A new study by researchers at Columbia and Cornell Universities has found that addiction to screen use—particularly on social media, smartphones, and video games—is associated with worsening mental health in adolescents. Importantly, the findings emphasize that it is not overall screen time, but addictive patterns of use, that are linked to increased risks.
Published June 18 in JAMA, the study tracked nearly 4,300 children starting at age eight, monitoring their screen usage behaviors and mental health over a four-year period.
Addictive Use Patterns Differ by Device
The study identified screen addiction as excessive use that interferes with school, family responsibilities, or other activities. Roughly 50% of children reported high levels of smartphone addiction at the start of the study, which persisted into adolescence. An additional 25% showed increasing addiction over time. For social media, around 40% of participants reported similarly high or rising levels of compulsive use.
In contrast, video game use showed only two patterns: high or low, with no increasing trend over time.
Children who showed frequent or escalating screen addiction were more likely to experience worsening mental health outcomes, such as anxiety, depression, aggression, and even suicidal thoughts or behaviors.
“These children display strong cravings and difficulty stopping their behavior—similar to substance addiction,” said psychiatrist Dr. J. John Mann, senior co-author of the study. Mann is a professor at Columbia University Vagelos College of Physicians and Surgeons and the New York State Psychiatric Institute. “Parents noticing these patterns should seek professional evaluation and support.”
Focusing on Addiction, Not Just Screen Time
While national surveys have long documented increasing screen time among youth, this is the first longitudinal study to map addiction trajectories and their timing, offering insight into when and for whom risks emerge.
“Policymaking needs to shift away from generic screen time limits and toward identifying and addressing addictive usage patterns,” said lead author Dr. Xuejun Yu, assistant professor of population health sciences and psychiatry at Weill Cornell Medicine.
Dr. Mann emphasized the importance of regular assessments: “If we don’t track these children over time, we risk missing the large group that moves from low to high risk during adolescence.”
Study Background and Methodology
The research was part of the ongoing Adolescent Brain Cognitive Development (ABCD) Study, a large-scale investigation into child brain development. Researchers collected four years of data on participants’ mental health and their use of social media, mobile phones, and video games.
Participants responded to statements indicating addictive behaviors—for example, “I play video games to forget my problems” or “I increasingly feel the need to use social media apps.” These responses were used to identify distinct patterns of addictive use and analyze their links to mental health outcomes.
Mental Health Risks Outweigh Total Screen Time
By the study’s fourth year, around 5% of participants reported suicidal behavior, ranging from ideation to attempts. Children with high or increasing addiction to social media and smartphones were two to three times more likely to experience suicidal thoughts and behaviors than those with low addiction levels.
Notably, overall screen time alone was not associated with suicide risk or other mental health outcomes.
Implications for Prevention and Treatment
The findings suggest that preventive efforts should target addictive screen use, rather than attempting to restrict total screen time.
“Now that we know addiction patterns matter most, we need targeted interventions—and these should be tested in clinical trials,” said Dr. Mann. However, he cautioned that it remains unclear whether interventions should aim for total screen abstinence or merely limit usage. “From addiction research, we know that even limited exposure can quickly reinforce addictive behaviors,” he added.
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