impact of social media on youth during covid 19 essay

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Social media & COVID-19: A global study of digital crisis interaction among Gen Z and Millennials

Who, wunderman thompson, the university of melbourne and pollfish share the outcomes of a global study investigating how gen z and millennials get information on the covid pandemic.

The full report available now

The unfolding of the COVID-19 pandemic has demonstrated how the spread of misinformation, amplified on social media and other digital platforms, is proving to be as much a threat to global public health as the virus itself. Technology advancements and social media create opportunities to keep people safe, informed and connected. However, the same tools also enable and amplify the current infodemic that continues to undermine the global response and jeopardizes measures to control the pandemic.

Although young people are less at risk of severe disease from COVID-19, they are a key group in the context of this pandemic and share in the collective responsibility to help us stop transmission. They are also the most active online, interacting with an average number of 5 digital platforms (such as, Twitter, TikTok, WeChat and Instagram) daily.

To better understand how young adults are engaging with technology during this global communication crisis, an international study was conducted, covering approximately 23,500 respondents, aged 18-40 years, in 24 countries across five continents. This project was a collaboration between the World Health Organization (WHO), Wunderman Thompson, the University of Melbourne and Pollfish. With data collected from late October 2020 to early January 2021, the outcomes provide key insights on where Gen Z and Millennials seek COVID-19 information, who they trust as credible sources, their awareness and actions around false news, and what their concerns are. Some key insights uncovered include:

Science content is seen as shareworthy

When asked what COVID-19 information (if any) they would likely post on social media, 43.9% of respondents, both male and female, reported they would likely share “scientific” content on their social media. This finding appears to buck the general trend on social media where funny, entertaining and emotional content spread fastest.

Awareness of false news is high but so is apathy

More than half (59.1%) of Gen Z and Millennials surveyed are “very aware” of “fake news” surrounding COVID-19 and can often spot it. However, the challenge is in recruiting them to actively counter it, rather than letting it slide, with many (35.1%) just ignoring.

Gen Z and Millennials have multiple worries beyond getting sick

While it is often suggested that young adults are ‘too relaxed' and do not care about the crisis, this notion is not reflected in the data, with over 90% of respondents were very concerned or somewhat concerned about the risk of infection. Beyond getting sick themselves, the top concerns of respondents (55.5%) was the risk of friends and family members contracting COVID-19, closely followed by the economy crashing (53.8%).

WHO wants young people to be informed about COVID-19 information, navigate their digital world safely, and make choices to not only protect their health but also the health of their families and communities. These insights can help health organizations, governments, media, businesses, educational institutions and others sharpen their health communication strategies. Ensuring policy and recommendations are relevant to young people in a climate of misinformation, skepticism and fear. 

WHO hosted a webinar on the 31st March with guests from Wunderman Thompson, University of Melbourne and Pollfish to discuss methodology, key insights and implications. To watch the video,  click here .

Sarah Hess Technical Officer, Health Emergencies Programme World Health Organization [email protected]

Ellie Brocklehurst Head of Marketing & PR, APAC Wunderman Thompson [email protected]

Thomas Brauch Chief Data Officer, APAC Wunderman Thompson [email protected]

Professor Ingrid Volkmer Digital Communication and Globalization Faculty of Arts University of Melbourne [email protected]

EPI-WIN: WHO Information Network for Epidemics

Epi-win webinars, youth engagement, key insights document, watch the video recording.

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• Coping with COVID-19: How Young People Use Digital Media to Manage Their Mental Health

March 15, 2021

March 2021 marks the one-year anniversary of the start of the coronavirus pandemic in the United States. After a year of lockdowns and remote schooling and the disruption of social norms, teens and young adults are reporting growing levels of depression, stress, and anxiety.

Common Sense partnered with Hopelab and the California Health Care Foundation to better understand how young people have been using social media and digital health tools to take care of their mental health during the pandemic. Our new report,  Coping with COVID-19: How Young People Use Digital Media to Manage Their Mental Health  (ISSN: 2767-0163), reveals that depression rates have increased significantly since 2018, especially among teens and young adults who have had coronavirus infections in their homes. Exposure to hate speech on social media also is on the rise.

The good news is that young people are proactive in supporting their own mental health. Despite the negative content they see, digital media has been a lifeline for many of them to access critical health information, stay connected to their peers, find inspiration, and receive comfort in a difficult time.

In addition to quantitative data, the report brings the experiences of young people into focus through their own words, and provides insight into how we can best support them in their mental health journeys.

This pre-pandemic snapshot of young kids' media use presents a unique opportunity to understand the impact of the pandemic when combined with future research. But the results of this report are vitally important to finding solutions that provide all children with access to media that supports learning, health, and opportunity.

Fact sheets:

• Coping with COVID-19 Fact Sheet: COVID-19, depression, and social media use
• Coping with COVID-19 Fact Sheet: COVID-19, depression, and social media use (en español)
• Coping with COVID-19 Fact Sheet: Black youth
• Coping with COVID-19 Fact Sheet: Hispanic/Latinx youth
• Coping with COVID-19 Fact Sheet: Hispanic/Latinx youth (en español)
• Coping with COVID-19 Fact Sheet: LGBTQ+ youth
• Coping with COVID-19 Fact Sheet: Female youth
• Coping with COVID-19 Fact Sheet: Problematic substance use
• Coping with COVID-19 Fact Sheet: Telehealth

• Open access
• Published: 17 May 2022

Social media use and mental health during the COVID-19 pandemic in young adults: a meta-analysis of 14 cross-sectional studies

• Youngrong Lee 1 ,
• Ye Jin Jeon 2 ,
• Sunghyuk Kang 2 , 3 ,
• Jae Il Shin 4 ,
• Young-Chul Jung 3 &
• Sun Jae Jung 1 , 2  

BMC Public Health volume  22 , Article number:  995 ( 2022 ) Cite this article

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Metrics details

Public isolated due to the early quarantine regarding coronavirus disease 2019 (COVID-19) increasingly used more social media platforms. Contradictory claims regarding the effect of social media use on mental health needs to be resolved. The purpose of the study was to summarise the association between the time spent on social media platform during the COVID-19 quarantine and mental health outcomes (i.e., anxiety and depression).

Studies were screened from the PubMed, Embase, and Cochrane Library databases. Regarding eligibility criteria, studies conducted after the declaration of the pandemic, studies that measured mental health symptoms with validated tools, and studies that presented quantitative results were eligible. The studies after retrieval evaluated the association between time spent on social media platform and mental health outcomes (i.e. anxiety and depression). The pooled estimates of retrieved studies were summarised in odds ratios (ORs). Data analyses included a random-effect model and an assessment of inter-study heterogeneity. Quality assessment was conducted by two independent researchers using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS). This meta-analysis review was registered in PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ , registration No CRD42021260223, 15 June 2021).

Fourteen studies were included. The increase in the time spent using social media platforms were associated with anxiety symptoms in overall studies (pooled OR = 1.55, 95% CI: 1.30–1.85), and the heterogeneity between studies was mild (I 2  = 26.77%). Similarly, the increase in social media use time was also associated with depressive symptoms (pooled OR = 1.43, 95% CI: 1.30–1.85), and the heterogeneity between studies was moderate (I 2  = 67.16%). For sensitivity analysis, the results of analysis including only the “High quality” studies after quality assessment were similar to those of the overall study with low heterogeneity (anxiety: pooled OR = 1.45, 95% CI: 1.21–1.96, I 2  = 0.00%; depression: pooled OR = 1.42, 95% CI: 0.69–2.90, I 2  = 0.00%).

Conclusions

The analysis demonstrated that the excessive time spent on social media platform was associated with a greater likelihood of having symptoms of anxiety and depression.

Peer Review reports

Introduction

Despite the tremendous worldwide efforts including the introduction of vaccines, developing therapeutics and social distancing, the coronavirus outbreak is not expected to dampen due to the continuous emergence of new viral strains and difficulty in effective quarantine interventions. As a result of strong quarantine measures, private meetings, gatherings, and physical contact with intimate relatives have been reduced [ 1 ]. Prolonged social distancing and loss of intimate interpersonal contact increase feelings of frustration, boredom, anxiety, and potentially depression [ 2 ].

Studies have found that young, socially active populations or workers at high risk of infection, especially college students and frontline healthcare workers, bear a disproportionate burden of mental health problems worldwide (e.g., high levels of anxiety and depression), highlighting the need for appropriate intervention in these populations [ 3 , 4 ].

Social media in digital platforms is reportedly considered as a new channel of communication that could relieve aforementioned negative aspects of isolation through helping people escape negative emotions [ 5 ], projecting their personality as they desire, and evoking the impression of gaining back some control [ 6 ]. Social media may be helpful for relieving anxiety and depression by providing information regarding the pandemic [ 7 , 8 ].

However, prolonged use of social media by the isolated could be a double-edged sword that can adversely affect mental health due to sustained exposure to excessive information and misinformation [ 9 , 10 , 11 ]. While social media in digital platforms does help to promote social inclusion among adolescents and young adults, the risk associated with their excessive or problematic use cannot be overlooked [ 12 ]. Due to conflicting evidence and views regarding the effect of social media platform on the mental health, the recommendation for the use of social media in pandemic has been questioned.

Therefore, a meta-analysis was conducted to solve the contradictory effects of social media platform on anxiety and depression based on studies reporting an association between the use of social media and mental health outcomes (i.e., anxiety and depression) on the pandemic setting.

Eligibility criteria

Studies were included which met the following criteria: (1) use of the English language; (2) conducted after March 11, 2020 (date the WHO declared a pandemic) and published by December 20, 2020; (3) collected data using a validated tool of mental health symptoms (e.g., Patient Health Questionnaire: PHQ9, Generalized Anxiety Disorder-7 items: GAD-7); (4) full texts available; (5) measured time spent on social media platform in either continuous or categorical variable; (5) provided their results in OR, β, and/or Pearson’s r, and (6) studies measured mental health symptoms such as anxiety and depression.

Studies with the following characteristics were excluded: (1) Studies examined traditional social media (e.g., television and radio); (2) case reports, letters, comments, and narrative reviews without quantitative results, and (3) studies using a language other than English.

Studies investigating the association between time spent on social media and mental health outcomes (e.g., anxiety and depression) were summarised in Supplementary Material 1 . The pooled effect size of this meta-analysis was mainly presented in an odds ratio (Fig.  2 ).

Study selection

The search strategy principles were as follows: (1) “Social media” or individual names of social media in the title, keyword and abstract results; (2) Terms referring to mental health with COVID-19 specified in the title (e.g. depression, anxiety or blue).

A systematic literature search of the PubMed, Embase, and Cochrane Library databases was performed to identify studies. Publication date restrictions are from March 2020 to December 20, 2020. The search terms for a systematic search were as following: (1) (“COVID-19“ OR “corona“) AND (“mental health” OR depress* OR anxiety) AND (“social media” OR “Instagram” OR “Facebook” OR “twitter”) for PubMed, (2) (“coronavirus disease 2019’/exp/mj) AND (“mental health“/exp/mj OR “depression“/exp OR “anxiety“/exp) AND (“social media”/exp./mj OR “Facebook”/exp. OR “twitter”/exp. OR “Instagram“/exp) for Embase; (3) (“COVID-19″ OR “corona”) AND (“mental health“ OR depress* OR “anxiety”) AND (“social media“ OR ‘Instagram” OR “Facebook” OR “twitter”) for Cochrane Library.

Articles were first screened by reviewing titles, followed by a full-text review. Every selection stage involved three independent researchers (two medical doctors [SJJ and YRL] and one graduate student from the Epidemiology Department [YJJ]). Every article was independently evaluated by two researchers (YJJ and YRL) in first hand, and a third researcher (SJJ) mediated the final selection in case of differences in opinion.

Data extraction

Study data were extracted by two independent researchers (YRL and YJJ). A single author first extracted the information and a second author checked for accuracy. The extracted information is as follows: country of study, participant group sampled, age group of sample, date of data collection, mental health measures, effect size information, social media use time, and whether the adjustment was made for each analysis (see Supplementary Material 1 ). Studies were subdivided into categories according to the summary estimate of effect sizes (odds ratio [OR], beta estimate from multiple linear regression [β], and correlation coefficient [Pearson’s r]).

Exposure variables

The final studies after retrieval measured the amount of time spent on social media, which was either categorical or continuous variables (see Supplementary Material 1 ). It was measured based on the response to an item in the questionnaire: “How often were you exposed to social media? [categorical]” and “How long (in hours) were you exposed to social media? [continuous].” The measurement of exposure was expressed in different wordings as follows: “Less” vs. “Frequently,” “Less” vs. “Often”, “less than 1 hour” vs. “2 hours or more,” or “less than 3 hours” vs. “3 hours or more.” To calculate the overall effect, these individually measured exposure levels were operationally redefined (e.g., “Less” and “Few” were considered the same as “less than 2 hours;” “less than 1 hour,” “Frequently,” and “Often” were treated the same as “2 hours or more” and “3 hours or more”).

Outcome variables

The outcomes of included studies were “anxiety”, and “depression”. Anxiety was ascertained by using GAD-7 (cut-off: 10+), DASS-21, and PHQ-9, while depression was measured using PHQ-9 (cut-off: 10+), WHO-5 (cut-off: 13+), and GHQ-28 (cut-off: 24+). Anxiety and depression measured by using screening tools with cut-offs presented results in odds ratios (see Supplementary Material 1 ).

Statistical analysis

All statistical analyses and visualisations were performed with the “meta,” “metaphor,” and “dmeter” package of R version 3.6.3 ( https://cran.r-project.org/ ), using a random-effect model [ 13 , 14 , 15 ]. The effect measures were odds ratio, regression coefficient, and Pearson’s r, which calculated the association between the increase in social media use time and anxiety and depressive symptoms. In each study, the association with the mental health level of the social media frequent use group (compared to the low frequency group) was calculated as the odds ratio, and the association with the increase in the mental health level per hour increase was calculated as the regression coefficient (β) and Pearson’s r. Statistics used for calculating pooled effects (e.g., odds ratio, regression coefficient, and Pearson’s r) were utilized as its adjusted value with covariates from each study, not the unadjusted crude values.

The pooled effect sizes, Cochrane’s Q, and I 2 to assess heterogeneity were calculated. The pooled effect sizes, CIs, and prediction intervals were calculated by estimating the pooled effect and CIs using the Hartung-Knapp-Sidik-Jonkman method, which is known as the one of the most conservative methods [ 16 ]. The degree of heterogeneity was categorised as low, moderate, or high with threshold values of 25, 50, and 75%, respectively [ 17 ]. Possible causes of heterogeneity among study results were explored by statistical methods such as influential analysis, the Baujat plot, leave-one-out analysis, and Graphic Display of Heterogeneity analysis [ 18 ]. In addition, publication bias was assessed using funnel plots, Egger’s tests, and the trim-and-fill method [ 19 ].

Quality assessment

Quality assessment was conducted by two independent researchers, a psychiatrist (SHK) and an epidemiologist (YRL), using the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS), which can assess cross-sectional studies [ 20 ]. RoBANS has been validated with moderate reliability and good validity. RoBANS applies to cross-sectional studies and comprises six items: participant selection, confounding, exposure measurement, blinding of outcome assessments, missing outcomes, and selective reporting of outcomes. Each item is measured as having a “high risk of bias,” “low risk of bias,” or “uncertain.” For example, based on “participant selection,” each researcher marked an article as having a “high risk of bias” if, for example, the patient definitions of depression were generated by self-reported data. In cross-sectional studies, misclassification cases due to an unreliable self-contained questionnaire for categorizing depressive patients were rated as “high risk.” For the qualitative assessment, studies with two or more “high risk of bias” grades were then classified as “low quality”. The study was rated as “high quality” only if the evaluation of both raters was congruent. For sensitivity analysis, additional analysis including only “high quality” studies was conducted and it compared with the pooled estimates of overall results (see Table  1 ).

Ethical approval

The preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines 2020 were followed for this study. No ethical approval and patient consent are required since this study data is based on published literature. This meta-analysis review was registered with PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ , registration No CRD42021260223, 15 June 2021).

Included and excluded studies

Total of 346 studies were selected from the database search (288 from PubMed, 34 from Embase, and 24 from the Cochrane Library). After removing 19 duplicate publications, 327 studies were included for the title and full-text review (see Fig.  1 ). Non-original studies and those conducted with irrelevant subjects ( n  = 218) were excluded. Another 95 studies were excluded finally due to inconsistent study estimates. As summarised in Supplementary material 1 and 8 , 13 papers studied anxiety as an outcome (6 studies in odds ratio, 3 in regression coefficient, 4 in Pearson’s r), and a total of 9 papers studied depression as an outcome (6 studies in odds ratio, 3 in regression coefficient). Each of the final distinct 14 studies (after excluding duplicate studies) measured multiple mental health outcome variables (i.e., anxiety and depression), and pooled effect sizes were calculated for each outcome. Six studies that dealt with anxiety symptoms and six with depression (Supplementary Material 1 –1-1, 1–2-1) reported ORs and their 95% confidence intervals (CIs) ( n  = 9579 and n  = 13,241 for anxiety and depressive symptoms, respectively). Three studies each on anxiety and depression (Supplementary Material 1 –1-2, 1–2-2) reported their findings in β ( n  = 2376 and n  = 2574 for anxiety and depression, respectively). All included studies were cross-sectional studies. The pooled effect size was presented in odds ratio.

Flowchart of literature search and selection of the publications

Time spent on social media and mental health outcomes

Table 1 shows the result of the meta-analysis about the relationship between time spent on social media and mental health outcomes (i.e., anxiety and depression) of the selected cross-sectional studies. The increase in the time spent using social media platforms were associated with anxiety symptoms in overall studies (pooled OR = 1.55, 95% CI: 1.30–1.85, prediction intervals: [1.08–2.23]), and the heterogeneity between studies was mild (I 2  = 26.77%) (see Fig. 2 ). The three cross-sectional studies (presented in β) were insignificant (β = 0.05, 95% CI: − 0.32–0.15; a unit increment of each screening tool score per hour) with relatively high inter-study heterogeneity (I 2  = 76.07%). The overall estimate of the four cross-sectional studies (Pearson’s r) was 0.18 (95% CI: 0.10–0.27) with high inter-study heterogeneity (I 2  = 73.04%). The increase in social media use time was also associated with depressive symptoms (pooled OR = 1.43, 95% CI: 1.30–1.85, prediction intervals: [0.82–2.49]), and the heterogeneity between studies was moderate (I 2  = 67.16%) (see Fig. 2 ).

Forest plot for social media exposure and symptoms of mental health (i.e. anxiety & depression) in cross-sectional studies. Estimates presented in odds ratios (OR)

As result of quality assessment analysis, pooled effect size of studies classified as “high quality” was presented in Table 1 . The results were similar to the overall outcome (anxiety: OR = 1.45, 95% CI: 1.21–1.96; depression: OR = 1.42, 95% CI: 0.69–2.90). High-quality studies had low inter-study heterogeneity (anxiety: I 2  = 0.00%; depression: I 2  = 0.00%). The kappa statistic (inter-rater agreement) was 33.3%, indicating fair agreement.

Publication bias

Publication bias was assessed by funnel plot analysis and Egger’s test (Supplementary Material 4 –1). Funnel-plot analyses revealed symmetrical results (Supplementary Material 4 –2). In addition, all results of the Egger test were statistically insignificant, indicating improbable publication bias. After applying the trim-and-fill method, the funnel plot revealed no asymmetry (Supplementary Material 5 ), indicating no significant publication bias.

The study aimed to present a comprehensive direction of relevance by analysing studies investigating the association between time spent on social media during the COVID-19 pandemic and mental health symptoms (i.e., anxiety and depressive) among the public. The increase in the time spent on social media in digital platforms was associated with symptoms of anxiety and depression.

The pooled results are in line with previous systematic reviews and meta-analysis performed before the pandemic. A systematic literature review before the COVID-19 outbreak (2019) found that the time spent by adolescents on social media was associated with depression, anxiety, and psychological distress [ 21 ]. A meta-analysis of 11 studies (2017) also reported a weak association between social media use and depressive symptoms in children [ 22 ]. A meta-analysis of 23 studies (2018) reported significant correlation between social media use and psychological distress [ 23 ]. Likewise, this study also observed a similar trend of a negative effect of social media on mental health outcomes in the COVID-19 pandemic. However, the estimates of inter-study heterogeneity of these meta-analysis were relatively high (meta-analysis of 11 studies: I 2  = 92.4%; meta-analysis of 23 studies: I 2  = 62.00% for anxiety, I 2  = 80.58% for depression) compared to the analysis, which implies relatively higher homogeneity of the study population and reliable results.

Unverified information and opinions can be easily disseminated on social media platform and perceived as facts without verification. There has been a stream of news regarding the pandemic, creating a sense of urgency and anxiety. Repeated exposure to the news may affect the construct of external reality and may lead to a delusion-like experience, which has been linked to anxiety and social media overuse [ 24 , 25 ].

Additionally, discrimination and stigma related to COVID-19 on social media can make people fearful of being infected and exacerbate depression and anxiety [ 26 ]. Fear of COVID-19 may be compounded by coexisting depression and anxiety disorders [ 27 ]. Due to the high accessibility of social media platform and the ease of socialisation in a controlled setting, individuals with underlying depression may be more drawn to social media interactions rather than face-to-face ones, more so in the pandemic era [ 28 ].

Also, implementation of social distancing mandates new norms limiting physical conducts in almost all sectors of life, including educational institutes and vocational venue. Rapid transition to the new remote educational environment and telecommuting may trigger mental health issues [ 29 ].

In interpreting the findings of this study, several limitations should be considered. First, all the studies included were cross-sectional design. The possibility of a reverse causal relationship cannot be ruled out. Further studies with longitudinal data are warranted. Second, the results do not represent the general population since most of the studies recruited participants through a web-based survey, which may have had a selection bias. Lastly, some of the analysis showed a relatively high inter-study heterogeneity (range: I 2  = 0.00–80.53%). The results of the statistical approaches to identify the cause of heterogeneity (i.e. influential analysis, Baujat plot, leave-one-out analysis, and GOSH analysis) were summarised in Supplementary Material 6 and 7 .

Despite these limitations, this study exhibits a number of strengths; to the best of our knowledge, the study is the first meta-analysis to examine the relationship between use of social media and mental health outcomes during the COVID-19 pandemic, to validate the results by various verification methods such as trim-and-fill methods, influential analysis, and heterogeneity analysis. In addition, sensitivity analysis was also conducted with unbiased “high quality” studies through quality assessment.

The analysis demonstrates that excessive time spent on social media platform is associated with increased anxiety and depressive symptoms in the pandemic. While social media may be considered as an alternative channel for people to connect with their peers in the pandemic, the findings suggest that excessive use of social media can be detrimental for mental health. Further observation studies with longitudinal design to determine the true effect of social media platform are required.

Availability of data and materials

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

Coronavirus disease 2019

Confidence interval

Patient Health Questionnaire-9

Shortened version of PHQ

General Health Questionnaire-28

Depression Anxiety and Stress Scales

World Health Organization-Five Well-Being Index

Generalized Anxiety Disorder-7

Shortened version of GAD

Risk of Bias Assessment Tool for Nonrandomized Studies

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Acknowledgements

The authors would like to thank the Editage ( www.editage.co.kr ) for English language editing.

This study was supported by the National Research Foundation of Korea, funded by the Ministry of Science and ICT (2020R1C1C1003502), awarded to SJJ.

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Conceptualization: YRL, SJJ. Data curation: SJJ, JIS, YCJ, YRL. Formal analysis: YRL, SJJ. Funding acquisition: SJJ. Methodology: JIS, YCJ, YRL, SJJ. Project administration: SJJ. Visualization: YRL. Writing – original draft: YRL, YJJ, SHK, SJJ. Writing – review & editing: YRL, YJJ, SHK, JIS, YCJ, SJJ. The corresponding author attests that all listed authors meet authorship criteria and that no others meeting the criteria have been omitted. The author(s) read and approved the final manuscript.

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Lee, Y., Jeon, Y.J., Kang, S. et al. Social media use and mental health during the COVID-19 pandemic in young adults: a meta-analysis of 14 cross-sectional studies. BMC Public Health 22 , 995 (2022). https://doi.org/10.1186/s12889-022-13409-0

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Promote reliable information and combat misinformation, promote the healthy development of social media, conflict of interest statement, the important role of social media during the covid-19 epidemic.

Published online by Cambridge University Press:  10 September 2020

The 2019 coronavirus disease (COVID-19) epidemic has received close attention from governments, researchers, and the public in various countries. 1 , Reference Han, Wang, Zhang and Tang 2 In this case, billions of people are eager to get information about COVID-19 through social media. The rapid dissemination of topics and information related to COVID-19 has affected the behavior of the public during the epidemic. Today, more than 2.9 billion people use social media regularly. Reference Merchant and Lurie 3 These social media have an amazing spread speed, coverage, and penetration rate. During the COVID-19 epidemic, the social media platforms play an important role in dissemination information. Reference Merchant and Lurie 3

The World Health Organization (WHO) has found that the outbreak of COVID-19 and the response measures are accompanied by abundant information, and it is difficult to find reliable sources and reliable guidance. For rumors and false information spread on social media, it is necessary to coordinate the search for sources, identify, and reduce their spread. Reference Merchant 4 A study evaluating the number of times people watch COVID-19 medical videos on YouTube found that independent users were more likely to post misleading videos than useful ones (60.0% vs 21.5%, P = 0.009). Reference D’Souza, D’Souza and Strand 5 The actions of government agencies and social media giants have shown that public-private cooperation to identify, fact-check, and even delete false or outdated information may be an effective way to prevent these online information from hindering or even worsening public health efforts. Reference Limaye, Sauer and Ali 6 Social media operators can monitor high-traffic information and combine artificial intelligence to remove misleading information in a timely manner.

As clinicians in China, we often hear patients say that they have wanted to see a doctor for a long time. When they saw some reports in the media, they did not dare to go out or even come to the hospital. Some patients have said: “COVID-19 is a terrible infectious disease, most patients will die after infection,” or “the virus is still in the air, I dare not open the window.” Although the Health Committee of the People’s Republic of China recommends that people do not need to wear masks when there is no crowd outdoors, 7 some people are afraid to take off the masks because they are worried about being infected with airborne viruses. In fact, social media play a vital role in the dissemination of public health knowledge. However, during the epidemic, it is sometimes abused to spread unrealistic news, which may cause mental health problems. Reference Depoux, Martin and Karafillakis 8 Therefore, social media need to publish and update information about the epidemic in a timely manner, and popularize knowledge through the government and medical professionals to help guide the public correctly and stabilize public sentiment.

The WHO, academic institutions, and other official health institutions should consider using influential social media to disseminate accurate medical information to the general public. The information quality of social media should also be monitored. Ideally, established health care experts should ensure that potential misinformation is not disseminated. For global institutions, such as the WHO, the dissemination of correct information in different languages could be considered, especially in developing countries.

The authors have no conflicts of interest to declare.

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• Volume 15, Issue 4
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• DOI: https://doi.org/10.1017/dmp.2020.330

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The impact of media on children during the COVID-19 pandemic: A narrative review ☆

a Sapienza, University of Rome, Department of Dynamic Clinical and Health Psychology, Via degli Apuli, 1, 00186, Rome, Italy

L. Cerniglia

b International Telematic University Uninettuno, Faculty of Psychology, Corso Vittorio Emanuele II, 39, 00186, Rome, Italy

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No data was used for the research described in the article.

Although mobile technologies are a fundamental part of daily life, several studies have shown increased use of electronic devices, TV, and gaming during childhood in conjunction with the COVID-19 pandemic. The virus affected almost every country, causing uncertainty about the future, social isolation, and distress. This narrative review has searched the scientific literature in the field focusing on children. A non-systematic literature review was conducted in May 2022. Various databases were employed to conduct the document research for this paper, such as “Google Scholar”, “PubMed”, “Web of Science”. Keywords for the search included “screen time”, “media”, “digital use”, “social media”, “COVID-19”, “pandemic”, “lockdown”, “children”, “effect of media on children during COVID”. It was found that both children and adolescents seem to have used technologies to confront struggles provoked by COVID-19, such as the onset or exacerbation of symptoms of anxiety, depression, and attention-deficit/hyperactivity disorder. However, moreover, other studies have suggested that increased media use can have positive effects on children depending on usage and monitoring by the parents.

Media; Children; COVID-19; Narrative review.

1. Introduction

1.1. background: children and media.

Earlier literature has pointed out that media, particularly the Internet, affect individuals' health, interpersonal relationships, concerns and opinions, and sleep ( Do et al., 2020 ; Tran et al., 2017 , 2020 ; Zhang et al., 2017 ). Particularly for children, media contribute to daily life throughout development ( Calvert and Valkenburg, 2013 ): today's children are born and grow involved in media, as brilliantly described by the expression "digital natives" ( Prensky, 2001 ). Mobile technologies are a gateway to a wide range of information: their continued modernization, such as electronic tablets and smartphones, allows children and adolescents to be connected to media and move between them 24/7: youths can use their mobile phones to text or call one another, watch online television programs or movies, play online games, or use mobile apps ( Calvert, 2015 ).

Digital progress has supplied more innovative educational opportunities and easier access to information and communication ( Chauhan et al., 2021 ). Therefore, the digital age has fundamentally changed the lives of children, affecting their learning, social relationships, play, and overall development. At the same time, there are concerns about the possible harm caused by the excessive use of digital technology ( Huber et al., 2018 ; Przybylski et al., 2020 ) that could even result in a full-blown Internet addiction ( Mak et al., 2014 ).

There is significant literature highlighting the various problems that may result from excessive exposure to digital media, and the concerns are specific to each age group, from infants to adolescents ( Chonchaiya et al., 2011 ; Heffler et al., 2020 ; Srisinghasongkram et al., 2021 ).

Previous studies suggest that children's cognitive, behavioral, and emotional development might be impaired by exposure to digital media early in life, as it narrows their interests and limits areas of exploration and learning. This makes it difficult for kids to involve themselves in non-electronic tasks, decreases play time with other children, and thus impairs the development of imaginative skills, creativity, and social skills. Digital media also impairs children's maturation of language, attention, reading, and reasoning ( Chonchaiya et al., 2011 ; Heffler et al., 2020 ), the latter of which is also hindered by the many behavioral problems that can develop, like hyperactivity and inattention, aggression and conduct problems ( Srisinghasongkram et al., 2021 ). All of this has a huge negative effect and involves several areas of the individual: cognitive (intellectual) disorders, lack of attention, poor school performance, impulsivity, and poorer logical reasoning ( Srisinghasongkram et al., 2021 ).

A recent publication ( Stiglic and Viner, 2019 ) showed moderately convincing support for a correlation betwixt display time and depressive symptomatology and weak evidence for an association betwixt screen time and behavior problems, anxiety, hyperactivity, inattention, decreased self-esteem, and decreased psychosocial well-being in young children.

Another serious consequence is cyberbullying: children may be bullied and exposed to traumatic and pornographic/sexually explicit images. All of these may develop further adverse psychological implications ( American Academy of Pediatrics, 2016 ).

1.2. The impact of the COVID-19 pandemic

At the end of 2019, Coronavirus Disease 2019 (COVID-19) was first reported in China; it is a severe infectious disease with high contagiousness and rapid transmission rate, affecting the entire world population and causing various inconveniences in daily life ( Phelan et al., 2020 ). Several studies have shown that the policy of social isolation to control the circulation of COVID-19 did carry a complex influence on psychological well-being ( Chen et al., 2020 ; Duan et al., 2020 ; Lee et al., 2021 ; Xie et al., 2020 ).

COVID-19 took place when digitization was now global, in a society where anyone can be connected in any part of the globe ( Serra et al., 2021 ). Millions of children have been adversely affected by it: due to school closures, many youths have been forced to continue their education online and rely on digital media to stay connected with their peers ( Gupta and Jawanda, 2020 ). Consequently, social network use has increased: children spent more time with smartphones, tablets, and computers (e.g., Chen et al., 2021 ; Dong et al., 2020 ; Eales et al., 2021 ; Kamaşak et al., 2022 ; Serra et al., 2021 ; Susilowati et al., 2021 ; Teng et al., 2021 ).

Internet and social media provided kids and teenagers to remain connected with peers and relatives but also an avenue to confront unavailability of human interactions during COVID-19 and thus adverse emotions ( Cauberghe et al., 2021 ; Götz et al., 2020 ; Marciano et al., 2021 ). In compliance with these studies, the Compensatory Internet Use Theory ( Kardefelt-Winther, 2014 ) argues that adverse life events and stressors can provide motivation for anyone to turn to the Internet to mitigate adverse feelings related to these factors.

Nevertheless, it is crucial to consider that during the pandemic internet access was justified by online classes and peer communication, causing possible misuse ( Li et al., 2021a ) .

Because chronic stress during the pandemic can result in adverse emotional disorders, such as depression and anxiety (e.g., Pfefferbaum and North, 2020 ; Qiu et al., 2020 ), it has been observed that during the COVID-19 emergency, some people relied on dangerous coping strategies, such as using smartphones more frequently to consult the Internet and social media in order to alleviate pandemic-related anxiety and follow the news ( Király et al., 2020 ).

Indeed, using the Internet as entertainment can be a regular way for infants to discharge emotions and stress and cope with reality ( Kwon, 2011 ); however, excessive media use can lead users, especially children, to be less interested in real life and focus only on what is happening on the Internet ( King and Delfabbro, 2014 ). The World Health Organization (WHO) indicates a limit of 1 h of display time for 5-year-olds as a guideline ( WHO, 2019 ). Nevertheless, parents experienced many pressures related to screens and technologies since before the onset of the pandemic ( Radesky et al., 2016 ). Considering COVID-19, the inability of the majority of families to comply with the instructions on screens has been recognized.

During the pandemic, the news trended mostly negatively ( Ogbodo et al., 2020 ; Robertson et al., 2021 ; Priest, Sehgal, & Cook, 2020). Exposure to this kind of news, such as increased infections and deaths or the resulting economic crisis, causes stress and anxiety, and even panic attacks, especially among susceptible groups ( Scheufele, 1999 ). In fact, cross-cultural research centered on the moment of isolation found almost 50 percent of the world's infants were frightened by reports of COVID-19 ( Götz et al., 2020 ). Since pandemic-related news on social media channels was frequently misinformative, getting exposed to this could have adverse emotional implications ( Gabarron et al., 2021 ).

In addition, children can be exposed to inappropriate content and cyberbullying: according to a study conducted by Hunduja and Patchin (2020), even in the pre-COVID-19 period, the Internet was seen to expose children to increased cyberbullying, which can result in low self-esteem and even suicide attempts.

Indeed, the increase in media use is one of the most insidious threats of our time, as it has lowered the age of Internet use and awareness, consequently increasing the related risks and dangers. Therefore, the pandemic fueling this condition has left its mark on further development ( Kamaşak et al., 2021 ).

Earlier literature has focused mainly on adulthood (e.g., Wang et al., 2021a ; Wang et al., 2021b ) or adolescents ( Ren et al., 2021 ), paying less attention to the impact that media has on children, particularly during COVID-19. Therefore, this paper is designed to recapitulate the impact of media on infancy during COVID-19 and its implication on welfare.

The methodological approach of the present paper consists of a narrative review ( Green et al., 2006 ; Pan, 2008 ) and it is a type of interpretive-qualitative publication that does not answer a specific question but aims to discuss the state of the literature on a given issue and increase the scientific community's debate on it ( Grant and Booth, 2009 ).

A non-systematic literature review was conducted in May 2022. Since this was a narrative review, we did not use a risk of bias instrument, as some authors believe that this type of review may or may not include a quality assessment ( Grant & Booth, 2009 ; Pautasso, 2013 ).

Various databases were consulted in the search for papers, such as “Google Scholar”, “PubMed”, “Web of Science”. Keywords for the search included “screen time”, “media”, “digital use”, “social media”, “COVID-19”, “pandemic”, “lockdown”, “children”, “effect of media on children during COVID”. These keywords were combined with Boolean operators to restrict the results. The studies were filtered by two of the authors (A.R. and M.M.) and the relevant ones were included in this review, while the unrelevant ones were excluded, as shown in Figure 1 . Consequent information is summarized in Table 1 .

Table 1

Search strategy.

As for the eligibility criteria, we considered the age group 2–13 years, and papers that did not treat the main theme of the age group were discarded. Only studies published between 2020 and 2022 were considered. Since limiting the inclusion of studies by the language of publication is a widespread practice in reviews ( Stern and Kleijnen, 2020 ), we chose to follow this line: articles published not in English were not considered in the present paper. Also, some thesis dissertations (n = 2) were included. We examined each publication's title and abstract using our focus as a guide.

This manuscript aimed to summarize the evidence on the influence of media on children during COVID-19 and its impact on well-being. Table 2 provides a brief description of the selected studies.

Table 2

List of selected publications: Author/Year; Title; Main Issues and Measures.

Several papers selected in this review proved that the pandemic influenced children's habits toward electronic media, such as gaming and time spent on social media or smartphones ( Adachi et al., 2022 ; Camerini & Albanese, 2021; Chen et al., 2021 ; Chen et al., 2022 ; Hmidan, 2022 ; Kim et al., 2021 ; Marfua, 2021 ; Sciberras et al., 2022 ; Serra et al., 2021 ; Werling et al., 2021a , Werling et al., 2021b ).

It is possible to summarize the various contributions in this article by following a few main themes: the psychological and physical outcomes of using and owning technological gadgets during COVID-19 ( Adachi et al., 2022 ; Camerini et al., 2022 ; Chen et al., 2021 ; Chen et al., 2022 ; Cowan et al., 2021 ; Guo et al., 2021 ; Hmidan, 2022 ; Limone and Toto, 2021 ; Werling et al., 2021a ; Serra et al., 2021 ); behavioral problems related to overuse of media during COVID-19 ( Li et al., 2021b ; Marfua, 2021 ); the relationship between eating and sleeping disorders and the use of media during the pandemic ( Kamaleddine et al., 2022 ; Kim et al., 2022 ; Kotrla Topić et al., 2021 ); the effect of media in groups of clinical and ADHD children ( Sciberras et al., 2022 ; Shuai et al., 2021 ).

First, several focused on the outcomes of media on psychological and physical well-being, showing that some aversive outcomes due to the use of smartphones were noticed significantly more often in the study population during COVID-19, compared to the pre-pandemic time. In particular, the study by Serra et al. (2021) revealed a considerable risk of smartphone addiction in the pandemic (31.5 % before vs during the emergency 46.7% were outlined and 27.2% were high risk). Moreover, a study ( Adachi et al., 2022 ) instead focused on smartphone ownership and revealed a dissimilar result on depressive symptoms depending on whether children owned a smartphone or not: those who owned a cell phone had significantly higher and lower rates at the cutoff than expected. Consistent with these results on the effects of media overuse in children during COVID-19, the work of Chen et al. (2021) showed that IGDS, BSMAS, SABAS, depression, anxiety, and stress scores were positively and significantly related. In this study, mediation analyses indicated that social media and smartphone activities were mediators in the association between depression, anxiety, and stress, and increased playtime during school hiatus. In a longitudinal study ( Chen et al., 2022 ) repeated-measures analyses of variance noted a significant difference in mean psychological distress, problematic smartphone use, and problematic gaming. Moreover, other researchers not only gave attention to the emotional state of children but also of mothers, showing that maternal anxiety/depression was related to an overuse of handheld Internet devices, especially smartphones, among infants and children ( Guo et al., 2021 ).

In line with these results, very interesting is Hmidan's (2022) study that explored and demonstrated a significant association between screen time and internalizing behaviors: time spent on the screen was a positive predictor of internalizing behaviors (p < .05). In contrast, no association was noted between screen time and externalizing behaviors.

In the second place, on behavioral problems, two studies ( Li et al., 2021b ; Marfua, 2021 ) found a worsening in children's conduct during COVID-19 concerning media usage. The study by Li and colleagues (2021) showed that in younger children, higher time spent using TV or digital media was associated with higher levels of behavior problems and hyperactivity/disattention ( Li et al., 2021b ). In the same paper ( Li et al., 2021b ), was found that in older children (M = 11.3 +/- 3.3 years) more time spent using digital media or watching TV was connected with higher levels of depression, irritability, inattention, and hyperactivity; more time spent in online learning was linked with higher levels of depression and anxiety; higher levels of video-chatting time were associated with higher levels of depressive symptoms ( Li et al., 2021b ). Marfua (2021) noted that 55% of mothers reported a change in their children's behavior because of the long time spent on screens during the spread of COVID-19: children shower overactivity, attention problems, reduced interest in learning, showed aggressive attitude, were unable to control emotion and began to hide information (ibidem). In addition, a significant correlation was also found: the prosocial behavior of children decreases in relation to higher screen time (ibidem). The correlation between conduct, hyperactivity, peer relationship, and screen time was non-statistically significant.

Other studies have given importance to the adverse effects of screen time on physical health during the COVID-19 pandemic, such as eating habits, physical activities, and sleep. In particular, some studies focused on unhealthy eating habits. One study ( Kamaleddine et al., 2022 ) conducted a logistic regression analysis using food consumption while using media devices as a dependent variable. The significant independent variables that predicted children's habit of eating foods while using electronic devices were total time spent on screen ≥2 h, time spent on smartphone screen ≥2 h, sleep problems, the ownership of technological device, and not eating unhealthy foods (ibidem). Another study (Kim et al., 2022) that seems to confirm this result states that during the closure of school children gained weight, have done less sport, and have suffered increased exposure to screens. This study also observed that children's sleep problems were associated with time spent on tablets and smartphones, but not their frequency. In line with these results the study of Camerini et al. (2022) emphasized a reduction in the time that children have spent outdoors (green time) and an increase in media time with an overall reduction in children's health.

The work of Kotrla Topić et al. (2021) concerns sleep. In this study, sleep quality was investigated independently for three age groups of children (attending kindergarten, lower, or upper elementary school grades); in all three age groups, parents reported that their children had a good or very good sleep quality. The findings showed a significant negative association between sleep quality and age (partial r = -0.213, p < 0.001). For children, partial correlations were calculated between parents' ratings of sleep quality and digital technology usage, and the effect of age was controlled for. Researchers found a significant negative correlation between sleep quality and smartphone use in leisure time, implying that those who most frequently used smartphones for leisure time had poorer sleep quality.

An interesting study by Werling et al. (2021a) focused on a clinically referred sample and conducted a repeated-measures analysis of gaming time, finding that the primary outcome of gaming over time and the game interaction divided by gender were significant. A pairwise comparison showed that after the lockdown, female patients reported a play time similar to the pre-pandemic, but this did not occur in male patients. Planned contrasts disclosed significant differences in time spent on social media from T1 to T2 and T1 to T3. The pairwise comparisons revealed significant differences between time spent on social media from T1 to T3 in girls but not in boys. According to the results of this study, during the lockdown, the negative effects of using devices on family quality of life have intensified. In the last two weeks, these negative outcomes seem to have returned to normal levels for most parents. Taken together, however, according to parents' perceptions, the lockdown appears to have had very little effect on problem behaviors and specific risks related to the media usage. Parents were requested to indicate if the intensity of the main psychopathological problem had varied since January 2020 and during the lockdown. Most replied that there had been no significant change, meanwhile an increase in problems was referred by an average percentage of parents (37.7%) and a worsening by 21.2%. Statistical comparison between groups concerning estimated screen time in patients with worsened, unaltered, and improved symptoms during the lockdown found noticeable and significant effects. In children between 10 and 13 years with worsening symptomatology, the total time expended on media was significantly higher compared to other groups with no change or improvement in symptoms of the psychopathological disorder. It was also explored if overall time spent on media was correlated with the number of psychopathological disorders reported by parents, the frequency of online school during the lockdown and the frequency of allowed activities outside the home during the lockdown. Neither of these factors had a significant effect on the total time dedicated to media.

Finally, two studies have considered children with ADHD. In the first one ( Sciberras et al., 2022 ), children's stress about COVID-19 was significantly associated with a higher use of social media; the hypothesis of an association between COVID-19 worries and increased gaming has not been confirmed by statistical analysis. Shuai et al. (2021) also focused on children with ADHD: subjects were distinct in ADHD with and without PDMU (problematic digital media use). The ADHD group with PDMU had significantly worse symptoms in attention scores, in oppositional defiant scores, behavioral problems, and emotional difficulties when compared with the ADHD group without PDMU. The children with problematic digital media use presented significantly more impaired executive function on shift, emotional control, initiation, working memory, plan, and behavior regulation index, metacognition than the group without this condition. The total score on the depression self-rating scale for children and the screening child anxiety-related emotional disorders was significantly worse in ADHD with problematic digital media use group compared the other group. The ADHD children in the PDMU group spent more time on screens independently for playing video games than for using social media.

4. Discussion

The present study aims to highlight the implication of media use on children during COVID-19. The emergency that the world has faced over the past two years has had serious repercussions in every sphere of human life, affecting the psychological and non-psychological habits and welfare of everyone, regardless of age, putting family relationships and children's social-emotional maturation at risk ( Witt et al., 2020 ). Especially for children and adolescents the crisis has favored increased vulnerabilities and affected the stability of family members ( Douglas et al., 2020 ; Garcia and Duarte, 2020 ; Wang et al., 2020a ; Lee, 2020 ; Viner et al., 2020).

Considering the 18 selected articles in our review, we can highlight that the issues the authors focused on most are the problematic use of devices in early childhood and the psychological and physical impact that technology can have on children and their mental health. There is no doubt that COVID-19 there was an increase in the time spent at home compared to before the lockdown and so on screens, even for younger children ( Kotrla, Varga & Jelovčić., 2021 ; Andrew et al., 2020 ; Moore et al., 2020 ). In fact, the prevalence of technology device use increased significantly during the pandemic due to the lack of outdoor activity and indoor confinement. The increase of technology device employment during COVID-19 has been brought to 15 percent ( Ammar et al., 2021 ) and this has led to dysfunction in normal functioning ( Lau et al., 2022 ). In fact, increased use of technological devices is a prodrome for the eventual onset of sleep disorders, irritability but also Internet addiction, and gaming problems ( Mohan et al., 2021 ). Earlier studies have observed that Internet addiction is significantly correlated with the onset of psychiatric symptoms such as ADHD, depression, and anxiety ( Ho et al., 2014 ).

There is ample evidence that screen overexposure (≥4 h per day) can be a prodrome for major depressive disorder and social phobia in children ( Kim et al., 2020 ), emphasizing the need to restrict children's exposure to screens, regardless of their age ( Hmidan, 2022 ). According to research by Kim et al. (2021) , children gained weight during the blockade and engaged in less physical activity and more media use; the most used media was online educational content (97.2%); however, YouTube was found to be one of the most used contents (87.6%) immediately followed by online games (78.3%). This increased use of media and the Internet could lead not only to physical problems but also to internalizing and externalizing symptoms ( Hmidan, 2022 ). In this study, the author noticed a positive correlation between screen time and internalizing behaviors and hypothesized that age-related factors may moderate the strength of the correlation (ibidem).

Another crucial point is that the school hiatus, and consequently the lockdown related to the pandemic, could have caused psychological distress in elementary school children ( Chen et al., 2021 ), and the negative impact can be extended to the problematic use of social media and smartphones. Longitudinal research conducted by Chen et al. (2022) shows that the pandemic has worsened psychological health and increased problematic Internet use in a large sample of schoolchildren increasing digital media-related distress.

In addition, in research conducted by Atia Marfua (2021) , mothers noted various behavioral and health concerns in their sons and daughters during COVID-19 related to the prolonged use of screens and technological devices. Other researchers ( Li et al., 2021b ) found that increased screen use was related to greater rates of psychological health symptoms in children and adolescents during COVID-19, consistent with findings in the pre-pandemic literature ( Stiglic and Viner, 2019 ; Hoare et al., 2016 ; Suchert, Hanewinkel & Isensee, 2015 ). In particular, in young children, increased time spent on TV or digital media has proven to be related to conduct issues and hyperactivity/disattention ( Cost et al., 2022 .; Patterson et al., 2002). Television has had a significant impact during this period of isolation because everyone has it in the home: greater and more constant access to information regarding the pandemic has been positively related to symptoms of anxiety and depression as well as PTSD ( Wang et al., 2020b ; Xiong et al., 2020 ). Such negative consequences can strike especially hard with children: in fact, it has been shown that watching television before age 3 can negatively affect children's cognitive functions ( Zimmerman and Christakis, 2005 ).

Gaming has also played a significant role in entertaining children during isolation, even bringing in some cases positive, and non-negative, effects such as improving mental health and helping combat isolation ( Barr and Copeland-Stewart, 2022 ). In fact, video games are functional stress-relieving tools for both children and adults: they are believed to reduce both anxiety and depression and increase other abilities ( Bowman et al., 2022 ; Limone, 2021 ; Yee and Sng, 2022 ).

However, Werling et al. (2021) found that although most of the effects due to dysfunctional media use seemed reversible, this was not the case in a clinical champion of young males with psychiatric disorders. It is, therefore, possible to conclude, based on the earlier research cited above, that excessive media use was only temporary in most individuals, however, for those who were already at risk for technological dependence, the lockdown may have exacerbated the problem.

In addition, our investigation shows that children who engaged more in activities involving screens during the pandemic are more likely to develop higher levels of anxiety and psychosomatic symptoms ( Camerini et al., 2022 ), thus confirming previously observed findings ( Ho et al., 2014 ; Mohan et al., 2021 ).

A very interesting point to consider is that during COVID-19 infants experienced different age-related challenges ( Eales et al., 2021 ): in particular, while younger children may not need media to stay in virtual contact with peers, older children may have contacts outside the family to maintain ( Masten and Motti-Stefanidi, 2020 ). These researchers, in line with others, cited so far, have also found that in general an improve in children's media use was observed and that older children, in particular, are often left alone with technological devices as they are considered more independent.

Regarding mental health during COVID-19, some studies have found a correlation not only between device ownership and depression in school-aged children ( Adachi et al., 2022 ), but also between maternal symptomatology and excessive use of handheld Internet devices, particularly smartphones, among children ( Guo et al., 2021 ), and this association varies according to the age of the children. This is a crucial point because we need to consider that children's social isolation and the activities, they engage in during the shutdown also affect parents' mental health. Maternal mental state can affect the child in several ways: for example, mothers with internalizing disorders might make excessive use of electronic devices, act as role models for children, or use screen time to replace insufficient maternal companionship ( Bjelland et al., 2015 ; Faltýnková et al., 2020 ; Wu, 2016) or children may take relief from portable internet devices when the mother is unable to provide emotional support.

However, it is worth noting that the media can further have a beneficial impact: it has been shown that children and adolescents can benefit because social media helps increase communication skills and develop technical skills ( Tartari, 2015 ). During the lockdown, social media shares allowed for similar feelings to be shared: in fact, it was observed that those who perceived they had more support on social media had a better level of mental health ( Kaya, 2020 ; Canale et al., 2022 ).

Further, COVID-19 allowed new intervention methods for chronic disease management that proved to be extremely useful in that they allowed essential services needed during isolation not to be interrupted ( Shamsabadi et al., 2022 ).

Psychotherapy has also had to adapt to the period of isolation, resorting to the use of virtual platforms. Regarding the treatment of symptoms due to the pandemic, it has been found that cognitive-behavioral therapy via the Internet is the most effective therapy ( Ho et al., 2020 ; Zhang and Ho, 2017 ).

Overall, therefore, digital technologies can be useful resources in addressing issues posed by COVID-19.

Ultimately, the increased reliance on technology during COVID-19 has a complex impact. Technological devices have indeed provided an escape from loneliness but, at the same time, maybe a prodrome for the development of depression, anxiety, irritability, and sleep problems. This review has some limitations explained below. First, we only included papers published in English; we chose to follow this line due to lack of time and unavailability of language resources, which, as suggested by Neimann Rasmussen and Montgomery (2018) , are among the most common reasons for not including languages other than English. Another limitation may be related to the survey methods of the articles included in this manuscript; in fact, in most cases, they are based on parental observation. Since the results of the studies considered refer to a potentially frightening and depressing period for the children, likely, the time spent with the parents, which was greatly increased due to the closure, and the quality of the relationship may also have been affected; this situation could therefore have influenced the parents' ability to observe and, consequently, the results obtained. A controlled type of data collection would be useful to try to isolate possible causal agents.

5. Conclusions

We are aware that COVID-19 sets a unique issue and raises the need to find innovative solutions to the latest problems. We suggest that emphasis and attention be placed on children's psychological health during the pandemic because it is important to limit the negative impact of restrictions on their health to avoid long-term consequences. The family atmosphere plays a key role in promoting dialogue and a protective environment, especially in this period. Parents have a key role in this context and should check their children for negative outcomes of increased technology and media use. An effective strategy might be to limit screen time in favor of more interactive, creative, and in-person games; in addition, it would be helpful to promote time spent outdoors as much as possible, as access to green spaces has been combined with improved psychological health and maturation in infants ( Becker et al., 2017 ; McCormick, 2017 ; Tremblay et al., 2015 ). We hope that more in-depth research can be conducted in the future on how the media influenced the well-being of children during the COVID-19 pandemic.

Declarations

Author contribution statement.

All authors listed have significantly contributed to the development and the writing of this article.

Funding statement

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Data availability statement

Declaration of interest's statement.

The authors declare no conflict of interest.

Additional information

No additional information is available for this paper.

☆ This article is a part of the "The effects of media on children during the COVID-19″ Special issue.

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• Open access
• Published: 22 June 2023

Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic

• Abouzar Nazari   ORCID: orcid.org/0000-0003-2155-5438 1 ,
• Maede Hosseinnia   ORCID: orcid.org/0000-0002-2248-7011 2 ,
• Samaneh Torkian 3 &
• Gholamreza Garmaroudi   ORCID: orcid.org/0000-0001-7449-227X 4  

BMC Psychiatry volume  23 , Article number:  458 ( 2023 ) Cite this article

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Social media causes increased use and problems due to their attractions. Hence, it can affect mental health, especially in students. The present study was conducted with the aim of determining the relationship between the use of social media and the mental health of students.

Materials and methods

The current cross-sectional study was conducted in 2021 on 781 university students in Lorestan province, who were selected by the Convenience Sampling method. The data was collected using a questionnaire on demographic characteristics, social media, problematic use of social media, and mental health (DASS-21). Data were analyzed in SPSS-26 software.

Shows that marital status, major, and household income are significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Also, problematic use of social media (β = 3.54, 95% CI: (3.23, 3.85)) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). Income and social media use (β = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Major was significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status).

This study indicated that social media had a direct relationship with mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects.

Peer Review reports

• Social media

Social media is one of the newest and most popular internet services, which has caused significant progress in the social systems of different countries in recent years [ 1 , 2 ]. The use of the Internet has become popular among people in such a way that its use has become inevitable and has made life difficult for those who use it excessively [ 3 ]. Social media has attracted the attention of millions of users around the world owing to the possibility of fast communication, access to a large amount of information, and its widespread dissemination [ 4 ]. Facebook, WhatsApp, Instagram, and Twitter are the most popular media that have attractive and diverse spaces for online communication among users, especially the young generation [ 5 , 6 ].

According to studies, at least 55% of the world’s population used social media in 2022 [ 7 ]. Iranian statistics also indicate that 78.5% of people use at least one social media. WhatsApp, with 71.1% of users, Instagram, with 49.4%, and Telegram, with 31.6% are the most popular social media among Iranians [ 8 , 9 ].

The use of social media has increased significantly in all age groups due to the origin of the COVID-19 pandemic [ 10 ] .It affected younger people, especially students, due to educational and other purposes [ 11 , 12 ]. Because of the sudden onset of the COVID-19 pandemic, educational institutions and learners had to accept e-learning as the only sustainable education option [ 13 ]. The rapid migration to E-learning has brought several challenges that can have both positive and negative consequences [ 14 ].

Unlike traditional media, where users are passive, social media enables people to create and share content; hence, they have become popular tools for social interaction [ 15 ].The freedom to choose to participate in the company of friends, anonymity, moderation, encouragement, the free exchange of feelings, and network interactions without physical presence and the constraints of the real world are some of the most significant factors that influence users’ continued activity in social media [ 16 ]. In social media, people can interact, maintain relationships, make new friends, and find out more about the people they know offline [ 17 ]. However, this popularity has resulted in significant lifestyle changes, as well as intentional or unintentional changes in various aspects of human social life [ 18 ]. Despite many advantages, the high use of social media brings negative physical, psychological, and social problems and consequences [ 19 ], but despite the use and access of more people to the Internet, its consequences and crises have been ignored [ 20 ].

Use of social media and mental health

Spending too much time on social media can easily become problematic [ 21 ]. Excessive use of social media, called problematic use, has symptoms similar to addiction [ 22 , 23 ]. Problematic use of social media represents a non-drug-related disorder in which harmful effects emerge due to preoccupation and compulsion to over-participate in social media platforms despite its highly negative consequences [ 24 , 25 , 26 ], which leads to adverse consequences of mental health, including anxiety, depression, lower well-being, and lower self-esteem [ 27 , 28 , 29 ].

Mental health & use of social media

Mental health is the main pillar of healthy human societies, which plays a vital role in ensuring the dynamism and efficiency of any society in such a way that other parts of health cannot be achieved without mental health [ 30 ]. According to World Health Organization’s (WHO) definition, mental health refers to a person’s ability to communicate with others [ 31 ]. Some researchers believe that social relationships can significantly affect mental health and improve quality of life by creating a sense of belonging and social identity [ 32 ]. It is also reported that people with higher social interactions have higher physical and mental health [ 33 ].

Scientific evidence also shows that social media affect people’s mental health [ 34 ]. Social studies and critiques often emphasize the investigation of the negative effects of Internet use [ 35 ]. For example, Kim et al. studied 1573 participants aged 18–64 years and reported that Internet addiction and social media use were associated with higher levels of depression and suicidal thoughts [ 36 ]. Zadar also studied adults and reported that excessive use of social media and the Internet was correlated with stress, sleep disturbances, and personality disorders [ 37 ]. Richards et al. reported the negative effects of the Internet and social media on the health and quality of life of adolescents [ 38 ]. There have been numerous studies that examine Internet addiction and its associated problems in young people [ 39 , 40 ], as well as reports of the effects of social media use on young people’s mental health [ 41 , 42 ].

A study on Iranian students showed that social media leads to depression, anxiety, and mental health decline [ 25 ]. A study on Iranian students showed that social media leads to depression, anxiety, and mental health decline [ 25 ]. But no study has investigated the effects of social media on the mental health of students from a more traditional province with lower individualism and higher levels of social support (where they were thought to have lower social media use and better mental health) during the COVID-19 pandemic. As social media became more and more vital to university students’ social lives during the lockdowns, students were likely at increased risk of social media addiction, which could harm their mental health. University students depended more on social media due to the limitations of face-to-face interactions. In addition, previous studies were conducted exclusively on students in specific fields. However, in our study, all fields, including medical and non-medical science fields were investigated.

The present study was conducted to determine the relationship between the use of social media and mental health in students in Lorestan Province during the COVID-19 pandemic.

Study design and participants

The current study was descriptive-analytical, cross-sectional, and conducted from February to March 2022 with a statistical population made up of students in all academic grades at universities in Lorestan Province (19 scientific and academic centers, including centers under the supervision of the Ministry of Health and the Ministry of Science).

Sample size

According to the convenience sampling method, 781 people were chosen as participants in the present study. During the sampling, a questionnaire was created and uploaded virtually on Porsline’s website, and then the questionnaire link was shared in educational and academic groups on social media for students to complete the questionnaire under inclusion criteria (being a student at the University of Lorestan and consenting to participate in the study).

The research tools included the demographic information questionnaire, the standard social media use questionnaire, and the mental health questionnaire.

Demographic information

The demographic information age, gender, ethnicity, province of residence, urban or rural, place of residence, semester, and the field of study, marital status, household income, education level, and employment status were recorded.

Psychological assessment

The students were subjected to the Persian version of the Depression Anxiety Stress Scale (DASS21). It consists of three self-report scales designed to measure different emotional states. DASS21 questions were adjusted according to their importance and the culture of Iranian students. The DASS21 scale was scored on a four-point scale to assess the extent to which participants experienced each condition over the past few weeks. The scoring method was such that each question was scored from 0 (never) to 3 (very high). Samani (2008) found that the questionnaire has a validity of 0.77 and a Cronbach’s alpha of 0.82 [ 43 ].

Use of social media questionnaire

Among the 13 questions on social media use in the questionnaire, seven were asked on a Likert scale (never, sometimes, often, almost, and always) that examined the problematic use of social media, and six were asked about how much time users spend on social media. Because some items were related to the type of social media platform, which is not available today, and users now use newer social media platforms such as WhatsApp and Instagram, the questionnaires were modified by experts and fundamentally changed, and a 22-item questionnaire was obtained that covered the frequency of using social media. Cronbach’s alpha was equal to 0.705 for the first part, 0.794 for the second part, and 0.830 for all questions [ 44 ]. Considering the importance of the problematic use of the social media, six questions about the problematic use were measured separately.

To confirm the validity of the questionnaire, a panel of experts with CVR 0.49 and CVI 0.70 was used. Its reliability was also obtained (0.784) using Cronbach’s alpha coefficient. Finally, the questionnaire was tested in a class with 30 students to check the level of difficulty and comprehension of the questionnaire. Finally, a 22-item questionnaire was obtained, of which six items were about the problematic use of social media and the remaining 16 questions were about the rate and frequency of using social media. Cronbach’s alpha was 0.705 for the first part, including questions about the problematic use of the social media, and 0.794 for the second part, including questions about the rate and frequency of using the social media. The total Cronbach’s alpha for all questions was 0.830. Six questions about the problematic use of social media were measured separately due to the importance of the problematic use of social media. Also, a separate score was considered for each question. The scores of these six questions on the problematic use of the social media were summed, and a single score was obtained for analysis.

Statistical analysis

Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 26.0 (SPSS Inc., Chicago, IL, USA). The normal distribution of continuous variables was analyzed using the Kolmogorov-Smirnov test, histogram, and P-P diagram, which showed that they are not normally distributed. Descriptive statistics were calculated for all variables. Comparison between groups was done using Mann-Whitney and Kruskal-Wallis non-parametric tests. Multiple linear regression analysis was used to investigate the relationship between mental health, problematic use of social media, and social media use (The result of merging the Frequency of using social media and Time to use social media). Generalized Linear Models (GLM) were used to assess the association between mental health with the use of social media and problematic use of social media. Due to the high correlation (r = 0.585, p = < 0.001) between the use of social media and problematic use of social media, collinearity, we run two separate GLM models. Regression coefficients (β) and adjusted β (β*) with 95% CI and P-value were reported.

A total of 781 participants completed the questionnaires, of which 64.4% were women and 71.3% were single. The minimum age of the participants was 17 years, the maximum age was 45 years, and about half of them (48.9%) were between 21 and 25 years old. A total of 53.4% of the participants had bachelor’s degrees. The income level of 23.2% of participants was less than five million Tomans (the currency of Iran), and 69.7% of the participants were unemployed. 88.1% were living with their families and 70.8% were studying in non-medical fields. 86% of the participants lived in the city, and 58.9% were in their fourth semester or higher. Considering that the research was conducted in a Lorish Province, 43.8% of participants were from the Lorish ethnicity.

The mean total score of mental health was 12.30 with a standard deviation of 30.38, and the mean total score of social media was 14.5557 with a standard deviation of 7.74140.

Table  1 presents a comparison of the mean problematic use of social media and mental health with demographic variables. Considering the non-normality of the hypothesis H0, to compare the means of the independent variables, Mann-Whitney non-parametric tests (for the variables of gender, the field of study, academic semester, employment status, province of residence, and whether it is rural or urban) and Kruskal Wallis (for the variables age, ethnicity, level of education, household income and marital status). According to the obtained results, it was found that the score of problematic use of social media is significantly higher in women, the age group less than 20 years, unemployed, non-native students, dormitory students, and students living with friends or alone, Fars students, students with a household income level of fewer than 7 million Tomans(Iranian currency), and single, divorced, and widowed students were higher than the other groups(P < 0.05).

By comparing the mean score of mental health with demographic variables using non-parametric Mann-Whitney and Kruskal Wallis tests, it was found that there is a significant difference between the variable of poor mental health and all demographic variables (except for the semester variable), residence status (rural or urban) and education level. (There was a significant relationship (P < 0.05). In such a way that the mental health condition was worse in women, age group less than 20 years old, non-medical science, unemployed, non-native, and dormitory students. Also, Fars students, divorced, widowed, and students with a household income of fewer than 5 million Tomans (Iranian currency) showed poorer mental health status. (Table  1 ).

The final model shows that marital status, field, and household income were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Being single (β* = -23.03, 95% CI: (-33.10, -12.96), being married (β* = -38.78, 95% CI: -51.23, -26.33), was in Medical sciences fields (β* = -8.15, 95% CI: -11.37, -4.94), and have income 7–10 million (β* = -5.66, 95% CI: -9.62, -1.71) were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Problematic use of social media (β* = 3.54, 95% CI: (3.23, 3.85) was significantly associated with higher mental health scores (a higher DASS21 score means worse mental health status). (Table  2 )

Age, income, and use of social media (β* = 1.02, 95% CI: 0.78, 1.25) were significantly associated with higher DASS21 scores (a higher DASS21 score means worse mental health status). Marital status and field were significantly associated with lower DASS21 scores (a lower DASS21 score means better mental health status). Age groups < 20 years (β* = 6.36, 95% CI: 0.78, 11.95) and income group < 5 million (β* = 6.58, 95% CI: 1.47, 11.70) increased mental health scores. Being single (β* = -34.72, 95% CI: -47.06, -38.78), being married (β* = -38.78, 95% CI: -51.23, -26.33) and in medical sciences fields (β* = -8.17, 95% CI: -12.09, -4.24) decreased DASS21 scores. (Table  3 )

The main purpose of this study was to determine the relationship between social media use and mental health among students during the COVID-19 pandemic.

University students are more reliant on social media because of the limitations of in-person interactions [ 45 ]. Since social media has become more and more vital to the social lives of university students during the pandemic, students may be at increased risk of social media addiction, which may be harmful to their mental health [ 14 ].

During non-adulthood, peer relations and approval are critical and social media seems to meet these needs. For example, connection and communication with friends make them feel better and happier, especially during the COVID-19 pandemic and national lockdowns where face-to-face communication was restricted [ 46 ]. Kele’s study showed that the COVID-19 pandemic has increased the time spent on social media, and the frequency of online activities [ 47 ].

Because of the COVID-19 pandemic, e-learning became the only sustainable option for students [ 13 ]. This abrupt transition can lead to depression, stress, or anxiety for some students due to insufficient time to adjust to the new learning environment. The role of social media is also important to some university students [ 48 ].

Staying at home, having nothing else to do, and being unable to go out and meet with friends due to the lockdown measures increased the time spent on social media and the frequency of online activities, which influenced their mental health negatively [ 49 ]. These reasons may explain the findings of previous studies that found an increase in depression and anxiety among adolescents who were healthy before the COVID-19 pandemic [ 50 ].

According to the results, there was a statistically significant relationship between social media use and mental health in students, in such a way that one Unit increase in the score of social media use enhanced the score of mental health. These two variables were directly correlated. Consistent with the current study, many studies have shown a significant relationship between higher use of social media and lower mental health in students [ 45 , 51 , 52 , 53 , 54 ].

Inconsistent with the findings of the present study, some previous studies reported the positive effect of social media use on mental health [ 55 , 56 , 57 ]. The differences in findings could be attributed to the time and location of the studies. Anderson’s study in France in 2018 found no significant relationship between social media use and mental health. This may be because of the differences between the tools for measuring the ability to detect fake news and health literacy and the scales of the research [ 4 ].

The present study showed that the impact of using social media on the mental health of students was higher than Lebni’s study, which was conducted in 2020 [ 25 ]. Also, in Dost Mohammad’s study in 2018, the effect of using social media on the mental health of students was reported to be lower than in the present study [ 58 ]. Entezari’s study in 2021, was also lower than the present study [ 59 ]. It seems that the excessive use of social media during the COVID-19 pandemic was the reason for the greater effects of social media on students’ mental health.

The use of social media has positive and negative characteristics. Social media is most useful for rapidly disseminating timely information via widely accessible platforms [ 4 ]. Among the types of studies, at least one shows an inverse relationship between the use of social media and mental health [ 53 ]. While social media can serve as a tool for fostering connection during periods of physical isolation, the mental health implications of social media being used as a news source are tenuous [ 45 ].

The results of the GLM analysis indicated that there was a statistically significant relationship between the problematic use of social media and mental health in students in such a way that one-unit increase in the score of problematic use of social media enhanced the mental health score, and it was found that the two variables had a direct relationship. Consistent with our study, Boer’s study showed that problematic use of social media may highlight the potential risk to adolescent mental health [ 60 ]. Malaeb also reported that the problematic use of social media had a positive relationship with mental health [ 61 ], but that study was conducted on adults and had a smaller sample size before the COVID-19 pandemic.

Saputri’s study found that excessive social media use likely harms the mental health of university students since students with higher social media addiction scores had a greater risk of experiencing mild depression [ 62 ]. A systematic literature review before the COVID-19 pandemic (2019) found that the time spent by adolescents on social media was associated with depression, anxiety, and psychological distress [ 63 ]. Marino’s study (2018) reported a significant correlation between the problematic use of social media by students and psychological distress [ 64 ].

Social media has become more vital for students’ social lives owing to online education during the COVID-19 pandemic. Therefore, this group is more at risk of addiction to social media and may experience more mental health problems than other groups. Lebni also indicated that students’ higher use of the Internet led to anxiety, depression, and adverse mental health, but the main purpose of the study was to investigate the effects of such factors on student’s academic performance [ 25 ]. Previous studies indicated that individuals who spent more time on social media had lower self-esteem and higher levels of anxiety and depression [ 65 , 66 ]. In the present study, students with higher social media addiction scores were at higher mental health risk. Such a finding was consistent with research by Gao et al., who found that the excessive use of social media during the pandemic had adverse effects on social health [ 14 ]. Cheng et al. indicated that using the Internet, especially for communication with people, can harm mental health by changing the quality of social relationships, face-to-face communication, and changes in social support [ 24 ].

A reason for the significant relationship between social media use and mental health in students during the COVID-19 pandemic in the present study was probably the students’ intentional or unintentional use of online communication. Unfortunately, social media published information, which might be incorrect, in this pandemic that caused public fear and threatened mental health.

During the pandemic, social media played essential roles in learning and leisure activities. Due to electronic education, staying at home, and long leisure time, students had more time, frequency, and opportunities to use social media in this pandemic. Such a high reliance on social media may threaten student’s mental health. Lee et al. conducted a study during the COVID-19 pandemic and confirmed that young people who used social media had higher symptoms of depression and loneliness than before the COVID-19 pandemic [ 67 ].

The present study showed that there was a significant positive relationship between problematic use of social media and gender, so that women were more willing to use social media, probably because they had more opportunities to use social media as they stayed at home more than men; hence, they were more exposed to problematic use of social media. Consistent with our study, Andreassen reported that being a woman was an important factor in social media addiction [ 68 ]. In contrast to our study, Azizi’s study in Iran showed that male students use social media significantly more than female students, possibly due to differences in demographic variables in each population [ 69 ].

Moreover, there was a significant relationship between age and problematic use of social media in that people younger than 20 were more willing to use social media in a problematic way. Consistent with the present study, Perrin also indicated that younger people further used social media [ 70 ].

According to the findings, unemployed students used social media more than employed ones, probably because they had more time to spend in virtual space, leading to higher use and the possibility of problematic use of social media [ 71 ].

Moreover, non-native students were more willing to use the social media probably because students who lived far away from their families used social media problematically due to the lack of family control over hours of use and higher opportunities [ 72 ] .

The results showed that rural students have a greater tendency to use social Medias than urban students. Inconsistent with this finding, Perrin reported that urban people were more willing to use the social media. The difference was probably due to different research times and places or different target groups [ 70 ].

According to the current study, people with low household income were more likely to use social media, most likely because low-income people seek free information and services due to a lack of access to facilities and equipment in the real world or because they seek assimilation with people around them. Inconsistent with our findings, Hruska et al. reported that people with high household income levels made much use of social media [ 73 ], probably because of cultural, economic, and social differences or different information measurement tools.

Furthermore, single, divorced, and widowed students used social media more than married students. This is because they spend more time on social media due to the need for more emotional attention, the search for a life partner, or a feeling of loneliness. This also led to the problematic use of social media [ 74 ].

According to the results, Fars people used social media more than other ethnic groups, but this difference was insignificant. This finding was consistent with Perrin’s study, but the population consisted of people aged 18 to 65 [ 70 ].

In the current study, there was a significant relationship between gender and mental health, so that women had lower mental health than men. The difference was in health sociology. Consistent with the present study, Ghasemi et al. indicated that it appeared necessary to pay more attention to women’s health and create an opportunity for them to use health services [ 75 ].

The findings revealed that unemployed students had lower mental health than employed students, most likely because unemployed individuals have lower mental health due to not having a job and being economically dependent on others, as well as feeling incompetent at times. Consistent with the present study, Bialowolski reported that unemployment and low income caused mental disorders and threatened mental health [ 76 ].

According to this study, non-native students have lower mental health than native students because they live far from their families. The family plays an imperative role in improving the mental health of their children, and mental health requires their support. Also, the economic, social, and support problems caused by being away from the family have endangered their mental health [ 77 ].

Another important factor of the current study was that married people had higher mental health than single people. In addition, divorced and widowed students had lower mental health [ 78 ]. Possibly due to the social pressure they suffer in Iranian society. Furthermore, they received lower emotional support than married people. Therefore, their lower mental health seemed logical [ 79 , 80 , 81 ]. A large study in a European population also reported differences in the likelihood of mood, anxiety, and personality disorders between separated/divorced and married mothers [ 82 ].

A key point confirmed in other studies is the relationship between low incomes with mental health. A meta-analysis by Lorant indicated that economic and social inequalities caused mental disorders [ 83 ]. Safran also reported that the probability of developing mental disorders in people with low socioeconomic status is up to three times higher than that of people with the highest socioeconomic status [ 84 ]. Bialowolski’s study was consistent with the current study but Bialowolski’s study examined employees [ 76 ].

The present study was conducted during the COVID-19 pandemic and therefore had limitations in accessing students. Another limitation was the use of self-reporting tools. Participants may show positive self-presentation by over- or under-reporting their social media-related behaviors and some mental health-related items, which may directly or indirectly lead to social desirability bias, information bias, and reporting bias. Small sample sizes and convenience sampling limit student population representativeness and generalizability. This study was based on cross-sectional data. Therefore, the estimation results should be seen as associative rather than causative. Future studies would need to investigate causal effects using a longitudinal or cohort design, or another causal effect research design.

The findings of this study indicated that the high use of social media affected students’ mental health. Furthermore, the problematic use of the social media had a direct relationship with mental health. Variables such as age, gender, income level, marital status, and unemployment of non-native students had significant relationships with social media use and mental health. Despite the large amount of evidence suggesting that social media harms mental health, more research is still necessary to determine the cause and how social media can be used without harmful effects. It is imperative to better understand the relationship between social media use and mental health symptoms among young people to prevent such a negative outcome.

Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to express their gratitude to all academic officials of Lorestan universities and Mr. Mohsen Amani for their cooperation in data collection.

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Abouzar Nazari

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Maede Hosseinnia

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Abouzar Nazari and Maedeh Hossennia designed the study, collected the data and drafted the manuscript. Samaneh Torkian performed the statistical analysis and prepared the tables. Gholamreza Garmaroudi, as the responsible author, supervised the entire study. All authors reviewed and edited the draft manuscript and approved the final version.

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Nazari, A., Hosseinnia, M., Torkian, S. et al. Social media and mental health in students: a cross-sectional study during the Covid-19 pandemic. BMC Psychiatry 23 , 458 (2023). https://doi.org/10.1186/s12888-023-04859-w

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DOI : https://doi.org/10.1186/s12888-023-04859-w

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Remote learning, lockdowns and pandemic uncertainty have increased anxiety and depression among adolescents, and heightened concerns about their mental health.

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Positive and negative impact of social media in the COVID-19 era

Affiliations.

• 1 Division of Internal Medicine, Mexican Institute of Social Security, Merida, 97150, Yucatan, Mexico.
• 2 Division of Nephrology, Texas A&M College of Medicine at Dallas, 75246, Texas, United States.
• 3 University of Illinois at Chicago/ Advocate Christ Medical Center, Oak Lawn, 60453, IL, United States.
• PMID: 33388000
• DOI: 10.31083/j.rcm.2020.04.195

Social Media usage has been shown to increase in situations of natural disaster and other crises. It is crucial for the scientific community to understand how social media works in order to enhance our capabilities and make a more resilient community. Through social media communication, the scientific community can collaborate around the globe in a faster way the most important findings of a disease, with a decreased knowledge transition time to other healthcare providers (HCPs). This is greatly important to coordinate research and knowledge during a time of uncertainty and protentional fake news. During the 2020 global pandemic, social media has become an ally but also a potential threat. High volumes of information compressed into a short period can result in overwhelmed HCPs trying to discern fact from noise. A major limitation of social media currently is the ability to quickly disseminate false information which can confuse and distract. Society relies on educated scientists and physicians to be leaders in delivering fact-based information to the public. For this reason, in times of crises it is important to be leaders in the conversation of social media to guide correct and helpful information and knowledge to the masses looking for answers.

Keywords: COVID-19; Social media; misinformation; webinars.

© 2020 Venegas-Vera et al. Published by IMR Press.

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Conflict of interest statement

The authors declare no conflicts of interest statement.

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