Rises in adolescent media use have paralleled increases in youth major depressive disorder (MDD) and suicidal thoughts and behaviors (STBs). Studies linking screen time and decreased mental health focus on older adolescents and overlook media content. This study examined how frequency and content of media related to MDD and STBs in children and early adolescents enriched for psychopathology. Youth ages 8-12 (N = 191; Mage = 10.13) completed clinical interviews assessing MDD and STBs. They reported how frequently they engage with (a) different media formats, (b) media portraying different mature content, and (c) media centered on suicide. Greater self-reported media use, regardless of format, was associated with increased odds of MDD. Engagement with violent and substance-related themes was associated with increased odds of both MDD and STBs. Increased engagement with suicide-related content was specifically associated with STBs. Findings underscore the importance of considering content in addition to duration of media exposure.
BarrR.KirkorianH.RadeskyJ.CoyneS.NicholsD.BlanchfieldO.RusnakS.StockdaleL.RibnerA.DurnezJ.EpsteinM.HeimannM.KochF. S.SundqvistA.Birberg-ThornbergU.KonradC.SlussareffM.BusA.BellagambaF.FitzpatrickC. (2020). Beyond screen time: A synergistic approach to a more comprehensive assessment of family media exposure during early childhood. Frontiers in Psychology, 11(9), 1283. https://doi.org/10.3389/fpsyg.2020.01283
CataldoM. G.NobileM.LorussoM. L.BattagliaM.MolteniM. (2005). Impulsivity in depressed children and adolescents: A comparison between behavioral and neuropsychological data. Psychiatry Research, 136(2), 123–133. https://doi.org/10.1016/j.psychres.2004.12.012
7.
CooperM. T.BardD.WallaceR.GillaspyS.DeleonS. (2018). Suicide attempt admissions from a single children’s hospital before and after the introduction of Netflix series 13 reasons why. Journal of Adolescent Health, 63(6), 688–693. https://doi.org/10.1016/j.jadohealth.2018.08.028
8.
den HamerA. H.KonijnE. A.PlaisierX. S.KeijerM. G.KrabbendamL. C.BushmanB. J. (2017). The Content-based Media Exposure Scale (C-ME): Development and validation. Computers in Human Behavior, 72, 549–557. https://doi.org/10.1016/j.chb.2017.02.050
9.
DonohueM. R.WhalenD. J.GilbertK. E.HennefieldL.BarchD. M.LubyJ. (2019). Preschool depression: A diagnostic reality. Current Psychiatry Reports, 21(12), 128. https://doi.org/10.1007/s11920-019-1102-4
10.
FergusonC. J. (2019). 13 reasons why not: A methodological and meta-analytic review of evidence regarding suicide contagion by fictional media. Suicide and Life-Threatening Behavior, 49(4), 1178–1186. https://doi.org/10.1111/sltb.12517
11.
FergusonC. J. (2021). One less reason why: Viewing of suicide-themed fictional media is associated with lower depressive symptoms in youth. Mass Communication and Society, 24(1), 85–105. https://doi.org/10.1080/15205436.2020.1756335
12.
FergusonC. J.KayeL. K.Branley-BellD.MarkeyP.IvoryJ. D.KlisaninD.SmythM.HoggJ. L.McDonnellD.NicholsD.SiddiquiS.GregersonM.WilsonJ. (2022). Like this meta-analysis: Screen media and mental health. Professional Psychology: Research and Practice, 53(2), 205–214. https://doi.org/10.1037/pro0000426
13.
ForsP. Q.BarchD. M. (2019). Differential relationships of child anxiety and depression to child report and parent report of electronic media use. Child Psychiatry & Human Development, 50(6), 907–917. https://doi.org/10.1007/s10578-019-00892-7
14.
FoxK. R.HarrisJ. A.WangS. B.MillnerA. J.DemingC. A.NockM. K. (2020). Self-injurious thoughts and behaviors interview—revised: Development, reliability, and validity. Psychological Assessment, 32(7), 677–689. https://doi.org/10.1037/pas0000819
15.
GoodmanS. H.RouseM. H.ConnellA. M.BrothM. R.HallC. M.HeywardD. (2011). Maternal depression and child psychopathology: A meta-analytic review. Clinical Child and Family Psychology Review, 14(1), 1–27. https://doi.org/10.1007/s10567-010-0080-1
16.
GouldM.JamiesonP.RomerD. (2003). Media contagion and suicide among the young. American Behavioral Scientist, 46(9), 1269–1284. https://doi.org/10.1177/000276420225067
17.
HennefieldL.WhalenD. J.TillmanR.BarchD. M.LubyJ. L. (2024). Preschool-onset major depressive disorder as a strong predictor of suicidal ideation and behaviors into preadolescence. Journal of the American Academy of Child & Adolescent Psychiatry, 63(9), 919–930. https://doi.org/10.1016/j.jaac.2023.11.008
18.
HoughtonS.LawrenceD.HunterS. C.RosenbergM.ZadowC.WoodL.ShiltonT. (2018). Reciprocal relationships between trajectories of depressive symptoms and screen media use during adolescence. Journal of Youth and Adolescence, 47(11), 2453–2467. https://doi.org/10.1007/s10964-018-0901-y
19.
JoinerT. (2005). Why people die by suicide. Harvard University Press.
20.
LeibenluftE.StoddardJ. (2013). The developmental psychopathology of irritability. Development and Psychopathology, 25(4pt2), 1473–1487. https://doi.org/10.1017/S0954579413000722
21.
LinS.-Y.EatonN. R.SchleiderJ. L. (2020). Unpacking associations between mood symptoms and screen time in preadolescents: A network analysis. Journal of Abnormal Child Psychology, 48(12), 1635–1647. https://doi.org/10.1007/s10802-020-00703-x
22.
LiuJ.WuL.SunX.BaiX.DuanC. (2023). Active parental mediation and adolescent problematic internet use: The mediating role of Parent–Child relationships and hiding online behavior. Behavioral Sciences, 13(8), 679. https://doi.org/10.3390/bs13080679
23.
LubyJ. L.BarchD. M.WhalenD.TillmanR.FreedlandK. E. (2018). A randomized controlled trial of parent-child psychotherapy targeting emotion development for early childhood depression. American Journal of Psychiatry, 175(11), 1102–1110. https://doi.org/10.1176/appi.ajp.2018.18030321
24.
McAllisterC.HislerG. C.BlakeA. B.TwengeJ. M.FarleyE.HamiltonJ. L. (2021). Associations between adolescent depression and self-harm behaviors and screen media use in a nationally representative time-diary study. Research on Child and Adolescent Psychopathology, 49(12), 1623–1634. https://doi.org/10.1007/s10802-021-00832-x
25.
NiederkrotenthalerT.StackS.TillB.SinyorM.PirkisJ.GarciaD.RockettI. R. H.TranU. S. (2019). Association of increased youth suicides in the United States with the release of 13 reasons why. JAMA Psychiatry, 76(9), 933–940. https://doi.org/10.1001/jamapsychiatry.2019.0922
26.
OdgersC. L.JensenM. R. (2020). Annual research review: Adolescent mental health in the digital age: Facts, fears, and future directions. Journal of Child Psychology and Psychiatry, 61(3), 336–348. https://doi.org/10.1111/jcpp.13190
27.
Padilla-WalkerL. M.CoyneS. M.KroffS. L.Memmott-ElisonM. K. (2018). The protective role of parental media monitoring style from early to late adolescence. Journal of Youth and Adolescence, 47(2), 445–459. https://doi.org/10.1007/s10964-017-0722-4
28.
PatalayP.FitzsimonsE. (2018). Development and predictors of mental ill-health and wellbeing from childhood to adolescence. Social Psychiatry and Psychiatric Epidemiology, 53(12), 1311–1323. https://doi.org/10.1007/s00127-018-1604-0
29.
PosnerK.BrownG. K.StanleyB.BrentD. A.YershovaK. V.OquendoM. A.MelvinG. A.GreenhillL.ShenS.MannJ. J. (2011). The Columbia–suicide severity rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. American Journal of Psychiatry, 168(12), 1266–1277. https://doi.org/10.1176/appi.ajp.2011.10111704
30.
RideoutV.PeeblesA.MannSRobbM.B. (2021). The Common Sense census: Media use by tweens and teens, 2021. Common Sense Media.
31.
RileyA. W. (2004). Evidence that school-age children can self-report on their health. Ambulatory Pediatrics, 4(4), 371–376. https://doi.org/10.1367/A03-178R.1
32.
RuchD. A.HorowitzL. M.HughesJ. L.SarkisianK.LubyJ. L.FontanellaC. A.BridgeJ. A. (2024). Suicide in US preteens aged 8 to 12 years, 2001 to 2022. JAMA Network Open, 7(7), Article e2424664. https://doi.org/10.1001/jamanetworkopen.2024.24664
33.
Sevilla-FernándezD.Díaz-LópezA.Caba-MachadoV.MachimbarrenaJ. M.Ortega- BarónJ.González-CabreraJ. (2025). Parental mediation and the use of social networks: A systematic review. PLoS One, 20(2), Article e0312011. https://doi.org/10.1371/journal.pone.0312011
34.
StuartA. L.PascoJ. A.JackaF. N.BrennanS. L.BerkM.WilliamsL. J. (2014). Comparison of self-report and structured clinical interview in the identification of depression. Comprehensive Psychiatry, 55(4), 866–869. https://doi.org/10.1016/j.comppsych.2013.12.019
35.
ThorpH. H. (2024). Unsettled science on social media. In Science (384, p. 1389). American Association for the Advancement of Science (AAAS). https://doi.org/10.1126/science.adr1730
36.
TortoleroS. R.PeskinM. F.BaumlerE. R.CuccaroP. M.ElliottM. N.DaviesS. L.LewisT. H.BanspachS. W.KanouseD. E.SchusterM. A. (2014). Daily violent video game playing and depression in preadolescent youth. Cyberpsychology, Behavior, and Social Networking, 17(9), 609–615. https://doi.org/10.1089/cyber.2014.0091
37.
TwengeJ. M.CampbellW. K. (2019). Media use is linked to lower psychological well-being: Evidence from three datasets. Psychiatric Quarterly, 90(2), 311–331. https://doi.org/10.1007/s11126-019-09630-7
38.
TwengeJ. M.FarleyE. (2021). Not all screen time is created equal: Associations with mental health vary by activity and gender. Social Psychiatry and Psychiatric Epidemiology, 56(2), 207–217. https://doi.org/10.1007/s00127-020-01906-9
39.
TwengeJ. M.JoinerT. E.RogersM. L.MartinG. N. (2018). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science, 6(1), 3–17. https://doi.org/10.1177/2167702617723376
40.
World Health Organization. (2023). Preventing suicide: A resource for media professionals, 2023 update.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
