Teenagers who show signs of being addicted to social media, mobile phones, or video games are at greater risk of emotional distress and mental health challenges, according to research.

A study that tracked more than 4,000 adolescents over four years found that nearly one in three reported increasingly compulsive use of social media or mobile phones. Those whose use followed this trajectory were significantly more likely to experience serious emotional and behavioural difficulties by the end of the study.

The findings do not prove screen use was the direct cause of mental health problems, but they highlight compulsive use—which appears to be very common—as a significant risk factor that parents and healthcare providers should monitor closely.

Yunyu Xiao, an assistant professor of population health sciences at Weill Cornell Medicine and the study’s lead author, said: “For parents and educators, the discussion around mobile phones and social media has focused on limiting or banning use, but our results indicate more complex factors are involved. Testing interventions that work against other types of addiction may be one way to approach this type of social media and mobile phone use.”

The findings come amid growing concern over youth mental health and increasing pressure on governments to implement safeguards around smartphone and social media use. Meanwhile, scientists continue to grapple with the difficulty of linking highly personalised, evolving screen habits to real-world mental health outcomes.

The study tracked nearly 4,300 adolescents, aged nine to ten at the start. Instead of simply measuring screen time, the researchers assessed “addictive use” — such as whether technology disrupted schoolwork and exercise, or if users felt craving or distress when separated from their devices. Machine learning was used to group participants based on how their screen use developed over time.

For mobile phones, about half the children reported persistently high levels of compulsive use, while a quarter showed a growing pattern of such use as they aged.

In terms of social media, 41 percent of participants had high or increasing levels of compulsive use. These patterns were associated with significantly higher risks of mental health concerns — including anxiety, depression, and difficulty regulating emotions — compared to peers with low-addictive use trajectories.

More than 40 percent of youths also exhibited high-risk use of video games. These adolescents were more likely to report symptoms of anxiety, depression, aggression, or disruptive behaviour.

Interestingly, the total amount of time spent on screens was not linked to poorer mental health outcomes. What mattered most was whether the usage patterns suggested compulsive behaviour, emotional distress, or a loss of control.

“There are many factors that may lead to compulsive screen use, such as the design of social media and games, or underlying issues like bullying or adverse childhood experiences, which may push kids to seek comfort in screens—only to find they can’t stop using them later,” Xiao said.

The study, published in JAMA, raises further questions about how parents and caregivers should approach screen use. “We don’t yet know if restricting access will help, unless it’s total restriction, because we know from addiction research that partial access can reinforce dependency,” Xiao explained.

Amy Orben, who leads the Digital Mental Health Group at the University of Cambridge, noted that the study does not prove causation. An alternative explanation could be that underlying issues, such as poor self-control, drive both problematic screen use and mental health struggles.

“Still, the study importantly highlights that why and how young people use technology — and how they feel about its impact — may matter more to their mental health than how much time they spend online,” she added.