Temporal Associations Between Social Media Use and Depression

Published:December 10, 2020DOI:


      Previous studies have demonstrated cross-sectional associations between social media use and depression, but their temporal and directional associations have not been reported.


      In 2018, participants aged 18–30 years were recruited in proportion to U.S. Census characteristics, including age, sex, race, education, household income, and geographic region. Participants self-reported social media use on the basis of a list of the top 10 social media networks, which represent >95% of social media use. Depression was assessed using the 9-Item Patient Health Questionnaire. A total of 9 relevant sociodemographic covariates were assessed. All measures were assessed at both baseline and 6-month follow-up.


      Among 990 participants who were not depressed at baseline, 95 (9.6%) developed depression by follow-up. In multivariable analyses conducted in 2020 that controlled for all covariates and included survey weights, there was a significant linear association (p<0.001) between baseline social media use and the development of depression for each level of social media use. Compared with those in the lowest quartile, participants in the highest quartile of baseline social media use had significantly increased odds of developing depression (AOR=2.77, 95% CI=1.38, 5.56). However, there was no association between the presence of baseline depression and increasing social media use at follow-up (OR=1.04, 95% CI=0.78, 1.38). Results were robust to all sensitivity analyses.


      In a national sample of young adults, baseline social media use was independently associated with the development of depression by follow-up, but baseline depression was not associated with an increase in social media use at follow-up. This pattern suggests temporal associations between social media use and depression, an important criterion for causality.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Malhi GS
        • Mann JJ
        Lancet. 2018; 392: 2299-2312
        • Wang J
        • Wu X
        • Lai W
        • et al.
        Prevalence of depression and depressive symptoms among outpatients: a systematic review and meta-analysis.
        BMJ Open. 2017; 7e017173
        • Murray CJ
        • Vos T
        • Lozano R
        • et al.
        Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010 [published correction appears in Lancet. 2013;381(9867):628].
        Lancet. 2012; 380: 2197-2223
        • Mathers CD
        • Loncar D
        Projections of global mortality and burden of disease from 2002 to 2030.
        PLoS Med. 2006; 3: e442
        • Greenberg PE
        • Fournier AA
        • Sisitsky T
        • Pike CT
        • Kessler RC
        The economic burden of adults with major depressive disorder in the United States (2005 and 2010).
        J Clin Psychiatry. 2015; 76: 155-162
        • Mendelson T
        • Tandon SD
        Prevention of depression in childhood and adolescence.
        Child Adolesc Psychiatr Clin N Am. 2016; 25: 201-218
        • Primack BA
        • Bisbey MA
        • Shensa A
        • et al.
        The association between valence of social media experiences and depressive symptoms.
        Depress Anxiety. 2018; 35: 784-794
        • Rosen LD
        • Whaling K
        • Rab S
        • Carrier LM
        • Cheever NA
        Is Facebook creating “iDisorders”? The link between clinical symptoms of psychiatric disorders and technology use, attitudes and anxiety.
        Comput Hum Behav. 2013; 29: 1243-1254
        • Block M
        • Stern DB
        • Raman K
        • et al.
        The relationship between self-report of depression and media usage.
        Front Hum Neurosci. 2014; 8: 712
        • Primack BA
        • Shensa A
        • Escobar-Viera CG
        • et al.
        Use of multiple social media platforms and symptoms of depression and anxiety: a nationally-representative study among U.S. young adults.
        Comput Hum Behav. 2017; 69: 1-9
        • Kaplan AM
        • Haenlein M
        Users of the world, unite! The challenges and opportunities of social media.
        Bus Horiz. 2010; 53: 59-68
        • Uhls YT
        • Ellison NB
        • Subrahmanyam K
        Benefits and costs of social media in adolescence.
        Pediatrics. 2017; 140: S67-S70
        • Crone EA
        • Konijn EA
        Media use and brain development during adolescence.
        Nat Commun. 2018; 9: 588
        • Primack BA
        • Escobar-Viera CG
        Social media as it interfaces with psychosocial development and mental illness in transitional age youth.
        Child Adolesc Psychiatr Clin N Am. 2017; 26: 217-233
        • Institute of Medicine, National Research Council
        Investing in the Health and Well-Being of Young Adults.
        The National Academies Press, Washington, DC2015
        • Shensa A
        • Escobar-Viera CG
        • Sidani JE
        • Bowman ND
        • Marshal MP
        • Primack BA
        Problematic social media use and depressive symptoms among U.S. young adults: a nationally representative study.
        Soc Sci Med. 2017; 182: 150-157
        • Lin LY
        • Sidani JE
        • Shensa A
        • et al.
        Association between social media use and depression among U.S. young adults.
        Depress Anxiety. 2016; 33: 323-331
        • Moreno MA
        • Kota R
        • Schoohs S
        • Whitehill JM
        The Facebook influence model: a concept mapping approach.
        Cyberpsychol Behav Soc Netw. 2013; 16: 504-511
        • Ibarra JL
        • Agas JM
        • Lee M
        • Pan JL
        • Buttenheim AM
        Comparison of online survey recruitment platforms for hard-to-reach pregnant smoking populations: feasibility study.
        JMIR Res Protoc. 2018; 7: e101
        • Marie-Mitchell A
        • Kostolansky R
        A systematic review of trials to improve child outcomes associated with Adverse Childhood Experiences.
        Am J Prev Med. 2019; 56: 756-764
        • Choi SW
        • Schalet B
        • Cook KF
        • Cella D
        Establishing a common metric for depressive symptoms: linking the BDI-II, CES-D, and PHQ-9 to PROMIS depression.
        Psychol Assess. 2014; 26: 513-527
        • Hill AB
        The environment and disease: association or causation?.
        Proc R Soc Med. 1965; 58: 295-300
        • Twenge JM
        • Joiner TE
        • Rogers ML
        • Martin GN
        Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010 and links to increased new media screen time.
        Clin Psychol Sci. 2018; 6: 3-17
        • Heffer T
        • Good M
        • Daly O
        • MacDonell E
        • Willoughby T
        The longitudinal association between social-media use and depressive symptoms among adolescents and young adults: an empirical reply to Twenge et al. (2018).
        Clin Psychol Sci. 2019; 7: 462-470
        • Yoon S
        • Kleinman M
        • Mertz J
        • Brannick M
        Is social network site usage related to depression? A meta-analysis of Facebook–depression relations.
        J Affect Disord. 2019; 248: 65-72
        • Hoge E
        • Bickham D
        • Cantor J
        Digital media, anxiety, and depression in children.
        Pediatrics. 2017; 140: S76-S80
        • Seabrook EM
        • Kern ML
        • Rickard NS
        Social networking sites, depression, and anxiety: a systematic review.
        JMIR Ment Health. 2016; 3: e50
        • Meshi D
        • Tamir DI
        • Heekeren HR
        The emerging neuroscience of social media.
        Trends Cogn Sci. 2015; 19: 771-782
        • Lamblin M
        • Murawski C
        • Whittle S
        • Fornito A
        Social connectedness, mental health and the adolescent brain.
        Neurosci Biobehav Rev. 2017; 80: 57-68
        • Choudhury S
        • McKinney KA
        Digital media, the developing brain and the interpretive plasticity of neuroplasticity.
        Transcult Psychiatry. 2013; 50: 192-215
        • Escobar-Viera CG
        • Shensa A
        • Bowman ND
        • et al.
        Passive and active social media use and depressive symptoms among United States adults.
        Cyberpsychol Behav Soc Netw. 2018; 21: 437-443
        • Schembre SM
        • Liao Y
        • O'Connor SG
        • et al.
        Mobile ecological momentary diet assessment methods for behavioral research: systematic review.
        JMIR Mhealth Uhealth. 2018; 6: e11170
        • Bennett BL
        • Whisenhunt BL
        • Hudson DL
        • et al.
        Examining the impact of social media on mood and body dissatisfaction using ecological momentary assessment.
        J Am Coll Health. 2020; 68: 502-508
        • Stieger S
        • Lewetz D
        A week without using social media: results from an ecological momentary intervention study using smartphones.
        Cyberpsychol Behav Soc Netw. 2018; 21: 618-624
        • Ernala SK
        • Burke M
        • Leavitt A
        • Ellison NB
        How well do people report time spent on Facebook? An evaluation of established survey questions with recommendations.
        in: Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems; 2020 April 25–30; Honolulu, HI. ACM, New York2020
        • Scharkow M
        The accuracy of self-reported internet use—a validation study using client log data.
        Commun Methods Meas. 2016; 10: 13-27