A study by researchers at the University of Cambridge, published on 5 May 2025 in Nature Human Behaviour, has revealed that adolescents diagnosed with mental health conditions engage with social media differently compared with their peers. The findings highlight variations in time spent online, social comparison tendencies, and sensitivity to feedback received from peers.
Researchers L. Fassi et al. examined data from a nationally representative dataset in the United Kingdom called the 2017 Mental Health of Children and Young People. The sample included over 3000 adolescents between 11 and 19 years old, with mental health diagnoses established through standardized clinical assessments. The following are the main findings:
• Time Spent Online: Adolescents with diagnosed mental health conditions reported spending significantly more time on social media platforms than their counterparts. Researchers specifically estimated approximately 50 minutes more of daily social media use compared with unaffected adolescents.
• Social Comparison: Those with internalizing conditions, such as depression and anxiety, were substantially more likely to compare themselves with others online, with nearly 50 percent reporting frequent comparison compared with less than 25 percent of adolescents without mental health conditions.
• Feedback Sensitivity: Adolescents with internalizing conditions showed heightened sensitivity to online feedback. More than 25 percent of them reported experiencing mood changes after receiving likes or comments, compared with just 13 percent of adolescents without mental health conditions.
• Friendship Dissatisfaction: Those with mental health conditions also expressed greater unhappiness or dissatisfaction regarding the number of mutual connections they had in their social networks. The researchers suggest that this mindset reflects a broader sense of social dissatisfaction in digital environments.
• Honest Self-Disclosure: It is also worth mentioning that those with internalizing disorders reported lower willingness to express emotions or personal experiences honestly online. The researchers explained that this probably indicates or represents reduced authenticity and openness in digital interactions.
• Usage Self-Regulation: Adolescents with mental health conditions, particularly those with internalizing disorders, indicated weaker control over the amount of time spent online. This makes them more susceptible to compulsive or excessive engagement with social media platforms and other social media users.
• Externalizing Conditions: Those with externalizing disorders, such as attention deficit hyperactivity disorder and conduct disorders, reported higher social media use, but their engagement patterns resembled those of peers without diagnoses in areas like comparison, disclosure, and sensitivity to online feedback.
Effect size benchmarks were used to determine which differences were statistically and practically significant. Moderate effects were observed in dissatisfaction with online friend counts, higher social comparison, and mood reactivity among those with internalizing conditions. These underscore the importance of considering qualitative engagement.
The study highlighted several strengths that make it stand out from previous research. These include the use of clinical diagnostic assessments rather than only self-reported questionnaires, a nationally representative dataset, and a preregistered analysis plan that improved transparency and credibility of the results and conclusions reached.
Limitations were also acknowledged. The researchers noted that the data were cross-sectional. This renders actual causality impossible to establish. Self-reported measures of social media behavior may also reflect perceptions rather than actual usage. They also highlighted the fact that the survey data were collected in 2017 or before major platform changes.
The researchers emphasized that the associations cannot demonstrate whether social media causes poorer mental health, whether existing mental health conditions influence online engagement, or whether another factor explains both. They called for future experimental research with objective platform-level data to explore causal mechanisms more directly.
Implications for practice and policy are notable. The findings suggest that focusing solely on the amount of time adolescents spend on social media is insufficient. Instead, attention should be directed toward how young people interact online, particularly in cases of vulnerable groups with internalizing conditions. Tailored interventions may be necessary.
For clinicians, the results highlight the importance of discussing online behaviors with adolescent patients who have internalizing disorders. Awareness of risks such as excessive comparison may inform early interventions. These strategies can help mitigate negative effects while encouraging healthier digital engagement practices among adolescents.
FURTHER READING AND REFERENCE
- Fassi, L., Ferguson, A. M., Przybylski, A. K., Ford, T. J., and Orben, A. 2025. “Social Media Use in Adolescents With and Without Mental Health Conditions.” Nature Human Behaviour. 9(6): 1283-1299. DOI: 1038/s41562-025-02134-4