Social Media Use and Depressive Symptoms During Early Adolescence

JAMA Network Open | 2025, Vol. 8, No. 5, p. 1-10

Social Media Use and Depressive Symptoms During Early Adolescence

Jason M. Nagata, MD; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Christopher D. Otmar, PhD; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Joan Shim, MPH; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Priyadharshini Balasubramanian, MPH; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Chloe M. Cheng, MD; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Elizabeth J. Li, MPH; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Abubakr A. A. Al-Shoaibi, PhD; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Iris Y. Shao, PhD; Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco

Kyle T. Ganson, PhD; Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada

Alexander Testa, PhD; Department of Management, Policy, and Community Health, University of Texas Health Science Center at Houston

Orsolya Kiss, PhD; Center for Health Sciences, SRI International, Menlo Park, California

Jinbo He, PhD; School of Humanities and Social Science, The Chinese University of Hong Kong, Longgang District, Shenzhen, China

Fiona C. Baker, PhD; Center for Health Sciences, SRI International, Menlo Park, California

Importance: In 2023, the US Surgeon General issued the Advisory on Social Media and Youth Mental Health, identifying critical research gaps that preclude evidence-based guidance given that most studies of social media and mental health have been cross-sectional rather than longitudinal and have focused on young adults or older adolescents rather than on younger adolescents.

Objective: To evaluate longitudinal associations between social media use (time spent on social media) and depressive symptoms across 4 annual waves spanning a 3-year follow-up period from late childhood to early adolescence.

Design, Setting, and Participants: In this prospective cohort study using data from the Adolescent Brain Cognitive Development Study across 21 study sites from October 2016 to October 2018, children aged 9 to 10 years at baseline were assessed across 4 waves (baseline, year 1, year 2, and year 3), with year-3 follow-up through 2022. Sample sizes varied across waves and measures due to attrition and missing data. Analyses retained all available data at each wave. Data were analyzed from January 2024 to March 2025.

Exposures: Self-reported time spent on social media at baseline to 3-year follow-up.

Main Outcomes and Measures: Reciprocal associations between social media use and depressive symptoms (Child Behavior Checklist) at baseline and at 1, 2, and 3 years of follow-up were assessed using longitudinal, cross-lagged structural equation panel models. Covariates included sex, race and ethnicity, household income, and parental educational level.

Results: At baseline, the sample included 11 876 participants (mean [SD] age, 9.9 [0.6] years), of whom 6196 (52.2%) were male. After adjusting for stable between-person differences and covariates, within-person increases in social media use above the person-level mean were associated with elevated depressive symptoms from year 1 to year 2 (β, 0.07; 95% CI, 0.01-0.12; P = .01) and from year 2 to year 3 (β, 0.09; 95% CI, 0.04-0.14; P < .001), whereas depressive symptoms were not associated with subsequent social media use at any interval. The final random-intercept cross-lagged panel model demonstrated a good fit (comparative fit index, 0.977; Tucker-Lewis index, 0.968; root mean square error of approximation, 0.031 [90% CI, 0.029-0.033]). Between-person differences in social media use were not associated with depressive symptoms (β, −0.01; 95% CI, −0.04 to 0.02; P = .46) after accounting for demographic and family-level factors.

Conclusions and Relevance: In this cohort study of 876 children and adolescents, reporting higher than person-level mean social media use in years 1 and 2 after baseline was associated with greater depressive symptoms in the subsequent year. The findings suggest that clinicians should provide anticipatory guidance regarding social media use for young adolescents and their parents.

Social media use among adolescents has risen sharply in recent years, alongside growing concerns about mental health, with “42% of adolescents report[ing] persistent feelings of sadness or hopelessness, an increase of 50% from 2011.” Although associations between social media use and depressive symptoms have been documented, “the directionality of this relationship remains unclear,” mainly because “most prior studies have been cross-sectional and were therefore unable to determine temporality, directionality, or within-person changes.” Adolescence is described as a sensitive developmental period in which “heightened cognitive and emotional reactivity” may increase vulnerability to media effects, and social media use may operate bidirectionally, potentially “creating reinforcing cycles of use and distress.” Guided by the Differential Susceptibility to Media Effects Model, the aim was to examine “whether there are bidirectional associations between social media use and depressive symptoms in early adolescence” by focusing on within-person changes across time (p. 2).

Data were drawn from the Adolescent Brain Cognitive Development Study, a national prospective cohort following children aged 9 to 10 years across four waves from baseline to year-3 follow-up. Repeated assessments “allowed for a clearer examination of potential directionality—whether changes in social media use preceded shifts in depressive symptoms or vice versa.” Social media use was defined as “time spent on social media daily,” calculated as a weighted mean of weekday and weekend use, while depressive symptoms were measured using “the validated Child Behavior Checklist (CBCL) depressive problems score,” with raw scores selected to “capture the full distribution of symptom severity… and avoid the potential loss of within-person variability over time.” To examine reciprocal associations, random-intercept cross-lagged panel models were used to “separate stable between-person differences from within-person fluctuations over time,” allowing the analysis to focus on how “temporary (state-like) deviations” in one construct predicted later deviations in the other (p. 2-4).

Across waves, descriptive statistics showed “an overall increase in mean daily social media use from baseline to year 3 and a modest increase in mean depressive symptom scores.” Between-person analyses indicated that “there were no between-person associations between depressive symptoms and social media use,” suggesting that adolescents with consistently higher use were not the same individuals with consistently higher depressive symptoms after accounting for covariates. In contrast, within-person analyses revealed that “social media use higher than the person-level mean in year 1 was associated with greater depressive symptoms in year 2,” and that this association “continued from year 2 to year 3.” Effect sizes for these cross-lagged paths were in the medium range. No evidence emerged for the reverse direction, as “there were no cross-lagged associations between depressive symptoms and later social media use at either interval” (p. 4-6).

These findings indicate “a longitudinal association between increases in social media use and subsequent depressive symptoms at the within-person level,” providing “initial evidence of temporal ordering.” The pattern suggests that social media use “may be a potential contributing factor to adolescent depressive symptoms rather than merely a correlate or consequence of such symptoms.” When considered within the Differential Susceptibility to Media Effects Model, the results are consistent with the idea that “some adolescents may be more susceptible to negative media effects due to dispositional, developmental, and social-contextual factors.” In later waves, contemporaneous associations showed that adolescents reporting social media use higher than their person-level mean also reported depressive symptoms higher than their person-level mean, suggesting that “immediate factors (eg, negative peer social interactions, family conflict) may coincide with or amplify concurrent distress.” Overall, the findings underscore early adolescence as a sensitive period in which increases in social media use may shape subsequent depressive symptom trajectories (p. 6-7).