A new study published Wednesday in JAMA has found that addiction to smartphones, social media, and video games is associated with an increased risk of suicidal thoughts and behaviors in adolescents.
The findings, based on data from the ongoing Adolescent Brain Cognitive Development (ABCD) study, tracked more than 4,000 children starting at ages 9 and 10. By age 14, approximately one-third of the participants had become increasingly addicted to social media, a quarter showed growing dependency on smartphones, and over 40% displayed signs of video game addiction.
Dr. Yunyu Xiao, lead author of the study and a professor at Weill Cornell Medicine, said the adolescents exhibiting addictive patterns were significantly more likely to experience suicidal ideation and behaviors.
“This is an important study that raises awareness about screen addiction,” said Dr. Jason Nagata, a pediatrician at the University of California, San Francisco, who specializes in adolescent screen use. He emphasized that addictive behaviors—not just total screen time—are stronger indicators of worsening mental health and suicide risk.
Longitudinal Insights from the ABCD Study
Xiao and her team used data from the large-scale ABCD study, which monitors thousands of children over time, regularly assessing their average daily screen time and symptoms of addiction. Using a standardized questionnaire, researchers asked participants to respond to statements such as: “I spend a lot of time thinking about social media,” “I try to cut back but can’t,” “I feel anxious if I can’t access social media,” and “My schoolwork suffers because of excessive use.”
This approach allowed researchers to categorize teens into distinct groups based on addiction levels over several years.
For social media use, nearly 60% of participants showed consistently low addiction levels, while 10% exhibited increasing dependence, peaking in the study’s third and fourth years. Another third displayed a steady upward trend in addictive behavior.
In smartphone use, about half of the adolescents showed high levels of addiction, with a quarter experiencing worsening symptoms. Video game addiction revealed two distinct groups: approximately 60% remained at low levels, while 41% showed consistently high addiction.
Mental Health Risks and Suicidal Behavior
The study also assessed suicidal ideation and actions, capturing both passive and active thoughts, as well as behaviors like planning or attempting suicide. By the fourth year of the study, nearly 18% of adolescents reported suicidal thoughts, and 5% admitted to suicide-related behaviors.
Adolescents who fell into the high and rising addiction categories for social media and smartphones were more likely to report suicidal thoughts and actions. Those with high video game addiction also faced elevated risk compared to their low-dependence peers. Notably, total screen time alone was not linked to increased suicide risk.
“What surprised us was the sheer size of these at-risk groups, whose suicide risk was two to three times higher than average,” Xiao said.
Beyond Screen Time: Understanding Addiction
While many parents and educators rely on weekly screen time reports to evaluate device use, both Xiao and Nagata stressed that screen time alone is a limited metric.
“Screen time is easy to measure—it tells us how many hours we spend looking at screens,” Nagata said. “But it doesn’t tell us how the screen is being used.”
Psychologist Dr. Mitch Prinstein of the University of North Carolina at Chapel Hill noted that the content and context of screen use are more important than duration alone. “Some kids may be reading the news. Others might be visiting dangerous sites,” he said.
Dr. Mary Alvord, another psychologist, agreed: “What matters more is how teens use screen time. Are they chatting with real friends or AI-generated characters? Are they using screens to escape real-life problems?”
Escape-based usage, such as playing games to avoid worries, is considered a red flag and often a symptom of anxiety or depression.
“We’re beginning to better understand the specific behaviors that may be more concerning,” said Prinstein, who co-chaired the APA’s advisory panel on teen social media use. “If a child reports withdrawal, dependency, or an inability to stop, those are important signals.”
Widespread Symptoms and Growing Concerns
Nagata also used ABCD study data to explore how adolescents’ screen use patterns evolve over time and their relationship to mental health symptoms. He found that screen addiction symptoms are common and often increase with age.
Among 11–12-year-olds, nearly 48% said they “lost track of time” using their phones, 22.5% admitted they “constantly thought about social media,” and 18.4% used social media to “forget their worries.” By age 12–13, roughly a quarter of participants continued to report using social media as a coping tool.
Average daily social media use jumped from seven minutes at the study’s start to over 70 minutes four years later. Those who spent more time on social media were also more likely to show signs of depression.
“These findings should alert parents, teachers, and clinicians to the warning signs of screen addiction,” Nagata said. “Especially because these signs may indicate elevated risks for depression or suicide in teens.”
If You Need Help
If you or someone you know is in crisis, you can contact the 988 Suicide & Crisis Lifeline by phone, text, or online chat for confidential support.
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