Teenagers who show signs of being addicted to social media, mobile phones or video games are at greater risk of suicidal behaviour and emotional problems, according to research.

A study, which tracked more than 4,000 adolescents for four years, found that nearly one in three reported increasingly addictive use of social media or mobile phones.

Those whose use followed an increasingly addictive trajectory had roughly double the risk of suicidal behaviour at the end of the study.

The findings do not prove that screen use was the cause of mental health problems. But they highlight that compulsive use, which appears to be very common, is a significant risk factor that parents and healthcare services should be alert to.

Dr Yunyu Xiao, an assistant professor of population health sciences at Weill Cornell Medicine and first author of the study, said: “For parents and educators, the discussion around mobile phones and social media has focused on limiting or banning use, but our results indicate more complex factors are involved.
“Testing interventions that work against other types of addiction may be one way to approach this type of social media and mobile phone use.”

The findings come amid escalating mental health problems in young people and as governments are grappling with how to enforce safeguards around smartphones and social media.

Against this backdrop, scientists have faced a near-impossible challenge to try to pin down evidence of how rapidly evolving and highly personalised screen use might be linked to young people’s mental health.

The latest study tracked almost 4,300 adolescents aged nine to 10 when they started the study.

Rather than simply measuring screen time, the scientists assessed participants for “addictive use”, such as whether technology was interfering with activities like schoolwork and exercise and whether people experienced craving or feelings of distress when screens were withdrawn.

Machine learning was used to cluster participants into groups based on their screen use trajectories.

For mobile phones, about half of the children reported high addictive use from the start of the study that remained high through early adolescence, and a quarter developed increasing addictive use as they aged.

For social media, 41% of children had high or increasing addictive use.

For social media and mobile phones, the high and increasing addictive use trajectories were associated with a two to three times greater risk of suicidal behaviours and suicidal ideation compared with the low addictive use trajectory.

More than 40% of the youths had a high addictive use trajectory for video games.

These adolescents were significantly more likely to report suicidal thoughts or behaviours, as well as symptoms of anxiety, depression, aggression or rule-breaking.

By contrast, the total amount of time spent on social media, mobile phones and video games was not associated with future suicide-related or mental health outcomes. What mattered most was whether their use showed signs of compulsion, distress or loss of control.

Xiao said: “There are many factors that would induce addictive feelings, such as the designs of the social media or video games, some kids may also experience bullying and a more adverse childhood that they find using phones more comfortable, but later they cannot stop using it.”

The findings, published in the journal JAMA, raise further questions over how parents should manage children’s screen use.

“We do not know if just taking away access will help, unless it is taking away access 24/7, because we know from studies of addiction management that partial access can quickly reinforce the addiction,” Xiao said.

Prof Amy Orben, who leads the Digital Mental Health Group at the University of Cambridge, said the study could not prove that technology use caused mental health problems.

An alternative explanation would be that poor self-control could be the root cause of problematic screen use and mental health outcomes.

“Yet the study importantly highlights that why and how young people use technologies and how they feel technologies affect their lives may matter more to their mental health than the time spent online,” she added.

“As those reporting such issues are not a small proportion of the population, supporting them should be taken seriously.”