JMIR Publications

ABSTRACT

Background:

Although associations between social media use and adolescent mental health have been described, more information is needed on the potential components characterising this complex exposure in particular that of maintaining a public social media account.

Objective:

To investigate the association between having a public social media account, and anxiety and depression in school-going adolescents.

Methods:

Eighty secondary schools/further education colleges in England were sampled using a cross-sectional online survey as part of the 2023 OxWell Student Survey. Social media exposure was categorised into adolescents with the exposure of having a public social media account vs. those without a public social media account. Risk of clinical anxiety and depression was determined using the Revised Child Anxiety and Depression Scale. Adolescents self-reported content and platforms accessed in the previous 24 hours. Associations between having a public account and symptoms of anxiety and depression were assessed using logistic regression controlling for age, sex, bullying victimisation, online parental guidance style - describing parental approaches to adolescents’ online activity, proportion of close friendships primarily being online, poverty and placement in statutory care. Age, sex and online parental guidance style was assessed for primary association effect modification.

Results:

Data collected from 16,655 adolescents (11 to 18 years) were analysed. Forty percent had publicly available social media accounts, and the remainder without public accounts (59.6%) either had a private account or no social media. A total of 32.6% screened positive for symptoms of anxiety and depression, and adolescents with public accounts had higher odds of anxiety and depression (OR: 1.41, 95% CI: 1.32-1.50) compared to adolescents with no public account in an unadjusted model and in a fully adjusted model (OR: 1.39, 95% CI: 1.29-1.49). Adolescents reporting active parental guidance had lower odds of anxiety and depression (OR: 0.85, 95% CI: 0.75-0.93) compared to those reporting no parental guidance and these parental approaches to online activity significantly modified the association between having a public social media account and symptoms of anxiety and depression (P = .004, ?2 = 11.05)

Conclusions:

Our OxWell study findings suggest a potential mental health risk for adolescents with a public social media account. We show evidence indicating some protection from anxiety and depression among adolescents who do not have a public social media account and those who report some form of online parental guidance. This is pronounced in adolescents reporting active parental guidance approaches compared to stricter regulatory approaches or no online guidance at all. The specific roles that social media account choices and online parental guidance approaches play in supporting the mental health of adolescents are highlighted for further investigation.