Impacts of digital media use on children and young people's mental health and wellbeing: evidence review

Findings

2 Digital media use and mental health and wellbeing across developmental stages

Children and young people engage with digital media in different ways as they progress through childhood and adolescence. This section explores associations between digital media use and various mental health and wellbeing outcomes reported in the literature, presented according to developmental stages. The age ranges used to define developmental stages are approximate, reflecting variation in how age groups are defined across the literature. Studies are presented within the developmental stage most relevant to their sample and research focus.

2.1 Early years

Screen exposure commonly begins in the first year of life and by 24 months is reported to be widespread, shaped by parental use and shifting social attitudes towards screen time (Clayton et al., 2026). During the early years, here broadly defined as an age range of 0-4 years, literature predominantly considers associations between screen exposure and language, development and behavioural outcomes.

2.1.1 Development

Though some literature highlights potentially beneficial features of screen exposure for development, such as educational programmes or e-books supporting creativity and problem solving (Kar et al., 2025, OECD, 2025), authors also describe adverse impacts. Three studies included in a UK systematic review demonstrate associations between regular screen exposure in the early years with poorer executive function and weaker cognitive and socio-emotional development (Clayton et al., 2026). A longitudinal cohort study from New Zealand involving 6,131 children examined patterns of screen exposure from age 9 months to 8 years. Among participants, low and late-onset screen exposure profiles were associated with higher levels of language skills at age five. In contrast, high exposure was associated with lower levels of language skills and education skills (Gath et al., 2026).

2.1.2 Social and relational factors

Gath et al.’s (2026) longitudinal study also found an association between persistently high screen exposure across early childhood with greater peer relationship difficulties and lower prosocial behaviour, such as sharing, at age 8. It has been suggested that higher screen time may contribute to developmental delay by reducing opportunities for peer-play (Clayton et al., 2026). Two reviews considered potential associations between screen exposure and attention (OECD, 2025, Clayton et al., 2026), although the mechanisms linking screen time to attention difficulties are not well understood.

A recent longitudinal study drawing on Australian birth cohort data complicates relationships between screen time and behavioural and developmental outcomes. Analysis of behavioural and developmental birth cohort data for 887 children at age 2-3 years found that maternal and child screen use at 1 year of age were inconsistently and weakly related to child behavioural and developmental outcomes at 3 years. Poorer maternal mental health had a more consistent and stronger association with poorer behavioural outcomes than screen use, with family factors including maternal education and socioeconomic status also implicated in outcomes for children in this study (Sim et al., 2025).

Authors have suggested that the type and timing of screen exposure may also be important. A Portuguese cross-sectional study of 940 children with a mean age of 4 years found that smartphone exposure at 2 years or younger was associated with higher socio-emotional difficulties than for those exposed after age 2 (Männikkö et al., 2026). This is supported by longitudinal research finding that children with very low screen exposure during this developmental stage, even if exposure increased later, had better language outcomes than children with high early exposure (Gath et al., 2026). Männikkö et al. (2026) found that different types of digital media engagement may also matter, with television exposure at 2 years or younger not related to socio-emotional difficulties in their sample. Beyond duration, content, context and timing of screen use may therefore influence outcomes in this age group.

2.1.3 Physical health

A systematic review highlights evidence linking digital media use to physical health outcomes in this age group, including those with implications for later-life health, such as weight. Evidence suggests screen time and lower levels of outdoor activity are associated with eye health outcomes, including myopia (Clayton et al., 2026).

2.2 Older children

In this section, older childhood comprises experiences at approximately 5-12 years of age. Literature exploring this developmental stage demonstrates that digital media use increases with age (Priftis and Panagiotakos, 2023, Clayton et al., 2026, Krammer et al., 2026). For example, a Scottish longitudinal study tracking an initial cohort of 3,786 children at age 5, 10 and 15 years in Scotland found that the number spending 3 hours or more on total screen use per day increased from 944 (25.0%) at 5 years of age to 1,638 (52.4%) at 10 years of age (McQuaid et al., 2026).

2.2.1 Wellbeing

Reflecting approaches in the early years literature, studies exploring digital media use in older childhood largely consider screen exposure. Datasets from Turkey and Italy demonstrated associations with lower psychological wellbeing in 216 children with a mean age of 11 (Ünlü et al., 2026), and poorer psychosomatic health among 4,525 children aged 7-10 years (Barbieri et al., 2024) respectively. A cross-sectional study from Sweden, which entailed completion of a revised Children's Anxiety and Depression Scale by 4,002 children aged 8-17, also found increased symptoms of anxiety and depression, but only after 1–2 hours of screen time per day (Carlander et al., 2026). Data from the nationally representative Canadian Health Survey on Children and Youth highlights impacts for girls specifically. Analysis of 2019 data from 26,986 participants found girls who met recreational screen time recommendations were less likely to have a caregiver report that they often appeared sad or depressed, or that they had been diagnosed with an anxiety disorder, than girls who exceeded the recommendation of 2 hours or more (Toigo et al., 2025).

2.2.2 Behavioural impacts

One systematic review considered the impacts of digital media on wellbeing at age 4-6 years. Meta-analysis of data from 5 studies demonstrated that higher use of digital technology was associated with poorer social functioning, including poorer relationships with peers. However, there was no relationship between digital technology use and social competence, such as communication skills (Harverson et al., 2025). Data from the 2022 US National Health Interview Survey found that 70% of 4,932 participants aged 6-17 years had more than two hours of screen time per day. The study reported significant associations between screen time and emotional symptoms, conduct problems and peer relationship issues in both children and adolescents (Yu et al., 2025).

2.2.3 Physical health

A narrative review of 43 studies found associations between over 2 hours of daily screen time with cardiometabolic risk factors. The authors report a correlation between myopia and eyestrain with screen time, however, the reviewed literature was not conclusive. Migraines, impacts on bone health and neck and back pain were also linked to excessive screen time (Priftis and Panagiotakos, 2023).

2.2.4 Family contexts

Family contexts appear to shape the relationship between digital media use and wellbeing during childhood. A Finnish cross-sectional study with 671 children found that high levels of screen time were associated with attention and concentration difficulties, hyperactivity and impulsivity symptoms, as well as psychological symptoms among 5-year-olds. Associations remained despite controlling for parental factors including mental health and parenting style. However, the association between children’s screen time and psychosocial symptoms was more pronounced when mothers displayed symptoms of depression or stress (Niiranen et al., 2024). The significance of parental stress in influencing relationships between digital media use and children’s wellbeing is echoed in a longitudinal study of 1,319 US children aged 5, 9 and 15 (Kim et al., 2024). The authors found relationships between screen time, language ability and poor behaviour were more pronounced where there were high levels of parenting stress^[1].

Similar patterns are reported in a systematic review of 16 studies focused on social media use by children aged 6-13 years (Liu et al., 2024b). The authors found associations between frequent social media use and lower self-esteem, depressive symptoms, anxiety and other mental health challenges amongst older children in their sample. These impacts were influenced by age and gender, but also family support and parental involvement.

We have seen that literature on screen exposure during childhood echoes associations with poorer psychosocial, behavioural and wellbeing outcomes seen in the early years literature. However, it has also begun to engage more with screen use, not just time spent. This continues in the literature on adolescence.

2.3 Early adolescence

Reviewed literature exploring this period of development (approximately 11-15 years) looks further beyond screen time alone, considering different ways early adolescents engage with digital media and their reasons for doing so. This literature also more often explores potential benefits of digital media use.

2.3.1 Associations between digital media use and wellbeing

Overall, digital media use is again associated with poorer wellbeing among this age group. Several studies demonstrated a ‘dose response’ relationship with screen time, reporting that as screen time increased, so did symptoms of anxiety, depression and stress (Toigo et al., 2025). A Brazilian cross-sectional study with 982 adolescents aged 12-15 years found this was particularly pronounced for those spending 4 to 6 hours per day, and more than 6 hours per day on screens. These adolescents had a significant increase in symptoms of depression of 35% and 88% respectively, compared to those who met the recommendations of up to two hours per day (Francisquini et al., 2025).

Looking more closely at type of use rather than screen time, an Italian study considered digital media use for both school and private purposes among 4,525 children and adolescents according to two groups, aged 7-10 and 11-19 years. The authors found that higher levels of digital media use were associated with poorer psychosomatic wellbeing in both age groups. Associations were generally stronger for private use, particularly among the older age group (Barbieri et al., 2024). This study indicates that both age and type of screen use can impact associations between digital media and wellbeing. Age is also highlighted in a recent Australian longitudinal study, drawing on a sample of 1,195 adolescents completing annual surveys over 10 years. The authors found that more than 2 hours of social media use per day was associated with higher depressive symptoms and poorer wellbeing 1 year later, with increased risk most pronounced during early adolescence (11-13 years). The authors therefore suggest this could be a key period of vulnerability to social media-related harms (Vijayakumar et al., 2026).

2.3.2 Variation across study methodologies

Whilst several studies identified associations between digital media use during early adolescence and poorer mental health and wellbeing, the strength and consistency of these associations varied according to study design and measurement. Some studies reported weak or no associations, particularly when examining outcomes longitudinally or when accounting for wider contextual factors (Cheng et al., 2026, Bruneel et al., 2026).

Of interest to the Scottish context, McQuaid et al. (2026) analysed data from the Growing Up in Scotland birth cohort, following an initial cohort of 3,786 children at ages 5, 10 and 15 years between 2010 and 2020. The authors report limited and inconsistent associations between screen use and psychosocial development after adjusting for a wide range of family, socioeconomic and parent–child relationship factors. Most screen use was not associated with poorer psychosocial outcomes. Longitudinal analyses found that very high levels of screen use (more than 5 hours per day) at age 5 were associated with greater emotional and behavioural difficulties at age 10, however, this association did not persist to age 15. The authors suggest that guidelines focusing on screen time alone may be unlikely to improve psychosocial outcomes.

Variation in findings may be explained in part by methodology. Many studies cited above rely on cross-sectional measures at a single point in time. This limits the ability to draw conclusions about causality, or about the direction of the relationship between poorer mental health and wellbeing outcomes with digital media use. Longitudinal studies, such as those by Cheng et al. (2026) and McQuaid et al. (2026) have reported weaker associations than cross-sectional analyses. For example, whilst an Australian study of 3,205 adolescents aged 14-16 years found some evidence of cross-sectional associations between posting on social media and high psychological distress, there was little to no evidence of association longitudinally (Smout et al., 2026). Secondary analysis of data from 6,767 participants in the US National Longitudinal Study of Adolescent to Adult Health identified four trajectories of digital media use over time. The authors found little evidence that these predicted most mental health outcomes in young adulthood. Significant associations were limited to suicide attempts and short-term memory issues, and these were observed only among participants with persistently high levels of digital media use. The authors conclude that digital media use may therefore be one of several contextual factors associated with mental health, rather than a primary independent driver of anxiety or depression-related outcomes (Watson et al., 2026).

Li et al. (2025) also explored impacts of digital media use longitudinally, among 4,058 Australian adolescents with a mean age of 13 years. The authors found that higher levels of screen time were associated with depression when measured at the same point in time, but these associations weakened when measured 12 months later. Screen time was also associated with anxiety cross-sectionally, but not longitudinally. The authors therefore argue that depression and anxiety may influence screen use as much as screen use influences symptoms, indicating a bidirectional relationship rather than a simple causal pathway. They question whether measures of screen time are useful in examining these relationships.

2.3.3 Screen time as a measure of digital media use

Whether duration of use is the most informative measure of digital media engagement has also been questioned by other researchers. Studies have found that different forms of digital engagement have different associations with different outcomes. Passive scrolling has been more consistently associated with poorer mental health, whereas more active forms of engagement, such as posting content, have shown weaker associations (Choi et al., 2025). Problematic use is also differentiated in the literature. An Austrian study of 612 adolescents demonstrates associations between problematic use and dysphoria, agitated behaviour and fatigue (Krammer et al., 2026). Adolescents have also reported beneficial effects of some types of use, with screen time with friends found to mediate feelings of loneliness (Wang and Lee, 2026). These authors therefore argue that the relationship between digital media use and wellbeing may depend not only on type or duration of use, but also on the nature of engagement (see also Amaad and Mughal, 2026).

The complexity of this relationship is explored further by Mayen et al. (2025), drawing on a sample of 343 Austrian students. The authors found that associations between adolescents’ social media use and wellbeing differed depending on whether this was analysed between individuals, or within the same individual over time. Consistently high users of social media reported poorer affective wellbeing than their peers overall. However individual adolescents reported better affective wellbeing during periods when they used more social media than usual. This suggests that relationships between social media use and wellbeing may differ between individuals and within individuals over time, highlighting the complexity of interpreting associations between digital media use and mental health. The authors therefore propose that the implications of use may vary across young people, and that there may be a ‘sweet spot’ for digital media use.

2.3.4 The ‘Goldilocks hypothesis’

Mayen et al.’s (2025) conclusion supports the ‘Goldilocks hypothesis’, which proposes some screen time may be beneficial for children, but very high and very low levels may be detrimental to their mental health (Carlander et al., 2026). This relationship is demonstrated in a large study with 15 year olds across 24 countries. Analysing data on life satisfaction and 5 categories of social media use (from 0 hours up to 5+ hours), the authors reported not a linear, but an inverted ‘J-shaped’ relationship across their sample of almost 159,185 participants. Life satisfaction was highest amongst those with some social media use (1 to 3 hours per day), but lower amongst those with no engagement and those who used it heavily (Nennstiel and Ullrich, 2026).

The notion that digital media use may have potentially beneficial effects at moderate levels is explored further using data from the Canadian Health Behaviour in School-aged Children (HBSC) study, representing 13,113 adolescents aged 11-15 years (Clayborne et al., 2025). This research examined associations between social media use and positive mental health, contrasting with a tendency in the literature to analyse indicators of poor mental health and wellbeing. Whilst intense social media use was associated with lower life satisfaction, non-problematic, active use of social media was not generally associated with poorer mental health outcomes. The study therefore suggests that the relationship between social media and mental health depends not only on how much social media is used, but also on how it is used and which measures of mental health are considered.

Echoing this, HBSC data from 2010 and 2014 comprising 380,446 young people across 37 countries also found different types of screen time were associated with different wellbeing impacts. Low amounts of screen time spent watching television or videos were associated with positive life satisfaction (Khan et al., 2023). This data preceded the development of many smartphone applications widely used by this age group today, so the findings warrant caution. However, this study echoes others regarding potentially beneficial impacts of lower levels of digital media use, with poorer outcomes associated with very high use.

2.3.5 Diverse experiences of digital media

The literature reviewed for this report highlights variation in how individual children and young people experience digital media, including evidence of both positive and negative associations with educational and social outcomes. A German longitudinal study of 384 children and adolescents aged 10-14 years found nighttime smartphone use to be associated with attention problems over time, but also found a positive association with school performance. The authors suggest that this finding may be shaped by individual or school-related factors (Stevic et al., 2024). The Finnish Physical Activity and Nutrition in Children (PANIC) study followed 260 children for 8 years up to age 17 years, and reported that higher self-reported screen time during childhood was associated with better performance in tests of working memory and overall cognition in adolescence (Jalanko et al., 2026). Finally, a Norwegian study with 3,456 children found that between ages 10-14 years, greater social media use was associated with more time spent with friends offline. This suggests that social media may be used to maintain peer relationships and communication. At 16 to 18 years, these activities stabilised then declined (Steinsbekk et al., 2024). This highlights the importance of considering developmental stage when examining patterns of digital media use.

Qualitative studies can provide insight into why digital media use is associated with different experiences and outcomes for different young people. In one ethnographic study in the United States, 75 participants aged 10-14 years described using social media for a range of reasons including information-sharing, skill development and entertainment (Sanchez and Jenkins, 2024). Reasons and patterns of use were shaped by peer relationships and family contexts. The authors therefore argue that framing digital media use in adolescence as either harmful or beneficial reduces the complexity of lived experience.

2.4 Later adolescence

The reviewed literature on later adolescence, exploring digital media use at approximately 15-18 years, considers a wider range of mental health and wellbeing outcomes than in younger age groups. Anxiety and depression were the most commonly examined outcomes, though one literature review also considered body dissatisfaction, eating disorders, self-harm and suicidal ideation (Agyapong-Opoku et al., 2025). As with earlier developmental stages, findings could vary, with some studies reporting associations between digital media use and poorer mental health, while others identifying benefits or no clear relationship.

2.4.1 Variation in associations between digital media use and mental health and wellbeing

Associations during later adolescence vary according to both the mental health outcome examined and the type of digital engagement measured. For example, an Australian study with 1,319 students aged 13-18 years considered a range of mental health and wellbeing impacts. Those reporting higher frequency of social media posting had higher psychological distress at follow up, as well as increases in self-harm thoughts and behaviours. However, the authors did not find significant differences for eating disorder risk, life satisfaction and resilience, between frequent and non-frequent users. This was contrary to their hypothesis and to findings from previous research (Radunz et al., 2025). Variation in study findings is further illustrated by an analysis of 24 studies on associations between social media use and mental disorders in adolescents and young adults (Cabezas-Klinger et al., 2025). This study considered a range of different harms identified in the literature, including harmful content, sleep disruption and cyberbullying. Meta-analysis demonstrated extremely high heterogeneity, indicating that the strength of associations between social media and poor mental health varied across studies.

As well as attending to different measures of mental health and wellbeing, several studies suggest that associations between digital media use and wellbeing depend on type of use. A Spanish study with 632 adolescents found that probabilities of psychosocial health problems were higher among participants with high Instagram, Facebook, Snapchat and TikTok use, whereas significant associations were not found for Whatsapp and Twitter (Brand et al., 2024). The Whatsapp finding is supported by a large cross-sectional survey of adolescents from Norway. Those with high mental wellbeing were more likely to report increased engagement in social media activities related to social orientation and group chatting, suggesting this may be a ‘healthy’ digital activity (Reiten Finserås et al., 2025). Both of these studies were conducted during the COVID-19 pandemic, so should be interpreted in the context of wider changes to adolescent interaction during this time.

The above studies have interrogated different types of use, and varied wellbeing outcomes. They indicate that the relationship between social media use and mental health outcomes is not straightforward, and some authors suggest that wider contextual factors may play an important role.

2.4.2 The role of contextual factors in associations between digital media use and mental health and wellbeing

Several studies suggest that associations between digital media use and mental health and wellbeing are shaped by wider social and behavioural contexts. A Swedish survey of 3,566 adolescents aged 16-17 years found that while spending more than six hours per day on social media, gaming and video viewing was associated with poorer mental health outcomes and physical symptoms, these associations were substantially reduced after accounting for sociodemographic factors and health behaviours (Frielingsdorf et al., 2025). The authors also found that digital media use for schoolwork was associated with few adverse outcomes, indicating that the purpose of digital engagement may be important.

Similar conclusions are reported elsewhere. Analysis of Portuguese HBSC data from 7,643 adolescents found that those with higher wellbeing, stronger stress management skills, greater physical activity, higher socioeconomic status and supportive relationships with family and teachers were less likely to report problematic or dependent social media use (Gaspar et al., 2023). Echoing this, recent analysis of ‘Planet Youth’ survey data comprising 2,876 responses from adolescents aged 15-16 years found that the most significant predictors of wellbeing and mental health were issues such as feeling safe in school and at home, and having support from parents/guardians and peers, rather than time spent on social media (Whelan, 2026). These findings suggest that rather than digital media use acting as an independent influence on mental health and wellbeing, wider personal, social and environmental factors may shape this relationship.

2.5 Emerging Adulthood

Fewer studies on emerging adulthood, defined here as between 19-25 years, were identified than for other age groups in this review. The available evidence suggests that associations between digital media use and mental health and wellbeing continue into early adulthood, but findings remain mixed and are shaped by wider social and demographic factors.

Studies again highlighted that age may influence associations between digital media use and mental health. For example, a Canadian study of 15,235 young people aged 15-24 years found higher screen time to be associated with adverse impacts on mental health across their sample. These associations were stronger for younger participants, suggesting that age moderated the relationship between screen time and mental health (Atwal and Browne, 2024). Associations were also more pronounced among those from lower income households, and contrary to existing literature, stronger associations for some mental health outcomes were observed in males. This conflicts with a smaller study from the US, which found that associations between overall social media use and depressive symptoms did not differ across adolescence and emerging adulthood (Politte‐Corn et al., 2023). These findings may vary because they adopted different measures of digital media use: screen time and social media use respectively. The US study did find that age shaped the association between online social support and depressive symptoms, with social support associated with lower depressive symptoms at age 15, but not among older participants approximately age 19. This suggests online social support may be more beneficial for younger adolescents than emerging adults.

The literature considering digital media use among this age group, as well as being more limited than for other developmental stages, again demonstrates variation in findings. This suggests a complex relationship between digital media use and mental health and wellbeing, where causality is difficult to evidence. A Dutch longitudinal study examined internalising difficulties (anxiety and depression) amongst 321 16-25 year olds over a four-year period. When comparing different individuals, participants more frequently using social media reported higher levels of internalising difficulties. However, within individuals, there was little evidence that increases in passive social media use led to subsequent increases in symptoms. The authors therefore suggest that previous findings linking social media use to internalising difficulties may partly reflect differences between individuals, rather than changes occurring within the same individuals over time (Tibbs et al., 2025). This distinction is important because associations identified when comparing different individuals, who may use social media in different ways and within different contexts, do not necessarily demonstrate that changes in digital media use impact mental health and wellbeing at an individual level.

2.6 Conclusion

The nature of evidence considering associations between digital media use and mental health and wellbeing differs across developmental stages. In the early years, research focuses primarily on developmental outcomes, with digital media use measured in terms of exposure to screens. Studies identify associations between digital media use and language development, behavioural functioning and education level, and several recommend that screen time is limited during infancy and toddlerhood. Family and parental factors were also described as important influences, and in some studies, appeared more strongly associated with child outcomes than screen exposure alone.

Like early years, literature considering older childhood also shows associations between higher digital media use and poorer psychosocial, behavioural and wellbeing outcomes. However, the strength of these associations varies across studies, and the reliance on cross-sectional studies limits the ability to draw conclusions about the direction of these relationships. Family influences such as parental wellbeing are again shown to have an important influence on outcomes for children. The literature also begins to consider what is being viewed online, not just how long is spent on screens.

This shift in focus towards type of use continues into literature on adolescence. For this age group, studies suggest that how digital media is used may be just as or more important than duration of use. At this age, digital media increasingly becomes embedded within peer relationships, learning and recreation, and the benefits of digital media use for maintaining social connection are highlighted. Studies also indicate variation between young people, suggesting that the same forms of digital media engagement may have different implications depending on individual circumstances.

Evidence relating to emerging adulthood is comparatively limited, but broadly aligns with findings from adolescence. Associations between digital media use and poorer mental health outcomes remain present, although they are generally small and vary across studies. The evidence also highlights the role of socioeconomic circumstances, social support and type of use in shaping the impacts of digital media use in this age group.

Overall, the literature demonstrates associations between digital media and poorer mental health and wellbeing across childhood and adolescence, but some studies highlight potential benefits. It has been suggested that some age groups may benefit more from particular aspects of digital media use, such as social support, and other age groups may be associated with higher vulnerability. However, these relationships are not straightforward. Alongside age, the literature indicates that outcomes are shaped by how digital media is used, by who is using it and the wider contexts in which they are situated. Studies point to digital media use being one factor among many in influencing mental health and wellbeing, rather than a direct cause. As such, some authors suggest that guidelines focusing solely on reducing screen time may have limited impact on psychosocial outcomes.

Some of these wider factors are explored in the following section, which examines specific aspects of digital media use that may help explain associations with children and young people’s mental health and wellbeing.

3 Factors shaping the relationship between digital media use and mental health and wellbeing

This section considers factors that may influence associations between digital media use and mental health and wellbeing. The literature presented below explores how different types of use have different consequences for adolescents and young people. Literature looking at these connections in babies, toddlers and young children was not retrieved by the search. It also considers some of the mechanisms, or ‘mediators’, through which digital media use may cause harm, including social comparison, exposure to harmful content, and disruption to sleep.

3.1 Patterns of digital engagement

Literature identified for this review suggests that different forms of digital media engagement may have different implications for wellbeing. For example, a study with 585 US teenagers found that participants could experience both positive and negative impacts of social media simultaneously (Stewart et al., 2024), and a study from Australia concluded that whilst social media could help adolescents gain information and pursue hobbies, it could also provoke procrastination and social pressures (West et al., 2023). Type of digital media use also mattered in a cross-sectional study of 58,472 Canadian adolescents. This study used ‘flourishing’ as a measure of mental health, defined by the authors as a state of ‘optimal mental wellbeing’. Gaming showed the strongest negative association with flourishing, while social media, messaging and television viewing were associated with lower flourishing only after approximately 1.5–2 hours of daily use (Tézier et al., 2026). These studies suggest that digital media may support wellbeing through some forms of engagement and at different intensities of use, but undermine it through others. Such findings challenge attempts to characterise social media as either inherently beneficial or harmful.

Qualitative research provides deeper insight into how adolescents and young people engage with digital content. Platforms such as TikTok, Instagram and YouTube are often characterised as ‘passive content’, however a qualitative interview study with 19 Norwegian teenagers demonstrates that young people actively engage with a range of social media to support identity development, explore personal interests and connect with like-minded communities. These young people also reflected critically on the shaping of content they encountered by platform algorithms (Lüders, 2025). These insights are supported by a systematic review of qualitative studies, which found adolescents use digital media actively and strategically, to inspire emotions or manage stress (Carlén et al., 2026). A photo elicitation study with 27 UK adolescents found that benefits and risks associated with social media were situated within young people’s wider contexts, shaped by developmental stage, emotional state at the time of engagement, and their social circumstances (Winstone et al., 2026).

Further evidence that different forms of engagement matter comes from a data-driven longitudinal study analysing data on screentime, activations and notifications across different apps amongst Swiss adolescents (Liu and Marciano, 2024). Echoing literature above, this study identified associations between social media use and wellbeing, but these were generally small or non-significant. Significant associations were found with YouTube and Instagram use, which was correlated with increased wellbeing and feeling more connected. Importantly, different effects were observed for TikTok, Snapchat and WhatsApp, suggesting different platforms were associated with wellbeing in different ways. This is affirmed in a Chinese study, which found that exposure to educational apps and shopping/food delivery apps was associated with increased emotional and behavioural problems amongst 10,770 adolescents, while use of short video platforms and video games was associated with greater emotional symptoms and hyperactivity/inattention. These relationships were moderated by individual, family and school factors, suggesting that wider context may influence the relationship between screen exposure and mental health outcomes (Liu et al., 2026b). A Turkish study with 397 parent-respondents also pointed to the significance of type of digital media engagement. Leisure screen time was associated with higher internalising and externalising problems among children aged 6–17 years, whereas interactive online education was not (Meral et al., 2026).

3.1.1 Individual users

Who is engaging with digital content may also be important, and studies demonstrate that users of digital media should not be considered a homogenous group. For example, authors of Dutch longitudinal research attempted to understand social media use by categorising it according to whether use was public/private as well as passive/active. They found substantial variation between their 387 participants. Some experienced positive effects, some negative effects, and many demonstrated no measurable effects at all (Beyens et al., 2024). Diary studies from Belgium and Slovenia also indicate that effects of digital media on wellbeing may depend on adolescents’ self-perceptions at the time of engagement (Devos et al., 2023), and that levels of self-esteem and affective wellbeing can be influenced by how positively adolescents feel about their smartphone use day-to-day (Rosič et al., 2026). These findings suggest that there may be no single or universal effect of social media use on wellbeing, with outcomes varying not only between adolescents but also within the same individual over time.

Two studies suggest that factors beyond time spent using digital media may be important in shaping outcomes. An experimental study with 66 Portuguese students aged 13-15 years considered short term patterns of use, and found no evidence that a 30-minute period of social media use affected cognitive performance, irrespective of participants' weekly screen time. The authors suggest that longer-term or habitual patterns of use may have more influence on outcomes than short-term exposure alone (Mendonça et al., 2025). A large Chinese study found that social media use profiles encompassing high duration and many friends were more strongly associated with adverse impacts on mental health than other high duration profiles (Liu et al., 2024a). Again, these studies suggest that the relationship between digital media use and wellbeing may depend not only on duration of use, but also on patterns of engagement and the contexts within which this occurs.

3.2 Self-presentation and social pressures

Having considered that different patterns of digital media engagement have different impacts on health and wellbeing, and that this can vary between and even within individuals, it is important to explore how these impacts may occur. Relevant literature identified for this review largely explored this in relation to three factors: self-presentation and social pressures, impacts on sleep and exposure to online harms.

3.2.1 Online selves

Children and young people may engage with digital media to express identity (Lüders, 2025), for example by connecting with like-minded peers or curating and maintaining online selves (Varadi, 2025). The latter may entail the use of platform-specific features, such as augmented reality filters. These can be experienced positively, but also generate social pressures and negative emotions (Szambolics et al., 2023). In one study drawing on cross-sectional data from the 2022 Norwegian HBSC study, data demonstrated a clear association between heightened self-presentation on social media and decreased mental wellbeing among 1,982 adolescents aged 13 and 15 years. There was a stronger link between self-presentation and mental wellbeing in girls (Aryal et al., 2025).

As well as content creation, the consumption of digital content also plays a role in identity formation. Two studies identified for this review point to the impact of social media influencers on adolescent health and wellbeing. A questionnaire study with 800 Spanish participants aged 8 to 16 years found that influencer-generated content may affect wellbeing through the parasocial, or ‘one-sided’ relationships adolescents develop with influencers. These could be associated with greater psychological discomfort, problematic use and imitation of risky behaviours (Martín-Cárdaba et al., 2024). The second study, a literature review, reported some benefits of engaging with content by influencers, however most of the included studies raised challenges posed by influencers to young people’s mental health. These included unrealistic body image, the encouragement of unhealthy behaviours, and inaccurate advice about diagnosis and treatment (Engel et al., 2024).

Viewing content about others online, including influencers, can have impacts on self-image and self-esteem through social comparison (Engel et al, 2024). Upward comparison, whereby an individual compares themselves to someone they believe to be better off, has been associated with problematic social media use (Díaz-Moreno et al., 2026). A systematic review of 25 qualitative studies identified two related aspects of social media use that can also influence mental health and wellbeing. The first is the search for validation through ‘likes’ and ‘comments’, which can have a negative effect on confidence when these are not achieved. Secondly, young people may compare their appearance to idealised images online, despite being aware that online photos are often edited (Falcón-Linares et al., 2023). Similar themes were identified in another literature review which found that adolescents frequently described social media as influencing self-esteem, body image and self-evaluation. This occurred through comparison, exposure to idealised representations of others, and social media metrics such as comments or likes (Carlén et al., 2026).

A longitudinal study with 1,103 Chinese adolescents found that concern with ones’ appearance online could predict lower wellbeing, with this effect stronger amongst younger adolescents (Tie et al., 2026). As an element of preoccupation with appearance, two systematic reviews explored body image in more depth. Fortunato et al. (2026) found a significant association between higher social media engagement and increased body image and eating disorder symptoms across studies, though with small effects. This relationship was stronger in females, and in those who engaged with Instagram as a platform. A systematic review of 21 studies from 12 countries found that disordered eating, compulsive overeating and weight control behaviours were all positively associated with social media exposure. However, the authors noted that data showed a high level of heterogeneity, preventing comparison across studies (Blanchard et al., 2023).

3.2.2 Fear of missing out (FOMO) and pressure to be online

Studies identified for this review have examined the pressure experienced by young people to stay connected, as well as concerns they have about their use. These suggest that subjective experiences related to digital media use, as well as use itself, may be associated with wellbeing. One study from Norway engaged with specific aspects of social media use, to identify which might be considered problematic. Cross-sectional survey data from 2,023 adolescents demonstrated three factors associated with poor mental health: the feeling they were spending too much time online; feeling overwhelmed and worrying that their use was problematic; and third, the feeling of a need to be present on social media (Finserås et al., 2023).

The first factor accords with qualitative research demonstrating young people’s awareness of the impacts of digital media on their wellbeing (Lüders, 2025). However, Finserås et al.’s finding demonstrates that this awareness, and negative perceptions about social media, can be associated with poor mental health in itself. The authors suggest that adolescents' subjective experiences of social media may be more strongly associated with mental health than time spent online (Finserås et al., 2026). This is supported by another study analysing the same Norwegian survey data. Of 3,568 participants aged 16-18 years, 35% reported social media as a stressor at least sometimes, with girls being most affected. Adolescents’ concerns that they were distracted from other activities, going to bed later and feeling addicted to social media, were important contributors to experiences of social media-related stress (Andersen et al., 2025).

The Norwegian research described above echoes the concept of ‘fear of missing out’ (FOMO), whereby individuals feel concerned that they may miss information or social interactions. A Dutch study explored the direction of associations between FOMO, problematic social media use and lower levels of life satisfaction amongst adolescents (Li et al., 2024). The authors took a longitudinal approach with 1,419 students aged 12-16 years, and found that adolescents who experienced greater FOMO were more likely to develop problematic social media use over time. Lower life satisfaction predicted higher levels of FOMO among younger adolescents. These findings suggest that FOMO may act as a risk factor for problematic social media use, rather than being caused by it.

Consistent with literature highlighting the importance of subjective experiences of digital media use, a Croatian survey of 1,072 children found that preoccupation with technology, defined as a persistent focus on or concern with digital technology, may be a more informative indicator of wellbeing than time spent using digital devices alone (Topić et al., 2023). Similarly, a longitudinal Chinese study of 1,008 students age 12-18 years found that emotional connection to social media, and experiences of withdrawal, played a central role in the relationship between social media intensity and problematic use (Liu et al., 2026a). These studies show that young people’s psychological relationships with digital media may be as important as duration of use in understanding associations between digital media and wellbeing.

Qualitative research supports the suggestion that preoccupation with digital technologies has important implications for mental health and wellbeing. Interviews and focus groups with 15 Canadian students demonstrate the effort involved in maintaining social networks and an online presence, which can entail pressure to be available to peers. Participants described finding it difficult to disengage from social media, which could become habitual (Varadi, 2025). Evidence from Scotland also suggests that social media and messaging are deeply embedded in young people’s lives. In a Scottish Government survey of 2,484 young people aged 17, over one-third (34.3%) reported checking social media or messaging applications at least every 30 minutes after school, college or work, while almost a further third (31.7%) checked at least hourly. Young women reported checking more frequently than young men. A little less than one in five young people ‘agreed’ or ‘agreed strongly’ that they felt anxious when unable to check social media or messaging apps regularly (18.4%). Again, this was expressed more often by young women (Knudsen et al., 2025). These findings are supported by a study based on international HBSC data from 280,000 young people across 44 countries. This demonstrated high rates of continuous online contact, with 36% of adolescents, reporting continuous online contact with friends and others, particularly among girls (Boniel-Nissim et al., 2024).

The embeddedness of social media within friendships, and the difficulty of disengaging, means that adolescents may face practical and social barriers to reducing screen use, even when they recognise its negative consequences.

3.3 Sleep

Several studies identified for this review suggest that digital media use, particularly where there is difficulty disengaging from platforms, can affect sleep quality and duration. This in turn has implications for mental health and wellbeing. A 2025 ‘Planet Youth’ survey of 7,662 pupils aged 13-15 years in six areas of Scotland found that half of respondents reported an average of 7 hours or less sleep each night. Spending too much time on digital devices was the most common factor affecting young people’s sleep, with social media reported by 49%, and texting and gaming affecting 44% and 32% respectively (Bibby and Piazza, 2026: 40). A Polish survey of 9,083 13-17 year olds found that difficulties falling asleep and back pain were the most frequently reported complaints associated with screen use (Mazur et al., 2026). Carlén et al. (2026)’s systematic review of qualitative studies found disrupted sleep can affect an individual's routines, leading to tiredness, exhaustion and feeling mentally drained. A second research review also found that impacts on sleep may vary according to how and what digital media platforms are used, with problematic social media use showing stronger adverse effects on sleep than general use (Ndubisi et al., 2026).

One US study of data reported by parents for 564 children explored the relationship between sleep, screen use and behavioural health. Echoing the Scottish ‘Planet Youth’ survey, longer screen use was associated with greater sleep disturbances and shorter sleep duration, with this observed across developmental stages between ages 3-17 years. Whilst the researchers did not observe direct effects of screen use on later behavioural health, their findings lead them to suggest that sleep may act as an indirect pathway, or ‘mediator’, through which digital media use influences wellbeing (Rojo‐Wissar et al., 2024).

This complexity is echoed in a study with 407 Canadian young people, using objective measures of screen time rather than parent-reports. This study again found no direct association between screen time and behavioural symptoms, but a significant indirect effect via sleep duration. However, they found no evidence of an association, even through sleep, with internalising symptoms such as anxiety (Marin-Dragu et al., 2025). The effects of social media on mental health outcomes through sleep, distrust and self-image were considered in a longitudinal analysis of data from 8,913 participants in the UK Millenium Cohort Study. The author concludes that social media use itself may not cause poor outcomes. Instead, it may contribute to changes in how adolescents view themselves, how well they sleep and how much they trust others, which appeared to be associated with later psychiatric outcomes (Tsomokos, 2025). Effects of digital media use on sleep are therefore not uniform and may overlap with other aspects of digital engagement, including problematic use and social comparison, making these associations complex.

3.4 Exposure to online harms

Alongside social pressures and disruption to life offline, digital media use is also associated with negative impacts because it exposes children and young people to harmful online experiences. These include cyberbullying and exposure to harmful content, which can themselves contribute to poor mental health and wellbeing^[2].

3.4.1 Cyberbullying

Use of social media can mean young people report feeling more vulnerable to bullying (Falcón-Linares et al., 2023). Recent UK research using secondary analysis of the 2022 ‘Understanding Society’ and 2025 ‘How do people feel about AI?’ datasets identified cyberbullying as a key concern among children under the age of 18. As many as two-fifths (39%) of participants aged 11–25 years reported having experienced cyberbullying in their lifetime (Modhvadia, 2025). Analysis of 2018 HBSC data from 142,298 adolescents across 35 countries found cyberbullying to be related to problematic social media use. The authors concluded that adolescents who experience cyberbullying are more likely to report physical and emotional health complaints, and a small but meaningful part of this link (about 12%) appears to operate through addictive-style use of social media (Peprah et al., 2024).

Feng et al. (2024) propose that cyberbullying victimisation may be an important mechanism linking elevated screen time, defined as screen use of 3 or more hours per day, with poorer mental health and suicidality among adolescents. In their study of 13,982 high school students, elevated screen time increased the likelihood of cyberbullying by 28% among female students, though not in males. Adolescents with high levels of social media addiction have also been found to experience more cybervictimization and engage in cyberbullying, with both negatively influencing wellbeing (Torun et al., 2026).

Cybervictimisation is also explored in longitudinal research from Sweden with two cohorts of adolescents aged between 13-15 years. This found that whilst cybervictimisation and aggression were associated with poor mental health, its contribution was small when compared with in-person behaviours and relationships. The authors therefore suggest that harmful online experiences may amplify existing mental health and wellbeing difficulties, but are unlikely to be the primary drivers of poorer mental health among young people (Nilsson et al., 2025).

3.4.2 Suicidal thoughts and behaviours, and non-suicidal self-injury

A common concern in discussion around online harms is exposure to content relating to suicide and self-harm. Exposure to suicide and self-injury content affects children and young people’s health and wellbeing, prompting negative emotions including anxiety and fear (IPSOS UK and TONIC Research, 2024). A UK-wide study with approximately 1,500 children aged 11-17 found that 73% had seen or heard at least one form of harmful content online in a four-week period. Three in ten had been exposed to at least one form of the most harmful content, which includes pornographic, suicide, self-injury or eating disorder content (Ofcom, 2026).

Literature has examined the relationship between digital media use more broadly with suicide/self-harm. Findings from these studies are mixed. A US study, analysing data from 14,243 participants in the 2023 Youth Risk Behaviour Surveillance Survey, found no direct association between increased social media use and suicidal thoughts and behaviours. In contrast, school-based bullying, cyberbullying, and alcohol use did have statistically significant findings on all suicide risk factors. Again, this suggests that offline behaviour and relationships may have more impact on poor mental health and wellbeing than use of digital media (Bird et al., 2026). This is reflected in a survey study from Spain which, when considered independently, found no significant direct effect of problematic social media use on the risk of suicide among 256 adolescents and young adults (Díaz-Moreno et al., 2026).

Other studies suggest more complex relationships. A longitudinal study with 60 US teenagers demonstrated that higher levels of negative experiences on social media could lead them to more frequently report suicidal ideation. However, positive experiences could have a protective effect, allowing them to feel supported (Hamilton et al., 2024). In a Chinese study of social media addiction and self-injury, the authors observed a relationship whereby one reinforces the other. Among a large cohort of 2,628 high school students, psychological resilience was identified as a powerful protective factor, which could uncouple the link between social media use and self-harm (Deng and Guo, 2026).

3.5 Conclusion

Studies identified for this review have challenged distinctions between older children and young people’s engagement with digital media as either passive or active, and complicated understandings of use as inherently beneficial or harmful. The literature has shown that digital media platforms can provide important spaces for social connection and self-expression. However, they also may generate pressures relating to appearance, social comparison and maintaining an online presence, which can negatively impact wellbeing for some young people.

Recent studies have tried to understand this complexity by considering the specific platforms that young people engage with. Authors have found that different platforms are associated with different impacts on wellbeing, and that effects can vary between individuals. Their findings suggest that there is not a universal effect of social media use on wellbeing, with outcomes varying not only between adolescents but also within the same individual at different times. This suggests that what young people do online may be as important as, or more important than, the amount of time they spend using digital media.

Studies described in this section also explored how specific aspects of use may influence mental health and wellbeing. These included self-presentation and social comparison, body image concerns, pressure to be online, exposure to harms such as cyberbullying, and disruption to sleep. A recurring theme across the literature is that digital media use does not occur in isolation. Many authors argued that wider social experiences, existing vulnerabilities and offline contexts help shape engagement with digital media experiences and its consequences. This suggests that digital media should not be understood as a direct cause of poor wellbeing, but as one factor operating within a wide range of personal and social contexts that shape older children and young people's mental health and wellbeing.

4 Impacts of digital media use across different groups of young people

The literature reviewed for this report demonstrates that digital media does not affect all children and young people in the same way. Studies highlight variation in digital experiences and outcomes for older children and young people according to gender, social and economic circumstances and identity. This section explores digital media use and experience within specific groups of older children and young people according to gender, social and economic circumstances, LGBTQ+ and gender diverse young people, and those with particular lived experience. The evidence presented provides insight into how specific benefits and harms in digital environments may be experienced by these individuals.

4.1 Gender

Many studies explored differences between male and female experiences of digital media use. There is evidence that girls spend more time on social media (Tveit and Biele, 2025), and are disproportionately affected by harms associated with social media use (Liu et al., 2024b; Rucki et al., 2026). Girls are also more likely to experience problematic use (OECD, 2025: 16). This is reflected in Scottish data from the 2022 HBSC study, which demonstrated an increase in problematic social media use among girls in all age groups between 2018-2022, but not among boys (Inchley et al., 2023).

These findings are consistent with large international studies including the World Happiness Report, which presents analysis of data from 15 to 16 year olds across 47 countries. This report found lower life satisfaction and higher levels of depressive symptoms among heavy users of social media, especially among girls (Helliwell et al., 2026). Similar analysis of data from the 2022 Programme for International Student Assessment (PISA) study, of 159,185 15 year olds across 24 countries, found lower life satisfaction associated with both no social media use and high use. When the results were adjusted for socioeconomic status and bullying, this association remained only for girls. This indicates that girls may be more vulnerable to the negative wellbeing aspects of both non-use and very high social media use (Nennstiel and Ullrich, 2026).

Digital media can negatively impact young women and girls in several ways. Studies described in the previous section have highlighted that associations between self-presentation on social media and lower mental wellbeing can be stronger in girls (Aryal et al., 2025). A study of 1,563 Bahamian students also found poorer outcomes for girls. In this study use of apps like Instagram, and exposure to online risks, were associated with depression and suicidal ideation among both boys and girls. However, girls were more likely than boys to report using social media for three hours or more per day (78% vs 57%). The study also highlighted specific online harms. Participants who had experienced cyberbullying or sexting had around twice the odds of reporting mental health issues, and girls were more likely than boys to report experiencing cyberbullying (55% vs 37%) (Kim et al., 2025). A US study using data from 3,944 students also reported higher prevalence of sadness and hopelessness associated with cyberbullying among girls (Jackson et al., 2025).

Experiences of online abuse are highlighted in a recent report based on survey data comprising 538 responses from young women in Scotland. Respondents described feeling unsafe online, with many commenting on the risk of bullying and misogynistic harassment and abuse on messaging apps and social media (The Young Women's Movement, 2025). UK-wide research has also indicated that girls are more likely to experience non-consensual sharing of intimate images, and receive hurtful messages online, suggesting a gendered nature to this harm (Modhvadia, 2025). Such findings suggest that girls may experience digital media differently, rather than just being more negatively affected by it.

Studies have shown that girls can experience particular online exposures or pressures, including appearance-related pressures (Aryal et al., 2025, Fortunato et al., 2026). This may help explain why poorer mental health outcomes are more commonly reported among girls. The gendered nature of online harms is explored in more detail in a small but intensive US study exploring how gendered facets of social media use, such as sexism and unwanted exposure to explicit images, relate to wellbeing. Analysing longitudinal data from 97 adolescents, the authors found that two gendered aspects of social media use, exposure to sexually explicit content and frequency of use, were negatively associated with the stability of participants’ sense of purpose over time. However, overall, the study found limited evidence that increased social media use directly affected wellbeing, nor did the authors find evidence that girls were more negatively affected by social media. This suggests that specific online experiences, particularly unwanted exposure to explicit content, may be more important in describing differences in how adolescents respond to social media than gender alone (Shawcroft and Cingel, 2026).

Other studies have also challenged the associations between gender and wellbeing impacts of digital media use described in existing literature. For example, Atwal and Browne (2024) conducted a large cross-sectional Canadian study, and found stronger negative associations for some outcomes among males. A longitudinal study from Norway, using data from nationwide longitudinal surveys comprising 40,014 individual responses, also identified small increases in anxiety and depressive symptoms associated with social media use among boys but not girls (Tveit and Biele, 2025). Some also report no differences by gender. For example, Grund et al. (2025) found significant differences in the prevalence of depressive symptoms in their secondary analysis of US Youth Risk Behaviour Survey data from 10,334 young people, with female participants having 2.8 times the odds of reporting depressive symptoms. However, the authors did not find a statistically significant interaction between social media use and gender. Two studies using longitudinal datasets also found little or no evidence that gender altered associations between forms of social media behaviour and mental health outcomes (Tibbs et al., 2025, Smout et al., 2026). Finally, it has been suggested that associations between social media use and affective wellbeing may evolve differently for boys and girls over the course of adolescence (Mayen et al., 2025).

We have already observed that associations between digital media use and poorer mental health and wellbeing among girls are influenced by cyberbullying and appearance related pressures. A large study of HBSC data from Switzerland, comprising data from 59,622 participants, also points to the role of socioeconomic factors. Increased social media use was associated with lower life satisfaction for girls and younger women from households with low or middle parental education, with these effects not found for other groups of adolescents in their analysis (Mader et al., 2025). These findings suggest that gender in itself may not explain differences in digital media experiences and wellbeing outcomes. Instead, multiple factors, including socioeconomic circumstances, online experiences and social context, may interact to shape how digital media affects different groups of young people. The role of socioeconomic circumstances is explored further in the following section.

4.2 Social and economic circumstances

Socioeconomic circumstances may shape the extent to which problematic social media use is associated with poorer adolescent wellbeing. Analysis of 2018 and 2022 HBSC data from 43 countries found that problematic social media use was associated with poorer wellbeing across all socioeconomic groups, but associations were strongest among adolescents from lower socioeconomic status (SES) backgrounds (Helliwell et al., 2026). Socioeconomic inequalities were particularly pronounced in the Anglo-Celtic region, which includes Scotland, where increasing problematic use was associated with a greater rise in psychological complaints among lower-SES adolescents. The authors conclude that while problematic social media use is a widespread risk factor for adolescent wellbeing, its impacts are unequally distributed across socioeconomic groups.

Evidence suggests that social and economic circumstances may play a role in these associations by shaping engagement with digital media. For example, a follow-up study of 9,475 children and caregivers from the US determined that youth from historically marginalized groups, as well as those from single-parent households or with lower parental education, were more likely to receive their first smartphone before the age of 10 (Carvalho et al., 2026). As well as access, analysis from the 2022 HBSC study found that socioeconomic status may also shape patterns of use. Adolescents from more affluent families had higher online contact and intense social media use, whilst those from less affluent contexts had higher non-active social media use (Boniel-Nissim et al., 2024). The complexity of the relationship between socioeconomic status and the impacts of digital media on wellbeing is explored further in a 10-wave longitudinal study (2009-2019) on deprivation and social media use from the UK. In the sample of 23,155 adolescents, those experiencing deprivation reported lower life satisfaction and less access to social media. However, once access was established, they spent slightly more time accessing social media. Importantly, though both greater social media use and deprivation were independently associated with lower life satisfaction, deprivation did not appear to strengthen the relationship between social media use and wellbeing (Kurten et al., 2025). This suggests that social and economic inequalities shape young people's digital access and use, but that poorer wellbeing among disadvantaged adolescents cannot be explained by social media use alone.

Kurten et al. (2025) propose that wider social factors beyond deprivation shape associations between digital media use and wellbeing in older children and young people. As described elsewhere, these may include family support, physical activity and relationships within school and family contexts (Gaspar et al., 2023). Social inequalities and experiences of marginalisation may also influence how digital media is used and experienced. A cross-sectional study of 27,336 US high school students found that Latino students were most at-risk for high usage of social media (Srisarajivakul et al., 2026). The authors suggest that broader social experiences affecting these youths, such as discrimination, may contribute to this, with online spaces potentially serving as sites of belonging^[3]. A qualitative study with 43 Latino adolescents in the US found that social media heightened awareness of neighbourhood risks, discrimination and police violence, amplifying the effects of these incidents on their mental health. However, it also provided opportunities for community connection and social support (Campos‐Castillo et al., 2025). Similarly, a US survey with 117 urban adolescents from minoritised ethnic backgrounds found that those from some communities, particularly Middle Eastern or North African, were more likely to describe using social media for community-building and belonging (Stiles-Shields et al., 2026).

These studies have shown that digital media may interact with existing social and economic inequalities. In some cases, inequalities can be amplified. However, digital media also provides opportunities to mitigate the effects of inequality through information sharing and community building. As such, digital media can both reinforce and protect against wider social inequalities, depending how it is experienced and used. This dual role is also evident among other communities, such as LGBTQ+ and gender diverse adolescents.

4.3 LGBTQ+ and gender diverse young people

Six articles identified for this review considered associations between digital media use and mental health and wellbeing among LGBTQ+ young people. Some highlighted beneficial aspects of engagement with digital media among this group. For example, online spaces can afford opportunities to experiment with gender identity before coming out to friends and family (Herrmann et al., 2024). They can provide spaces for community building, where young people can connect with others like themselves (Fisher et al., 2024). The suggestion that digital media may have different implications for this group of young people is affirmed by a large study of adolescents aged 12-18 in five Canadian provinces. Cross-sectional analyses found that trans and gender diverse young people, comprising around 4% of the sample, showed weaker negative associations between social media use and depression, anxiety symptoms and personal relationships than cisgender adolescents. They did experience stronger negative associations with flourishing than cisgender boys (Curle et al., 2026).

Though offering opportunities for connection and identity affirmation, digital media use can also expose LGBTQ+ and gender-diverse young people to discrimination, cyberbullying and social exclusion. This is illustrated in a mixed-methods study considering social media and mental health with 406 LGBTQ+ adolescents in the US, comprising both cisgender (77.1%) and transgender/gender non-binary youths (22.9%). Most described social media experiences in terms of feeling rejected (43.10%), with a smaller group describing a duality of experiences (18.97%). Those who experienced rejection described social media as an environment characterised by hostility. This could lead to feelings of isolation (Fisher et al., 2024). 52% of participants in Hermann’s (2024) study with German young people also reported negative online experiences including cyberbullying or other adverse online reactions.

A survey of 8,158 Austrian participants aged between 10 and 24 years, 1.9% of whom were gender diverse, found that gender diverse adolescents were more vulnerable to adverse associations between several forms of digital media use and depression than cisgender adolescents, particularly males (Klinger et al., 2024). This suggests that this group may be more susceptible to adverse impacts of digital media use. Supporting this suggestion, a study of 109 adolescents comprising 51% sexual minority and 31% gender minority youths found that negative social media experiences were associated with negative impacts on wellbeing, with the effect more pronounced in sexual and gender minority participants. Conversely, and contrary to the authors’ hypothesis, positive social media experiences afforded heightened protection for sexual and gender minority participants. The authors suggest digital spaces may hold particular significance for these young people, due to their important role in identity affirmation, meaning they may have a stronger influence on wellbeing than for non- sexual and gender minority youth (Bitran et al., 2026).

Evidence identified for this review has demonstrated that digital media can play an important role in the lives of LGBTQ+ and gender diverse young people. Online spaces can provide opportunities for identity affirmation and connection that may not be found offline. However, they can also entail exposure to negative experiences such as cyberbullying, hurtful content and feelings of isolation. It has been suggested that these young people can be more sensitive to both positive and negative aspects of digital media, and two studies therefore characterise digital media as a “double-edged sword” for this group.

4.4 Digital media and lived experience

A small number of studies identified for this review highlighted that groups with lived experience of adversity may be more vulnerable to digital media harms. For example, qualitative research with UK young people who had encountered content which promoted suicide, self-harm or eating disorders found those participants with lived experience of these issues were more likely to actively seek harmful online content using hashtags or search functions. This may be through seeking out content relating to their own health condition. They were also more likely to generate their own content about experiences of these issues (IPSOS UK and TONIC Research, 2024). Another qualitative study comprising 11 interviews with care experienced young people, and 11 interviews with non-care experienced youth aged 13-25 years also suggested that care-experienced young people may be more susceptible to social media harms, such as its addictive design. Lived experience participants suggested this was attributable to elevated levels of vulnerability, established through trauma during their early lives. However, as in the previous section, these young people also cited benefits, such as the ability to connect with others with shared experience (Pepper et al., 2023).

Finally, two studies focused on experiences of digital media use among those with health conditions. The first, a qualitative interview study with 19 young people living with Type 1 diabetes found that like other lived experience groups, digital media use could enable connection with peers. It could also facilitate self-management of the condition. However, as for young people more widely, it could expose participants to self-comparison and harmful content, and uniquely to this group of participants, subject them to a large amount of diabetes-related information, which could feel overwhelming and confusing (Berry et al., 2024).

The second study, an analysis of the 2018-19 US National Survey of Children’s Health, comprising data from autistic children and young people aged 6-17 years, found an association between elevated screen time and behavioural problems. However, contrary to existing literature an association between screen time with anxiety and depression was not found. The authors suggest that this is because this group may engage with digital media in different ways to neurotypical youth, with some of the adverse aspects of use described above, such as social comparison and the maintenance of an online presence, not as common (Menezes et al., 2024).

4.5 Conclusion

The literature reviewed in this section has demonstrated that relationships between digital media use and health and wellbeing are not uniform across young people. It has also shown that different types of use can have specific impacts for different groups. Gender was frequently addressed, with many studies reporting stronger negative associations between digital media use and wellbeing among girls. However, recent research suggests these associations may be attributable to specific online experiences, including self-presentation pressures, cyberbullying and exposure to harmful content, rather than users’ gender alone.

The literature has also suggested that a range of social and economic factors beyond gender influence the association between digital media use and mental health and wellbeing. Socioeconomic status, experiences of marginalisation and gender identity all shape how digital media is accessed and engaged with. Patterns of engagement and exposure to risks and support varied across different groups of young people, and digital media use was associated with both benefits and harms. The literature suggests that digital media provides opportunities to support wellbeing for some groups of young people. It also highlights the importance of considering young people who may be more susceptible to negative impacts of digital media use on health and wellbeing, and through which mechanisms, to mitigate some of the potential harms outlined in this report. Findings relating to factors that may promote resilience and protect wellbeing are explored in the following section.

5 Protective factors

The aim of this review has been to explore the impacts of digital media use on mental health and wellbeing among children and young people. Approaches to mitigating harms, including protective factors and interventions, were not stated within the search strategy. Nevertheless, a number of studies examined factors that may mitigate or weaken associations between digital media use and poor mental health and wellbeing outcomes among older children and young people. As these findings may be of practical relevance to policymakers and practitioners, they are presented here. Three broad categories of protective factors emerged from the literature: supportive relationships and family involvement, digital literacy and critical engagement with digital media, and physical activity.

5.1 Supportive relationships and family involvement in digital media use

Several studies point to the role of positive relationships in mitigating harmful impacts of digital media use. A US study with 963 socioeconomically diverse adolescents found that positive peer relationships were a strong predictor of mental health, even among adolescents with high social media use, while poor peer relationships increased the probability of belonging to a troubled mental health group as social media use increased (Blackwell et al., 2025).

Several studies also highlighted the influence of family relationships. A Chinese study with 10,770 participants, found that better family functioning, measured using the family APGAR scale^[4], weakened associations between some forms of digital media use and emotional and behavioural problems (Liu et al., 2026b). Longitudinal research from Spain, with 3,573 18-24 year olds over 3 waves of data collection, found that greater satisfaction with family relationships was associated with lower levels of internalising symptoms (García-Manglano et al., 2024).

One aspect of family relationships is parental involvement in young people’s digital media use, and parental monitoring has been identified as a protective factor (Grund et al., 2025). The literature reviewed suggests that not all forms of parental monitoring are equally beneficial. Evidence generally demonstrates that supportive engagement with young people's digital media use may offer more protection for young people than restrictive monitoring. For example, Barry and Kim (2024) conducted surveys with 316 parent and adolescent pairs (aged 14-17 years) in the US, and found that open communication was associated with lower loneliness amongst adolescents. Restrictive strategies showed only weak relationships with mental health outcomes. Overall, they found that neither form of parental monitoring moderated the relationship between social media use and adolescent wellbeing.

Similar findings are reported in a Spanish study exploring three categories of parental monitoring; active mediation (which included discussing, evaluating and interpreting media content with their child); restrictive strategies; and co-viewing content. The only strategy that had a protective effect was active mediation. However, this protective effect was significantly weaker amongst those children who owned an electronic device. Restrictive strategies were associated with greater psychological discomfort and problematic usage (Martín-Cárdaba et al., 2024). An Italian study with 5,832 parents of children aged 6-17 years also found limited evidence that technology-based parental controls had a protective effect against adverse impacts of digital media on mental wellbeing across age ranges (Barbieri et al., 2026). In these studies, parental oversight centred on communication was more consistently associated with positive outcomes than strategies focused on restricting access.

5.2 Digital literacy and critical perspectives on digital media

Many articles identified for this review proposed digital literacy among children and young people as a protective factor or intervention (Cabezas-Klinger et al., 2025, Li et al., 2025, Mendonça et al., 2025, Díaz-Moreno et al., 2026). This evidence is limited, however, as studies were largely qualitative with small sample sizes. Further, as this topic was not a specific focus of the literature search, few studies analysed this in depth. An exception was a Finnish study considering competencies that may aid adolescents should they encounter problematic situations related to social media use. The three most important competencies identified were the ability to act responsibly on social media, knowing what kinds of activity are prohibited, and knowing where to seek support when exposed to cyberbullying, or harassment (Lahti et al., 2024). However, these were determined by a panel of researchers, teachers and health professionals, rather than with young people themselves. Although distinct from digital literacy, resilience also emerged as a factor that may help young people navigate digital environments more safely. A Chinese study with 2,628 students found psychological resilience, assessed by the ability to adapt to change and recover from adversity, was found to moderate pathways between problematic social media use and non-suicidal self-injury (Deng and Guo, 2026).

Three studies described the potential protective role of digital literacy with regard to specific features of digital media. For example, a qualitative interview study found that an appreciation of how content is shaped by algorithms can allow adolescents to exert greater agency over their digital media use, making engagement more deliberate rather than passive (Lüders, 2025). Digital literacy can also help young people appraise information from social media influencers (Engel et al., 2024) and identify content that has been manipulated by filters and other digital tools, as well as locate features that enhance wellbeing. The ability to understand terms and conditions of use of different platforms is also highlighted in a focus group study with 40 European adolescents (Szambolics et al., 2023). Responsible use of online platforms and identification of misinformation can foster digital resilience among older children and young people (Welsh Government, 2024).

The above studies also highlighted the role of policy and regulation in protecting children and young people from harm, including restrictions on marketing and enforcing ethical approaches amongst developers and influencers. The location of responsibility with government and technology companies is further voiced by young people themselves (Modhvadia, 2025, Scottish Youth Parliament, 2026). A qualitative study with 22 young people, half of whom were care-experienced, recognised the addictive design of social media platforms and that they can facilitate negative experiences. Almost all discussed the role of social media designers in protecting young people from online harm (Pepper et al., 2023). The studies discussed above therefore indicate that digital literacy may extend beyond the ability to use and understand digital technologies, to include an appreciation of online risks and responsibilities, and critical awareness of platform design.

5.3 Physical activity

Finally, three studies cited physical activity as having the potential to protect children and young people from adverse impacts of digital media use. A narrative review of 25 articles found physical activity to be a protective factor, citing explanations including better sleep, reduced loneliness, and the potential of improved cerebral blood flow and hormone regulation to protect against the negative effects of excessive screen time (Stępień et al., 2026).

A potential protective effect is supported by a study of 4,421 Danish adolescents examining patterns of screen use, physical activity and sleep. The authors identified three distinct behavioural profiles. Adolescents in the group characterised by higher physical activity tended to report better mental wellbeing, fewer psychosomatic complaints and more positive body image (Nygaard et al., 2026). Niemistö et al. (2026) considered whether physical activity impacts the relationship between problematic use and mental health by monitoring physical activity in 130 adolescents using a body worn device and tracking social media use. The authors found that regular engagement in physical activity played a protective role for girls, buffering the negative effects of problematic social media use. These studies from Denmark and Finland indicate that physical activity may not only support positive wellbeing outcomes, but also reduce vulnerability to some of the adverse effects associated with digital media use.

5.4 Conclusion

The literature reviewed in this section has introduced several factors that may help protect older children and young people from some of the potential harms associated with digital media use. Healthy relationships, including supportive family involvement in digital media use and good communication, have been associated with better wellbeing outcomes, even among young people with higher digital media engagement.

Digital literacy is identified as an important protective factor, allowing young people to recognise harms, critically appraise online content, and know who to turn to should harmful content be encountered. Psychological resilience was protective against self-harm behaviours in one study. Critical perspectives and an awareness of the mechanisms underlying social media platforms was highlighted in qualitative literature as having the potential to enable more active engagement with digital media. Active engagement has been associated with better wellbeing outcomes than passive use.

Physical activity was associated with more positive wellbeing outcomes, and in one study was found to offer a protective effect. Whilst this rests within individuals and families, several studies also highlight the importance of wider structural influences. These include platform design, influencer practices and the regulation of digital media. Protective factors alluded to elsewhere in this review also include gender, socioeconomic status, and positive experiences at school (Gaspar et al., 2023). This suggests that supporting positive wellbeing outcomes in digital environments for older children and young people is likely to require action at multiple levels.