New longitudinal study links problematic social media use with rising ADHD symptoms in adolescent boys

A new study by Dr Jason Nagata and colleagues, published in JAMA Network Open, adds to growing evidence that healthcare professionals should look beyond screen time alone and pay closer attention to patterns of problematic social media use.

As conversations around children’s digital health continue to evolve, one of the most important questions remains whether social media contributes to attention difficulties or whether children with attention difficulties are simply drawn to social media.

A new longitudinal study from researchers at the University of California, San Francisco (UCSF), provides important new evidence that helps address this question.

Following more than 11,000 adolescents over five years, the Nagata study found that increases in problematic social media use were followed by increases in ADHD symptoms one year later, particularly among adolescent boys. Importantly, researchers did not find consistent evidence that ADHD symptoms preceded increasing problematic social media use.

While the study cannot establish causation, it strengthens an emerging body of evidence suggesting that addictive patterns of social media use may contribute to poorer cognitive and behavioural outcomes during adolescence.

Looking beyond screen time

One of the most valuable aspects of this study is that researchers were not simply measuring how long young people spent online.

Instead, they assessed problematic social media use, sometimes referred to as addictive social media use, which shares characteristics with behavioural addictions, including impaired control, withdrawal, relapse and tolerance.

Adolescents were asked about behaviours including:

• thinking frequently about social media
• wanting to reduce their use but being unable to do so
• using social media to escape problems
• experiencing distress when attempting to cut back
• allowing social media to interfere with sleep, schoolwork or relationships.

This distinction is important.

Increasingly, evidence suggests that the quality and pattern of engagement may be more clinically meaningful than screen time alone.

What did the study find?

The researchers analysed data from the Adolescent Brain Cognitive Development (ABCD) Study, the largest long-term study of brain development and child health in the United States.

The study followed 11,286 adolescents from approximately 12 to 16 years of age, collecting annual data on social media use alongside parent-reported ADHD symptoms.

The findings showed that:

• increases in problematic social media use were associated with small but significant subsequent increases in ADHD symptoms
• the strongest associations were seen among boys aged 14–15 years
• ADHD symptoms did not consistently predict later increases in problematic social media use.

This temporal relationship strengthens the argument that problematic social media use may precede worsening attention difficulties, rather than simply reflecting pre-existing ADHD.

Why might this happen?

Social media platforms are intentionally designed to maximise engagement.

Features such as endless scrolling, algorithmically personalised feeds, variable rewards, notifications and continuous novelty encourage repeated checking and frequent task switching.

For developing brains, particularly during adolescence, when executive functioning and inhibitory control are still maturing, these design features may make self-regulation especially difficult.

As Dr Jason Nagata notes, problematic social media use is characterised by behaviours similar to other addictive disorders, including withdrawal, impaired control and relapse.

For many young people, reducing social media use is not simply a matter of willpower.

Supporting evidence from the UK

These findings closely align with the UK Government’s recently published family pilot exploring different approaches to reducing social media use.

One particularly striking finding was that restricting social media to short daily periods often proved more difficult and distressing for young people than removing social media altogether.

Families who removed social media reported improvements in wellbeing, with children describing themselves as:

• happier
• calmer
• less stressed
• better able to concentrate.

Taken together, these findings suggest that once patterns of problematic use have developed, partial restriction may not always be the easiest strategy for families.

Clinical implications

The Nagata study highlights the importance of routinely exploring a child’s digital environment during clinical assessment.

Alongside asking how much time a young person spends online, clinicians may wish to explore questions such as:

• Can they stop using social media when they want to?
• Does social media interfere with sleep, education or relationships?
• Does reducing use lead to distress or conflict?
• Do parents describe compulsive or repetitive checking behaviours?

Understanding these patterns may provide valuable insight into a child’s functioning and inform conversations with families about healthier digital habits.

Strengths and limitations

This study has several important strengths.

It is one of the largest longitudinal investigations of problematic social media use and ADHD symptoms to date, following participants over five years within a diverse, nationally representative cohort.

Unlike cross-sectional studies, longitudinal research allows researchers to examine how changes unfold over time, providing stronger evidence regarding the direction of observed associations.

However, the findings should also be interpreted appropriately.

The study demonstrates an association rather than causation, and the observed increases in ADHD symptoms were relatively small. As with all observational research, unmeasured factors may also contribute to the relationship.

Nevertheless, the findings add meaningful evidence to a growing body of research indicating that problematic social media use is an important consideration for clinicians working with children and adolescents.

Looking ahead

As healthcare professionals increasingly recognise the role of digital environments in children’s health, research such as the Nagata study reinforces the need to move beyond measuring screen time alone.

Understanding how children are engaging with social media, and recognising the signs of problematic use, may prove increasingly important in supporting attention, wellbeing and healthy development.

Read the full study here.

---

Reference

Nagata JM, et al. (2026). Problematic Social Media Use and Attention-Deficit/Hyperactivity Disorder Symptoms in Adolescents. JAMA Network Open.

---