ImportanceIn response to widespread concerns about social media’s influence on adolescent mental health, most research has studied adolescents from the general population, overlooking clinical groups.ObjectiveTo synthesize, quantify, and compare evidence on the association between social media use and internalizing symptoms in adolescent clinical and community samples.Data SourcesPeer-reviewed publications from MEDLINE, Web of Science, PsycInfo, and Scopus (initially reviewed in May 2022 and updated in October 2023) and preprints from Europe PubMed Central (February 2023) published in English between 2007 and 2023.Study SelectionTwo blinded reviewers initially identified 14 211 cross-sectional and longitudinal studies quantifying the association between social media use and internalizing symptoms, excluding experimental studies and randomized clinical trials.Data Extraction and SynthesisPRISMA and MOOSE guidelines were followed, pooling data using a random-effects model and robust variance estimation. The quality of evidence was assessed using the Quality of Survey Studies in Psychology Checklist.Main Outcomes and MeasuresArticles were included if they reported at least 1 quantitative measure of social media use (time spent, active vs passive use, activity, content, user perception, and other) and internalizing symptoms (anxiety, depression, or both).ResultsThe 143 studies reviewed included 1 094 890 adolescents and 886 effect sizes, 11% of which examined clinical samples. In these samples, a positive and significant meta-correlation was found between social media use and internalizing symptoms, both for time spent (n = 2893; r, 0.08; 95% CI, 0.01 to 0.15; P = .03; I2, 57.83) and user engagement (n = 859; r, 0.12; 95% CI, 0.09 to 0.15; P = .002; I2, 82.67). These associations mirrored those in community samples.Conclusions and RelevanceThe findings in this study highlight a lack of research on clinical populations, a critical gap considering public concerns about the increase in adolescent mental health symptoms at clinical levels. This paucity of evidence not only restricts the generalizability of existing research but also hinders our ability to evaluate and compare the link between social media use and mental health in clinical vs nonclinical populations.

中文翻译：

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临床和社区青少年样本中社交媒体的使用和内化症状


重要性为了回应人们对社交媒体对青少年心理健康影响的广泛关注，大多数研究都是从普通人群中研究青少年，忽视了临床群体。目的综合、量化和比较关于社交媒体使用与青少年临床和心理健康中内化症状之间关系的证据。数据来源来自 MEDLINE、Web of Science、PsycInfo 和 Scopus 的同行评审出版物（最初于 2022 年 5 月评审，于 2023 年 10 月更新）以及欧洲 PubMed Central（2023 年 2 月）于 2007 年至 2023 年间以英文出版的预印本。选择两名盲审员最初确定了 14211 项量化社交媒体使用与内化症状之间关联的横断面和纵向研究，不包括实验研究和随机临床试验。数据提取和合成遵循 PRISMA 和 MOOSE 指南，使用随机效应模型汇集数据和稳健的方差估计。使用心理学检查表中的调查研究质量来评估证据的质量。主要结果和测量如果文章报告了至少 1 项社交媒体使用的定量测量（花费的时间、主动与被动使用、活动、内容、用户感知、和其他）和内化症状（焦虑、抑郁或两者兼而有之）。结果审查的 143 项研究包括 1 094 890 名青少年和 886 个效应量，其中 11% 检查了临床样本。在这些样本中，我们发现社交媒体使用与内化症状之间存在正相关且显着的元相关性，两者均与花费的时间有关（n = 2893； r , 0.08; 95% CI，0.01 至 0.15；磷= .03；我2 ，57。83) 和用户参与度 (n = 859; r , 0.12; 95% CI，0.09 至 0.15；磷= .002；我2 ，82.67）。这些关联反映了社区样本中的关联。结论和相关性本研究的结果凸显了对临床人群的研究的缺乏，考虑到公众对临床水平上青少年心理健康症状增加的担忧，这是一个关键的差距。证据的缺乏不仅限制了现有研究的普遍性，而且还阻碍了我们评估和比较社交媒体使用与临床和非临床人群心理健康之间联系的能力。