Today’s teenagers are spending an increasing amount of their free time using different digital media, such as smartphones, computers and tablets . In Sweden, the proportion of 14-year-olds using the Internet for more than 3 hours per day increased from 30% in 2010 to 76% in 2020 and in the United States, 45% of teenagers say they are online “almost constantly” . At the same time, the rate of depression, anxiety and suicide among adolescents has reached historically high levels over the past 10 to 15 years. [4,5,6]. For example, the level of depression among Swedish girls aged 10-17 rose from around 500 to over 1,000 per 100,000 from 2008 to 2018. . Although the reasons for this increase in the rate of depression are likely to be manifold, including changing diagnostic criteria, the use of digital media is gaining increasing attention as a potential causative factor. .
The association between digital media use (eg, playing games, using social media, watching TV) or social media use more specifically (eg, different activities on Instagram, Facebook or Snapchat) and well-being has been examined (and debated) [9, 10] in several studies with mixed results [11,12,13]. While the majority of studies – many of which were based on cross-sectional designs – found a negative association [8, 11]the few longitudinal studies available have shown either that social media use predicts lower well-being in terms of depression and internalizing symptoms (e.g., depression, anxiety, hypersensitivity, headaches, worry) [14,15,16,17]no associations [18,19,20]or that depression predicts increased social media use [21, 22]. Additionally, some researchers have found evidence of a U-shaped curvilinear association [23, 24]. Other research has examined potential mediators and found that the association between social media use and well-being may be influenced by factors such as cyberbullying, lack of sleep, and reduced physical activity. .
An intriguing possibility is that inconsistent results in the existing literature are related to key methodological differences between studies, limiting generalizability and the conclusions that can be drawn. . To overcome these limitations, we conducted a large cross-sectional study and used in-depth measures of social media activities and internalizing symptoms, which are an important aspect of mental well-being. Our goal was to provide a deeper understanding of not only where adolescents spend their time on the Internet, but also what kind of activities might contribute to changes in mental well-being. To clarify the specific contributions of our study, we begin by listing three central limitations of existing research.
A first limitation of previous research that may contribute to the mixed results is the lack of interest in specific digital media activities, and the extent to which they are differentially associated with well-being. [18, 25, 26]. For example, studies that do not clearly distinguish between various digital media activities have found both negative effects and non-existent associations with well-being . Internet use can include a wide range of activities that differ by gender in terms of agency, mode of display, and social significance. Therefore, it is important to consider the different activities separately. A number of studies have shown that playing games is associated with lower well-being in terms of internalizing problems and depressive symptoms [28,29,30,31]. Importantly, social media use was found to be more strongly associated with well-being than gaming. [1, 14]. One explanation for this difference could be that social media provides more opportunities for social comparison, which is known to decrease well-being, compared to games. .
A second limitation of previous research that may contribute to the mixed results is the variety of measures used to more specifically assess social media use. For example, teens were asked to self-define social media and self-declare how active they have been on different platforms [20, 33]whether they are chatting or interacting with their friends on different platforms [17, 34]and use a combined measure of instant messaging, photo sharing or other social media activity across different platforms . Different means of assessing social media could draw on distinct activities with varying relevance to development and expression of well-being. We argue that it is important to go beyond existing approaches to examine both how and in what manner different social media activities are associated with the well-being of boys and girls separately.
To answer these open questions, our study focuses on three different social media activities: (i) chatting in real time with friends on “private” platforms (one-to-one or private group chats); (ii) online sociability, meaning communication taking place in public social media that can be seen by others (not necessarily in real time); and (iii) self-presentation, such as selfies, film clips, or other types of personal information that may be seen by others. To our knowledge, no previous study has examined how these three activities are associated with the well-being of boys and girls. Self-presentation, which has been highlighted as a key factor underlying the association between social media use and adolescent well-being [35,36,37,38]indicates an individual’s motivation to “brand” themselves and achieve digital social status through likes and new followers . This search for social rewards lays the groundwork for social comparisons, which are known to negatively affect well-being. [35, 40]. Indeed, recent meta-analyses [41, 42] demonstrate that social comparison in general, and upward social comparison (i.e. comparison with the superior other) in particular, predicts a decline in well-being [35, 39, 43]. The lack of positive feedback (i.e. social rewards) and the presence of social punishment from the social media community has been shown to negatively influence adolescent well-being. . [13, 44]. In light of these lines of research, we hypothesize that a greater reliance on self-presentation makes the individual more vulnerable to negative reactions.
A third limitation of previous research is that previous studies have treated gender as a control variable, ignoring the possibility that the association between digital media use and well-being is different for boys and girls. [14, 26]. For example, some researchers have analyzed boys and girls together, finding that digital media use is not associated with well-being. while others have shown girls to have lower well-being, as indicated by, for example, depressive symptoms [6, 37, 45]anxiety [6, 45] and internalization issues . Girls use social media [1, 2, 28, 46] and chat with friends  more than boys who, in turn, tend to spend more time playing [1, 2, 28]. Additionally, girls post different types of selfies more frequently, use filters, manipulate their photos, and delete messages more frequently than boys, while boys update their profiles more often on sports and tech. [2, 37, 43, 47, 48]. In this context, we argue that it is important to examine associations by sex.
The importance of including gender as a variable is supported by previous research that the use of social media is more strongly associated with the well-being of girls than boys. [1, 17, 49, 50]while some found no gender difference . Differences in selfie culture may be one explanation that helps us understand why the association between self-presentation and depressive symptoms is stronger in girls. . Play has been shown to be associated with the well-being of boys and girls . These gender differences indicate that social media use and different social media activities may have a broader association with girls’ well-being, and that the association between gambling and well-being might be quite similar for boys and girls.
In summary, we identified three areas of limitations in previous research related to the importance of separately examining the role of (1) types of digital media activities, (2) different types of activities in the use of social media and (3) gender. In our cross-sectional study, we aim to use various measures of digital media activities, well-developed ratings of social media activities, and examine how these activities are associated with internalizing symptoms as a measure of girls’ and girls’ well-being. boys. Despite the inherent limitations of cross-sectional designs, which do not allow strong causal claims to be made, we believe that these methodological improvements will contribute to our understanding of the specific processes linking social media use and mental health issues and well-being. in adolescents. .
We test the following three hypotheses:
H1: Different digital media activities are associated differently with internalizing symptoms: (a) social media use will be positively associated with internalizing symptoms, and (b) playing games will be positively associated with internalizing symptoms , but the association will be stronger for social media. use in relation to games.
H2: Different social media activities, such as (a) chatting, (b) online sociability, and (c) self-presentation, will all be positively associated with internalizing symptoms.
H3: Social media use and different social media use activities, such as (a) chatting, (b) online sociability, and (c) self-presentation will be more strongly associated with internalizing symptoms for girls than for boys. The association between playing games and internalizing symptoms will not differ between girls and boys.