
The findings suggest repeated assessment of social media and mobile phones in children entering adolescence for addictive use patterns could be valuable. "Children who initially display low or moderate trajectories are not typically considered at-risk, but follow-up can detect concerning trends such as development of more severe addictive use over time,” Dr. Xiao said.
Though the study does not prove addictive screen use causes mental health problems—higher addiction use trajectories are linked to roughly double the risk of suicidal behavior in the near future of these teens. “This calls for further study and evaluation of approaches that have worked for other addictions in children and adolescents for this issue,” Dr. Mann said.
Next, Dr. Xiao and her colleagues plan to extract profiles of children who comprise different trajectories with their demographic and socioeconomic information. The researchers are also developing interventions to address addictive use behaviors at their onset to reduce the likelihood of suicidal behaviors.
Dr. Timothy T. Brown, associate director for research at the Berkeley Center for Health Technology at the University of California, Berkeley, and Dr. Katherine M. Keyes, professor of epidemiology at the Columbia University Mailman School of Public Health, also contributed to this study.
Journal
JAMA
Article Title
Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths
Article Publication Date
18-Jun-2025
Addictive screen use trajectories and suicidal behaviors, suicidal ideation, and mental health in US youths
JAMA Network
About The Study:
This study identified distinct trajectories of addictive use of social media, mobile phones, and video games from childhood to early adolescence and found links to suicidal behaviors, suicidal ideation, and worse mental health outcomes. High or increasing addictive use trajectories were common. Addictive screen use trajectories warrant further study regarding potential use for clinical evaluation of risk and for the design and testing of interventions to improve youth mental health.
Corresponding Author: To contact the corresponding author, Yunyu Xiao, PhD, email yux4008@med.cornell.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jama.2025.7829)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
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Journal
JAMA
Racial and ethnic differences in mental health service use among adolescents
JAMA Network Open
About The Study:
In this cross-sectional study of 23,000 adolescents, members of racial and ethnic minority groups were significantly less likely to access mental health visits or receive psychotropic medications or services in outpatient, telemental health, or school settings compared with white adolescents. These findings highlight the need to improve mental health access for adolescent members of racial and ethnic minority groups.
Corresponding Author: To contact the corresponding author, Yanlei Ma, PhD, email yanleima@hsph.harvard.edu.
To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/
(doi:10.1001/jamanetworkopen.2025.16612)
Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.
# # #
Embed this link to provide your readers free access to the full-text article
About JAMA Network Open: JAMA Network Open is an online-only open access general medical journal from the JAMA Network. On weekdays, the journal publishes peer-reviewed clinical research and commentary in more than 40 medical and health subject areas. Every article is free online from the day of publication.
Journal
JAMA Network Open
