How digital media use and academic stress jointly relate to adolescent psychological distress: a response surface analysis of competing risks

Short video addiction and academic burnout are prevalent risk factors for adolescent psychological distress, but their joint effects are poorly understood. This study used response surface analysis with 1647 Chinese adolescents (Mage = 15.2 years, 51.5% boys). Polynomial regression tested cumulative risk, synergy, and asymmetry. Multigroup analyses compared left‑behind (17.4%) and non‑left‑behind adolescents. The congruence line slope was positive (a₁ = 0.732, p < .001), indicating higher distress when both risks were high. Positive curvature (a₂ = 0.029, p = .001) supported synergy. The incongruence slope was negative (a₃ = − 0.386, p < .001), revealing that high burnout with low addiction (predicted mean = 35.5) was associated with greater distress than the reverse pattern (predicted mean = 23.4). The curvature along the incongruence line was also significant (a₄ = 0.041, p < .001). Findings were comparable across left‑behind and non‑left‑behind subgroups (exploratory analysis, p = .283). Short video addiction and academic burnout are synergistically associated with adolescent distress (R 2 = .201). Academic burnout is more distressing when risks diverge. Integrated interventions addressing both domains are warranted.

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Publication Details

Journal
BMC Public Health
Published
2026-08-20
DOI
https://doi.org/10.1186/s12889-026-29052-y
Primary Topic
Impact of Technology on Adolescents
Type
article
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article

How digital media use and academic stress jointly relate to adolescent psychological distress: a response surface analysis of competing risks

Huaqiang Liu, Zhensong Lan, Qing Wang
BMC Public Health
Impact of Technology on Adolescents
article

How digital media use and academic stress jointly relate to adolescent psychological distress: a response surface analysis of competing risks

Huaqiang Liu, Zhensong Lan, Qing Wang
article en

Abstract

Short video addiction and academic burnout are prevalent risk factors for adolescent psychological distress, but their joint effects are poorly understood. This study used response surface analysis with 1647 Chinese adolescents (Mage = 15.2 years, 51.5% boys). Polynomial regression tested cumulative risk, synergy, and asymmetry. Multigroup analyses compared left‑behind (17.4%) and non‑left‑behind adolescents. The congruence line slope was positive (a₁ = 0.732, p < .001), indicating higher distress when both risks were high. Positive curvature (a₂ = 0.029, p = .001) supported synergy. The incongruence slope was negative (a₃ = − 0.386, p < .001), revealing that high burnout with low addiction (predicted mean = 35.5) was associated with greater distress than the reverse pattern (predicted mean = 23.4). The curvature along the incongruence line was also significant (a₄ = 0.041, p < .001). Findings were comparable across left‑behind and non‑left‑behind subgroups (exploratory analysis, p = .283). Short video addiction and academic burnout are synergistically associated with adolescent distress (R 2 = .201). Academic burnout is more distressing when risks diverge. Integrated interventions addressing both domains are warranted.

BMC Public Health
Guangxi Medical University (CN), Yibin University (CN), Jiangxi University of Finance and Economics (CN)
Good health and well-being
Openalex Percentile: Top 4%
Impact of Technology on Adolescents
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