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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

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Appendix C

Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health

Committee and staff conducted three literature searches between January and June 2023, adjusting search terms each time with input from the committee. The terms aimed to find literature reviews, systematic reviews, and meta-analyses with a focus on the health effects of social media exposure on adolescent health that had been published since 2018. In addition, the committee and staff conducted hand searches for relevant landmark reviews or meta-analyses, some of which predate 2018. The results in the table below are not comprehensive but do convey some of the more notable results from the current literature available on the topic.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

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TABLE C-1 Select Recent Systematic Reviews and Meta-Analyses on Social Media Exposure and Adolescent Health Outcomes

Reference	Time Period of Review	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
Alimoradi et al., 2019	2007–2018	n = 23 studies	Cohort, case-control, cross-sectional	Any age, assessed for internet addiction	Internet addiction	Sleep disturbances (presence of sleep problems and sleep duration)	Internet addiction is associated with sleep problems across all 23 studies, but the relationship may be influenced by the tool used to evaluate sleep problems. Children, teenagers, and young adults appear most susceptible to internet addiction as they are still developing.
Alimoradi et al., 2019	2007–2018	n = 23 studies	Cohort, case-control, cross-sectional	Any age, assessed for internet addiction	Internet addiction		No evidence of publication bias.
Alonzo et al., 2021	January 1990 to November 2019 AND forward and backward citation tracing until April 2020	n = 42 studies	Prospective cohort Cross sectional	Population of interest: ages 16–25 years Studies included: ages 12–30 years	Active social media use	Sleep quality and mental health outcomes	Longitudinal research suggests that sleep problems (sleep disruption and poor quality sleep) may at least partially explain the relationship between excessive social media use and mental health problems. Cross-sectional research is less conclusive. Social media use can contribute to mental health problems both directly and indirectly through sleep disturbance.
Alonzo et al., 2021		n = 42 studies	Prospective cohort Cross sectional		Active social media use	Sleep quality and mental health outcomes	No discussion of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

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Appel et al., 2020	Not specified	Well-being n = 4	Meta-analyses	General, students when relevant to question	Social networking site use	General well-being, academic performance, and narcissism	There is no strong linear association between social networking use and loneliness, self-esteem, life satisfaction, or self-reported depression.
		Academic performance n = 3
							Social networking sites may provide a venue to create social capital and relationships—both close and shallow, but there is no strong evidence that social networking promotes well-being.
		Narcissism n = 3
							There is no evidence of a pronounced effect of social networking use on academic performance.
							There is evidence of small to moderate associations between social networking site use and narcissism.
							Tests for publication bias not applicable, but topic discussed.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Reference	Time Period of Review	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
Berger et al., 2022	January 2012 to March 2021	n = 26 studies	Cohort or cross-sectional; qualitative, quantitative, or mixed methods	LGBTQ youths and adolescents (10–24 years)	Use of social media	Mental health outcomes	The quality of the research is limited, and causation cannot be inferred. Overall, there are both positive and negative aspects for social media use for LGBTQ young people. There is evidence of social media being beneficial for social connection and exploration of identity. Social media is associated with decreased symptoms of mental illness among LGBTQ young people, including decreased feelings of isolation and increased well-being. Heavy social media use can be associated with feelings of loneliness and sensitivity among LGBTQ young people.
Berger et al., 2022	January 2012 to March 2021	n = 26 studies		LGBTQ youths and adolescents (10–24 years)	Use of social media	Mental health outcomes	No discussion of publication bias.
Brautsch et al., 2023	January 2010 to April 2021	n = 42 studies	Cross sectional Longitudinal	16–25 years	Digital media use	Sleep outcomes	There is an association between general screen use and poor sleep quality and reduced duration of sleep; there is an association between use of social media, mobile phone, computer, and the internet and poor sleep quality and reduced duration of sleep.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

							Most studies found an association between digital media use at night or before bed and poor sleep.
							No discussion of publication bias.
Cataldo et al., 2021	2006 to July 31, 2020	n = 44 studies	Studies assessing mental health and psychological disorders	10–19 years with a profile on a popular social media site	Assessment of psychiatric disorders in developmental ages	Level of psychological well-being or diagnosis of psychiatric disorder	Some evidence of positive associations between having a social media profile and various mental health problems.
							No discussion of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Reference	Time Period of Review	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
Cunningham et al., 2021	2012–2018	n = 62 studies	Any quantitative studies	Interest in children and adolescents but included studies that had adult-only populations	Social media or social networking site use (examines time spent using social networking sites, intensity of use, and problematic use as three distinct constructs)	Depression or depressive symptoms	There is a weak association between time spent using social networking sites and depressive symptoms.
							Evidence of publication bias toward reporting higher effect sizes, effect size adjusted.
							There is a weak association between intensity of social networking site use and depressive symptoms.
							No evidence of publication bias.
							There is a moderate association between problematic use of social networking and depressive symptoms. This effect was not moderated by participants age or gender, by year of study, or by method of recruitment.
							No evidence of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Keles et al., 2020	2011–2018	n = 13 studies	Cross-sectional (12) Longitudinal (1)	Ages 13–18 years	Measurement of social media use	Depression, anxiety, or psychological distress assessed by validated instruments	Time spent on social media; activity on social media; investment in the experience; and addiction were all correlated with depression, anxiety, and psychological distress. The direction of this relationship is not clear.
							Causality was unclear owing to the cross-sectional study designs and lack of comparator group.
							No discussion of publication bias.
Kuss et al., 2021	April 2013 to September 2019	n = 64 studies	Cross-sectional studies with quantitative, qualitative, and mixed methods	Not specified, most samples primarily adolescent or young adult	Internet and internet gaming use Online gambling Online pornography use Social media use	Internet and internet gaming addiction Online gambling addiction Online pornography addiction Social media addiction	Estimates of the prevalence of internet addiction range from 12.6% to more than two-thirds. Risk factors for internet addiction include: psychological distress, mood disorders, suicidality, impulsivity, aggression, and sleep problems. Therapy may be effective at combating internet addiction.
							No discussion of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Reference	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
Liu et al., 2016	n = 58 studies	Empirical studies that used a Pearson correlation (r) or sufficient information from which an effect size for the association between social networking site use and social capital could be derived	Not specified in search	Social networking site use	Bonding and/or bridging of social capital	There is a moderate positive association between use of social networking sites and measures of bridging social capital. No evidence of publication bias.
						There is small positive association between use of social networking sites and bonding social capital. Mixed evidence of publication bias; effect size was adjusted accordingly.
						Social networking sites are useful to help people build social capital, but more so with bridging than bonding social capital.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Lozano-Blasco et al., 2022	2017–2020	n = 20 studies k = 28 samples	Experimental and quantitative studies reporting standardized psychometric evaluations	Adolescents	n/a	Prevalence of internet addiction	Heterogeneity of results is high.
							Internet addiction or problematic use is comorbid with many other problems including obesity, anxiety, depression, stress, and internalizing disorders.
							There are personality factors that can predispose young people to internet addiction including: “introversion, inhibition, submissiveness, self-evaluation, obsessive-compulsive tendencies, phobic anxiety, hostility, paranoia, borderline personality, hostility, and low self-esteem.”
							Environmental factors such as family dysfunction, bad family communication, and boredom are associated with risk of addiction to technologies. A good relationship with teachers, positive feelings about one’s school, academic success, and physical activity are protective against internet addiction.
							Age explains 24% of the variance in internet addiction; gender does not explain the variance in prevalence of internet addiction.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Reference	Time Period of Review	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
							Some studies suggest that internet addiction is the effect of other psychopathologies, not a cause of them.
							No evidence of publication bias.
Mackenzie et al., 2022	Inception until November 26, 2020	n = 14	Studies with a qualitative component with verbatim quotes linking sleep and social media	Studies with at least 80% participants ages 10–24 years	Use of social media, social networks, Twitter, Facebook, smartphones, and screentime	Perceived impact of social media use at bedtime on sleep	Themes of a social motivation for using social media at bedtime, habitual smartphone use, and recognition of the use as a problem emerged from qualitative studies.
Mackenzie et al., 2022	Inception until November 26, 2020	n = 14		Studies with at least 80% participants ages 10–24 years		Perceived impact of social media use at bedtime on sleep	Tests for publication bias not applicable.
McComb et al., 2023	September 2006 to September 2021	n = 48 studies	Experimental designs with random assignment and a control condition, social comparison through social media was key exposure	General, clinical populations excluded	Upward comparison on any social media platform	Subjective well-being, body image, mental health, and self-esteem	There is a small negative effect of upward social comparison on social media and users’ self-evaluation and emotions.
							There is a small negative effect of upward social comparison on body image, well-being, mental health, and self-esteem.
							Effects do not vary by age or gender.
							Mixed evidence of publication bias, effect size adjusted accordingly

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

McCrae et al., 2017	No time period applied to search	n = 11 studies	Cross-sectional, longitudinal	Ages 5–18 years	Social media (defined by authors as websites used primarily for social interaction, e.g., Facebook, WhatsApp, Instagram)	Depression or depressive symptoms	Authors found small correlation between social media use and depressive symptoms in children and adolescents.
							Mixed evidence of publication bias which reduced estimate of random effects.
Meier and Reinecke, 2021	2010 to 2019	n = 34 reviews	Systematic reviews and meta-analyses	General, some children and adolescent, some older adults	Computer-mediated communication: social media use, social networking, internet use, mobile phone use	Various mental health outcomes	Reviews suggest a very small negative association between social networking and mental health, even this depends largely on choice of mental health indicators; for applications other than social networking, evidence shows little to no association with mental health outcomes.
							Tests for publication bias not applicable to study design. However the meta-analyses included in the meta-review overall found little evidence of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Reference	Time Period of Review	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
Memon et al., 2018	No time limit	n = 9 studies	Observational and interven-tional studies	Ages 13–17 years	Use of social networking sites such as Facebook, Instagram, and Snapchat	Deliberate self-harm or suicidality	More time spent on social media is associated with greater self-harming behavior; social media is also an important medium for suicidal youth to seek help.
Memon et al., 2018	No time limit	n = 9 studies	Observational and interven-tional studies	Ages 13–17 years		Deliberate self-harm or suicidality	No discussion of publication bias.
Sedgwick et al., 2019	Database inception through January 25, 2019	n = 9 studies	Cross-sectional	Ages 11–18 years	Social networking site usage, problematic internet use, pathological internet use, or hours of noneducational internet use	Suicide attempts	Heterogeneity of exposures and outcomes prevented the combining of results in a meta-analysis, but data suggest problematic use of social media or the internet are associated with suicide risk; the direction of the potential association is not clear.
Sedgwick et al., 2019	Database inception through January 25, 2019	n = 9 studies	Cross-sectional	Ages 11–18 years		Suicide attempts	No discussion of publication bias.
Shannon et al., 2022	January 2017 to April 2021	n = 18 studies	Cross-sectional	Ages 12–30 years	Problematic social media use	Depressive symptoms, anxiety symptoms, and stress measured using validated instruments	There is evidence of a moderate correlation between problematic social media use and depression, anxiety, and stress.
Shannon et al., 2022	January 2017 to April 2021	n = 18 studies	Cross-sectional	Ages 12–30 years	Problematic social media use		No evidence of publication bias on anxiety and stress outcomes, mixed evidence on depressive outcomes.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Sina et al., 2022	2008 to 2021	n = 35 studies	Randomized, controlled trials, cross-sectional and longitudinal studies	Ages 2–18 years	Social media exposure	Dietary behaviors	There is an association between social media exposure and unhealthy diet in children and adolescents.
							There was no relationship between exposure to social media and nutrition knowledge.
							Prolonged smartphone use is associated with unhealthy eating behaviors.
							No discussion of publication bias.
Sohn et al., 2019	January 1, 2011 to October 15, 2017	n = 41	Cohort (3) Cross-sectional (38)	Eligibility criteria included studies of mobile device exposure focusing on children and young people (with a mean population age of no greater than 25)	Problematic smartphone use	Prevalence of mental health issues, including depression, anxiety, stress, and sleep quality	Of the 41 studies included 22 were of poor methodological quality, 19 of moderate quality.
							Estimates of the prevalence of problematic smartphone use among children and adolescents was 23.3% (confidence interval 14.0 to 31.2%).
							No discussion of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Reference	Time Period of Review	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
Stevens et al., 2021	2010–2019	n = 53	Studies reporting prevalence of internet gaming disorder or gaming disorder	Age not specified but majority of studies that provided the information had adolescent-only samples	n/a	Global prevalence of gaming disorder	Meta-analysis suggests a prevalence of gaming disorder between 3.05% (confidence interval: 2.38, 3.91 percent), but this figure was adjusted to 1.96% (confidence interval 0.19, 17.12% when considering only studies of higher methodological rigor.
							Choice of screening tool accounted for more than three-quarters of the variance in these results.
							Males outnumber females by 2.5 to 1 in prevalence of gaming disorder.
							The global burden of gaming disorder is comparable to obsessive-compulsive disorder and some substance-use disorders.
							No evidence of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Tang et al., 2021	2005 through August 2020	n = 35 studies	Longitudinal only	Young people (ages 10–24 years)	Any type of screen time: television or video viewing time, computer/internet use, mobile phone use, social media use, and videogame use	Mental health outcomes: depression, anxiety, emotional problems, internalizing problems, etc.	“Some evidence to suggest a very small to small positive association between screen time and subsequent depressive symptoms”; relatively few studies find evidence of association between depressive symptoms and subsequent screen time. “Limited evidence of an association between television or videogames and subsequent depression”; “relatively stronger evidence of associations between mobile phone, computer, or internet use and subsequent depression. Evidence of the association between social media use and subsequent depression is mixed.”
							No discussion of publication bias.
Valkenburg et al., 2022	2019 to mid-2021	n = 25	Systematic reviews, narrative reviews, and meta-analyses	Focused on adolescents	Active, passive, private, and public social media use, including social networking sites, Facebook	Mental health outcomes	Meta-analyses suggest weak association between social media use and higher ill-being and weak associations between social media use and levels of wellbeing, with considerable variability in the associations. Systematic and narrative reviews find small effects and inconsistent findings leaving more room from varying interpretations.
							Test for publication bias not applicable.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×

Reference	Time Period of Review	Number of Studies	Study Designs Included	Populations Included (if specified)	Exposure(s) Included	Study Outcome(s)	Results
Yin et al., 2019	2005–2016	n = 63 studies	Any quantitative study reporting a correlation or effect size	General population	Social networking site use excluding addictive or problematic behavior	Wellbeing, life satisfaction, depression, loneliness, anxiety, positive affect, negative affect	Use of social networking sites has small associations with both positive and negative indicators of mental health. These small effects appeared influenced by how social networking is measured, gender, and cultural background.
Yin et al., 2019	2005–2016	n = 63 studies		General population			No evidence of publication bias.
Yoon et al., 2019	Before February 2018	Time on social networking n = 33	Observational studies assessing depression by self-report or clinical interview	General population, including some specific to undergraduates	Time spent on social networking sites, frequency of checking sites, social comparisons	Depression	There is a small, positive correlation between frequency of checking social networking sites and time spent on sites and depressive symptoms, and this effect was not dependent on gender or age.
		Frequency of checking social networking n = 12					No evidence of publication bias.
		Social comparison n = 5					There is a small-to-medium correlation between depressive symptoms and social comparisons on social networking sites.
							No evidence of publication bias.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

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							There is a medium correlation between depressive symptoms and upward social comparison. Social comparison, both general and upward, is more correlated with depressive symptoms than social networking usage is.
							No evidence of publication bias.

Page 254 Cite

Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

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Valkenburg, P. M., A. Meier, and I. Beyens. 2022. Social media use and its impact on adolescent mental health: An umbrella review of the evidence. Current Opinion in Psychology 44:58-68.

Yin, X.-Q., D. A. de Vries, D. A. Gentile, and J.-L. Wang. 2019. Cultural background and measurement of usage moderate the association between social networking sites (SNSS) usage and mental health: A meta-analysis. Social Science Computer Review 37(5):631-648.

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Suggested Citation:"Appendix C: Table of Recent Systematic Reviews and Meta-Analyses on the Association Between Social Media and Adolescent Health." National Academies of Sciences, Engineering, and Medicine. 2024. Social Media and Adolescent Health. Washington, DC: The National Academies Press. doi: 10.17226/27396.

×