Problematic and addictive use of smartphones, social media and video games in early adolescence is associated with an increased risk of mental health problems, sleep disorders and suicidal behaviour. This is according to new longitudinal research among American young people aged 11 and 12. The findings show that it is not so much the total screen time, but rather the uncontrollable, stress-inducing use that determines later health risks. This week, a study by the Vodafone Foundation was also published. It states that only 23 per cent of Dutch young people between the ages of 13 and 18 experience good digital well-being.
Early adolescence is a crucial developmental phase. During this period, screen use increases significantly, while at the same time the first signs of mental health problems, sleep problems and substance use often emerge. In the United States, it is estimated that nearly half of adolescents have experienced a mental health condition at some point. Until now, much research has focused on older teenagers and the total number of hours spent on screens. This study shifts the focus to younger adolescents and problematic, addictive patterns of digital use.
What is problematic screen use?
Lead researcher Jason M. Nagata, a paediatrician affiliated with the University of California San Francisco, defines problematic screen use as follows: "Problematic screen use is when children no longer have control over their time online, even when they try to, and it causes stress, conflict or problems at school or at home. It can also lead to withdrawal symptoms, needing more and more screen time to feel satisfied, and repeated relapses, similar to other addictive behaviours."
The researchers analysed data from more than 8,000 participants in the large-scale Adolescent Brain Cognitive Development (ABCD) study. These young people were followed for one year from the age of 11–12. The American study was recently published in the American Journal of Preventive Medicine.
Increased risks
The results show that problematic use of mobile phones and social media is associated with higher scores on depressive symptoms, physical complaints, attention deficit and behavioural problems, as well as suicidal behaviour, sleep disturbance and the onset of substance use. Problematic video game use was also found to be associated with more depressive symptoms, attention and behavioural problems, sleep problems and suicidal behaviour.
It is striking that these correlations are stronger than previously reported relationships between mental health and total screen time. The study thus emphasises that the nature of use is more important than the amount of time spent behind a screen.
Digital wellbeing of young people
The Connected Childhood report published this week during Safer Internet Day by the Vodafone Foundation and Save the Children concludes that only 23 per cent of Dutch young people between the ages of 13 and 18 experience good digital wellbeing. Although young people in the Netherlands have above-average digital skills and know how to stay safe online, they have great difficulty regulating their online behaviour and consciously going offline.
The study is part of the new Digital Wellbeing and Resilience Index (DWRI) 2026, which compares nine European countries. It shows that around three-quarters of young people do not experience optimal digital wellbeing. The Netherlands scores lowest on “digital self-management”. Many young people say they stay online longer than they want to, partly because of the design of apps and social media. This leads to stress and sleep problems.
According to the report, digital balance is therefore no longer an individual responsibility, but a systemic issue. The organisations advocate stricter “safe by design” standards for platforms, structural attention to media literacy and self-regulation in education, and better support for parents and teachers in discussions about online behaviour.
Implications for healthcare and policy
The American study echoes concerns previously expressed by the American Surgeon General about social media and young people's mental health. Due to its prospective design and focus on young adolescents, the study provides important new insights for policy and clinical practice. According to the researchers, this calls for interventions specifically targeted at this age group, precisely because psychological vulnerabilities often become apparent for the first time at this stage of life.
Nagata emphasises that nuance remains important. ‘Not all screen time is harmful. The real risk arises when use becomes addictive or problematic, when children can no longer stop, experience stress without use, or when sleep, mood and daily functioning are disrupted.’
According to him, digital platforms and families also have a responsibility. ‘Our findings suggest that both developers and parents need to think about ways to reduce the addictive features of apps and social media. These usage patterns are influenceable and can have a major impact on the mental health of young people.’
The study thus emphasises the need to explicitly include digital health in prevention, youth care and health policy, with particular attention to the vulnerable phase of early adolescence.
