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Published Online: 27 March 2020

Increases in Depression, Self‐Harm, and Suicide Among U.S. Adolescents After 2012 and Links to Technology Use: Possible Mechanisms

Publication: Psychiatric Research and Clinical Practice

Abstract

Objective

Increases in depression among adolescents have been concurrent with increases in digital media use. In this article, recent trends in mental health among U.S. adolescents and young adults are discussed and theories about their possible connection with concurrent increases in digital media use are presented.

Methods

Large studies of trends in mental health in the 2000s and 2010s are described and possible mechanisms for the trends are discussed based on existing literature.

Results

After remaining stable during the early 2000s, the prevalence of mental health issues among U.S. adolescents and young adults began to rise in the early 2010s. These trends included sharp increases in depression, anxiety, loneliness, self‐harm, suicidal ideation, suicide attempts, and suicide, with increases more pronounced among girls and young women. There is a growing consensus that these trends may be connected to the rise in technology use. Increased digital media and smartphone use may influence mental health via several mechanisms, including displacement of time spent in in‐person social interactions, individually and across the generation, as adolescent cultural norms evolve; disruption of in‐person social interactions; interference with sleep time and quality; cyberbullying and toxic online environments; and online contagion and information about self‐harm.

Conclusions

U.S. adolescents and young adults are in the midst of a mental health crisis, particularly among girls and young women. The rise of digital media may have played a role in this problem via several mechanisms.

HIGHLIGHTS

Depression, self‐harm, suicide, and unhappiness suddenly increased among adolescents after 2012, especially among girls and young women.
Increases in depression among adolescents have been concurrent with increases in digital media use.
Increased digital media and smartphone use may influence mental health via several mechanisms, including displacement and disruption of in‐person social interactions, interference with sleep, cyberbullying, and online information about self‐harm.
In the early 2010s, reports began to surface that more adolescents and young adults were seeking help for mental health issues (1, 2). This finding could have indicated greater comfort with seeking help, however, rather than a true increase in the prevalence of mental health issues (3). To determine whether the prevalence of mental health issues has actually risen in the population of U.S. adolescents as a whole, data from unscreened, representative samples—not just those who seek help—are necessary (4). Below, I describe studies documenting recent trends in such samples.

Trends in Mental Health Among U.S. Adolescents

Large screening studies (most nationally representative) of U.S. samples of adolescents and young adults since 2010 have shown declines in happiness, life satisfaction, and flourishing (5, 6) and increases in loneliness (7), anxiety (5), depressive symptoms (5, 8, 9), major depressive episodes in the past year (10, 11), hospital admissions for self‐harm behaviors (nonsuicidal self‐injury) (12), suicidal ideation (13), self‐harm and suicide attempts via poisoning (14), suicide attempts (13, 15), self‐reported suicidal ideation (11), and in the suicide rate (9, 11, 16).
These mental health indicators have shown similar patterns, with increases beginning in the early 2010s (Figure 1), when iGen/GenZ (born 1995–2012) began entering adolescence, succeeding millennials (born 1980–1994) (17). In most cases, the increases in indicators of poor mental health have been larger among girls and young women than among boys and young men. Many of these indicators have increased considerably: self‐poisonings among 10‐ to 12‐year‐old girls quadrupled (14); hospital admissions for self‐harm tripled among 10‐ to 14‐year‐old girls (12); major depressive episode among 12‐ to 17‐year‐old girls increased 52%, from 13.1% in 2005 to 19.9% in 2017 (11); emergency room visits for suicidal ideation and attempts nearly doubled among children and adolescents (15); and suicide among 10‐ to 14‐year‐old girls doubled (16).
image
FIGURE 1. Indicators of poor mental health among U.S. girls and young women, 2001–2018a
aStandard deviations are within means at the generational level, not at the individual level, and thus should not be used to calculate individual‐level effect sizes.
bSource: Centers for Disease Control and Prevention. Suicide rates among 12‐ to 14‐year‐old girls.
cSource: Spiller et al. (14). Self‐poisoning among 13‐ to 15‐year‐old girls.
dSource: Twenge et al. (11). Major depressive episode among 14‐ to 15‐year‐old girls.
eSources: Keyes et al. (8) and Twenge et al. (9). Depressive symptoms among eighth‐grade girls.
Thus, after improvement or stability during the early 2000s, U.S. adolescents’ mental health worsened considerably during the 2010s. Because these trends included increases in objectively measured behaviors linked to mental health issues (self‐harm, suicide attempts, and suicides), they cannot be dismissed as stemming from greater help‐seeking, awareness of mental health conditions, or willingness to admit problems. Similar increases in mental health issues have also appeared among adolescents in the United Kingdom and Canada (Haidt and Twenge, 2019, unpublished). With such similar trends across many measures and sources, an overwhelming amount of evidence indicates that adolescent mental health has deteriorated since 2010.
The more difficult question to answer is why this trend has occurred. It seems unlikely that these trends have been caused by economic factors, given that the U.S. economy improved from 2012 to 2018. Even if some of the distress originated in economic troubles, it seems unlikely that it would peak from 2017 to 2018, when the economy was strongest. In addition, the largest increases in mental health problems have appeared among the youngest teens, the age group least likely to be concerned with economic issues. Other economic trends, such as income inequality and the decline of the manufacturing sector, have been ongoing since the 1980s and did not suddenly increase after 2012 (18).
There is a growing consensus that the decline in mental health may be linked instead to the increasing popularity of smartphones and social media around this same time (8, 9, 14, 19). For example, smartphone ownership exceeded 50% by the end of 2012 and reached 81% by 2018 (20). Similarly, daily use of social media increased among teens, from about 50% to more than 80%, and time spent online doubled (21). Unlike the economic recession, the effects of which have receded, the impact of increased technology use has continued to grow. Although digital media use among adolescents has benefits for connections and friendships, there also may be costs, especially for excessive use (22).

Possible Mechanisms by Which Digital Media Use May Influence Mental Health Trends

If the sharp increase in mental health issues is connected to the rise of digital media and electronic device use, it is important to understand how such use may contribute to mental health. The simplest explanation is that more frequent digital media use leads to mental health issues, so as digital media use rises, mental health issues will also rise. However, this explanation does not determine why more frequent digital media use may cause mental health issues, nor does it explore consequences of digital media use beyond time spent. In addition, it does not recognize that effects operate not just at the individual level but also at the group level, such that the rise in digital media use among adolescents may affect even those who are not frequent users.
Below, I explore six mechanisms by which digital media use may be related to mental health and happiness. I define digital media use as including social media, online game playing, texting, other online activities, and streaming videos. Given the focus of studies to date, digital media use in this review refers to use during leisure time and not to use for work, school, or homework.

Displacement of In‐Person Social Interaction (Individual Level)

Studies of large, representative samples of adolescents (22, 23, 24, 25, 26, 27, 28) have found that heavy users of digital media are more likely to be unhappy, depressed, or have risk factors for suicide (29). In many cases, however, the literature shows that nonusers of technology are slightly worse off than light users (those who use technology about 1 hour/day), with well‐being declining with progressively higher levels of use in an exposure‐response pattern. This finding suggests that heavy use, not digital media itself, is the issue. Heavy digital media use may displace time that might otherwise have been spent in in‐person social interaction, an activity with established links to better mental health and happiness (21, 30).
Although some studies have concluded that the associations between digital media use and well‐being are small (25, 31, 32), several of these studies included television use in their calculations of effect size. The association between television watching and well‐being is weaker than the association between digital media use and well‐being. Furthermore, because television watching among teens has declined since 2010 (21), this activity cannot credibly explain the increase in teen depression. In addition, several studies controlled for variables (e.g., physical activity or attitudes toward school) that may mediate the associations between technology use and well‐being; this approach can lower effect sizes by explaining away mechanisms of interest and is thus discouraged in correlational modeling (33). Furthermore, most of the studies that have shown small effects used percentage of variance explained (r‐squared), an analysis technique that can minimize and distort effects (34). For example, r=0.20 is twice that of r=0.10, but, after squaring, 4% is four times as large as 1%, leading Funder and Ozer (34) to describe the r‐squared approach as misleading. When other analysis techniques have been used, effect sizes for the same data sets have been considerable (Figure 2). For example, Kelly et al. (23) found that twice as many heavy users of social media (versus nonusers) had clinical levels of depressive symptoms in the Millennium Cohort Study, the same data set that Orben and Przybylski studied (32). Similarly, Twenge and Campbell (28), with the same data set studied by Przybylski and Weinstein (25), found that heavy users of smartphones were twice as likely as light users to experience low well‐being.
image
FIGURE 2. Proportion of adolescents with depression or low psychological well‐being, by hours a day of social media or smartphone use
aSource: Kelly et al. (23).
bSource: Przybylski and Weinstein (25) and reanalyzed by Twenge and Campbell (28).
Przybylski and Weinstein (25) and Orben and Przybylski (32) noted that the associations they identified between well‐being and screen time were smaller than those for other common risk factors for mental health problems, such as binge drinking, marijuana use, or skipping breakfast. However, they did not mention that, in the same data set, social media use among girls was more strongly associated with depression than was heroin use, exercise, or obesity (35) or that the association was similar to the correlation between childhood lead exposure and IQ (36). With arbitrarily chosen comparison variables, it can be difficult to judge practical importance. It would be helpful if future studies used the same statistical techniques to analyze associations. Because of the curvilinear pattern, with the inflection point often around 1 to 2 hours of screen time per day, a relative risk or odds ratio calculation comparing use of <2 hours and >2 hours a day might be helpful. Another possible method may be to compare heavy users of digital media with light users. Both of these techniques compare the number of people affected, a useful gauge of practical importance (34).
In addition, it is important to note that most causes of mental health issues (e.g., genetic predisposition) do not change in short periods of time. Thus this discussion is not focused on all possible causes of mental health issues, but instead on what changed in the lives of adolescents while mental health issues among adolescents increased. The rapid and widespread adoption of digital media and their impact on the daily lives of adolescents suggest they may play a role in this increase.
Many studies examining associations between digital media use and well‐being have been cross‐sectional and thus unable to determine the direction of causation or to rule out all possible confounding variables. However, two random‐assignment studies on late adolescents and adults found that limiting social media use lowered depressive symptoms (37, 38), and another study found that even 20 minutes of social media use lowered happiness (39). These studies suggest that at least some of the increase in mental health issues has been driven by social media use. More research is needed on the effect of social media on adolescent mental health, especially with larger and more representative samples.

Displacement of In‐Person Social Interaction (Generational Level)

Displacement is usually understood at the individual level: if an individual spends more time on digital media, she or he has less time to spend on other activities. However, because many activities compete for time, digital media time and in‐person time are not mutually exclusive. For example, likely because of individual differences in sociability, adolescents who spend more time on social media also spend more time with friends in person (7). Their social interaction time, both online and offline, may displace time that might otherwise have been spent on homework, paid work, or other activities.
However, displacement can also take place at the group or generation level, where the focus is on the behavior of the average teen in one year versus another year. For example, among adolescents, as average time spent on digital media rose after 2010, average time spent in person declined (7), even though time spent on paid work, homework, and extracurricular activities declined or stayed steady (40). This finding suggests that digital media time displaced in‐person time at the generation level; the cultural norm for adolescents shifted away from in‐person interaction and toward digital interaction.
This change in cultural norms has implications for mental health across the adolescent population. Even if an individual adolescent chooses not to use digital media or to use it lightly—thus achieving immunity from individual‐level effects on mental health—the prevailing cultural norm may have an impact. Imagine Emma, a 13‐year‐old in 2020 who does not use social media. Social media use cannot increase Emma's depression directly (at the individual level) because her use is zero. At the group level, however, Emma is affected. If Emma would rather see her friends in person instead of communicating via social media (as was the norm in the 1990s and earlier), she may be unsuccessful. Who will she go out with if her friends are all at home on Instagram? Thus, the mental health of many adolescents, not just heavy social media users, may suffer over time as the culture of adolescent social life changes. Future research should examine group‐level effects of changes in social norms (e.g., in‐person versus digital communication) among adolescents.
It is not likely that the displacement of in‐person social interaction at the group level affects all age groups equally. For example, social interactions among adolescents likely have changed more profoundly than those among adults. Adolescent culture centers around peers of similar age, so generational shifts will be more apparent and consistent among adolescents than among middle‐aged and older adults, who are more likely to have relationships with people of varying ages. It is not likely that time spent in in‐person social interaction has changed as much among middle‐aged and older adults as among adolescents, which may be one reason mental health trends since 2012 have been more negative for adolescents and young adults compared with older individuals. Impacts may also differ by gender. Girls spend more time on social media, and boys spend more time playing online games. If social media use is more strongly associated with depression than game playing is and is more strongly associated with depression among girls (23, 41), that may explain why depression rates have increased more sharply among girls. Changes in social interaction may also have more impact on girls than boys. Girls tend to spend more time in friendship dyads whereas boys spend more time in groups (42), and girls focus more on social relationships and popularity than boys do (43), especially during adolescence (44). Girls’ friendships are both more intimate (45) and more fragile (46) than those of boys. Perhaps as a result, adolescent girls’ moods are more influenced by interpersonal events than are boys’ moods (47, 48). Thus, trends in social interaction are likely to have a larger impact on girls’ mental health than on that of boys, and the increases in mental health issues have, in fact, been larger among girls and young women.

Interference With In‐Person Social Interaction

Unlike previous technological innovations, such as television, smartphones are portable and are often present during social interactions. A series of studies has demonstrated that the presence of a smartphone during social interactions lessens enjoyment of the activity and decreases pleasant interactions among people (49, 50, 51). In addition, several studies have established the negative emotions associated with having one's interaction partners looking at their phones—an action known as phubbing (a combination of “phone” and “snubbing”) (52). Thus, digital media can directly interfere with the benefits of in‐person social interaction when it does occur.

Interference With Sleep

Time spent on digital media may also displace sleep time. This displacement has been shown at the generational level, where the amount of sleep among adolescents began to fall around 2012 (53), and at the individual level, where those who use digital media more frequently sleep less (54, 55). Randomized controlled trials (56) also show shorter and compromised sleep after digital media use. Digital media use may also increase sleep latency (the time it takes to fall asleep) and sleep quality, because the blue light from devices suppresses melatonin production (57). Shortened and poor quality sleep are known risk factors for mental health issues, especially depression (58). Future research should explore how digital media use affects sleep, especially whether engaging in different digital media activities immediately before bedtime (e.g., social media use versus playing games) has differing effects.

Cyberbullying and Toxic Environments

Many adolescents experience cyberbullying (i.e., bullying via digital media). As digital media use has become the norm, more adolescents are vulnerable to cyberbullying for more hours. Cyberbullying is a significant risk factor for suicidal ideation and attempts (59) and has been identified as a key mediator for the link between social media use and mental health (60).
Even if online behavior does not reach the level of cyberbullying, online environments can become uncivil more quickly than in‐person environments (61, 62). Digital media gives the impression of anonymity, which can result in an increase in incivility and aggressive behavior known as the online disinhibition effect (63). Social media may also foster unhealthy amounts of social comparison, with users feeling that their lives do not measure up to the lives of others (64, 65). In particular, social media comparison may increase body image concerns, especially among girls (9).

Self‐Harm Information and Contagion

Although there are many advantages of instant access to information via the Internet, that accessibility also means that adolescents can easily find information about self‐harm and suicide techniques (for example, via YouTube) (66). With more children and younger adolescents having their own smartphones, more may have access to information about self‐harm. This access may fuel contagion behaviors, with adolescents encouraging each other to self‐harm and self‐harm appearing popular (14). This mechanism may operate relatively independently from the amount of time spent on digital media, because children and adolescents may access self‐harm information quickly. Thus, the connection between digital media and self‐harm may be more about the specific activities engaged in online, rather than about how much time adolescents spend online.
Practitioners may need to consider digital media use when counseling adolescents who have mental health issues, particularly depression and self‐harm behavior. Suggestions such as keeping devices out of the bedroom at night, not using devices within an hour of sleep time, and limiting digital media use during leisure time to ≤2 hours a day may be warranted. In most cases, limiting (rather than eliminating) device use may be the best course, but in more acute cases (such as self‐harm contagion) elimination of device use for a period of time may be necessary. More research is needed to explore therapy and treatment techniques for situations in which digital media use may be contributing to mental health issues, and randomized controlled trials are needed to explore the effectiveness of the above suggestions.

Conclusions

In conclusion, we are in the midst of a mental health crisis among adolescents in the United States. This crisis will necessitate more resources for treatment in the coming years and potentially far into the future, given that those who experience their first episode of depression as adolescents are more likely to relapse as adults (67). The cause of this crisis is difficult to determine, but the rise of digital media is one possibility. The interaction between digital media use and mental health is complex, appearing to operate directly and indirectly, at the individual and generational levels, and via time spent as well as through specific experiences. With more adolescents diagnosed as having depression and engaging in self‐harm behavior and suicide attempts, it is imperative to not only treat those with these conditions but to explore how to prevent their onset.

Footnote

Dr. Twenge has received honoraria or consulting fees from Barrett Asset Management, Porter Wright, Verizon, and Jana Partners. She has received royalties from Simon & Schuster, McGraw‐Hill Higher Education, and Pearson Education.

References

REFERENCES

1.
Anderssen E: Why are today's teenagers feeling so anxious? The Globe and Mail, January 21, 2013. https://www.theglobeandmail.com/life/health-and-fitness/health/conditions/why-are-todays-teenagers-feeling-so-anxious/article7604612. Accessed Feb 28, 2020.
2.
Novotney A: Students under pressure: college and university counseling centers are examining how best to serve the growing number of students seeking their services. Monitor on Psychology 2014; 45:36
3.
Lauriello S: The real reason record numbers of college students are seeking mental health treatment. Health.com. https://www.health.com/condition/depression/anxiety-depression-college-university-students. Accessed January 25, 2019.
4.
Collishaw S: Annual research review: secular trends in child and adolescent mental health. J Child Psychol Psychiatry 2015; 56: 370–393
5.
Duffy, ME, Twenge, JM, Joiner, TE: Trends in mood and anxiety symptoms and suicide‐related outcomes among US undergraduates, 2007–2018: evidence from two national surveys. Journal of Adolescent Health 2019; 65:590–598
6.
Twenge JM, Martin GN, Campbell WK: Decreases in psychological well‐being among American adolescents after 2012 and links to screen time during the rise of smartphone technology. Emotion 2018; 18:765–780
7.
Twenge JM, Spitzberg BH, Campbell WK: Less in‐person social interaction with peers among US adolescents in the 21st century and links to loneliness. J Soc Pers Relat 2019; 36:1892–1913
8.
Keyes KM, Gary D, O'Malley PM, et al: Recent increases in depressive symptoms among US adolescents: trends from 1991 to 2018. Soc Psychiatry Psychiatr Epidemiol 2019; 54:987–996
9.
Twenge JM, Joiner TE, Rogers ML, et al: Increases in depressive symptoms, suicide‐related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clin Psychol Sci 2018; 6:3–17
10.
Mojtabai R, Olfson M, Han B: National trends in the prevalence and treatment of depression in adolescents and young adults. Pediatrics 2016; 138:e20161878
11.
Twenge JM, Cooper AB, Joiner TE, et al: Age, period, and cohort trends in mood disorder indicators and suicide‐related outcomes in a nationally representative dataset, 2005–2017. J Abnorm Psychol 2019; 128:185–199
12.
Mercado MC, Holland K, Leemis RW, et al: Trends in emergency department visits for nonfatal self‐inflicted injuries among youth aged 10 to 24 years in the United States, 2001–2015. JAMA 2017; 318:1931–1933
13.
Plemmons G, Hall M, Doupnik S, et al: Hospitalization for suicide ideation or attempt: 2008–2015. Pediatrics 2018; 141:e20172426
14.
Spiller HA, Ackerman JP, Spiller NE, et al: Sex‐ and age‐specific increases in suicide attempts by self‐poisoning in the United States among youth and young adults from 2000 to 2018. J Pediatr 2019; 210:201–208
15.
Burstein B, Agostino H, Greenfield B: Suicidal attempts and ideation among children and adolescents in US emergency departments, 2007–2015. JAMA Pediatr 2019; 173:598–600
16.
Ruch DA, Sheftall AH, Schlagbaum P, et al: Trends in suicide among youth aged 10 to 19 years in the United States, 1975 to 2016 JAMA Netw Open 2019; 2:e193886
17.
Twenge JM : iGen: Why Today's Super‐Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy—and Completely Unprepared for Adulthood. New York, Atria Books, 2017
18.
Twenge JM: Why increases in adolescent depression may be linked to the technological environment. Curr Opin Psychol 2019; 32:89–94
19.
Luby J, Kurtz S: Increasing suicide rates in early adolescent girls in the United States and the equalization of sex disparity in suicide: the need to investigate the role of social media. JAMA Netw Open 2019; 2:e193916
20.
Fact Sheet Internet and Technology. Washington, DC, Pew Research Center, 2019. https://www.pewinternet.org/fact-sheet/mobile. Accessed Feb 28, 2020.
21.
Twenge JM, Martin GN, Spitzberg BH: Trends in US adolescents’ media use, 1976–2016: the rise of digital media, the decline of TV, and the (near) demise of print. Psychology of Popular Media Culture 2019; 8:329–345
22.
Uhls YT, Ellison NB, Subrahmanyam K: Benefits and costs of social media in adolescence. Pediatrics 2017; 140(suppl 2):S67–S70
23.
Kelly Y, Zilanawala A, Booker C, et al: Social media use and adolescent mental health: findings from the UK Millennium Cohort Study. EClinicalMedicine 2019; 6:59–68
24.
Lin LY, Sidani JE, Shensa A, et al: Association between social media use and depression among US young adults. Depress Anxiety 2016; 33:323–331
25.
Przybylski AK, Weinstein N: A large‐scale test of the Goldilocks hypothesis. Psychol Sci 2017; 28:204–215
26.
Riehm KE, Feder KA, Tormohlen KN, et al: Associations between time spent using social media and internalizing and externalizing problems among US youth. JAMA Psychiatry 2019; 1–9
27.
Sampasa‐Kanyinga H, Lewis RF: Frequent use of social networking sites is associated with poor psychological functioning among children and adolescents. Cyberpsychol Behav Soc Netw 2015; 18:380–385
28.
Twenge JM, Campbell WK: Media use is linked to lower psychological well‐being: evidence from three datasets. Psychiatr Q 2019; 90:311–331
29.
Twenge JM: More time on technology, less happiness? Associations between digital media use and psychological well‐being. Curr Dir Psychol Sci 2019; 28:372–379
30.
Baumeister RF, Leary MR: The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull 1995; 117:497–529
31.
Ferguson CJ: Everything in moderation: moderate use of screens unassociated with child behavior problems. Psychiatr Q 2017; 88:797–805
32.
Orben A, Przybylski AK: The association between adolescent well‐being and digital technology use. Nat Hum Behav 2019; 3:173–182
33.
Rohrer JM: Thinking clearly about correlations and causation: graphical causal models for observational data. Adv Methods Pract in Psychol Sci 2018; 1:27–42
34.
Funder DC, Ozer DJ: Evaluating effect size in psychological research: sense and nonsense. Adv Methods Pract in Psychol Sci 2019; 2:156–168
35.
Twenge JM, Haidt J, Joiner TE, et al: Meaningful associations between digital technology use and adolescent well‐being: comment on Orben and Przybylski. Nat Hum Behav (in press)
36.
Reuben A, Caspi A, Belsky DW, et al: Association of childhood blood lead levels with cognitive function and socioeconomic status at age 38 years and with IQ change and socioeconomic mobility between childhood and adulthood. JAMA 2017; 317:1244–1251
37.
Hunt MG, Marx R, Lipson C, et al: No more FOMO: limiting social media decreases loneliness and depression. J Soc Clin Psychol 2018; 37:751–768
38.
Tromholt M: The Facebook experiment: quitting Facebook leads to higher levels of well‐being. Cyberpsychol Behav Soc Netw 2016; 19:661–666
39.
Yuen EK, Koterba EA, Stasio MJ, et al: The effects of Facebook on mood in emerging adults. Psychol Pop Media Cult 2019; 8:198–206
40.
Twenge JM, Park H: The decline in adult activities among US adolescents, 1976–2016. Child Dev 2019; 90:638–654
41.
Twenge JM, Martin GN: Gender differences in associations between digital media use and psychological well‐being: evidence from three large datasets. J Adolesc 2020; 79:91–102
42.
Rose AJ, Rudolph KD: A review of sex differences in peer relationship processes: potential trade‐offs for the emotional and behavioral development of girls and boys. Psychol Bull 2006; 132:98–131
43.
Watkins D, Cheng C, Mpofu E, et al: Gender differences in self‐construal: how generalizable are Western findings? J Soc Psychol 2003; 143:501–519
44.
LaFontana KM, Cillessen AHN: Developmental changes in the priority of perceived status in childhood and adolescence. Soc Dev 2010; 19:130–147
45.
Rose AJ: Co‐rumination in the friendships of girls and boys. Child Dev 2002; 73:1830–1843
46.
Benenson JF, Christakos A: The greater fragility of females’ versus males’ closest same‐sex friendships. Child Dev 2003; 74:1123–1129
47.
Flook L: Gender differences in adolescents’ daily interpersonal events and well‐being. Child Dev 2011; 82:454–461
48.
Shih JH, Eberhart NK, Hammen CL, et al: Differential exposure and reactivity to interpersonal stress predict sex differences in adolescent depression. J Clin Child Adolesc Psychol 2006; 35:103–115
49.
Dwyer R, Kushlev K, Dunn E: Smartphone use undermines enjoyment of face‐to‐face social interactions. J Exp Soc Psychol 2018; 78:233–239
50.
Kushlev K, Hunter JF, Proulx J, et al: Smartphones reduce smiles between strangers. Comput Human Behav 2019; 91:12–16
51.
Przybylski AK, Weinstein N: Can you connect with me now? How the presence of mobile communication technology influences face‐to‐face conversation quality. J Soc Pers Relat 2013; 30:237–246
52.
Roberts JA, David ME: My life has become a major distraction from my cell phone: partner phubbing and relationship satisfaction among romantic partners. Comput Human Behav 2016; 54:134–141
53.
Twenge JM, Krizan Z, Hisler G: Decreases in self‐reported sleep duration among US adolescents 2009–2015 and association with new media screen time. Sleep Med 2017; 39:47–53
54.
Hale L, Guan S: Screen time and sleep among school‐aged children and adolescents: a systematic literature review. Sleep Med Rev 2015; 21:50–58
55.
Twenge JM, Hisler GC, Krizan Z: Associations between screen time and sleep duration are primarily driven by portable electronic devices: evidence from a population‐based study of US children ages 0–17. Sleep Med 2019; 56:211–218
56.
Chang A‐M, Aeschbach D, Duffy JF, et al: Evening use of light‐emitting eReaders negatively affects sleep, circadian timing, and next‐morning alertness. Proc Natl Acad Sci USA 2015; 112:1232–1237
57.
Wood B, Rea MS, Plitnick B, et al: Light level and duration of exposure determine the impact of self‐luminous tablets on melatonin suppression. Appl Ergon 2013; 44:237–240
58.
Lovato N, Gradisar M: A meta‐analysis and model of the relationship between sleep and depression in adolescents: recommendations for future research and clinical practice. Sleep Med Rev 2014; 18:521–529
59.
Sampasa‐Kanyinga H, Roumeliotis P, Xu H: Associations between cyberbullying and school bullying victimization and suicidal ideation, plans and attempts among Canadian schoolchildren. PLoS One 2014; 9:e102145
60.
Viner RM, Gireesh A, Stiglic N, et al: Roles of cyberbullying, sleep, and physical activity in mediating the effects of social media use on mental health and well‐being among young people in England: a secondary analysis of longitudinal data. Lancet Child Adolesc Health 2019; 3:685–696
61.
Anderson A, Brossard D, Scheufele DA, et al: The “nasty effect”: online incivility and risk perceptions of emerging technologies. J Comput Mediat Commun 2014; 19:373–387
62.
Antoci A, Delfino A, Paglieri F, et al: Civility vs incivility in online social interactions: an evolutionary approach. PLoS One 2016; 11:e0164286
63.
Lapidot‐Lefler N, Barak A: Effects of anonymity, invisibility, and lack of eye contact on toxic online disinhibition. Comput Human Behav 2012; 28:434–443
64.
Chou H‐TG, Edge N: “They are happier and having better lives than I am”: the impact of using Facebook on perceptions of others’ lives. Cyberpsychol Behav Soc Netw 2012; 15:117–121
65.
Krasnova H, Widjaja T, Buxmann P, et al: Why following friends can hurt you: an exploratory investigation of the effects of envy on social networking sites among college‐age users. Inf Syst Res 2015; 26:585–605
66.
Lewis SP, Heath NL, St Denis JM, et al: The scope of nonsuicidal self‐injury on YouTube. Pediatrics 2011; 127:e552–e557
67.
Garcia‐Toro M, Rubio JM, Gili M, et al: Persistence of chronic major depression: a national prospective study. J Affect Disord 2013; 151:306–312

Information & Authors

Information

Published In

Go to Psychiatric Research and Clinical Practice
Psychiatric Research and Clinical Practice
Pages: 19 - 25

History

Received: 13 June 2019
Revision received: 23 December 2019
Accepted: 8 January 2020
Published online: 27 March 2020
Published in print: Summer 2020

Keywords

  1. depression
  2. self‐harm
  3. suicide
  4. digital media
  5. social media

Authors

Details

Jean M. Twenge, Ph.D.
Department of Psychology, San Diego State University, San Diego

Notes

Correspondence
Dr. Twenge
Email: [email protected]

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