Summary: A large new study shows that adolescents who develop compulsive, addictive patterns of using social media, mobile phones or video games face a significantly higher risk of suicidal thoughts, suicide attempts, and other mental health problems. The research found that it’s the compulsive nature of use—feeling unable to stop, feeling distressed when offline, or using devices to escape—that best predicts poor outcomes, not simply how many hours are spent on screens.
Young people following high or increasing addiction-like trajectories for social media, smartphones, or gaming had up to three times the risk of suicide-related behaviors. The results point to the importance of early, targeted interventions that address problematic use patterns rather than focusing only on reducing total screen time.
Key points:
- Addictive pattern matters more than duration: Overall screen time was not the key risk factor—addictive, compulsive use patterns were.
- Markedly higher risk: Adolescents with increasing or high addictive use trajectories were two to three times more likely to report suicidal thoughts or behaviors.
- Wider behavioral effects: Addictive use was associated with both internalizing symptoms (anxiety, depression) and externalizing symptoms (aggression, rule-breaking, inattention).
Source: Weill Cornell University
New findings show that rising addictive use of social media, smartphones and video games in early adolescence is linked to greater risk of suicide-related outcomes and emotional or behavioral problems.
Published June 18 in JAMA, the study was led by investigators from Weill Cornell Medicine, Columbia University and the University of California, Berkeley.
Rather than measuring screen time at a single point, the researchers tracked how children’s patterns of compulsive or addictive use evolved over time. They focused on behaviors such as an inability to stop using a device, feeling upset when disconnected, and using screens as a form of escape.
The study found that simply spending more time on screens at age 10 was not linked with later suicide-related outcomes or worse mental health. Instead, trajectories showing growing or persistently high signs of addictive use were the strongest predictors of later problems.
“Public conversations often center on cutting or banning phones and social media, but our results show the picture is more nuanced,” said Dr. Yunyu Xiao, assistant professor of population health sciences at Weill Cornell Medicine and first author on the paper.
“Clinical trials that limited phone use during school, for example, did not reduce suicidal behavior or significantly improve mental health, suggesting interventions should focus on addictive behaviors rather than just time limits,” Dr. Xiao added.
Senior author Dr. John Mann, the Paul Janssen Professor of Translational Neuroscience in Psychiatry and Radiology at Columbia University and the New York State Psychiatric Institute, noted that these findings could shift how clinicians, caregivers and schools approach digital use in young people.
Quality over quantity
Over four years, the study followed nearly 4,300 youths who were about nine to ten years old at the start. The sample included participants identifying as Asian, Black, Hispanic, White or multiracial. Using machine learning and repeated self-reports, researchers identified three distinct addiction-like trajectories for social media and mobile phone use and two for video game use.
By age 14, roughly one in three participants followed a high or increasing addictive trajectory for social media, one in four for mobile phone use, and over 40% showed a high addictive trajectory for video games. Adolescents in these trajectory groups were significantly more likely to report suicidal thoughts or behaviors and to exhibit symptoms of anxiety, depression, aggression or rule-breaking.
Each type of screen activity showed somewhat different associations: high and increasing addictive trajectories for social media and phones were linked to a two- to threefold greater risk of suicidal ideation and behaviors compared with low-addiction trajectories. High or increasing trajectories were also associated with elevated internalizing symptoms (like anxiety and depression) or externalizing symptoms (like impulsiveness and aggression), depending on the activity.
“Parents and educators should pay attention to how children use devices and consider professional evaluation if signs of addictive use appear,” said co-first author Dr. Yuan Meng, a postdoctoral associate in population health sciences at Weill Cornell. “If an addiction is present, simply limiting access for part of the day may inadvertently reinforce problematic patterns; clinical guidance is important.”
A potential paradigm shift
The study’s main take-away is that the pattern and quality of digital engagement—especially compulsive, distress-linked or loss-of-control use—matter more for adolescent mental health than raw screen time totals. Repeated assessment of addictive use patterns during the transition into adolescence could help identify youth at higher risk who would otherwise appear low- or moderate-risk at a single point in time.
While the research does not establish that addictive screen use directly causes mental health problems, youths on high or increasing addictive trajectories showed roughly double the near-term risk of suicidal behavior compared with peers on low trajectories. The authors call for further research and the testing of interventions adapted from treatments for other types of addiction.
Next steps for the research team include profiling the demographic and socioeconomic characteristics of children in different trajectories and developing early interventions to address addictive use behaviors before they escalate and increase the likelihood of suicidal behaviors.
Contributors to the study also include Dr. Timothy T. Brown, associate director for research at the Berkeley Center for Health Technology at the University of California, Berkeley, and Dr. Katherine M. Keyes, professor of epidemiology at the Columbia University Mailman School of Public Health.
About this mental health and neurodevelopment research news
Author: Barbara Prempeh
Source: Weill Cornell University
Contact: Barbara Prempeh – Weill Cornell University
Image credit: Neuroscience News
Original research: Open access. “Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths” by Yunyu Xiao et al., JAMA. DOI: 10.1001/jama.2025.7829
Abstract
Addictive Screen Use Trajectories and Suicidal Behaviors, Suicidal Ideation, and Mental Health in US Youths
Importance
Rising use of social media, video games and mobile phones among children and adolescents has raised concerns about links to mental health problems. Most prior studies examined total screen time at a single moment rather than longitudinal patterns of addictive use.
Objectives
To identify trajectories of addictive use for social media, mobile phones and video games and to evaluate their associations with suicidal behaviors, suicidal thoughts, and mental health outcomes in youth.
Design, setting, and participants
This cohort study analyzed data from baseline through four-year follow-up in the Adolescent Brain Cognitive Development (ABCD) Study (2016–2022), using population-based samples from 21 US sites.
Exposures
Addictive use of social media, mobile phones and video games measured using validated child-reported instruments at years 2, 3 and 4 of follow-up.
Main outcomes and measures
Suicidal behaviors and ideation were assessed with child- and parent-reported information using the Kiddie Schedule for Affective Disorders and Schizophrenia. Internalizing and externalizing symptoms were measured with the parent-reported Child Behavior Checklist.
Results
The analytic sample included 4,285 participants (mean age 10.0 years at baseline; 47.9% female; 9.9% Black, 19.4% Hispanic, 58.7% White). Latent class linear mixed models identified three addictive use trajectories for social media and mobile phones and two for video games. Nearly one-third of participants followed an increasing addictive trajectory for social media or mobile phones beginning around age 11. Adjusted models showed that increasing addictive trajectories were associated with higher risks of suicide-related outcomes compared to low-addiction trajectories (for example, increasing addictive social media use had a risk ratio of 2.14 for suicidal behaviors). High addictive trajectories for all screen types were also associated with suicide-related outcomes (for example, a high-peaking addictive social media trajectory had a risk ratio of 2.39 for suicidal behaviors). The high video game addictive trajectory showed the largest relative increase in internalizing symptoms, while the increasing social media addictive trajectory showed the largest relative increase in externalizing symptoms. Baseline total screen time was not associated with later outcomes.
Conclusions and relevance
High or increasing trajectories of addictive use of social media, mobile phones or video games were common in early adolescence and were associated with greater risk of suicidal behaviors, suicidal ideation, and poorer mental health. Monitoring and addressing addictive patterns of digital use, rather than focusing solely on screen time totals, may help identify at-risk youth and guide more effective interventions.