Adolescents spending more than three hours a day on social media reported experiencing both internal and external problems


A new study from researchers at the Johns Hopkins Bloomberg School of Public Health found that adolescents who spend more than three hours a day on social media are more likely to report high levels of internalizing behaviors compared to adolescents who do not use social media at all.

The study, published online September 11 in JAMA Psychiatry, examined the time adolescents reported spending on social media and two types of behaviors that can be indicators of mental health problems: internalizing and externalizing.

Internalizing can involve social withdrawal, difficulty coping with anxiety or depression or directing feelings inward.

Externalizing can include aggression, acting out, disobeying or other observable behaviors.

The study found the use of social media for any amount of time was associated with both a greater risk of reporting internalizing problems alone and concurrent symptoms of both internalizing and externalizing problems.

The study found no significant association with social media use and externalizing problems alone. Teens who spent at least three hours on social media a day had the greatest risk for reporting internalizing problems alone.

“Many existing studies have found a link between digital or social media use and adolescent health, but few look at this association across time,” says lead author Kira Riehm, MSc, a doctoral student in the Department of Mental Health at the Bloomberg School.

“Our study shows that teens who report high levels of time spent on social media are more likely to report internalizing problems a year later. We cannot conclude that social media causes mental health problems, but we do think that less time on social media may be better for teens’ health.”

Social media use among teens is widespread. Recent polls have found that 95 percent of teens in the U.S. have access to a smartphone and close to 75 percent of teens have at least one social media account.

The use of social media has both health risks and benefits.

These platforms often provide ways to connect with peers and information and resources on causes important to them, but there are risks of cyberbullying and other digital aggressions.

For their study, the researchers used a nationally representative sample of U.S. adolescents ages 13 to 17 from the federally funded Population Assessment of Tobacco and Health Study (PATH) between 2013 and 2016.

The study collected data over three years and the analysis involved 6,595 respondents. Each year, participants were asked how much time they spent on social media as well as questions pertaining to symptoms of internal and external mental health problems.

The study found that less than 17 percent of adolescents did not use social media. For those who did report using social media, 2,082 or 32 percent, reported spending less than 30 minutes; 2,000, or about 31 percent, reported spending 30 minutes to three hours; 817, or 12 percent, reported spending three to six hours; and 571, or 8 percent, reported spending more than six hours per day.

Researchers also found that 611 respondents, or about 9 percent, reported experiencing only internalizing problems, while 885, or 14 percent, reported experiencing externalizing problems only; 1,169, or about 18 percent, reported experiencing both internal and external problems; and 3,930, or about 59 percent, reported no/low problems.

The study found no links between social media use and mental health problems and gender.

Social media has the ability to connect adolescents who may be excluded in their daily life. We need to find a better way to balance the benefits of social media with possible negative health outcomes,” says Riehm. “Setting reasonable boundaries, improving the design of social media platforms and focusing interventions on media literacy are all ways in which we can potentially find this equilibrium.”

Social networks have had a major influence on students’ performance in recent years. These networks create many opportunities and threats for students in various fields. Addiction to social networking and its impact on students’ academic performance caused the researcher to design and conduct this study.

The purpose of this study was to investigate the relationship between social networking addiction and academic performance of students in Iran.


In this cross-sectional study, 360 students were enrolled by stratified random sampling. The study tools included personal information form and the Bergen Social Media Addiction Scale. Also, the students’ overall grade obtained in previous educational term was considered as the indicator of academic performance. Data were analyzed using SPSS-18.0 and descriptive and inferential statistics.


The mean social networking addiction was higher in male students (52.65 ± 11.50) than in female students (49.35 ± 13.96) and this difference was statistically significant (P < 0.01). There was a negative and significant relationship between students’ addiction to social networking and their academic performance (r = − 0.210, p < 0.01).


The social networking addiction of the students was at moderate level and the male students had a higher level of addiction compared to the female students.

There was a negative and significant relationship between the overall use of social networks and academic performance of students.

Therefore, it is imperative that the university authorities take interventional steps to help students who are dependent on these networks and, through workshops, inform them about the negative consequences of addiction to social networks.


In recent years, significant changes have taken place around the world regarding the quantitative and qualitative expansion of internet, social networks and number of people who use them. Social networks include websites and applications that allow users to share content, ideas, opinions, beliefs, feelings, and personal, social, and educational experiences.

They also allow communication between a wide range of users at global level [12]. Instagram, Telegram, Facebook, Twitter, Skype, and WhatsApp are among the most popular and commonly used virtual social networks [38].

Currently (2018), the number of internet users in the world is about 4.021 billion and also 3.196 billion people use social networks on a regular basis worldwide [9].

Iran is one of the developing countries where internet and social networks have grown significantly.

The use of social media has tripled over the past three years, and more than 47 million Iranians are using social networks, according to the Iranian Center of Statistics [10].

Social networks play a crucial role in learning environments as a key communicational channel and a source of social support [11].

Many social networking websites, such as Edmodo, are specifically designed for learning [12]. Social networks have many advantages in learning as they provide wide access to information and information resources, reduce barriers to group interaction and telecommunications [13], support collaborative learning activities [14], encourage learners to learn more about self-learning [15], increase engagement and learner’s motivation [16], enhance engagement of learners with each other and their teachers [17] and support active and social learning [15].

In general, the emergence of new technologies such as internet and social networks, in addition to providing opportunities in facilitating and improving the quality of global communications, has created some threats [18].

When the use of social networks is managed poorly, they can have negative consequences at the individual and social levels. Social networking addiction is one of the consequences that many social network users may experience [19]. Thus, the extensive use of social networks is a new form of soft addiction [20].

There are many different theories about the addiction to internet and social networks. The most important theories include dynamic psychology theory, social control theory, behavioral explanation, biomedical explanation, and cognitive explanation.

According to dynamic psychology theory, the roots of social networking addiction are in the psychological shocks or emotional deficiencies in childhood, personality traits, and psychosocial status.

According to the social control theory, since addiction varies in terms of age, sex, economic status, and nationality, certain types of addiction are more likely to be found in certain groups of society than in other groups [21].

The theory of behavioral explanation believes that, a person uses social networks for rewards such as escaping reality and entertainment.

Based on the biomedical explanation theory, the presence of some chromosomes or hormones, or the lack of certain chemicals that regulate brain activity, are effective in addiction [2223]. According to the cognitive explanation theory, social networking addiction is due to faulty cognition, and people tend to use social networks to escape from internal and external problems [24]. In general, addiction to social networking is classified as a form of cyber-relationship addiction [25].

Social networking addiction refers to mental concern over the use of social networks and the allocation of time to these networks in such way that, it affects other social activities of individuals such as occupational and professional activities, interpersonal relationships and health [19] leading to disruption of their life [20].

Social networking has a negative impact on physical and psychological health and causes behavioral disorders [26], depression [2728], anxiety and mania [28]. I

n this regard, results of a study on German students (2017) showed a positive relationship between addiction to facebook, with narcissism character, depression, anxiety and stress [29]. It is believed that addiction to social networking is higher in people with anxiety, stress, depression and low self-esteem [4].

Grifith (2005) suggests that addictive behavior is a behavior that has certain characteristics such as salience, mood modification, tolerance, withdrawal symptoms, conflict, and relapse [30].

Addictive behavior refers to repeated habits that increase the risk of a disease or social problems in a person. Over the past decade, addictive behaviors, such as overuse of internet or social networks, have become a part of everyday life of students. Social networking addiction includes the characteristics such as ignoring the real problems of life, neglecting oneself, mood swing, concealing addictive behaviors, and having mental concerns [4].

In this regard, signs and symptoms of addiction to social networking can include experiencing disturbances in day-to-day work and activities, spending more than one hour a day on social networks, being curios to see the old friends’ profiles, ignoring work and daily activities due to the use of social networks, and feeling anxious and stressed due to the lack of access to social networks [31].

Evidence suggests that many factors are associated with addiction to internet and social networks. Among these factors are online shopping, dating, gaming and entertainment, using mobile phones for access to internet, searching for pornographic images, user personality trails, and low self-esteem [19303234].

Students are one of the most important users of the virtual world and social networks. The overuse of social networks has positive and negative academic, social, and health consequences for the students [35]. Reduced academic performance is one of the most important consequences of social networking overuse for students.

The results of a study on medical students showed that students who used social networks and internet more than average had a poor academic achievement and low level of concentration in the classroom [36].

The results of another study on Qatari students showed that Grade Point Average (GPA) was lower among students who were addicted to social networking compared to other students [37]. The results of a study in India showed that internet and social networking addiction had a negative effect on academic performance and mental health of students [38]. The results of a Korean study revealed a negative correlation between the use of internet for non-academic purposes and academic performance of students [39]. Findings of a study in Iran (2018) also showed a significant correlation between addiction to the internet and educational burnout [40].

Thus, considering the key role of students in promoting the quality of physical and mental health of society, and also due to the lack of knowledge on the type of relationship between social networking addiction and academic performance of the students of medical sciences in Kermanshah University of Medical Sciences (KUMS), the present study was designed and implemented.

The purpose of this study was to investigate the extent of social networking addiction among the students of medical sciences and its relationship with academic performance of the students.

Thus, we sought to examine the following hypothesis in this study:

1) There is significant relationship between the mean of social networking addiction and students gender.

2) Social networking addiction have a negative and significant correlation with academic performance.


The level of social networking addiction of the students was moderate, and male students had a higher level of addiction to social networking than female students.

A significant and negative relationship was found between the social networking addiction and GPA. Considering the negative effects of social networking on students’ academic performance, the issue of addiction to social networking should be comprehensively reviewed and considered.

Also, appropriate planning should be made to prevent addiction to social networking, control its use, and increase the opportunities and reduce the threats of this tool. In this regard, allocating some of the research priorities to the positive and negative applications of social media at individual, social and academic levels can be beneficial.

Given the importance of addiction to social networking and its potentially destructive impact on students’ academic performance, similar studies are recommended in other universities and in different fields to obtain a more conclusive result. In this regard, the use of mix methods can help to better understand the phenomenon of addiction to social networking and its relationship with the academic performance of students.

More information: “Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among U.S. Youth” JAMA Psychiatry (2019). DOI: 10.1001/jamapsychiatry.2019.2325

Journal information: JAMA Psychiatry
Provided by Johns Hopkins University Bloomberg School of Public Health


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