August 1, 2024

expert reaction to two studies and a perspective piece looking at problematic smartphone use in teenagers

Two studies published in the BMJ Mental Health and Acta Paediatrica looks at problematic smart phone use in young people.

Prof Chris Fergurson, Professor of Psychology, Stetson University, said:

“I think one of the important findings is that time spent on smartphones wasn’t associated with negative mental health outcomes.  This isn’t really a change in our understanding…in fact, the evidence on this has been quite clear. Put together with other research we should really stop thinking about social media or smartphones as being directly related to teen mental health.

“The issue of “problematic” behaviour is a tricky one.  There’s no official diagnosis for the condition, and no agreed upon set of criteria for how to define it.  One issue is that many “normal” behaviours could be over pathologised, and that can lead to unusually high prevalence estimates. I think these figures of 14-19% of teenagers reporting  “problematic smartphone use” could also include kids who might be fine but just really like their phones and social media, if the survey used isn’t specific enough.

“The other issue is that “problematic smartphone use” isn’t really a problem of smartphones. Problematic smartphone use is an internal issue…a psychological issue, not something “done to” kids by screens.  Meaning, even if we could wave a magic wand and make all smartphones go away, these kids could still have problems overdoing other stuff.  There is little evidence here that smartphones/social media are the culprit and that, instead, phone/social media overuse should be considered more a “red flag” for other underlying issues. Some of the methods for reducing smartphone use employed by these young people could therefore miss the root cause of issues. 

“Self reporting, as seen in these surveys, can skew data towards what young people may think they should say, in this survey it could reflect what parents or teachers have said to them about smartphone use, rather than their true concerns or lack of concern.

“Ultimately, I think this data suggests we do need to reframe our approach to technology.  There’s little evidence here, or elsewhere, that restricting technology, putting age limits on social media, or banning smartphones in schools is helpful in improving teen wellness or academic performance.  Technology overuse is best understood as a new symptom of age-old disorders such as depression, anxiety or ADHD, not a new set of problems.  Further indulging a moral panic over smartphones and social media is unlikely to help any youth.”

Prof Bernadka Dubicka, Professor of Child and Adolescent Psychiatry Hull and York Medical School University of York, said:

“Although the conclusions from these findings need to be limited due to the small, non-representative sample, the studies do raise important issues. Other than for very young children, screen time is not a helpful term in research, as young people may be using screens in many different ways, which could be helpful or harmful. These studies looked at screen time and problematic screen use separately, as well as different platforms. Most research has only looked at screen time and unsurprisingly few effects have been found. This study does point to the potentially important impact of screen addiction on mental health as well as the impact of different platforms. Young people want help and support with navigating their online lives, and it is important that tech companies are held to account by the Online Safety legislation and make the online world safer for children and young people. We will only know the true impact of online activities on children and young people when tech companies agree to share the vast amount of data they hold with independent researchers, and we no longer have to rely on highly selective self-report data. In particular, there are many very vulnerable children and young people such as those with existing mental health conditions, where the impact of technology has not been sufficiently studied, and who are likely to be the most vulnerable to any negative effects.”

‘There’s more to life than staring at a small screen’: a mixed methods cohort study of problematic smartphone use and the relationship to anxiety, depression and sleep in students aged 13–16 years old in the UK’ by Ben Carter et al. was published in BMJ Mental Health.

DOI: 10.1136/bmjment-2024-301115

‘A multi- school study in England, to assess problematic smartphone usage and anxiety and depression’ by Ben Carter et al. was published in Acta Paediatrica.

DOI: 10.1111/apa.17317 

“Problematic smartphone use: What can teenagers and parents do to reduce use?” by Nicola Kalk et al. was published in Acta Paediatrica

DOI: 10.1111/apa.17365 

They were published at 00:01 UK time on Thursday 1 August.

Declared interests

Prof Chris Fergurson: I have no COI to declare.

Prof Bernadka Dubicka: I am funded by the NIHR – Chief Investigator of the BAY trial, which is testing a brief intervention for depression in CAMHS.

This Roundup was accompanied by an SMC Briefing.