Prospective Associations Between Early Adolescent Problematic Screen Use, Mental Health, Sleep, and Substance Use.

Problematic mobile phone use was prospectively associated with higher scores across multiple mental health problem domains one year later.

• Sample consisted of 8,119 ABCD Study participants aged 11-12 years at baseline (Year 2, 2018-2020), analyzed in 2025
• Sample was 47.5% female and 43.8% racial/ethnic minority
• Problematic mobile phone use was associated with higher depressive, somatic, attention/deficit, oppositional defiant, and conduct problems scores at Year 3
• Associations were determined using linear or logistic regression analyses adjusting for potential confounders measured at Year 2

Problematic social media use was prospectively associated with higher scores across multiple mental health problem domains, suicidal behaviors, sleep disturbance, and substance initiation one year later.

• Problematic social media use was associated with higher depressive, somatic, attention/deficit, oppositional defiant, and conduct problems scores
• Problematic social media use was also associated with suicidal behaviors, sleep disturbance, and substance initiation at Year 3
• Measured using the Social Media Addiction Questionnaire at Year 2
• Outcomes were assessed approximately one year after baseline screen use measures

Problematic video game use was prospectively associated with higher depressive, attention/deficit, and oppositional defiant problem scores, suicidal behaviors, and sleep disturbance one year later.

• Problematic video game use was measured using the Video Game Addiction Questionnaire at Year 2
• Unlike problematic mobile phone and social media use, problematic video game use was not associated with somatic problems, conduct problems, or substance initiation
• Associations with suicidal behaviors and sleep disturbance were observed for problematic video game use
• Analyses adjusted for potential confounders assessed at Year 2

The study design was prospective, allowing temporal examination of problematic screen use preceding mental and behavioral health outcomes, extending prior cross-sectional findings.

• Data were drawn from the Adolescent Brain Cognitive Development (ABCD) Study, a national cohort
• Baseline screen use was measured at Year 2 (ages 11-12, 2018-2020) and outcomes at Year 3, approximately one year later
• Three distinct types of problematic screen use were assessed: mobile phone (Mobile Phone Involvement Questionnaire), social media (Social Media Addiction Questionnaire), and video games (Video Game Addiction Questionnaire)
• The prospective design addresses a key limitation of prior cross-sectional studies on screen use and adolescent health

The authors recommend that clinicians assess not only screen time but also problematic (addiction-like) screen use and provide guidance including the development of a family media plan.

• The study distinguished between total screen time and problematic or addiction-like patterns of screen use
• Clinical implications were directed at both adolescents and parents
• The recommendation to develop a family media plan was specifically mentioned as a practical intervention
• Findings applied to children aged 11-12 years, representing early adolescence