The impact of problematic social media use on mental health among rural adolescents: a systematic review and meta-analysis

The widespread adoption of social media platforms has raised concerns about their potential negative effects on mental health, particularly among vulnerable populations such as rural adolescents. This systematic review and meta-analysis aimed to synthesise existing research on the correlation between problematic social media use and mental health outcomes in this demographic. A comprehensive literature search was conducted across multiple databases, including PubMed, Cochrane Library, Web of Science and China National Knowledge Infrastructure, using standardised Boolean search strategies related to social media use and mental health outcomes. Studies meeting the inclusion criteria were assessed for quality using the Newcastle–Ottawa Scale, with explicit quality-grading criteria. Meta-analyses, subgroup analyses, meta-regression and sensitivity analyses were performed to examine the correlations between problematic social media use and depressive, anxiety and stress symptoms. Publication bias was further evaluated using the trim-and-fill method, and a risk-of-bias analysis was systematically conducted for all included studies. Eighteen studies met the inclusion criteria, comprising 9,269 participants across various countries and regions. Meta-analysis results revealed significant correlational relationships between problematic social media use and mental health problems. Contrary to conventional interpretive frameworks, pooled effect sizes indicated that problematic social media use was correlated with reduced odds of depressive symptoms (hazard ratio = 0.25, 95% CI: 0.20, 0.32, p < 0.001), anxiety symptoms (odds ratio [OR] = 0.33, 95% CI: 0.27, 0.41, p < 0.001) and stress (OR = 0.30, 95% CI: 0.22, 0.41, p < 0.001). Substantial heterogeneity was observed across studies for all outcomes ( I² > 88%). Subgroup analyses confirmed that age, gender and regional cultural differences partially explained the high heterogeneity. Trim-and-fill correction verified potential overestimation of raw effect sizes caused by publication bias. This meta-analysis identifies correlational associations between problematic social media use and mental health outcomes among rural adolescents and young adults. Due to substantial inter-study heterogeneity, potential publication bias, inherent limitations of cross-sectional data and conceptual overlap of measurement tools, the current evidence cannot be regarded as robust. However, the observed protective correlational effects challenge mainstream assumptions, highlighting complex interactive relationships between social media engagement and mental health. Further rigorous longitudinal research is required to clarify bidirectional mechanisms and moderating factors in this relationship.