Addictive Digital Habits in Early Adolescence Linked to Mental Health Struggles, Study Finds

New research following US adolescents ages 11–12 shows that problematic use of mobile phones, social media, and video games was associated with higher risks of mental health problems, sleep disturbance, and suicidal behaviors one year later. The study in the American Journal of Preventive Medicine, published by Elsevier, reveals that the links between problematic screen use and mental health are stronger than those previously reported for overall screen time and highlights the risks of addictive use.

Screen use increases rapidly during early adolescence, which is also a critical window when mental health challenges, sleep problems, and substance use often begin to emerge. An estimated 49.5% of adolescents in the US have experienced mental illness.

While much of the prior research has focused on overall screen time or older adolescents, this research focused on problematic, addiction-like patterns of screen use in early adolescence and whether they are associated with later adverse health outcomes.

Lead investigator Jason M. Nagata, MD, Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, explains, “Problematic screen use is when kids can’t control their time online, even if they try, and it starts to cause stress, conflicts, or problems at school or home. It can also lead to withdrawal-like feelings, needing more time online to feel satisfied, and repeated relapses, much like other addictive behaviors.”

The researchers analyzed data from over 8,000 participants in the Adolescent Brain Cognitive Development (ABCD) Study, the largest long-term study of brain development and child health in the US, following youth from ages 11–12 to one year later.

The study found that problematic mobile phone and social media use were prospectively associated with higher depressive, somatic, attention/deficit, oppositional defiant, and conduct problems scores; suicidal behaviors; sleep disturbance; and substance initiation.

Problematic video game use was associated with higher depressive, attention/deficit, and oppositional defiant scores; suicidal behaviors; and sleep disturbance.

This study addresses key evidence gaps highlighted by the US Surgeon General in a 2023 Advisory on Social Media and Youth Mental Health by using a prospective design, focusing on early adolescents, and examining problematic screen use rather than screen time alone.

Responding to ongoing concerns about youth mental health and the rapid rise of digital media use at younger ages, this study’s findings are poised to shape future health policy and clinical practice. The results underpin the necessity of interventions specifically tailored to early adolescents, as this is a critical period during which psychological vulnerabilities often first manifest.

Dr. Nagata points out, “Not all screen time is harmful. The real risk comes when use becomes addictive or problematic, when kids can’t stop, feel stressed if they don’t use it, or it starts to disrupt sleep, mood, or daily life.”

“Our findings suggest that digital platforms and families alike should consider ways to reduce addictive features of apps and social media, since these patterns of use are modifiable and can affect adolescent mental health,” he concludes.

The article is “ Prospective Associations Between Early Adolescent Problematic Screen Use, Mental Health, Sleep, and Substance Use,” by Jason M. Nagata, MD, Joan E. Shim, MPH, Priyadharshini Balasubramanian, MPH, Chloe M. Cheng, MD, Abubakr A.A. Al-Shoaibi, PhD, Iris Y. Shao, PhD, Kyle T. Ganson, PhD, Alexander Testa, PhD, Orsolya Kiss, PhD, Jinbo He, PhD, Fiona C. Baker, PhD (https://doi.org/10.1016/j.amepre.2025.108248). It appears online ahead of Volume 70, Issue 4 (April 2026) in the American Journal of Preventive Medicine, published by Elsevier.

The article is openly available at https://www.ajpmonline.org/article/S0749-3797(25)00716-0.

Full text of this article is also available to credentialed journalists upon request; contact Astrid Engelen at +31 6 14395474 or ajpmmedia@elsevier.com. Journalists wishing to interview the authors should contact Jason Nagata, MD, MSc, at jason.nagata@ucsf.edu.

This study was supported by funding from the National Institutes of Health, using data from the Adolescent Brain Cognitive Development (ABCD) Study.

The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health. The journal features papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women’s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and alcohol and drug abuse. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. The journal also publishes official policy statements from the two co-sponsoring organizations, health services research pertinent to prevention and public health, review articles, media reviews, and editorials. www.ajpmonline.org

Elsevier is a global leader in advanced information and decision support. For over a century, we have been helping advance science and healthcare to advance human progress. We support academic and corporate research communities, doctors, nurses, future healthcare professionals and educators across 170 countries in their vital work. We do this by delivering mission-critical insights and innovative solutions that combine trusted, evidence-based scientific and medical content with cutting-edge AI technologies to help impact makers achieve better outcomes. We champion inclusion and sustainability by embedding these values into our products and culture, working with the communities that we serve. The Elsevier Foundation supports research and health partnerships around the world.

Elsevier is part of RELX, a global provider of information-based analytics and decision tools for professional and business customers. For more information, visit www.elsevier.com