Digital media use and mental health

Digital media use and mental health
A teenage girl using a smartphone
The relationships between digital media use and mental health are under study.[1]
RelatedScreen time, gaming disorder, problematic internet use, problematic social media use, problematic smartphone use

The relationships between digital media use and mental health have been investigated by various researchers—predominantly psychologists, sociologists, anthropologists, and medical experts—especially since the mid-1990s, after the growth of the World Wide Web. A significant body of research has explored "overuse" phenomena, commonly known as "digital addictions", or "digital dependencies". These phenomena manifest differently in many societies and cultures. Some experts have investigated the benefits of moderate digital media use in various domains, including in mental health, and the treatment of mental health problems with novel technological solutions.

The delineation between beneficial and pathological use of digital media has not been established. There are no widely accepted diagnostic criteria, although some experts consider overuse a manifestation of underlying psychiatric disorders. The prevention and treatment of pathological digital media use is also not standardised, although guidelines for safer media use for children and families have been developed. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) does not include diagnoses for problematic internet use, problematic social media use, and gaming disorder (commonly known as video game addiction), whereas the eleventh revision of the International Classification of Diseases (ICD-11) recognises gaming disorder. Experts are still debating how and when to diagnose these conditions. The use of the term addiction to refer to these phenomena and diagnoses has also been questioned.

Digital media and screen time have changed how children think, interact and develop in positive and negative ways, but researchers are unsure about the existence of hypothesised causal links between digital media use and mental health outcomes. Those links appear to depend on the individual and the platforms they use. Several large technology firms have made commitments or announced strategies to try to reduce the risks of digital media use.

History and terminology

A child looks into a smartphone
A young boy engaged with a smartphone

The relationship between digital technology and mental health has been investigated from many perspectives.[2][3][4] Benefits of digital media use in childhood and adolescent development have been found.[5] Concerns have been expressed by researchers, clinicians and the public in regard to apparent compulsive behaviours of digital media users, as correlations between technology overuse and mental health problems become apparent.[2][6][7]

Terminologies used to refer to compulsive digital-media-use behaviours are not standardised or universally recognised. They include "digital addiction", "digital dependence", "problematic use", or "overuse", often delineated by the digital media platform used or under study (such as problematic smartphone use or problematic internet use).[8] Unrestrained use of technological devices may affect developmental, social, mental and physical well-being and may result in symptoms akin to other psychological dependence syndromes, or behavioural addictions.[9][7] The focus on problematic technology use in research, particularly in relation to the behavioural addiction paradigm, is becoming more accepted, despite poor standardisation and conflicting research.[10]

Internet addiction has been proposed as a diagnosis since the mid-1990s,[11] and social media and its relation to addiction has been examined since 2009.[12] A 2018 Organisation for Economic Co-operation and Development (OECD) report noted the benefits of structured and limited internet use in children and adolescents for developmental and educational purposes, but that excessive use can have a negative impact on mental well-being. It also noted an overall 40% increase in internet use in school-age children between 2010 and 2015, and that different OECD nations had marked variations in rates of childhood technology use, as well as differences in the platforms used.[13]

The Diagnostic and Statistical Manual of Mental Disorders has not formally codified problematic digital media use in diagnostic categories, but it deemed internet gaming disorder to be a condition for further study in 2013.[14] Gaming disorder, commonly known as video game addiction, has been recognised in the ICD-11.[15][16] Different recommendations in the DSM and the ICD are due partly to the lack of expert consensus, the differences in emphasis in the classification manuals, as well as difficulties utilising animal models for behavioural addictions.[9]

The utility of the term addiction in relation to overuse of digital media has been questioned, in regard to its suitability to describe new, digitally mediated psychiatric categories, as opposed to overuse being a manifestation of other psychiatric disorders.[3][4] Usage of the term has also been criticised for drawing parallels with substance use behaviours. Careless use of the term may cause more problems—both downplaying the risks of harm in seriously affected people, as well as overstating risks of excessive, non-pathological use of digital media.[4] The evolution of terminology relating excessive digital media use to problematic use rather than addiction was encouraged by Panova and Carbonell, psychologists at Ramon Llull University, in a 2018 review.[17]

Due to the lack of recognition and consensus on the concepts used, diagnoses and treatments are difficult to standardise or develop. Heightened levels of public anxiety around new media (including social media, smartphones and video games) further obfuscate population-based assessments, as well as posing management dilemmas.[3] Radesky and Christakis, the 2019 editors of JAMA Paediatrics, published a review that investigated "concerns about health and developmental/behavioural risks of excessive media use for child cognitive, language, literacy, and social-emotional development."[18] Due to the ready availability of multiple technologies to children worldwide, the problem is bi-directional, as taking away digital devices may have a detrimental effect, in areas such as learning, family relationship dynamics, and overall development.[19]