Objectively measured social media use and psychosocial wellbeing among adolescent girls: a prospective study

Abstract Objective Cross-sectional studies indicate associations between self-reported social media use and adolescent wellbeing outcomes. We aimed to evaluate longitudinal associations of objectively measured smartphone and social media use with psychosocial wellbeing. Design Observational study with one year of follow-up Setting High schools in Finland from 2022 to 2023 Population 259 adolescent girls (mean age 16.3 years at baseline) Main outcome measures screenshots depicting smartphone and social media use, Bergen Social Media Addiction Scale (BSMAS), Generalized Anxiety Disorder-7 questionnaire, Body Appreciation Scale 2 (BAS-2) and visual analogue scales (VAS) of mood, tiredness, and loneliness Results Across one year of follow-up, anxiety, body appreciation, and mood improved, but possible social media addiction increased from 15% to 17%.

Social media addiction at baseline was associated with increased anxiety (r=0.29, p<0.001), lower body appreciation (r=-0.15, p=0.022), and more loneliness (r=0.20, p=0.001) at follow-up. Anxiety at baseline was associated with social media addiction at follow-up (r=0.19, p=0.005). The highest quartile of TikTok users reported more social media addiction (BSMAS 19 [IQR 16-21] vs.

17 [IQR 14-20]; p=0.009) and lower body appreciation (BAS-2 32 [IQR 28-38] vs. 35 [IQR 29-40]; p=0.003) than did others. The highest quartile of Snapchat users reported more social media addiction (BSMAS 19 [IQR 15-21] vs.

17 [IQR 14-20]; p=0.007) and tiredness (VAS 21 [IQR 13-32] vs. 26 [IQR 15-35]; p=0.049) than did others. Conclusions Consistent with cross-sectional studies, social media addiction was associated with poorer psychosocial outcomes across follow-up.

Policies to protect adolescents from social media addiction are urgently needed. Key messages What is already known on this topic Longitudinal studies utilizing objectively collected data on smartphone and social media use to assess associations with adolescent wellbeing are infrequent, as are detailed analyses regarding different social media platforms. What this study adds The bidirectional association between social media addiction and anxiety across one year of follow-up suggests the possibility of a vicious cycle.

The most active users of TikTok and Snapchat scored especially high on social media addiction but presented some differences in wellbeing profiles. How this study might affect research, practice or policy Screenshots appear to be a valid instrument for objective assessment of smartphone and social media use. Policies are urgently needed to limit the addictiveness of social media.