Specific aspects of social media use and their associations with symptoms of five mental disorders among adolescents

Abstract Background Research on social media and adolescent mental health has largely focused on overall time spent on social media, which can obscure the distinct effects of specific aspects of social media use. This study examined the relative importance of five aspects of social media use for symptoms of five common mental disorders among adolescents. Methods Cross-sectional data were drawn from the PULS study, a school-based survey of 4,011 Norwegian adolescents (mean age 14 years; 50.5% boys) recruited from 21 lower secondary schools in South-Eastern Norway in autumn 2025. Social media use was assessed with the short-form Social Media Use Scale, which has five subscales: Hostility from others, social comparison, passing time, seeking support, and hostility towards others. Symptoms of attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and major depressive disorder (MDD) were measured with validated scales from the Brief Child and Family Phone Interview version 2 Youth Self-Report Questionnaire (12–18 years). Dominance analysis was used to determine the relative importance of each social media aspect, with analyses conducted separately by sex. Results Social comparison was the strongest predictor across all five symptom domains. It accounted for approximately 20–26% of variance in symptoms of internalizing conditions (GAD, SAD, MDD) and 6–9% in symptoms of externalizing conditions (ADHD, ODD) for both boys and girls. Experiencing hostility from others was the second most important predictor, explaining 3–6% of variance across outcomes. Showing hostility towards others was moderately associated with symptoms of ODD (8–11% of variance) but weakly associated with symptoms of internalizing conditions. Passing time and seeking support on social media showed negligible independent associations with the symptom groups. Conclusions Not all aspects of social media use are equally relevant to adolescent mental health. Social comparison and exposure to hostility from others show the strongest associations with mental health symptoms, particularly internalizing conditions. Should future research confirm causal relationships, interventions may be more effective when targeting specific social media features rather than restricting overall use alone.