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Currently submitted to: JMIR Mental Health

Date Submitted: Mar 27, 2026

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Parasocial Relationships with Social Media Influencers and Mental Health Outcomes: A Systematic Review and Meta-analysis

  • Yixuan Li; 
  • Zihao Liu; 
  • Fangqing Liu

ABSTRACT

Background:

Social media influencers occupy a pervasive role in billions of users’ daily digital lives, particularly among adolescents and young adults. Audiences develop parasocial relationships (PSRs) with these figures, which are stable, affectively charged bonds that mimic genuine social relationships. Despite growing concern about their mental health implications, no prior meta-analysis has quantitatively synthesised this evidence.

Objective:

To estimate the pooled association between influencer-directed PSRs and mental health outcomes, examine pre-specified moderators, and evaluate the quality of the existing evidence base.

Methods:

Seven databases (PsycINFO, EMBASE, MEDLINE, ERIC, PubMed, Web of Science, Scopus) were searched from inception. Studies quantitatively assessing PSRs or parasocial interactions (PSIs) with social media influencers and reporting mental health outcomes were eligible. A three-level random-effects meta-analysis was conducted using Pearson’r. Moderators examined included outcome domain, parasocial construct type, age group, gender, cultural region, and platform. The protocol was pre-registered on PROSPERO (CRD420261291637).

Results:

Seventeen studies (52 effect sizes) were included. A significant, moderate overall association was observed (r = .37, 95% CI [.22, .50]), with substantial heterogeneity (I² = 83%). PSRs were positively associated with both positive (r = .38) and negative outcomes (r = .24), with positive effects significantly stronger. Wellbeing showed the largest effects (r = .42), followed by social media addiction (r = .33). PSI demonstrated stronger associations than PSR (r = .56 vs. .22). Effects were largest among adolescents (r = .44) and in Eastern samples (r = .61 vs. .29). No evidence of publication bias was detected (Egger's p = .94; fail-safe N = 18,643).

Conclusions:

Influencer-directed PSRs function as a psychological double-edged sword, reliably linked to both enhanced wellbeing and problematic engagement. Positive effects were generally larger and more consistent than negative ones. Associations varied meaningfully by parasocial construct, developmental stage, and cultural context. Longitudinal, mechanism-based research with diverse samples is needed to clarify when parasocial engagement is most beneficial or harmful.


 Citation

Please cite as:

Li Y, Liu Z, Liu F

Parasocial Relationships with Social Media Influencers and Mental Health Outcomes: A Systematic Review and Meta-analysis

JMIR Preprints. 27/03/2026:96331

DOI: 10.2196/preprints.96331

URL: https://preprints.jmir.org/preprint/96331

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