Research Articles

Social Media Use and Mental Health in Young Adults of

Greece: A Cross-Sectional Study

Epameinondas Leimonis 1, Katerina Koutra 1

[1] Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Greece.

Clinical Psychology in Europe, 2022, Vol. 4(2), Article e4621, https://doi.org/10.32872/cpe.4621

Received: 2020-10-30 • Accepted: 2022-02-08 • Published (VoR): 2022-06-30

Handling Editor: Winfried Rief, Philipps-University of Marburg, Marburg, Germany

Corresponding Author: Katerina Koutra, Department of Psychology, School of Social Sciences, University of Crete,
Gallos Campus 74100 – Rethymno, Crete, Greece. Telephone: ++30 2810324999/++30 6977357108. E-mail:
koutra.k@gmail.com

Abstract
Background: Social media use has vastly increased during the past few years, especially among
young adults. Studies examining the relationship of social media use with mental health have
yielded mixed findings. Additionally, such studies are extremely limited in Greece. The present
study aimed to investigate the association between social media use, depressive symptoms and
self-esteem among Greek young adults.
Method: A total of 654 individuals (50.5% male) aged 18-30 years (Μ = 23.62, SD = 2.71) completed
self-reported questionnaires regarding social media use, depressive symptoms and self-esteem.
Results: Increased daily use of YouTube (more than five hours) showed a significant association
with higher depressive symptomatology, b = 2.99, 95% CI [.78, 5.20], p = .008, while daily use of
Facebook between two and five hours was related to significantly higher self-esteem, b = 1.61, 95%
CI [.78, 2.44], p < .001, after adjusting for participants’ gender, age, educational level and
employment status. The association of increased daily use of YouTube with depressive symptoms
was more pronounced in males than in females. Moreover, self-reported active use of Facebook and
Instagram were linked with significantly lower depressive symptoms and higher self-esteem
compared to passive involvement.
Conclusion: The results suggest that social media use is closely related to self-esteem and
depressive symptomatology in young adults. These findings may contribute to a deeper clinical
understanding of the association between electronic social networking and mental health.

Keywords
social media, mental health, self-esteem, depressive symptoms, young adults

This is an open access article distributed under the terms of the Creative Commons
Attribution 4.0 International License, CC BY 4.0, which permits unrestricted use,
distribution, and reproduction, provided the original work is properly cited.
Social Media Use and Mental Health 2

Highlights
• Increased daily time spent in YouTube (more than five hours) was significantly
associated with higher depressive symptomatology.
• YouTube daily use of more than five hours showed a stronger association with
depressive symptoms for males than for females.
• Daily use of Facebook between two and five hours was related to significantly higher
self-esteem.
• Self-reported active use of Facebook and Instagram were linked with significantly
lower depressive symptoms and higher self-esteem compared to passive involvement.

Electronic social networking is undoubtedly a worldwide technological phenomenon

with various extensions in modern human life. Through social media people are able
to communicate and interact with each other, while they also have the opportunity to
develop and share electronic data (Ellison et al., 2007; Kaplan & Haenlein, 2010). During
the past few years, social media have become extremely popular, especially among
young adults (Pew Research Center, 2015). Specifically, 90% of U.S. adults aged 18-29
are frequent users of at least one online social network, while YouTube and Facebook
are the most popular platforms (Pew Research Center, 2019). In Greece, almost 60% of
total population are involved in social media use (Hootsuite & We Are Social, 2020),
while young adults constitute the vast majority of users (Belenioti, 2015). Similarly to
other countries, Facebook and YouTube are the two most widely used social networks in
Greece (Drosos et al., 2015).
Due to the fast and constantly increasing penetration of social media in everyday life,
their association with mental health has gained considerable attention within the scien­
tific community. Recent studies have provided mixed results, either indicating harmful
effects of social networks on users’ psychological well-being (e.g. Rasmussen et al., 2020;
Sujarwoto et al., 2019) or suggesting non-significant associations (e.g. Coyne et al., 2020).
Social media users facing mental health difficulties appear to experience both benefits,
such as easy social interaction, access to peer support, increased involvement in various
services, and negative consequences, including increased symptoms and exposure to
aggressive online behaviour (Naslund et al., 2020). Overall, international research has
showed that social networking can affect mental health both positively and negatively
(Sharma et al., 2020).
Depression is a mood disorder considered as the primary cause of disability and one
of the most common causes of death between the ages of 15 and 29 years, since it is
responsible for more than 800,000 annual suicides (World Health Organization, 2020).
The relationship between social media use and depression has been in the spotlight of
research for about a decade, with many studies suggesting that increased involvement in
online social networking is associated with higher levels of depressive symptomatology
(Ivie et al., 2020; McDougall et al., 2016; Pantic et al., 2012; Woods & Scott, 2016). Elon­

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gated daily time spent in social media has been linked to higher odds of depression in
young adults (Lin et al., 2016), while the use of multiple social networking platforms has
been related to increased depressive symptoms (Primack et al., 2017). In a recent study,
the reduction of time spent in social networks was linked to significantly less negative
mental health outcomes, including less depressive symptoms, in young adults (Hunt et
al., 2018). Social comparison has often mediated the aforementioned associations (e.g.
Brown & Tiggemann, 2016; Lup et al., 2015), while envy has displayed a mediating effect
on the relationship between social comparison and adult users’ depressive symptoms
(Wang et al., 2020). Finally, addiction to social media has been significantly associated
with depression (Donnelly & Kuss, 2016).
Despite what appears to be evidence for a negative association between social media
and depressive symptomatology, other studies have showed that social media use can
have positive effects on individuals’ well-being. Communication and interaction through
these networks have been found to contribute to an increase in social capital and, thus,
a reduction in depressive symptoms (Bessière et al., 2010; de la Peña & Quintanilla,
2015; Ellison et al., 2007). Platforms such as Snapchat, Twitter, Instagram and Facebook
provide opportunities for participation in positive social interactions among various
sources of social support, which can alleviate depressive symptoms (Bessière et al., 2010).
Moreover, these platforms may help people form connections with other individuals
suffering from stigmatised health conditions such as depression (Merolli et al., 2014). In
a similar vein, active use of social networks (e.g. sharing content and communicating
with other users) has been linked with decreased depressive symptoms and pertinent
outcomes compared to passive use (e.g. avoiding posting new content, visiting other
users’ profiles and following their posts) (Escobar-Viera et al., 2018; Verduyn et al., 2015).
In general, the relationship between social media use and depressive symptoms appears
to be complicated and influenced by various individual and psychosocial factors (Baker &
Algorta, 2016).
Previous studies have suggested a negative association between depressive symptoms
and self-esteem (Conti et al., 2014; Franck et al., 2007). Self-esteem is defined as the
subjective way in which individuals perceive their personal value (MacDonald & Leary,
2012). With respect to the association between social media use and self-esteem, findings
appear to be mixed. Specifically, recent research indicates that increased involvement
in social networks is linked to lower self-esteem in adolescents and young adults (e.g.
Bergagna & Tartaglia, 2018; Vogel et al., 2014; Woods & Scott, 2016). On the contrary,
some researchers have found that social media use is related to higher self-esteem (e.g.
Gonzales & Hancock, 2011; Wilcox & Stephen, 2013). Two mechanisms that seem to ex­
plain or mediate such relationships include the kind of feedback that users receive from
online social networks (Valkenburg et al., 2017; Valkenburg et al., 2006) as well as social
comparison (Bergagna & Tartaglia, 2018; Vogel et al., 2014). Moreover, cyberbullying
through social media has been related to lower self-esteem levels (Palermiti et al., 2017).

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Little research has been conducted so far regarding electronic social networking
and aspects of mental health in the Greek population. Recent findings suggest that
almost 34% of Greek adolescent users report intense activity in social networks, while
approximately 10% display problematic use, which refers to addictive behaviour (Boer
et al., 2020). With regard to Greek young adults, excessive social media use has been
linked with higher levels of loneliness and decreased life satisfaction (Vasilikou, 2016).
In addition, excessive use of social networking sites has been significantly associated
with personality factors, such as neuroticism, along with increased depressive sympto­
matology in young Greeks (Giota & Kleftaras, 2013). Although little research has been
conducted, recent findings have suggested that the frequency of social media use, such
as Facebook, is not associated with self-esteem in adolescents (Botou & Marsellos, 2018).
However, cyberbullying has been related to low self-esteem in university students of
Greece (Giovazolias & Malikiosi-Loizos, 2016).
There is considerable evidence that social media use is linked with mental health,
including depressive symptomatology and self-esteem, positively or negatively (e.g.
Bessière et al., 2010; Lin et al., 2016). However, approximately half of previous studies
have examined social media use in general (Schønning et al., 2020), and many of them as
a single variable, without providing results regarding the use of different platforms (e.g.
Escobar-Viera et al., 2018; Lin et al., 2016; Woods & Scott, 2016). Studies assessing the use
of specific social networks in relation to mental health outcomes have focused mainly
on Facebook (e.g. Bergagna & Tartaglia, 2018; Wilcox & Stephen, 2013). Furthermore,
the amount of Greek data concerning the relationship between social networks and
human behaviour is extremely limited. Taking into consideration the above-mentioned
gap in the literature, the aim of the present study was to investigate the association
of different popular social media with self-esteem and depressive symptoms in a large
Greek sample of emerging adults. We hypothesised that increased time of social media
use was significantly associated with higher depressive symptoms and lower self-esteem
in young adults. We, also, hypothesised that active social media users would have lower
symptoms of depression and higher self-esteem compared to passive social media users.

Method
Participants
To be eligible for inclusion in the study, participants had to meet the following criteria:
(i) to be between 18 and 30 years old, (ii) to use at least one electronic social network,
and (iii) to have a good understanding of the Greek language. The sample included 654
young adults (50.5% male and 49.5% female) aged 18-30 years (Μ = 23.62, SD = 2.71).
The vast majority of them were Greek (98.9%) and residents of urban areas (94.3%). The
sample composition of participants’ highest level of education completed was: 58.3%

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high school/vocational education and training, 33.9% university/college degree, and 7.8%
postgraduate studies. Furthermore, 98.6% of the participants were unmarried and 59.9%
reported a low monthly income (up to 500€). Regarding employment status, 59.5% of
participants were not working. The sociodemographic characteristics of the participants
are presented in Table 1.

Table 1
Sociodemographic Characteristics of Participants and Associations With Depressive Symptoms and Self-Esteem (N
= 654)

Sociodemographic
variables Depressive symptoms Self-esteem

N % M SD p M SD p

Gender .330 .140

Male 330 50.5 9.24 7.98 30.86 4.59
Female 324 49.5 9.85 8.18 30.31 4.97
Nationality .514 .079
Greek 647 98.9 9.50 7.99 30.62 4.79
Other 7 1.1 13.29 14.44 27.43 3.74
Place of origin .086 .496
Urban 527 80.6 9.28 8.09 30.65 4.78
Rural 127 19.4 10.65 7.96 30.33 4.81
Place of residence .167 .483
Urban 617 94.3 9.43 8.11 30.62 4.81
Rural 37 5.7 11.32 7.27 30.05 4.43
Educational level .396 .610
High school/V.E.T. 381 58.3 9.85 8.25 30.67 4.61
University/College 222 33.9 8.94 7.49 30.36 5.01
Postgraduate studies 51 7.8 9.88 9.19 30.98 5.09
Employment status .191 .448
Working 265 40.5 10.04 8.23 30.76 5.03
Non-working 389 59.5 9.20 7.96 30.47 4.62
Net monthly income .396 .051
0 € - 500 € 392 59.9 9.70 8.35 30.29 4.73
> 500 € 249 38.1 9.15 7.49 31.05 4.86
Marital status .097 .814
Unmarried 645 98.6 9.60 8.10 30.59 4.81
Married 9 1.4 5.11 5.09 30.78 2.28
Min-
M SD max r p r p
Participants' age 23.62 2.71 18–30 -.043 .273 .058 .139
Note. t-test and ANOVA were used for differences between continuous variables; Pearson’s r was used for
correlation between continuous variables.

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Measures
Sociodemographic Characteristics
Sociodemographic variables included participants’ gender, age, nationality (Greek or
other), place of origin and residence (urban vs. rural), educational level that each partic­
ipant had completed (high school/vocational education and training, university/college
degree, postgraduate studies), employment status (working vs. non-working), marital
status (unmarried vs. married), and net monthly income (0-500€ vs. 501€ and above).

Social Media Use

We assessed participants’ social media involvement based on daily time use and type of
user (active/passive user), influenced by recent studies (Escobar-Viera et al., 2018; Lin
et al., 2016). Due to the lack of Greek standardised psychometric tools concerning the
above-mentioned variables, we designed a brief self-reported questionnaire consisting of
three items based on a previous study about internet and social media use in relation to
consumer behaviour (Koutsogiannopoulou, 2013). First, participants were asked whether
they had been using social media (“Do you use social media?”), responding to an alterna­
tive form question (“yes” or “no”), and provided estimates about their daily use of specific
popular platforms, including Facebook, Twitter, Instagram, YouTube, Tumblr, LinkedIn,
Skype, and blogs. Four response choices were offered in a Likert-type scale (“not at all”,
“less than two hours”, “two to five hours”, “more than five hours”). Moreover, individuals
were asked to characterise their involvement on each one of these networks as “pas­
sive” or “active” after explanation of these two terms was offered. Specifically, passive
users were considered those who maintained activities such as limited communication
and sharing of electronic content, along with passive following of other users’ posts.
Conversely, individuals who engaged more in interaction with others and sharing of
various types of content were considered as active users. To ensure participants’ best
comprehension of these patterns of activity, we used definitions and examples based on
previous studies (e.g. Escobar-Viera et al., 2018).

Self-Esteem
Self-esteem was measured by means of the Rosenberg Self-Esteem Scale (RSES;
Rosenberg, 1965). The RSES consists of 10 items in form of statements which are related
to self-esteem (e.g. “I feel I do not have much to be proud of”). Of these statements, five
are positively graded (1, 2, 4, 6, 7) and five are negatively graded (3, 5, 8, 9, 10). Each
individual is asked to respond to a four-point Likert scale, ranging from 1 (“strongly
disagree”) to 4 (“strongly agree”). Total score ranges from 10 to 40 with higher scores
indicating higher levels of self-esteem. High self-esteem scores suggest that individuals
have self-respect and consider him or herself worthy. Low self-esteem scores suggest an
unfavorable opinion of oneself and self-dissatisfaction. The scale has been translated and

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validated for the Greek population by Tsagarakis et al. (2007). In the present study, the
scale demonstrated satisfactory internal consistency (α = .84).

Depressive Symptoms
Depressive symptomatology was measured using the Beck Depression Inventory-II (BDI-
II; Beck et al., 1996). The BDI-II is a 21-item, self-report rating inventory that measures
characteristic attitudes and symptoms of depression (Beck et al., 1996), while it taps
major depression symptoms according to diagnostic criteria listed in the Diagnostic
and Statistical Manual for Mental Disorders (American Psychiatric Association, 2000).
Each item is assessed on a four-point scale (0–3). The total score indicates whether
the individual presents a mild, moderate or major depression (possible range 0-63). The
BDI-II has been translated and validated in Greek by Giannakou et al. (2013). In the
present study, the scale showed satisfactory internal consistency (α = .86).

Procedure
Participants were recruited through the research team contacting different academic
departments, and disseminating a web link to each student which provided details of the
study. Moreover, non-university student participants were recruited via online posts at
social media groups. Information about anonymous and voluntary participation was pro­
vided to participants prior to data collection. Confidentiality was assured and informed
consent was obtained from the participants. Finally, participants were given written
instructions for filling out the questionnaires and were informed about the estimated
time needed for completing the measures (approximately 15 minutes). The study was
conducted in accordance with the ethical standards delineated in the 1964 Declaration of
Helsinki and its later amendments or comparable ethical standards. Ethical approval was
granted by the Psychology Department’s Research Ethics Committee. Informed consent
was obtained from all individual participants included in the study.

Data Analysis
With regard to descriptive data, we computed percentages of sociodemographic varia­
bles, daily time use of social networks and type of social media use (active and passive
use). In terms of descriptive indices, we calculated means (M) and standard deviations
(SD) in order to better frame our results. Social media use was not assessed as a single
numeric variable, since we focused our analyses on daily time of use (less than two
hours, two to five hours, more than five hours) and self-reported type of use (passive vs.
active). Considering that YouTube, Facebook and Instagram showed by far the highest
percentages of daily users, our analyses were focused on the specific platforms.
t-test and ANOVA were used for the comparison of independent groups. Specifically,
we employed one-way ANOVAs, including post-hoc comparisons using Tukey, to sepa­

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rately investigate differences in depressive symptomatology and self-esteem between

categories regarding daily use of YouTube, Facebook and Instagram (less than two hours,
two to five hours, more than five hours). Moreover, we used independent samples
t-tests to assess differences in depressive symptoms and self-esteem between categories
concerning self-reported type of YouTube, Facebook and Instagram use (active and pas­
sive). Pearson’s r correlation coefficient was used to estimate the strength of the associ­
ation between self-esteem and depressive symptoms. Multiple linear regression models
were also implemented to further and separately examine the associations of YouTube,
Facebook and Instagram use (daily time and type of use) with depressive symptoms
and self-esteem, after adjusting for confounding variables. Potential confounders related
with both the outcome and/or the independent variables in group comparisons with
a p-value < .2 were included in the models. Therefore, each model was adjusted for
participants’ gender, age, educational level and employment status, while estimated asso­
ciations were described in terms of b-coefficients (beta). We were also able to examine
effect modification stratifying by gender. For interaction terms, we considered p-value <
.05 as nominally significant. All other hypotheses testing was conducted assuming a .05
significance level and a two-sided alternative hypothesis. All analyses were conducted by
means of the IBM SPSS Statistics 26 software.

Results
Prevalence of Social Media Use
In terms of daily time of engagement in social media, YouTube was the most popular
platform with respect to users (97.6%), followed by Facebook (93.3%), Instagram (81.8%),
blogs (15.9%), Skype (12.1%), LinkedIn (10.9%), Twitter (4.3%) and Tumblr (3.1%). Only
17.7% of the participants reported using some other platform except for the specific
ones. Overall, 99.4% of the participants were found to use more than one platform
daily. Concerning the self-reported type of social media use, 65.8% of daily YouTube
users reported being passive, while 51.3% of daily Facebook users mentioned being
active. Instagram demonstrated the highest self-reported active online engagement (75%).
Additionally, more than 50% of daily users of blogs, Skype, LinkedIn and Twitter stated
passive involvement in these platforms, whereas half of Tumblr everyday users reported
being active.

Associations Between Sociodemographic Characteristics and

Study Variables
Tables 1 and 2 show associations between participants’ sociodemographic characteristics
and the outcome variables of our study. Specifically, non-significant relationships were
found between sociodemographic variables, depressive symptomatology and self-esteem

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at a level of p-value < .05 (Table 1). According to Table 2, significant differences between
men and women were found in terms daily use of YouTube, χ2(2, N = 638) = 10.11, p
= .006, and Instagram, χ2(2, N = 535) = 11.74, p = .003, as well as self-reported type
of Instagram use, χ2(1, N = 535) = 9.20, p = .002. In addition, participants’ age was
significantly related to all social media use variables, while educational level showed
significant associations with self-reported type of YouTube, Facebook and Instagram use.
Employment status was linked with daily use of YouTube, χ2(2, N = 638) = 11.17, p = .004,
along with self-reported type of YouTube, Facebook and Instagram use. Individuals’ net
monthly income was significantly associated with daily use of YouTube, χ2(2, N = 625) =
6.59, p = .037.

Table 2
Participants’ Sociodemographic Characteristics and Social Media Use (N = 654)

Social media daily use Social media user type

a a a b
Sociodemographic variables YouTube Facebook Instagram YouTube Facebookb Instagramb

χ2 pc χ2 pc χ2 pc χ2 pc χ2 pc χ2 pc

Gender 10.11 .006** 4.50 .105 11.74 .003** 3.79 .053 1.51 .219 9.20 .002**
Nationality 1.58 .455 1.02 .602 1.05 .592 .00 .965 1.99 .160 .00 1.000
Place of origin 2.48 .289 .01 .995 1.38 .501 .04 .837 .69 .406 1.36 .244
Place of residence 2.07 .356 .16 .923 1.20 .548 .22 .638 .47 .494 .70 .404
Educational level 5.41 .247 6.18 .186 5.09 .278 40.78 < .001*** 18.02 < .001*** 16.91 < .001***
Employment status 11.17 .004** 1.26 .532 1.55 .461 9.54 .002** 4.78 .029* 4.22 .040*
Net monthly income 6.59 .037* 1.72 .422 1.81 .405 1.04 .307 2.40 .121 3.11 .078
Marital status 2.19 .700 1.00 .911 6.14 .189 .62 .733 1.68 .431 5.72 .057

F pd F pd F pd t pe t pe t pe

Participants' age 3.78 .023* 5.33 .005** 4.78 .009** 4.77 < .001*** 3.93 < .001*** 4.94 < .001***
a
Includes daily use of less than 2 hours, 2-5 hours, and more than 5 hours. bIncludes self-reported active user
and passive user. cp value derived using chi-square analysis. dp-value derived using one-way ANOVA. ep-value
derived using independent samples t-test.
*p < .05. **p < .01. ***p < .001.

Differences in Depressive Symptomatology and Self-Esteem by

Social Media Groups
Table 3 shows differences in depressive symptomatology and self-esteem by social media
groups. One-way ANOVA results indicated a statistically significant difference in the
mean score of self-esteem between the different categories of Facebook daily use, F(2,
607) = 6.88, p = .001, η2 = .02. Particularly, a post-hoc Tukey test showed that individuals
who reported two to five hours of Facebook everyday use had significantly higher
self-esteem (N = 185, M = 31.62, SD = 4.87) compared to those who had been using
Facebook for less than two hours daily (N = 365, M = 30.04, SD = 4.51, p = .001).

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Table 3

Group Differences in Depressive Symptomatology and Self-Esteem by Social Media Use (N = 654)

Social media use Depressive symptomatologya Self-esteema

N M SD F pb η2 M SD F pb η2

YouTube daily use 2.94 .053 .01 .35 .703 .00

Less than 2 hours 316 9.23 7.59 30.63 4.69
2-5 hours 262 9.33 7.87 30.73 4.68
More than 5 hours 60 11.90 10.31 30.15 5.67
Facebook daily use .94 .391 .00 6.88 .001** .02
Less than 2 hours 365 9.59 7.98 30.04 4.51
2-5 hours 185 9.03 7.60 31.62 4.87
More than 5 hours 60 10.62 8.56 30.72 5.33
Instagram daily use .74 .477 .00 1.00 .370 .00
Less than 2 hours 215 9.37 8.07 30.33 4.59
2-5 hours 254 9.69 7.91 30.95 4.91
More than 5 hours 66 10.74 8.35 30.86 5.30
N M SD t pc d M SD t pc d

YouTube user type .47 .641 .04 -1.56 .119 .13

Active users 218 9.32 7.97 31.03 4.96
Passive users 420 9.63 8.05 30.41 4.68
Facebook user type 2.55 .011* .21 -4.30 < .001*** .35
Active users 313 8.73 7.27 31.18 4.75
Passive users 297 10.36 8.51 29.75 4.61
Instagram user type 3.33 .001** .32 -2.32 .021* .23
Active users 401 9.03 7.61 30.97 4.81
Passive users 134 11.67 8.91 29.86 4.84
a
Depressive symptomatology and self-esteem were treated as continuous numeric variables. bp-value derived
using one-way ANOVA. cp-value derived using independent samples t-test.
*p < .05. **p < .01. ***p < .001.

According to t-test results, a significant mean difference was found between self-repor­
ted active Facebook users (N = 313, Μ = 8.73, SD = 7.27) and passive Facebook users (N
= 297, Μ = 10.36, SD = 8.51), t(583) = 2.55, p = .011, d = .21. There was also a significant
difference in depressive symptoms between self-reported active Instagram users (N =
401, Μ = 9.03, SD = 7.61) and passive Instagram users (Ν = 134, Μ = 11.67, SD = 8.91),
t(533) = 3.33, p = .001, d = .32. A significant difference was observed in self-esteem
between self-reported active Facebook users (Ν = 313, Μ = 31.38, SD = 4.75) and passive
Facebook users (Ν = 297, Μ = 29.75, SD = 4.61), t(608) = -4.30, p < .001, d = .35. Likewise,
there was a significant difference in self-esteem between active Instagram users (Ν = 401,
Μ = 30.97, SD = 4.81) and passive Instagram users (Ν = 134, Μ = 29.86, SD = 4.84), t(533) =
-2.32, p = .021, d = .23. Finally, self-esteem was significantly and negatively correlated
with depressive symptomatology, r(652) = -.55, p < .001.

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Multivariable Associations of Social Media Daily Use and User

Type With Depressive Symptomatology and Self-Esteem
According to multiple linear regression results (Table 4), daily YouTube use of more
than five hours was associated with significantly higher BDI-II scores, after controlling
for gender, age, educational level and employment status, b = 2.99, 95% CI [.78, 5.20], p
= .008. The model explained 2% (adjusted 1.1%) of the variance in BDI-II scores (R 2 =
.02). Daily use of Facebook and Instagram showed non-significant associations with
depressive symptoms.

Table 4
Adjusted Associations of Social Media Daily Use and User Type With Depressive Symptomatology and Self-Esteem
(N = 654)

Depressive symptomatologyb Self-esteemb

Modelsa Bc SE B 95% CIc p Bc SE B 95% CIc p

YouTube daily use

2-5 hours vs. < 2 hoursd .30 .67 [-1.01, 1.62] .652 .09 .40 [-.70, .88] .819
> 5 hours vs. < 2 hoursd 2.99 1.13 [.78, 5.20] .008** -.45 .68 [-1.78, .89] .512

Facebook daily use

2-5 hours vs. < 2 hoursd -.60 .71 [-1.99, .80] .402 1.61 .42 [.78, 2.44] < .001***
> 5 hours vs. < 2 hoursd .70 1.11 [-1.47, 2.87] .525 .83 .66 [-.46, 2.12] .205

Instagram daily use

2-5 hours vs. < 2 hoursd .01 .75 [-1.46, 1.47] .995 .82 .45 [-.06, 1.70] .068
> 5 hours vs. < 2 hoursd 1.04 1.13 [-1.17, 3.26] .356 .81 .68 [-.53, 2.14] .236

YouTube user type

Active vs. passived -.60 .69 [-1.96, .75] .383 .64 .41 [-.17, 1.45] .122

Facebook user type

Active vs. passived -1.92 .65 [-3.18, -.65] .003** 1.74 .38 [.99, 2.49] < .001***

Instagram user type

Active vs. passived -3.25 .81 [-4.83, -1.66] < .001*** 1.45 .49 [.49, 2.41] .003**
a b
All models adjusted for participants’ gender, age, educational level, and employment status. Depressive
symptomatology and self-esteem were treated as continuous numeric variables. cb-coefficients and 95% CI of b
retained from linear regression. dReference variable.
*p < .05. **p < .01. *** p < .001.

Daily Facebook use of two to five hours was associated with significantly higher self-es­
teem, after controlling for gender, age, educational level and employment status, b = 1.61,
95% CI [.78, 2.44], p < .001. The model explained 2% (adjusted 1%) of the variance in
depressive symptoms (R 2 = .02). Daily use of YouTube showed non-significant results
regarding self-esteem.

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Active Facebook use was significantly associated with lower BDI-II scores, after con­
trolling for gender, age, educational level and employment status, b = -1.92, 95% CI [-3.18,
-.65], p = .003. The model explained 2% (adjusted 1.5%) of the variance in depressive
symptoms (R 2 = .02). Likewise, self-reported active Instagram use was related to signifi­
cantly reduced depressive symptoms, after controlling for gender, age, educational level
and employment status, b = -3.25, 95% CI [-4.83, -1.66], p < .001). The model explained 4%
(adjusted 3.4%) of the variance in BDI-II scores (R 2 = .04). Self-reported type of YouTube
use showed non-significant results concerning depressive symptoms.
Active Facebook use was associated with significantly increased levels of self-esteem,
after controlling for gender, age, educational level and employment status, b = 1.74,
95% CI [.99, 2.49], p < .001. The model explained 4% (adjusted 3.4%) of the variance in
depressive symptoms (R 2 = .04). Similar results were also found concerning active use
of Instagram, after controlling for gender, age, educational level and employment status,
b = 1.45, 95% CI [.49, 2.41], p = .003). The model explained 3% (adjusted 2.5%) of the
variance in depressive symptoms (R 2 = .03). Self-reported type of YouTube use showed
non-significant results regarding self-esteem.

Interaction Effect Analyses

YouTube daily use of more than five hours showed a stronger association with depressive
symptoms for males than for females (p for interaction = .026).

Discussion
The present study investigated the association of social media use with self-esteem
and depressive symptomatology in young adults. According to the results, increased
daily time spent in YouTube (more than five hours) showed a significant association
with higher depressive symptoms, while daily use of Facebook between two and five
hours was related to significantly increased self-esteem, after adjusting for gender, age,
educational level and employment status. YouTube daily use of more than five hours
showed a stronger association with depressive symptoms for males than for females.
Additionally, self-reported active use of Facebook and Instagram were associated with
significantly lower depressive symptoms and higher self-esteem as compared to passive
use.
In accordance with previous findings from Greece (Drosos et al., 2015), YouTube and
Facebook displayed the highest percentages of everyday involvement with regard to our
sample. Moreover, in line with our first hypothesis and previous studies (e.g. Lin et al.,
2016; Pantic et al., 2012), daily YouTube use of more than five hours was associated
with increased depressive symptomatology. Recent research has suggested that YouTube,
unlike Facebook and Instagram, has been linked to increased perceived information

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Leimonis & Koutra 13

overload for users due to the great amount of available video content. In addition,
information overload in social media has been associated with higher depressive symp­
toms overtime (Matthes et al., 2020). On the other hand, depression is often associated
with social withdrawal (Girard et al., 2014), hence it is possible that individuals with
high depressive symptomatology tend to use YouTube more in comparison with other
platforms, as it encourages less interactive involvement (Burgess & Green, 2009).
We also found that the association of increased daily time use of YouTube with de­
pressive symptoms was more pronounced in males than in females. Conversely, Twenge
and Martin (2020) have recently indicated that the relationship between increased time
of social media use and low levels of psychological well-being is stronger in females.
Women appear to use social media more in order to sustain their existing relationships
compared to men (Muscanell & Guadagno, 2012), which has been associated with higher
self-esteem (Wilcox & Stephen, 2013). Therefore, female users could exhibit lower de­
pressive symptomatology compared to male, given that self-esteem is negatively related
to depressive symptoms (Conti et al., 2014). Additionally, men with increased depressive
symptoms have been found to be more susceptible to internet overuse compared to
women (Liang et al., 2016), which could also apply to social media use.
In contrast with our first hypothesis and recent studies (Bergagna & Tartaglia, 2018;
Woods & Scott, 2016), our results showed that increased daily use of Facebook is sig­
nificantly related to higher self-esteem, although the effect size is small. According to
Walther’s hyperpersonal model of computer-mediated communication (Walther, 2007)
and previous research (Gonzales & Hancock, 2011), selective self-presentation on Face­
book can lead to higher self-awareness and, therefore, an increase in users’ self-esteem.
Moreover, individuals focusing on close friendly relationships on social networks have
exhibited higher levels of self-esteem (e.g. Wilcox & Stephen, 2013). A possible mecha­
nism explaining this relationship could be the positive feedback that users receive from
their online friends, as it has been related to increased self-esteem levels (Valkenburg et
al., 2017; Valkenburg et al., 2006).
This study also indicated that self-reported active use of Facebook and Instagram are
linked with significantly lower depressive symptoms and higher self-esteem compared
to passive use. These results correspond to recent findings (Escobar-Viera et al., 2018;
Verduyn et al., 2015) and align with our second hypothesis. According to previous re­
search, passive use of social networks has been related to feelings of envy and decreased
life satisfaction (Krasnova et al., 2013), while envy on social media, such as Facebook,
has significantly predicted depressive symptoms (Tandoc et al., 2015). On the other hand,
higher self-esteem has been linked with increased life satisfaction (Moksnes & Espnes,
2013), and decreased feelings of envy (Vrabel et al., 2018). Thus, it appears that social
comparison as a mechanism might provide explanation concerning our findings, since
it could induce feelings of envy, while being related to passive activity in social media
(Rozgonjuk et al., 2019). Furthermore, it is possible that high self-esteem encourages

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active behaviour in social media, as previous data has suggested a significant association
between decreased feelings of self-worth and passive activities on platforms such as
Facebook (Tazghini & Siedlecki, 2013).

Strengths and Limitations

To our knowledge, the present study was one of the few focusing on the investigation
of the association between social media use and mental health in a Greek sample of
young adults. The large sample size along with the equal distribution of men and women
provided adequate power to detect small effects. Additionally, self-esteem and depressive
symptomatology were measured via standardised, valid and reliable psychometric tools
displaying good psychometric properties with regard to our sample. Finally, the simulta­
neous assessment of different social networking platforms, instead of examining social
media as a whole or focusing exclusively on a specific platform, was an additional
strength of this study. Our fine-grained assessment of multiple platforms likely improved
our measurement of overall frequency of social media use.
We acknowledge that there are also some limitations in our study. Given the cross-
sectional design of the study, we are not able to establish the direction of the observed
associations. Furthermore, even though both university students from various academic
departments and non-university students from different regions in Greece were included
in our study, generalizability in the Greek population may be limited. Moreover, due to
the lack of a standardised Greek scale assessing social media use we used three items
with specific artificial categories to measure daily time of social media involvement,
which could be a noteworthy limitation as well. A number of methodological studies
highlight a substantial loss of information as well as biased estimates when a continuous
measure is broken up in artificial categories. It is also important to note that there are
many different types of interactions that can be observed over social media, and our
study assessed only overall time spent and type of use (active vs. passive) to social
media sites. The type of social media use in terms of activity/passivity was examined
only through self-reported questions, which could have relied our results and deductions
exclusively on participants’ understanding of the terms “passive use” and “active use”.
Additionally, the assessment of self-esteem and depressive symptomatology through
self-reported scales instead of interviewing techniques, combined with our focus on
non-clinical population, could restrict the possible clinical extensions of our findings.
Furthermore, the small effect size reported was obtained in a sample of the general popu­
lation which is expected to underestimate the effect size expected to occur in a clinical
sample comprising persons displaying higher variability in self-reported symptom scales
such as the BDI-II and RSES, and are in principle more vulnerable to social stressors.
Additionally, the results from the multivariate linear regression analyses should be inter­
preted with caution given that the explained variance ranges between 1% and 4%; thus, if
reported the other way around 96% to 99% of variance is not explained by the predictors

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Leimonis & Koutra 15

in that model. Finally, although in our regression models we were able to adjust for a
large number of confounding factors, because of the observational study design, residual
confounding of other unmeasured confounders such as home environment or negative
life events may still occur.

Conclusion
The present study showed that there is a significant association between social media
use and young adults’ mental health in terms of self-esteem and depressive symptoma­
tology. Overall, our results add strength to previous research and could contribute to a
deeper understanding of the association between social networks and human behaviour.
However, a longitudinal investigation of this association is required to fully understand
the temporal relationships aiding early identification of youth at risk and thus effective
management of the social media use that lead to negative outcomes in mental health.
In addition, future research could further explore gender differences concerning the
relationship between social networking and young adults’ mental health. Moreover, up­
coming studies could investigate the potential moderating or mediating effect of different
patterns of use (e.g. passive and active involvement) on the relationship between time of
social media use and mental health.

Funding: The authors have no funding to report.

Acknowledgments: We are very grateful to all participants of the study.

Competing Interests: The authors have declared that no competing interests exist.

References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th
ed., text rev.). American Psychiatric Association.
Baker, D. A., & Algorta, G. P. (2016). The relationship between online social networking and
depression: A systematic review of quantitative studies. Cyberpsychology, Behavior, and Social
Networking, 19(11), 638–648. https://doi.org/10.1089/cyber.2016.0206
Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. The
Psychological Corporation.
Belenioti, Z. C. (2015). A snapshot of Greek social media users [Paper presentation]. “Users Across
Media” Conference, Copenhagen, Denmark, 6-8 May.
https://www.researchgate.net/publication/
282327907_A_snapshot_of_Greek_Social_Media_Users

Clinical Psychology in Europe

2022, Vol. 4(2), Article e4621
https://doi.org/10.32872/cpe.4621
Social Media Use and Mental Health 16

Bergagna, E., & Tartaglia, S. (2018). Self-esteem, social comparison, and Facebook use. Europe’s
Journal of Psychology, 14(4), 831–845. https://doi.org/10.5964/ejop.v14i4.1592
Bessière, K., Pressman, S., Kiesler, S., & Kraut, R. (2010). Effects of Internet use on health and
depression: A longitudinal study. Journal of Medical Internet Research, 12(1), Article e6.
https://doi.org/10.2196/jmir.1149
Boer, M., van den Eijnden, R. J. J. M., Boniel-Nissim, M., Wong, S., Inchley, J. C., Badura, P., Craig,
W. M., Gobina, I., Kleszczewska, D., Klanscek, H. J., & Stevens, G. W. J. M. (2020). Adolescents’
intense and problematic social media use and their well-being in 29 countries. The Journal of
Adolescent Health, 66, S89–S99. https://doi.org/10.1016/j.jadohealth.2020.02.014
Botou, A., & Marsellos, P. S. (2018). Teens’ perception about social networking sites: Does Facebook
influence teens’ self-esteem? Psychology, 9, 1453–1474. https://doi.org/10.4236/psych.2018.96089
Brown, Z., & Tiggemann, M. (2016). Attractive celebrity and peer images on Instagram: Effect on
women’s mood and body image. Body Image, 19, 37–43.
https://doi.org/10.1016/j.bodyim.2016.08.007
Burgess, J., & Green, J. (2009). Youtube: Online video and participatory culture. Polity Press.
Conti, J. R., Adams, S. K., & Kisler, T. S. (2014). A pilot examination of self-esteem, depression, and
sleep in college women. Journal About Women in Higher Education, 7(1), 47–72.
https://doi.org/10.1515/njawhe-2014-0004
Coyne, S. M., Rogers, A. A., Zurcher, J. D., Stockdale, L., & Booth, M. (2020). Does time spent using
social media impact mental health? An eight year longitudinal study. Computers in Human
Behavior, 104, Article 106160. https://doi.org/10.1016/j.chb.2019.106160
de la Peña, A., & Quintanilla, C. (2015). Share, like and achieve: The power of Facebook to reach
health-related goals. International Journal of Consumer Studies, 39(5), 495–505.
https://doi.org/10.1111/ijcs.12224
Donnelly, E., & Kuss, D. J. (2016). Depression among users of social networking sites (SNSs): The
role of SNS addiction and increased usage. Journal of Addiction and Preventive Medicine, 1(2),
Article 107. https://doi.org/10.19104/japm.2016.107
Drosos, D., Tsotsolas, N., Chalikias, M., Skordoulis, M., & Koniordos, M. (2015). A survey on the use
of social networking sites in Greece. In A. Kravets, M. Shcherbakov, M. Kultsova, & O.
Shabalina (Eds.), Creativity in intelligent technologies and data science (pp. 556-570). Springer.
https://doi.org/10.1007/978-3-319-23766-4_44
Ellison, N., Steinfield, C., & Lampe, C. (2007). The benefits of Facebook “friends”: Social capital and
college students’ use of online social network sites. Journal of Computer-Mediated
Communication, 12(4), 1143–1168. https://doi.org/10.1111/j.1083-6101.2007.00367.x
Escobar-Viera, C. G., Shensa, A., Bowman, N. D., Sidani, J. E., Knight, J., James, A. E., & Primack, B.
A. (2018). Passive and active social media use and depressive symptoms among United States
adults. Cyberpsychology, Behavior, and Social Networking, 21(7), 437–443.
https://doi.org/10.1089/cyber.2017.0668

Clinical Psychology in Europe

2022, Vol. 4(2), Article e4621
https://doi.org/10.32872/cpe.4621
Leimonis & Koutra 17

Franck, E., De Raedt, R., & De Houwer, J. (2007). Implicit but not explicit self-esteem predicts future
depressive symptomatology. Behaviour Research and Therapy, 45(10), 2448–2455.
https://doi.org/10.1016/j.brat.2007.01.008
Giannakou, M., Roussi, P., Kosmides, M. E., Kiosseoglou, G., Adamopoulou, A., & Garyfallos, G.
(2013). Adaptation of the Beck Depression Inventory-II to Greek population. Hellenic Journal of
Psychology, 10, 120–146.
https://www.researchgate.net/publication/
286135313_Adaptation_of_the_beck_depression_inventory-II_to_greek_population
Giota, K. G., & Kleftaras, G. (2013). The role of personality and depression in problematic use of
social networking sites in Greece. Cyberpsychology, 7(3), Article 6.
https://doi.org/10.5817/CP2013-3-6
Giovazolias, T., & Malikiosi-Loizos, M. (2016). Bullying at Greek universities: An empirical study. In
H. Cowie & C. A. Myers (Eds.), Bullying among university students: Cross-national perspectives
(pp. 110-126). Routledge.
Girard, J. M., Cohn, J. F., Mahoor, M. H., Mavadati, S. M., Hammal, Z., & Rosenwald, D. P. (2014).
Nonverbal social withdrawal in depression: Evidence from manual and automatic analyses.
Image and Vision Computing, 32(10), 641–647. https://doi.org/10.1016/j.imavis.2013.12.007
Gonzales, A. L., & Hancock, J. T. (2011). Mirror, mirror on my Facebook wall: Effects of exposure to
Facebook on self-esteem. Cyberpsychology, Behavior, and Social Networking, 14(1-2), 79–83.
https://doi.org/10.1089/cyber.2009.0411
Hootsuite, & We Are Social. (2020). Digital 2020: Greece.
https://datareportal.com/reports/digital-2020-greece
Hunt, M. G., Marx, R., Lipson, C., & Young, J. (2018). No more FOMO: Limiting social media
decreases loneliness and depression. Journal of Social and Clinical Psychology, 37(10), 751–768.
https://doi.org/10.1521/jscp.2018.37.10.751
Ivie, E. J., Pettitt, A., Moses, L. J., & Allen, N. B. (2020). A meta-analysis of the association between
adolescent social media use and depressive symptoms. Journal of Affective Disorders, 275, 165–
174. https://doi.org/10.1016/j.jad.2020.06.014
Kaplan, A., & Haenlein, M. (2010). Users of the world, unite! The challenges and opportunities of
social media. Business Horizons, 53(1), 59–68. https://doi.org/10.1016/j.bushor.2009.09.003
Koutsogiannopoulou, N. (2013). Tα νέα μέσα ηλεκτρονικής κοινωνικής δικτύωσης (Social Media) και η
σχέση τους με την καταναλωτική συμπεριφορά [Modern electronic media of social networking
(Social Media) and their relation to consumer behavior]. [Master’s thesis, University of Patras,
Patras, Greece]. NEMERTES – University of Patras Institutional Repository.
http://nemertes.lis.upatras.gr/jspui/handle/10889/6213
Krasnova, H., Wenninger, H., Widjaja, T., & Buxmann, P. (2013). Envy on Facebook: A hidden threat
to users’ life satisfaction? [Paper presentation]. 11th International Conference on
Wirtschaftsinformatik, Leipzig, Germany, 27th February – 1st March.
https://www.researchgate.net/publication/
256712913_Envy_on_Facebook_A_Hidden_Threat_to_Users'_Life_Satisfaction

Clinical Psychology in Europe

2022, Vol. 4(2), Article e4621
https://doi.org/10.32872/cpe.4621
Social Media Use and Mental Health 18

Liang, L., Zhou, D., Yuan, C., Shao, A., & Bian, Y. (2016). Gender differences in the relationship
between internet addiction and depression: A cross-lagged study in Chinese adolescents.
Computers in Human Behavior, 63, 463–470. https://doi.org/10.1016/j.chb.2016.04.043
Lin, y. L., Sidani, J. E., Shensa, A., Radovic, A., Miller, E., Colditz, J. B., Hoffman, B. L., Giles, L. M., &
Primack, B. A. (2016). Association between social media use and depression among U.S. young
adults. Depression and Anxiety, 33(4), 323–331. https://doi.org/10.1002/da.22466
Lup, K., Trub, L., & Rosenthal, L. (2015). Instagram #Instasad? Exploring associations among
Instagram use, depressive symptoms, negative social comparison, and strangers followed.
Cyberpsychology, Behavior, and Social Networking, 18(5), 247–252.
https://doi.org/10.1089/cyber.2014.0560
MacDonald, G., & Leary, M. R. (2012). Individual differences in self-esteem. In M. R. Leary & J. P.
Tangney (Eds.), Handbook of self and identity (pp. 354-377). Guilford.
Matthes, J., Karsay, K., Schmuck, D., & Stevic, A. (2020). “Too much to handle”: Impact of mobile
social networking sites on information overload, depressive symptoms, and well-being.
Computers in Human Behavior, 105, Article 106217. https://doi.org/10.1016/j.chb.2019.106217
McDougall, M. A., Walsh, M., Wattier, K., Knigge, R., Miller, L., Stevermer, M., & Fogas, B. S. (2016).
The effect of social networking sites on the relationship between perceived social support and
depression. Psychiatry Research, 246, 223–229. https://doi.org/10.1016/j.psychres.2016.09.018
Merolli, M., Gray, K., & Martin-Sanchez, F. (2014). Therapeutic affordances of social media:
Emergent themes from a global online survey of people with chronic pain. Journal of Medical
Internet Research, 16(12), Article e284. https://doi.org/10.2196/jmir.3494
Moksnes, U. K., & Espnes, G. A. (2013). Self-esteem and life satisfaction in adolescents—Gender and
age as potential moderators. Quality of Life Research, 22(10), 2921–2928.
https://doi.org/10.1007/s11136-013-0427-4
Muscanell, N. L., & Guadagno, R. E. (2012). Make new friends or keep the old: Gender and
personality differences in social networking use. Computers in Human Behavior, 28(1), 107–112.
https://doi.org/10.1016/j.chb.2011.08.016
Naslund, J. A., Bondre, A., Torous, J., & Aschbrenner, K. (2020). Social media and mental health:
Benefits, risks, and opportunities for research and practice. Journal of Technology in Behavioral
Science, 5, 245–257. https://doi.org/10.1007/s41347-020-00134-x
Palermiti, A. L., Servidio, R., Bartolo, M. G., & Costabile, A. (2017). Cyberbullying and self-esteem:
An Italian study. Computers in Human Behavior, 69, 136–141.
https://doi.org/10.1016/j.chb.2016.12.026
Pantic, I., Damjanovic, A., Todorovic, J., Topalovic, D., Bojovic-Jovic, D., Ristic, S., & Pantic, S.
(2012). Association between online social networking and depression in high school students:
Behavioral physiology viewpoint. Psychiatria Danubina, 24(1), 90–93.
https://www.ncbi.nlm.nih.gov/pubmed/22447092
Pew Research Center. (2015). Social media usage: 2005-2015.
http://www.pewinternet.org/2015/10/08/social-networking-usage-2005-2015/

Clinical Psychology in Europe

2022, Vol. 4(2), Article e4621
https://doi.org/10.32872/cpe.4621
Leimonis & Koutra 19

Pew Research Center. (2019). Social media fact sheet.

https://www.pewresearch.org/internet/fact-sheet/social-media/
Primack, B. A., Shensa, A., Escobar-Viera, C. G., Barrett, E. L., Sidani, J. E., Colditz, J. B., & James, A.
(2017). Use of multiple social media platforms and symptoms of depression and anxiety: A
nationally-representative study among U.S. young adults. Computers in Human Behavior, 69, 1–
9. https://doi.org/10.1016/j.chb.2016.11.013
Rasmussen, E. E., Punyanunt-Carter, N., LaFreniere, J. R., Norman, M. S., & Kimball, T. G. (2020).
The serially mediated relationship between emerging adults’ social media use and mental well-
being. Computers in Human Behavior, 102, 206–213. https://doi.org/10.1016/j.chb.2019.08.019
Rosenberg, M. (1965). Society and the adolescent self-image. Princeton University Press.
Rozgonjuk, D., Ryan, T., Kuljus, J., Täht, K., & Scott, G. (2019). Social comparison orientation
mediates the relationship between neuroticism and passive Facebook use. Cyberpsychology,
13(1), Article 2. https://doi.org/10.5817/CP2019-1-2
Schønning, V., Hjetland, G. J., Aarø, L. E., & Skogen, J. C. (2020). Social media use and mental health
and well-being among adolescents – A scoping review. Frontiers in Psychology, 11, Article 1949.
https://doi.org/10.3389/fpsyg.2020.01949
Sharma, M. K., John, N., & Sahu, M. (2020). Influence of social media on mental health. Current
Opinion in Psychiatry, 33(5), 467–475. https://doi.org/10.1097/YCO.0000000000000631
Sujarwoto, S., Tampubolon, G., & Pierewan, A. (2019). A tool to help or harm? Online social media
use and adult mental health in Indonesia. International Journal of Mental Health and Addiction,
17, 1076–1093. https://doi.org/10.1007/s11469-019-00069-2
Tandoc, E. C., Ferrucci, P., & Duffy, M. (2015). Facebook use, envy, and depression among college
students: Is facebooking depressing? Computers in Human Behavior, 43, 139–146.
https://doi.org/10.1016/j.chb.2014.10.053
Tazghini, S., & Siedlecki, K. L. (2013). A mixed method approach to examining Facebook use and its
relationship to self-esteem. Computers in Human Behavior, 29(3), 827–832.
https://doi.org/10.1016/j.chb.2012.11.010
Tsagarakis, M., Kafetsios, K., & Stalikas, A. (2007). Reliability and validity of the Greek version of
the revised experiences in close relationships measure of adult attachment. European Journal of
Psychological Assessment, 23(1), 47–55. https://doi.org/10.1027/1015-5759.23.1.47
Twenge, J. M., & Martin, G. N. (2020). Gender differences in associations between digital media use
and psychological well-being: Evidence from three large datasets. Journal of Adolescence, 79(1),
91–102. https://doi.org/10.1016/j.adolescence.2019.12.018
Valkenburg, P. M., Koutamanis, M., & Vossen, H. G. (2017). The concurrent and longitudinal
relationships between adolescents’ use of social network sites and their social self-esteem.
Computers in Human Behavior, 76, 35–41. https://doi.org/10.1016/j.chb.2017.07.008
Valkenburg, P. M., Peter, J., & Schouten, A. P. (2006). Friend networking sites and their relationship
to adolescents’ well-being and social self-esteem. Cyberpsychology & Behavior, 9(5), 584–590.
https://doi.org/10.1089/cpb.2006.9.584

Clinical Psychology in Europe

2022, Vol. 4(2), Article e4621
https://doi.org/10.32872/cpe.4621
Social Media Use and Mental Health 20

Vasilikou, K. (2016). Πώς η προβληματική χρήση των μέσων κοινωνικής δικτύωσης επηρεάζει και
επηρεάζεται από το νόημα της ζωής, την ικανοποίηση από τη ζωή και τη μοναξιά [How
problematic use of social media affects and is affected by the meaning of life, life satisfaction
and loneliness] [Master’s thesis, University of Thessaly, Volos, Greece].
https://doi.org/10.26253/heal.uth.4875https://doi.org/10.26253/heal.uth.4875
Verduyn, P., Lee, D. S., Park, J., Shablack, H., Orvell, A., Bayer, J., Ybarra, O., Jonides, J., & Kross, E.
(2015). Passive Facebook usage undermines affective well-being: Experimental and longitudinal
evidence. Journal of Experimental Psychology: General, 144(2), 480–488.
https://doi.org/10.1037/xge0000057
Vogel, E. A., Rose, J. P., Roberts, L. R., & Eckles, K. (2014). Social comparison, social media, and self-
esteem. Psychology of Popular Media Culture, 3(4), 206–222. https://doi.org/10.1037/ppm0000047
Vrabel, J. K., Zeigler-Hill, V., & Southard, A. C. (2018). Self-esteem and envy: Is state self-esteem
instability associated with the benign and malicious forms of envy? Personality and Individual
Differences, 123, 100–104. https://doi.org/10.1016/j.paid.2017.11.001
Walther, J. B. (2007). Selective self-presentation in computer-mediated communication:
Hyperpersonal dimensions of technology, language, and cognition. Computers in Human
Behavior, 23(5), 2538–2557. https://doi.org/10.1016/j.chb.2006.05.002
Wang, W., Wang, M., Hu, Q., Wang, P., Lei, L., & Jiang, S. (2020). Upward social comparison on
mobile social media and depression: The mediating role of envy and the moderating role of
marital quality. Journal of Affective Disorders, 270(1), 143–149.
https://doi.org/10.1016/j.jad.2020.03.173
Wilcox, K., & Stephen, A. T. (2013). Are close friends the enemy? Online social networks, self-
esteem, and self-control. The Journal of Consumer Research, 40(1), 90–103.
https://doi.org/10.1086/668794
Woods, H. C., & Scott, H. (2016). #Sleepyteens: Social media use in adolescence is associated with
poor sleep quality, anxiety, depression and low self-esteem. Journal of Adolescence, 51(1), 41–49.
https://doi.org/10.1016/j.adolescence.2016.05.008
World Health Organization. (2020). Depression. Geneva, Switzerland.
https://www.who.int/news-room/fact-sheets/detail/depression

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