Among 6,595 adolescents, adjusted internalizing-problem relative-risk ratios were 1.60 for more than 3 to 6 hours and 1.78 for more than 6 hours versus no use; adjusted comorbid-problem ratios were 2.01 and 2.44. Associations remained after adjustment, but self-report, residual confounding, and possible reverse association limit causal inference.
assuming a causal effect of social media use and no confounding—both strong assumptions
Discussion
Among 6,595 adolescents, adjusted internalizing-problem relative-risk ratios were 1.60 for more than 3 to 6 hours and 1.78 for more than 6 hours versus no use; adjusted comorbid-problem ratios were 2.01 and 2.44. Associations remained after adjustment, but self-report, residual confounding, and possible reverse association limit causal inference. The study reports relative-risk ratios, not a simple universal doubling of “poor mental health,” and expressly does not establish social-media causation.