TEMPORARY REMOVAL: Are public social interactions on Twitter associated with mental health outcomes?

It has been suggested that active use of social media (i.e. direct interactions with other users) is associated with improved mental health. Active use could help build relationships, and lead to feelings of social and emotional support. However, evidence is inconsistent, potentially because active use comprises many different behaviours. The impact of someone’s active use may depend on whether they are targeting specific users and the feedback they receive from other users. Our study explored the relationship between the public active use Twitter users performed and received, and mental health outcomes. We linked Twitter data from 2020-2022 to self-reported measures of mental health from the Avon Longitudinal Study of Parents and Children. We generated variables capturing the type of active use each participant performed, and the feedback they received from other users. We produced models predicting mental health from these variables, using data from 310 adults. We found evidence that receiving more feedback, both relative to other users and relative to one’s usual levels, was associated with poorer mental health, particularly elevated depressive symptoms. In contrast, we found no evidence that the type of active use (i.e. targeted or nontargeted) was associated with mental health. There was also no evidence that this association was influenced by the amount of feedback the participant received. Twitter is primarily designed for broadcasting and consuming information, rather than building strong social relationships. More feedback from weak social ties on Twitter could lead to feelings of pressure to maintain this engagement, and more addictive patterns of use. • We explore the links between social interactions on Twitter and mental health. • We combined self-reported measures of mental health with actual Twitter data. • Receiving more feedback relative to other users predicted poorer mental health. • Receiving more feedback relative to usual level also predicted poorer mental health. • The type of active use (i.e. targeted or nontargeted) did not predict mental health.