Screen time woes: Social media posting, scrolling, externalizing behaviors, and anxiety in adolescents

Adolescent screen time use increased significantly during the pandemic. Excessive social media and prolonged screen use are risk factors for internalizing and externalizing behaviors. However, limited understanding remains of pre-existing factors that predispose adolescents to adverse outcomes, and how quantitative (e.g., time spent) and qualitative (e.g., screen use behaviors) aspects relate to mental health, including anxiety and emotional/behavioral difficulties. Understanding these links is critical for evidence-based recommendations in healthcare and education. A community-based sample of 580 adolescents aged 12–17 years participated in an online survey from December 2022–August 2023. Demographic data, pre-existing vulnerabilities, screen use, emotional and behavioral difficulties and anxiety were collected using self-report questionnaires. The time spent on screens during weekdays and weekends, as well as screen-use behaviors such as frequency of use, total time, passive scrolling, and content posting on social media were analyzed. Notably, about 45 % of adolescents without pre-existing vulnerabilities reported anxiety in the clinical range. The odds ratio analysis showed that exceeding 2 h of screen time on weekdays doubled the odds of clinically-elevated anxiety and quadrupled the odds of experiencing emotional and behavioral difficulties. Although different aspects of screen use behaviors showed linear associations with mental health outcomes, passive scrolling had the strongest negative influence, even after controlling for age, gender, and pre-existing vulnerabilities, compared to active screen use or more general indicators (frequent and prolonged screen time). Managing screen time and activities based on individual mental health profiles, particularly regarding anxiety levels, may help support adolescent well-being. • Vulnerable adolescents had much higher anxiety and internalizing/externalizing issues. • About 45 % of those without vulnerabilities reported clinically heightened anxiety. • Weekday screen time over 2 h greatly increased mental health risks in adolescents. • More anxiety was linked to increased passive scrolling on screens. • Screen time behavior may be individualized based on mental health profiles.