High Social Media Use May Fuel ADHD in Teens

Megan Brooks

July 18, 2018

Heavy use of texting, video chatting, and social media may contribute to the onset of symptoms of attention-deficit/hyperactivity disorder (ADHD) in youth, new research suggests.

Dr Adam Leventhal

Among a large group of adolescents who did not have symptoms of ADHD at baseline, frequent use of digital media was found to be associated with the emergence of new ADHD symptoms.

"We cannot confirm whether there is a causal effect of digital media use on ADHD from our study. However, this study raises new concerns whether the proliferation of high-performance digital media technologies may be putting a new generation of youth at risk for ADHD," Adam Leventhal, PhD, director, Health, Emotion, and Addiction Laboratory, University of Southern California, Los Angeles, told Medscape Medical News.

"While digital media use in moderation might provide some benefits, like access to educational information or social support, excessive exposure to digital media entertainment could have adverse mental health consequences," said Leventhal.

The study was published online July 17 in JAMA.

Modest Association

The investigators tracked 2587 adolescents (mean age, 15 years; 54% girls) in 10 high schools in Los Angeles County, California, during a period of 2 years. None of participants had ADHD symptoms at baseline, as determined on the basis of scores on the Current Symptoms Self-Report Form. Participants completed surveys at baseline and at 6, 12, and 24 months.

At the start of the study, the students reported how often they used 14 popular digital media activities, such as checking social media, texting, playing digital games, video chatting, online browsing, or streaming videos, among others. On the basis of their responses, the researchers classified the participants into three categories: no use, medium use, and high use. The high-use category was defined as past-week use of all 14 different media activities multiple times a day.

The average number of digital media activities used at a high-frequency rate was 3.62. The most common media activity was checking social media; 54.1% of students were in the high-use category on this activity.

According to the researchers, higher-frequency use of digital media was significantly associated with subsequent symptoms of ADHD during the 24-month follow-up period (odds ratio, 1.11; 95% confidence interval [CI], 1.06 - 1.16 per each additional digital media activity).

On average, ADHD symptoms emerged during follow-up in 9.5% of the students who reported engaging in seven high-frequency digital media activities and in 10.5% of those who reported engaging in all 14 high-frequency digital media activities, compared with only 4.6% of students who reported not engaging in any of the digital media activities.

The association between higher-frequency digital media use and subsequent ADHD symptoms was "statistically significant but modest," the researchers write. Stronger associations between media use and ADHD were found among adolescents who had more mental health symptoms, such as delinquent behavior and depressive symptoms.

Leventhal told Medscape Medical News parents, educators, and pediatricians "should be aware about the link between media use and mental health and open a dialogue with teens about digital media use. One useful resource are digital applications that can be downloaded directly to a device and track how much time the user is spending on the device using specific apps. Simply having information on the extent of use may be a good starting point for thinking about whether changes in media use might be helpful," said Leventhal.

Several Potential Mechanisms

In an accompanying editorial, Jenny Radesky, MD, University of Michigan School of Medicine, Ann Arbor, says several mechanisms might explain the associations found in this study.

For example, instant access to highly engaging technologies may affect users' impulse control and expectations for immediate feedback, she explains. It has also been hypothesized that the ubiquitous, "always-on" nature of mobile media displaces opportunities for the brain to rest in its default mode, tolerate boredom, or practice mindfulness.

"Attentional shifts triggered by notifications may reduce a child's ability to stay focused on challenging, nonpreferred tasks that require top-down executive control. Displacement of sleep and exercise, both important to executive functioning, are also possible mechanisms that would explain the findings in this study," writes Radesky.

Interpret With Caution

That stronger associations between media use and ADHD were found among adolescents who had more mental health symptoms "suggests that emotional dysregulation may be an important mechanism in some adolescents," Radesky points out.

But Gabrielle Carlson, MD, professor, Department of Psychiatry, Stony Brook University, New York, cautions against jumping to the conclusion that high use of social media is contributing to ADHD.

"Although I am not a fan of social media, I don't think the data can say that social media is giving [teens] ADHD," she noted in an interview with Medscape Medical News.

It's also noteworthy, Carlson said, that the "biggest bumps in ADHD symptoms were in the first 6 months, and with successive follow-up, symptoms came down a bit, so it's hard for me to believe that that's really ADHD. If this is really a media impact, you'd expect to see symptoms increasing over time, not decreasing," she noted.

The study was supported by the National Institutes of Health. The authors have disclosed no relevant financial relationships.

JAMA. Published online July 17, 2018. Abstract, Editorial

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