fpubh-09-793868

SYSTEMATIC REVIEW
published: 01 February 2022

doi: 10.3389/fpubh.2021.793868
Digital Media Use and Adolescents’

Mental Health During the Covid-19
Pandemic: A Systematic Review and
Meta-Analysis
Laura Marciano 1,2*, Michelle Ostroumova 1 , Peter Johannes Schulz 1 and
Anne-Linda Camerini 1,2
1
Faculty of Communication, Culture and Society, USI Università della Svizzera italiana, Lugano, Switzerland, 2 Institute of
Public Health, USI Università della Svizzera italiana, Lugano, Switzerland
The Covid-19 physical distancing measures had a detrimental effect on adolescents’

mental health. Adolescents worldwide alleviated the negative experiences of social
distancing by spending more time on digital devices. Through a systematic literature
search in eight academic databases (including Eric, Proquest Sociology, Communication
& Mass Media Complete, Psychology and Behavioral Sciences Collection, PsycINFO,
CINAHL, Pubmed, and Web of Science), the present systematic review and
meta-analysis first summarized the existing evidence from 30 studies, published up to
Edited by:
September 2021, on the link between mental health and digital media use in adolescents
Giorgio Di Lorenzo, during Covid-19. Digital media use measures included social media, screen time, and
University of Rome Tor Vergata, Italy
digital media addiction. Mental health measures were grouped into conceptually similar
Reviewed by:
dimensions, such as well-being, ill-being, social well-being, lifestyle habits, and Covid-
Chidiebere Emmanuel Okechukwu,
Sapienza University of Rome, Italy 19-related stress. Results showed that, although most studies reported a positive
Maria Signorelli, association between ill-being and social media use (r = 0.171, p = 0.011) and ill-being
University of Catania, Italy
and media addiction (r = 0.434, p = 0.024), not all types of digital media use had adverse
*Correspondence:
Laura Marciano
consequences on adolescents’ mental health. In particular, one-to-one communication,
laura.marciano@usi.ch self-disclosure in the context of mutual online friendship, as well as positive and funny
online experiences mitigated feelings of loneliness and stress. Hence, these positive
Specialty section:
This article was submitted to
aspects of online activities should be promoted. At the same time, awareness of the
Public Mental Health, detrimental effects of addictive digital media use should be raised: That would include
a section of the journal making adolescents more aware of adverse mechanisms such as social comparison,
Frontiers in Public Health
fear of missing out, and exposure to negative contents, which were more likely to happen
Received: 12 October 2021
Accepted: 08 December 2021 during social isolation and confinement due to the pandemic.
Published: 01 February 2022
Keywords: adolescence, social media, mental health, media addiction, well-being, review, Covid-19 pandemic
Citation:
Marciano L, Ostroumova M,
Schulz PJ and Camerini A-L (2022) INTRODUCTION
Digital Media Use and Adolescents’
Mental Health During the Covid-19
The Covid-19 pandemic and its related containment measures unavoidably affected mental health,
Pandemic: A Systematic Review and
Meta-Analysis.
which can be defined as “a state of well-being in which an individual realizes his or her own abilities,
Front. Public Health 9:793868. can cope with the normal stresses of life, can work productively and is able to make a contribution
doi: 10.3389/fpubh.2021.793868 to his or her community” (1). Mental health is most affected during adolescence, when individuals
Frontiers in Public Health | www.frontiersin.org 1 February 2022 | Volume 9 | Article 793868

Marciano et al. Well-Being and Media Use During COVID-19
enlarge their social sphere, establish a sense of autonomy, and time for physical activity, decreased happiness, and more fast-
make crucial decisions to achieve long-term goals (2). The food consumption. Focusing on the use of digital technology
concomitant maturation of social and cognitive control areas in 1,860 adolescents aged 12–18 years, Salzano et al. (18)
of the brain supports the progress of these skills, together with reported that participants spent more than six hours a day
the exposure to and experience of appropriate contextual and on screens for educational purposes and from four-to-six
social stimuli (3). Indeed, for adolescents, the social environment hours a day for recreational activities. To note, adolescents
is important for developing essential brain functions, self- reported that, on average, they sent and received over 100
concept, and mental health in general (4). Hence, physical messages per day. Not surprisingly, more frequent symptoms of
distancing measures introduced during the Covid-19 pandemic smartphone dependency have been observed, especially among
may have had a detrimental effect on youth development. young females (19). The augmented time spent on digital
Several studies already showed that adolescent age is a risk technologies, particularly social media, might have alleviated
factor for diverse mental health problems, especially during feelings of loneliness and enhanced social connection. However,
epidemic outbreaks [e.g., (4–10)]. Particularly, social deprivation social media platforms also provided an overload of Covid-
during a developmental period characterized by a high need 19 related information, where one-third of Covid-19 updates
for peer interaction likely augments negative consequences on have been classified as fake (20), thus adding additional stress
mental health. to the already worrisome situation. Accordingly, social media
During the early months of the pandemic, many countries use has been identified as both a protective and risk factor for
worldwide went into complete lockdown. Mental health of mental well-being during Covid-19 (21). This evidence should be
youth was threatened due to the shift toward distant learning, interpreted in a larger, pre-pandemic context, where past reviews
the closure of leisure environments, the decrease in outdoor concluded that screen media use has negative but small effects on
activities, the impossibility to organize social events, and the adolescents’ health [e.g., (22, 23)] through various mechanisms
increase of distress related to the pandemic. As measures were such as upward social comparison and time displaced for other
taken across the globe, their long-term effects on adolescents’ activities. This poses the question of whether the augmented
mental health were unknown. To date, several reviews have use of screen media due to the pandemic may have exacerbated
summarized the immediate impact of the Covid-19 pandemic adverse outcomes by increasing social comparison and envy,
on the younger population. According to a review of ten studies displacing time for health-promoting activities such as sleep and
(11), school closure contributed to anxiety, loneliness, stress, exercising, and fostering cognitive distraction. Yet, screen media
depressive symptoms, frustration in young people, together with use could have also acted as a buffer, e.g., by initiating and
higher indiscipline and hyperactive conduct. Similarly, also an maintaining social connections in times of limited face-to-face
increase in Body Mass Index and overweight was reported. interactions or providing a way to get entertained. Additionally,
A rapid narrative review of 15 articles (12) highlighted that adolescents may have used digital media as a coping tool to deal
pandemic and lockdown measures impacted young persons’ with the stress generated by the Covid-19 confinement by self-
mental health in particular, leading to a general decrease in regulating their emotions using, for example, social media to
psychological well-being followed by changes in sleep habits. escape ongoing worries and boost their mood (24).
Stressors were mainly linked to academic, economic, and To the best of our knowledge, no systematic synthesis on
social issues. Another review of six studies reported a general the link between digital media use, including social media and
decrement in adolescents’ quality of life during Covid-19, smartphone use, and adolescents’ mental health during Covid-
including the perception of physical, psychological, and social 19 exists. Hence, the present systematic review and meta-analysis
well-being (8). Overall, these reviews showed that young people aims to fill this gap by focusing on the adolescent age, mental
were more vulnerable to psychological distress, highlighting the health, and digital media use during the Covid-19 pandemic.
need for targeted interventions and psychological support.
Adolescents around the world alleviated the negative
experiences of social distancing by spending more time online. METHODS
A general increment in the use of digital technologies has been
reported, especially of social media (13), with applications such Literature Search
as TikTok, Pinterest, Reddit, Facebook, Snapchat, Instagram, On 16th April 2021, a systematic search was carried out in
LinkedIn, and Twitter showing growth in active users ranging the titles and abstracts of scientific publications listed in eight
from 8 to 38% (14). Notably, teens reported staying connected academic databases, including Eric and Proquest Sociology (via
with others via text messages (83%), phone calls (72%), social Proquest), Communication & Mass Media Complete, Psychology
media and video chats (66%), instant messaging apps (48%), and, and Behavioral Sciences Collection, PsycINFO, and CINAHL (via
to a lesser extent, e-mails (37%) (15). Ebscohost), Pubmed (via Medline and Proquest), Web of Science
In line with this increment, a study on 5114 high school (via Clarivate Analytics). Key terms covered the population
students from five countries (16) showed that more than 40% (e.g., “adolescent∗ ”, “teen∗ ”, “young∗ ”), intervention/activity
increased their social media time to stay connected with others (e.g., “social media∗ , “screen time∗ ”), outcome (e.g., “well-
since they could not meet in person. Similarly, Munasinghe being∗ ”, “psych∗ ”, “mental∗ ”), and context (e.g., “covid∗ ”). They
et al. (17) reported augmented screen time – including social were combined using Boolean operators. The complete list of
media, Internet, and smartphone use – together with diminished keywords and their combination is reported in Table 1.

TABLE 1 | Complete list of keywords according to the PICO criteria. TABLE 2 | Adapted STROBE checklist.
Population: adolescent* OR teen* OR tween* OR young* Dimension Description

OR youth* OR child* student* OR adult*
AND Introduction Background/ Explain the scientific background and
rationale rationale for the investigation being
Intervention/activity: social network* OR social networking OR
reported
social media OR Facebook OR instagram OR
snapchat OR SNS* OR screen time OR Objectives State specific objectives, including all the
screen-time OR digital OR smartphone* OR hypotheses
Internet use* Methods Setting Describe the setting, locations, and
AND relevant dates, including periods of
recruitment, exposure, follow-up,
Outcome: well being* OR well-being* OR mood* OR
and data collection
anx* OR distress* OR stress* OR affect* OR
life satisfaction* OR psychopatolog* OR Participants Give the eligibility criteria, and the
psych* OR feeling* OR dependence* OR sources and methods of selection of
self-esteem* OR self-worth OR sleep* OR participants
irritab* OR attention* OR inattent* OR fear* Variables Clearly define all outcomes, exposures,
OR worry* OR insomnia* OR distract* OR predictors, potential confounders, and
panic* OR mental* OR health* OR behav* OR effect modifiers. Give
academic* OR school* diagnostic criteria, if applicable
AND Data sources/ For each variable of interest, give
Context: covid* OR covid-19* OR corona* OR measurement sources of data and details of methods
pandemic* OR quarantine* of assessment (measurement)
Statistical Describe all statistical methods. Explain
methods how missing data were addressed
Results Descriptive Give characteristics of study participants
To exclude any duplicates, all entries were imported in results (e.g., demographic, clinical, social)
Zotero, a reference management software. After duplicates were Outcome Report numbers of outcome events or
data summary measures
excluded, the remaining titles and abstracts were screened
Discussion Key results Summarise key results with reference to
by two coders according to the predefined eligibility criteria.
study objectives
Cohen’s kappa statistic (25) was calculated and used to measure
Limitations Discuss limitations of the study, taking
inter-coder reliability. Discrepancies that emerged after full-text into account sources of potential bias or
screening were resolved through a consensus meeting. Two imprecision.
additional hand searches were carried out on 15th June 2021 and Total Total score
15th September 2021 to update the initial search due to the rapid
rate of published works on the topic.
Study Selection
was conducted, study design (cross-sectional or longitudinal),
According to the PICO [Population, Intervention, Comparison,
sample size, type of recruitment (online vs. other), type of
and Outcome; (26)] definition of pre-specified eligibility criteria,
sampling (random vs. convenience), % of male participants, age
we included articles with original data on a population aged 10
of participants, theoretical background, construct and measure
to 24 years (P) (27), including measures of (problematic) digital
of digital media use, construct and measure of mental health
media as intervention (I), and mental health as the outcome (O),
(including its different facets as well-being and ill-being), a
in the context of the Covid-19 pandemic. We did not include
brief description of the results, and raw data convertible into
any comparison. Additionally, only studies published in peer-
effect sizes.
reviewed journals, written in English, and using a quantitative
methodology with a cross-sectional or a longitudinal design
were retained.
Articles were excluded if they were book chapters, pre-prints, Quality Assessment of the Included
conference papers, experimental studies, intervention studies, Studies
qualitative studies, studies focusing on gaming or cyberbullying, The quality assessment of the included studies was carried out
studies with no reference to Covid-19, as well as studies focusing using the Strobe-checklist (28). In particular, for each study,
on education, information-seeking behaviors, contact tracing, we evaluated the quality of the information regarding the
and clinical populations. Publications were also excluded if they background/rationale, objectives, setting, participants, included
reported only descriptive information of digital media use and variables, data sources/measurement, statistical methods,
mental health without linking the two concepts. descriptive results, outcome data, key results, and limitations.
The assessment of each study resulted in a total score from 0 to
Data Extraction 11. A summary of the studies’ quality can be found in Tables 2, 3.
The following information was collected for each study: First We also considered if the included studies used reliable measures
author, year, and title of the paper, the country where the research for digital media use and well-being.

Frontiers in Public Health | www.frontiersin.org
Marciano et al.
TABLE 3 | Quality assessment of the included studies.
Introduction Methods Results Discussion
Study ID Background/ Objectives Settings Participants Variables Data Statistical Descriptives Outcome Key results Limitations Total
rationale sources/ methods data data
Measurement
1 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
2 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
3 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
4 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
5 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
6 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
7 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
8 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
9 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
10 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ X 10
11 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
12 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
13 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
14 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
4
15 ✓ ✓ ✓ ✓ ✓ X ✓ ✓ ✓ ✓ ✓ 10
16 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
17 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
18 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
19 ✓ ✓ ✓ ✓ ✓ X ✓ ✓ ✓ ✓ ✓ 10
20 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
21 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
22 ✓ ✓ ✓ ✓ ✓ X ✓ ✓ ✓ ✓ ✓ 10
23 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
24 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
Well-Being and Media Use During COVID-19

25 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
February 2022 | Volume 9 | Article 793868
26 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
27 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
28 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
29 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ X 10
30 ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ 11
✓ = present; X = absent.
FIGURE 1 | PRISMA flowchart.
Meta-Analytic Procedure RESULTS

Due to the high heterogeneity of the included studies, meta-
analytic syntheses were carried out only for studies including General Overview
raw data convertible into effects sizes and similar investigated From the initial database search, 378 records were obtained. After
duplicates removal, the title and abstract of 217 records were
concepts. The “meta” (29) package in R statistical software was
screened independently by two coders based on the predefined
used for the meta-analysis. A Fisher’s r-to-z transformation was
eligibility criteria. Cohen’s kappa as a measure of intercoder
calculated as a measure of effect size, and results were converted
reliability was 0.80, indicating substantial agreement. After title
back to r correlation coefficients for interpretation. Conversion
and abstract screening, 45 articles were retained. Another 31
formulas (30, 31) were used when necessary to convert raw data articles were identified through the two additional hand searches,
to correlations. Several meta-analyses were carried out linking adding up to 76 articles for full-text screening. Of these, 30
(i) social media use, (ii) screen-time, and (iii) media addiction articles were retained in the systematic review and a subset of 23
to diverse mental health outcomes grouped into comparable in the meta-analysis (see PRISMA flowchart in Figure 1).
categories. We interpreted pooled effect sizes of r = 0.10, r = The included studies were mainly conducted in Asia (n =
0.30, and r = 0.50 as small, medium, and large, respectively 12) and Europe (n = 11). Few were conducted in Oceania (n
(32). An inverse-variance method with a random-effects model = 3), America (n = 2), and Middle East (n = 1). One study
and Hartung-Knapp-Sidik-Jonkman adjustment (33) was used (36) collected data from Italy, Argentina, and United Kingdom.
to adjust for study variability in sample sizes. Heterogeneity of Six studies adopted a longitudinal design, ranging from 14 days
results was calculated with the between-study-variance τ 2 , the (37) to twelve months (38). In all the studies, data were collected
restricted maximum-likelihood estimator (REML), and reported through online questionnaires, and three studies made use of
as I2 statistic (31, 34, 35). When possible (k = 10), additional a random sampling procedure. The median sample size was
meta-regression analyses were carried out to investigate the role 760, ranging from 102 to 13,525, with one longitudinal study
of moderators, such as the age and gender of participants. including 1,64,101 participants at the first time point of data

FIGURE 2 | Graphic representation of well-being investigated constructs.
collection (39). In general, females were slightly over-represented mental health, i.e. social media use and mental health, screen
(mean = 60%). Participants’ mean age was 17.75 years (ranging time (excluding social media use) and mental health, and media
from 9.50 to 25.5). addiction and mental health. A separate subchapter focuses on
Included studies mainly assessed social media use (n = 16), longitudinal studies investigating the different types of media use
screen time (n = 10; including time spent on different devices, and their causal relationships with mental health outcomes.
change in screen time, and type of usage), and media addiction (n
= 9; including measures of Internet and social media addiction).
Mental health was measured in terms of ill-being (n = 17, i.e.,
psychopathological problems such as symptoms of depression, Social Media Use and Mental Health
anxiety, mood disorder, ruminative thoughts), well-being (n = During Covid-19
6, including life satisfaction, optimism, happiness), social well- In general, studies reported that social media use increased
being (n = 12, covering the quality of social relationships, social during the Covid-19 pandemic (36, 47, 56, 60, 62), including
support, interpersonal conflict, and loneliness), lifestyle habits the usage of a variety of social media platforms (e.g., Instagram,
(n = 15, including physical activity, sleep, smoking, nutrition, Snapchat, TikTok). In particular, three studies reported that
and everyday health routines), and Covid-19-related stress (n about one-third of the participants used social media for more
= 10, covering distress, fear, and worries due to the Covid- than 5 h per day (40, 50, 56), with some participants reporting
19 pandemic). For a summary of the investigated concepts, see time spent on social platforms up to 10 h per day (40).
Figures 2, 3. Overall, meta-analytic results showed that time spent on social
A summary of the study characteristics can be found in media was positively correlated with ill-being (k = 11, r =
Tables 4–6. Applying the Strobe checklist, all studies were of 0.171, 95%CI [0.050–0.286], p = 0.011, I2 = 96%, Figure 4),
very good quality, except for three studies lacking detailed indicating that using social platforms was related to higher
information on data sources and measurement (55, 58, 66) and psychopatological symptoms. To note, meta-regression analyses
two studies with insufficient recognition of their study limitations showed that the strength of correlation slightly augmented with
(48, 64). age (β = 0.008, p = 0.027) and percentage of males in the
In the following subchapters, the studies are summarized sample (β = 0.333, p = 0.034). No significant association was
qualitatively and - when possible - quantitatively by grouping found for measures of well-being (k = 6, r = −0.051, 95%CI
them according to the type of media use and its association with [−0.194–0.0947], p = 0.411, I2 = 89%).

FIGURE 3 | Graphic representation of digital media use investigated constructs.
Looking at single studies examining ill-being, social media use more often as a strategy to adapt to the current emergency and
was associated with higher levels of depression, anxiety, mental – to a lower extent – as a way to keep in touch with family
health problems in general, and lower self-esteem, especially and friends (60). Interestingly, individuals who reported more
among girls (38). Furthermore, girls reported having had negative frequent experiences of Fear of Missing Out (FoMO) tended to
online experiences more often (55). One study found that use social media more frequently to seek and share information,
exposure to Covid-19 information likely increased levels of thus fueling a vicious cycle and leading to an even higher
anxiety and depression, especially when participants had already engagement with these platforms (64). The higher engagement
reported psychopathological symptoms before the pandemic in social media content was carried out also if the information
(50). Also, adolescents who - under normal circumstances - did received were perceived as overwhelming (42). Furthermore, the
not use social media so often reported a steeper increment in use of Instagram and, in particular, following appearance-focused
mental problems: Indeed, a three-fold increase in distress was accounts was related to higher body dissatisfaction, drive for
reported in young people who augmented social media time thinness and lower self-esteem in female adolescents. However,
up to 3 hours more than before the pandemic (56). Symptoms the effect sizes were small (47).
were also exacerbated through the mediating role of rumination To note, conflicting results were found when social media
- which refers to the persistent act of thinking about something use was considered in relation to social well-being (k = 5,
bad, hurtful, or uncertain for an extended period (67). That r = −0.002, 95%CI [−0.181–0.176], p = 0.972, I2 = 94%),
was probably due to the greater exposure to Covid-19 related since studies reported both positive and negative associations.
information online, although mindfulness skills buffered this In particular, although depressive symptoms augmented – social
adverse effect (49). A lack of cognitive control over the time spent media use mitigated the feeling of loneliness (40). However,
on social media platforms likely exacerbated psychopathological the way through which this positive effect acted is complex.
symptoms and augmented a sense of isolation from social reality, For example, disclosing oneself to a small group of people,
fueling an obsessive cycle of social media usage patterns (59). i.e. reciprocal online friendship, was found to relieve stress
Conversely, anxious participants reported using social media more than one-to-many online communication (45). Similarly,

a study found that messaging and the use of VoIP apps (e.g., reported comparable effect sizes on screen time and ill-being.
Skype, Viber, WhatsApp) were associated with lower levels However, meta-analytic results were not significant.
of loneliness. In contrast, general social media use increased Looking at the individual studies, the frequency and duration
feelings of loneliness via the mediating role of FoMO (36). A of recreational screen media use, as well as nighttime use,
study of thirteen-year-old participants found that positive online augmented, and this increment was related to increased
experiences (e.g., feeling valued, receiving advice) decreased psychopathology (46). Particularly, leisure screen time was
loneliness, whereas negative experiences (e.g., being cut-off negatively associated with mood problems, even after considering
and mistreated) augmented it (55). At the same time, one covariates such as physical activity and body mass index (57).
study showed that lonely participants were more inclined to In addition, young people showed less increment in Internet-
use social media as a coping tool, but social media did not related activities and lower psychological distress when involved
influence their happiness feelings (60). However, in the same in structured activities (37) or spent more time reading, studying
study, humorous coping - e.g., watching or sharing funny or exercising (62).
videos - was positively related to feelings of happiness, although Screen time that was not used for social interactions was
it was not influenced by loneliness or anxiety. These results negatively related to social well-being (k = 2, r = −0.115, 95%CI
underlined the positive associations between social media use [−0.178–−0.051], p = 0.028). Meta-analytic results linking
and mental health in a developmental period during which screen time and lifestyle behaviors were not significant. However,
connecting with peers is crucial for social well-being and showed increased sitting and screen time was followed by a precipitous
that the quality and the quantity of social connections play a decline in physical activity, which led to lower mood levels (57).
pivotal role. To note, the increment in screen and sedentary time was reported
Social media use was positively associated with Covid-19 irrespectively of the initial time dedicated to both activities (51).
related stress (k = 6, r = 0.253, 95%CI [0.049–0.437], p = 0.025, Participants with previous mental health problems were also at
I2 = 93%). In particular, Covid-19 information shared through higher risk of an unhealthy lifestyle, including lower levels of
social platforms have been perceived as excessively complex and physical activity, higher levels of screen time, and poorer sleep
overwhelming, thus augmenting both social media fatigue and quality (41). On the contrary, when adolescents used digital
fear of Covid-19 (42), with the risk to further bias information- platforms promoting physical activities, they were more likely to
processing capacities for the assessment of Covid-19 information. meet the recommended movement guidelines (53). Also, lower
Conversely, young people reporting more Covid-19-related stress television and mobile phone use levels were related to greater
fostered active use of social media as a coping tool [e.g., (40, 43)]. adherence to a Mediterranean diet, which was, in turn, related
Lifestyle behaviors closely linked to mental health were also to less perceived adversity and more happiness and quality of life
associated with time spent on social media. More precisely, during the lockdown (54).
higher levels of social media use were associated with lower levels Finally, although a meta-analysis was not possible due to
of physical activity, more frequent sleep problems, as well as the paucity of studies, participants reported that increased
higher levels of substance use. In the meta-analysis, including two screen time, including news consumption, helped them stay
studies (40, 41), a non-significant relationship between lifestyle up-to-date and cope with Covid-19 uncertainty, although news
behaviors and social media use during the pandemic was found. consumption also augmented fear of infection (37).
Media Addiction and Mental Health During

Screen Time and Mental Health During Covid-19
Covid-19 Across the studies included in this review, prevalence rates of
Screen time included any screen-based media use except for media addiction ranged from about 20 to 70% (44, 48, 52, 63, 65).
video gaming and social media use (excluded, unless studied Two studies revealed that media addiction levels grew during the
alongside other screen-based activities). The majority of the pandemic (46, 48). A study found that media addiction was more
included studies looking at screen time found that it augmented prevalent among youth who had difficulties organizing their daily
during the pandemic, especially for online leisure activities, schedules (59).
watching television, news consumption, and overall Internet During the Covid-19 pandemic, media addiction showed
usage through smartphones, computers, and tablets (37, 46, 50, a medium-to-large positive relation to ill-being (k = 6, r =
51, 54, 62, 65). In one study, participants reported spending up 0.434. 95% CI [0.092–0.685], p = 0.024, I2 = 98%, Figure 5)
to 11 h and more per day in front of screens (65). Also, young including internalizing and externalizing problems [e.g., (65)].
people living in urban areas reported an additional increase in Looking at the different types of addiction, Fung et al. (63)
their time spent in front of screens compared to those living in found a positive association between social media addiction
the countryside (51). and ill-being, likely caused by rumors and alarming news on
Two studies reported comparable effect sizes for screen time Covid-19 circulating on social media platforms. Nevertheless,
and well-being, the latter measured as general well-being and the same authors reported a decrease in the strength of the
happiness (41, 54). The meta-analytic results revealed a negative association between depression and anxiety with smartphone
yet marginally significant pooled correlation (k = 2, r = −0.196, addiction over time, possibly due to the recently designed
95%CI [−0.429–0.061], p = 0.065). The same studies also mental health apps (63). Also, according to Siste et al. (65),

TABLE 4 | Summary of the included studies.
ID Author and Title Country Study Duration Data N Sampling Males Age Theory
Year design collection
1 Arend et al. Increased screen use on Germany, L 14 days online 102 R 18.6% 25.5 –
(37) days with increased Austria
perceived
COVID-19-related
confinements - a day
level ecological
momentary assessment
study
2 Ellis et al. Physically isolated but Canada C online 1,054 C 21.9% 16.68 –
(40) socially connected:
psychological
adjustment and stress
among adolescents
during the intial
COVID-19 crisis
3 Li et al. (41) The impact of COVID-19 Australia C online 760 C 19% 14.8 –
on the loves and mental
health of Australian
adolescents
4 Liu et al. COVID-19 information United Kingdom C online 322 C 38.80% 18-25 Stimulus-
(42) overload and generation organism-
Z’s social media response
discontinuance intention (S-O-R) model
during the pandemic
lockdown
5 Zhao et al. COVID-19 stress and China C online 512 C 37.5% 22.12 Addictive social
(43) addictive social media media use,
use (SMU): mediating Theory of basic
role of active use and psychological
social median flow needs
6 Arslan et al. Coronavirus Anxiety and Turkey C online 315 C 23% 21.65 –
(44) Psychological
Asjustment in College
Students: Exploring the
Role of College
Belongingness and
Social media Addiction
7 Zhen et al. College students coping United States C online 215 C 21% 20.5 Stressful life
(45) with COVID-19: events, Social
stress-buffering effects penetration
of self-discolsure on theory
social media and
parental support
8 Dong et al. Internet Addiction and China C online 2,050 C 52% 12.34 –
(46) Related Psychological
Factors Among Children
and Adolescents in
China During the
Coronavirus Disease
2019 (COVID-19)
Epidemic
9 Vall-Roqué The impact of COVID-19 Spain C online 1,620 C 0% 14-24 –
et al. (47) lockdown on social
network sites use, body
image disturbance and
self-esteem among
adolescent and young
women
(Continued)

TABLE 4 | Continued
10 Sheoran Prevalence of India C online 300 C 50% 15.57 –

et al. (48) psychological distress
among adolescents in
relation to internet
addiction during
COVID-19 times
11 Hong et al. Social media exposure China C online 439 C 58.10% 20.37 Health belief
(49) and college students’ model,
mental health during the Integrated
outbreak of covid-19: model of
the emdiating role of ruminative
rumination and the response style,
moderating role of Diathesis-stress
mindfulness model
12 Magson Risk and protective Australia L 12 months online 248 C 50% 14.4 –
et al. (38) factors for prospective
changes in adoelscent
mental health during the
COVID-19 pandemic
13 Li et al. (50) Mental health among China L 2.5 months online T1: 164 101; C 37.40% college year –
college students during T2: 68 658 (freshman,
the COVID-19 pandemic sophomore,
in China: a 2-wave junior, senior,
longitudinal survey and graduate)
14 Chambonn Effect of the covid-19 France C online 6,491 C 38.80% 6-17 –
-iere et al. lockdown on physical
(51) activity and sedentary
behvaiors in french
children and
adolescents: new
results from the ONAPS
national survey
15 Islam et al. Problematic internet use Bangladesh C online 13,525 C 61.30% 23.7 –
(52) among yound and adult
population in
Bangladesh: Correlates
with lifestyle and online
activities during the
COVID-19 pandemic
16 Parker et al. The use of digital Australia C online 963 R 28.90% 16.2 –
(53) platforms for adult’s and
adolescents’ physical
activity during the
COVID-19 pandemic
(our life at home): survey
study
17 Dragun Have lifestyle habits and Croatia C offline/online T1: 1326; C 40% 18 –
et al. (54) psychilogical well-being T2: 531
changed among
adolescents and
medical students due to
COVID-19 lockdown in
Croatia?
18 Fumagalli Centennials, FOMO, Italy, L 1 month online 334 C 30.20% 21.5 Evolutionay
et al. (36) and loneliness: an Argentina, theory of
investigation of the United Kingdom loneliness
impact of social
networking and
messaging/VoIP apps
usage during the initial
stage of the coronavirus
pandemic
(Continued)

TABLE 4 | Continued
19 Magis- Positive and Negative Latin L 3 months online 735 C 38.80% 13.25 –
Weinberg Online Experiences and America
et al. (55) Loneliness in Peruvian
Adolescents During the
COVID-19 Lockdown
20 Rens et al. Mental distress and its Belgium C online 2,008 R 21.91% 22.27 –
(56) contributing factors
among young people
during the first wave of
COVID-19: a belgian
survey study
21 Xiao et al. Physical activity, screen China C online 1,680 C 51.30% 7-12 –
(57) time and mood
disturbance among
chinese adolescents
during COVID-19
22 Nomura Cross-sectional survey Japan C online 2,449 C 58% 20 –
et al. (58) of depressive symptoms
and suicide-related
ideation at a japanese
national unviersity during
the COVID-19
stay-home order
23 Hudimova The impact of social Ukraine C online 254 C NA 16-21 –
et al. (59) media on young web
user’s psychological
well-being during the
COVID-19 pandemic
progression
24 Cauberghe How adolescents use Belgio C online 2,165 C 34.4% 15.51 Mood
et al. (60) social media to cope management
with feelings of theory
loneliness and anxiety
during COVID-19
lockdown
25 Pigaiani Adolescent lifestyle Italy C online 306 C 72.90% 18.1 –
et al. (61) behaviors, coping
strategies and subjective
wellbeing during the
COVID-19 pandemic: an
online student survey
26 Islam et al. Problematic Bangladesh C Online 5,511 C 58.90% 21.2 (1.7) –
(52) Smartphone and Social
Media Use Among
Bangladeshi College
and University Students
Amid COVID-19: The
Role of Psychological
Well-Being and
Pandemic Related
Factors
27 Chen et al. Internet-Related China C Online 2,026 C 50.10% 10.71 (1.07) Interaction of
(62) Behaviors and Person- Affect-
Psychological Distress Cognition-
Among Schoolchildren Execution
During the COVID-19 (I-PACE) model
School Hiatus
(Continued)

TABLE 4 | Continued
28 Fung et al. Problematic Use of China L 6 months Online T1: 550; T2: C 51% 11.60 (.74) Components
(63) Internet-Related 543; T3: 489 model of
Activities and Perceived addiction
Weight Stigma in
Schoolchildren: A
Longitudinal Study
Across Different
Epidemic Periods of
COVID-19 in China
29 Hayran Well-Being and Fear of Europe C online 178 C 62 21.35 (1.82) –
et al. (64) Missing Out (FOMO) on
Digital Content in the
Time of COVID-19: A
Correlational Analysis
among University
Students
30 Siste et al. Implications of Indonesia C online 2,932 C 21,3% 17.38 (2.24) –
(65) COVID-19 and
Lockdown on Internet
Addiction Among
Adolescents: Data From
a Developing Country
Study design (C, correlational; L, longitudinal): Duration If longitudinal duration in months (between first and last wave); N, analytical sample size; Sampling (Type of sampling procedure)
(R, random; C, convenient; other, specify); Age (Mean, Standard deviation or Range, if Longitudinal, M and SD at T1 are reported).
adolescents were more susceptible to Internet addiction than of screen-based activities, like video gaming, Internet surfing,
young adults during Covid-19. The authors explained these and television watching. Fumagalli et al. (36) obtained screen-
findings with the fact that adolescents’ cognitive control system time usage data for a 4-week period from diverse countries. They
is still underdeveloped. On top of that, the pandemic has limited found that only social media use augmented at the beginning
physical peer contacts essential for adolescents’ growth and social of the lockdown in spring 2020. Furthermore, higher levels of
connection, pushing adolescents to alternative, online means to social media use predicted higher levels of loneliness through
stay in contact with peers and friends. Media addiction also the mediating role of FoMO. On the contrary, messaging and
deteriorated psychological adjustment via college belongingness: VoIP apps usage reduced loneliness and was not influenced by
Students with higher levels of college belongingness reported individuals’ FoMO levels. Also, VoIP apps consumption varied
better psychological adjustment. However, when social media greatly among countries, but time spent using these apps was
addiction was high, it likely interfered with the sense of belonging still lower with respect to time spent using social media apps.
to the school (44). Magis-Weinberg et al. (55) studied levels of loneliness and
Concerning the association between media addiction reported that they remained unchanged between weeks 6 and
and lifestyle behaviors, the former was related to irregular 11 of the lockdown in Spring 2020 in Perù. Yet, loneliness
physical exercise or physical inactivity, lower engagement was consistently more prevalent among females. Social media
with studying, ignoring earning activities and household use, including positive experiences, such as feeling valued and
chores, poor or heavy sleep, and alcohol or cigarettes receiving advice, predicted lower levels of loneliness over three
consumption (52, 66). Yet, the meta-analytic results based months, whereas negative experiences on social media as well
on the comparable effect sizes of the two studies were as overall screen time predicted the opposite. Furthermore, one
not significant. study (38) reported an increment in depressive and anxiety
symptoms and a decrease in life satisfaction from the pre-
Longitudinal Studies pandemic to the intra-pandemic period. However, exposure to
Six studies included in this review used a longitudinal design Covid-19 information on social media did not significantly affect
(36–38, 50, 55, 63), thus providing insights into the causal these changes in mental health. Fung et al. (63) collected data
mechanisms between (addictive) media use and mental health. from 11-years-old participants during the pre-, ongoing-, and
In particular, using Ecological Momentary Assessments (EMAs) post- Covid-19 lockdown, finding that the positive association
for 14 days, Arend et al. (37) found that more than 40% of between smartphone addiction and ill-being decreased across the
participants augmented daily time spent watching TV and using three waves. The opposite happened for social media addiction,
social media. Participants who reported frequent experiences of for which the association with depression and anxiety increased
structured daily activities also engaged in less intense sessions across the three waves. Finally, the study by Li et al. (50),

Marciano et al.
TABLE 5 | Digital media and well-being constructs investigated.
ID Author and Media Media Measures Reliability Media in Mental health Mental health Measures Reliability Mental health
Year construct the model construct in the model
1 Arend et al. SCREEN Screen time Watching TV, 5 items O COVID/ 1) Feeling restricted 1) Socially and in the Nr P, MOD
(37) Social media use, LIFESTYLE due to the pandemic; work environment; 2)
News 2) Perception of having Very/lowly structured
consumption, a structured day day
Video games,
Internet use
2 Ellis et al. (40) SOCIAL Social media use How many hours 2 items P COVID, 1) COVID-19 stress; 2) 1) Fear of the spread of 1) 8 items, O
per day you spent LIFESTYLE, Time in daily activities; the Covid, Swine Flu Swine Flu
on social media 6 ILLBEING, 3) Depression; 4) Anxiety scale; 2) How Anxiety Scale:
months before and SOCIAL Loneliness; 5) Physical have your days gone in Cronbach’s
during the activity the last 3 weeks since alpha = 0.60; 2)
pandemic the pandemic, how Nr; 3) 6 items,
much time spent in the Cronbach’s
single activities; 3) Brief alpha = 0.88; 4)
Symptom Inventory; 4) 8 items,
UCLA Loneliness Cronbach’s
Scale; 5) Godin alpha = 0.81; 5)
Leisure-time Exercise Si
Questionnaire
13
3 Li et al. (41) SCREEN Use of Screen time (not 3 items P COVID, 1) Covid exposure, 1) Covid exposure, 1) 9 items; 2) 2 O
technological including time for LIFESTYLE, perceived risk, and perceived risk, changes items for family
means online teaching), WELLBEING, changes in behavior; 2) in behavior (social functioning, 3) 7
How much time ILLBEING Impact of Covid on distance, hygiene,.); 2) items for sleep,
used for physical and mental Physical and mental Si for loneliness,
exchanges with well-being, well-being, school and Si for uncertainty
friends and family, school/education, and education, relationships about the future;
How technology relationships; 3) with others, family 4) Nr, K6, 7
use has changed Lifestyle; 4) Mental functioning; 3) items
since the well-being and well Exercise, insomnia SWEMWS, 3
pandemic being severity index, UCLA items BPSIAS
Loneliness Scale,
uncertainty about the

future; 4) Kessler-6,
seven-item Warwick
Edinburgh Mental
Well-being Scale, Body
Preoccupation Scale of
the Illness Attitude
Scales
(Continued)
Marciano et al.
TABLE 5 | Continued
4 Liu et al. (42) SOCIAL 1) Perceived Ad hoc items 1) 3 items, P, MED COVID, 1) Fear of missing out; Items used by another 1) 3 items, O, MOD, MED
COVID-19 Cronbach’s SOCIAL 2) Fear of Covid-19 study Cronbach’s
information alpha =0.834; 2) alpha =0.884; 2)
overload on 3 items, 4 items,
social media as Cronbach’s Cronbach’s
environmental alpha =0.871; 3) alpha =0.904
stimulus; 2) 4 items,
Social media Cronbach’s
fatigue; 3) Social alpha =0.813
media
discontinuance
intention
5 Zhao et al. ADDICTION, 1) Addiction to 1) Brief version of 1) 6 items, O, MED COVID Covid-19 stress SARS-related stress by 10 items P
(43) SOCIAL social media Bergen Facebook Cronbach’s Main et al.
use; 2) Active Addiction Scale; 2) alpha = 0.84; 2)
social media 4 items adapted 4 items,
use; 3) Social from the Cronbach’s
media flow; 4) assessment tool alpha = 0.78; 3)
Hours of social developed by 11 items,
media use Brailovskaia and Cronbach’s
14
Margraf; 3) alpha = 0.82, 4)

Modified version of 1 item
“Facebook flow”
developed by
Brailovskaia et al.;
4) Method of Lin et
al.
6 Arslan et al. ADDICTION Social media Bergen Social 6 items MED COVID, 1) Coronavirus anxiety; 1) Coronavirus Anxiety 1) 5 item; 2) 10 O, MED, P
(44) addiction Media Addiction SOCIAL, 2) College Scale; 2) College item; 3) 6 item
Scale ILLBEING belongingness; 3) Belongningness
Psychological Questionnaire; 3) Brief
Adjustment Adjustment Scale-6
7 Zhen et al. SOCIAL 1) Peripheral 1) Degree to which 1) 5 items, P COVID, 1) Disruption of daily life 1) 7-point Likert scale; 1) 5 items, O

(45) disclosure on participant willing Cronbach’s SOCIAL, due to the pandemic; 2) 7 items from Osatuyi Cronbach’s
social media; 2) to share general alpha = 0.71; 2) LIFESTYLE 2) Self-revelation; 3) et al. 2018; 3) alpha = 0.71; 2)
Core disclosure information on 2 items, Support from parents; shortened version of 34 items; 3) 10
on social media social media; 2) Cronbach’s 4) Perceived stress due MOS Social Support items,
Degree to which alpha = 0.82 to Covid Survey; 4) Perceived Cronbach’s
participant willing Stress Scale alpha = 0.94; 4)
to share private 10 items,
information and Cronbach’s
with whom on alpha = 0.88
social media
(Continued)
Marciano et al.
TABLE 5 | Continued
8 Dong et al. SCREEN, 1) Screen time; 1) Primary 1) Multi item; 2) P ILLBEING 1) Depression, Anxiety, Chinese version of 21 items O
(46) ADDICTION 2) Internet use; electronic devices 20 items, Stress Depression, Anxiety,
3) Internet used; 2) Cronbach’s and Stress Scale
addiction recreational use, alpha > 0.82 (DASS-21)
nightime use; 3)
Chinese version of
Young’s Internet
Addiction Test (IAT)
9 Vall-Roqué et SOCIAL Social media use Frequency of 4 items P ILLBEING, 1) Eating disorder and 1) The drive for thinnes 1) 7 items, 10 O
al. (47) instagram, WELLBEING drive for thinness; 2) and body items, drive for
youtube, tiktok, Self-esteem dissatisfaction thinness
twitter, and subscales of the Eating Cronbach’s
facebook usage Disorders Inventory, alpha = 0.92 e
before and during latter subscale; 2) body
the lockdown, Rosenberg Self-esteem dissatifscation
What profiles the Scale Cronbach’s
participant follows alpha = 0.90; 2)
15
on instagram 10 item,
before and during Cronbach’s
the lockdown alpha = 0.85
10 Sheoran et al. ADDICTION Internet Internet addiction 20 items, O, P ILLBEING Psychological distress Psychological distress 38 items, O, P
(48) addiction test Cronbach’s subscale of mental Cronbach’s
alpha between health inventory alpha = 0.94
0.54 and 0.82
11 Hong et al. SOCIAL Social media How much 6 items, P WELLBEING, 1) Mindfulness; 2) 1) Chinese version of 1) 10 items, O, ME
(49) exposure participants are Cronbach’s ILLBEING Rumination; 3) the Child and Cronbach’s
exposed to alpha =0.67 Psychological distress Adolescent alpha # =0.90;
information Mindfulness Measure; 2) 10 items,
regarding covid on 2) event- related Cronbach’s
the 6 most used rumination inventory; 3) alpha =0.93; 3)

social media in Kessler Psychological 10 items,
China Distress Scale Cronbach’s

alpha =0.94
(Continued)
Marciano et al.
TABLE 5 | Continued
12 Magson et al. SOCIAL Social media Social media 2 items P, MO ILLBEING, 1) General anxiety; 2) 1) Generalized anxiety 1) Cronbach’s O
(38) exposure exposure COVID, Depressive symptoms; subscale of the Spence alpha = T1-
SOCIAL 3) Life satisfaction; 4) Children’s Anxiety 0.86, T2- 0.87;
Covid-19 related Scale; 2) Short Mood 2) 13 items,
distress; 5) Disruption and Feelings Cronbach’s
to schooling; 6) Questionnaire-child alpha = T1-
Interpersonal conflict; version; 3) Student’s 0.91,T2- 0.93, 3)
7) Media exposure; 8) Life Satisfaction Scale; 9 items;
Social connectedness; 4) How much Cronbach’s
9) Adherence to perceived stress due to alpha = T1-
Covid-19 Australian Covid; 5) Perception of 0.91, T2- 0.92,
government homeschooling and 4) 18 items;
stay-at-home directive distance learning; 6) Cronbach’s
Conflicts with parents alpha = T2-
and siblings; 7) Social 0.91; 5) Nr; 6)
Connectedness Scale; Cronbach’s
8) How often left home alpha = 0.91; 7)
1 item
13 Li et al. (50) SOCIAL Social media Hours exposed to 3 items P ILLBEING, 1) Health behavior; 2) 1) Lifetime cigarette 1) Nr, 2) Acute O
exposure info regarding COVID, Mental health smoking, alcohol use stress
covid the previous SOCIAL, problems; 3) Exposure and daily physical symptoms: 6
16
week on social LIFESTYLE to Covid-19 epidemic activity; 2) Impact of items,

media and related factors; 4) Event Scale-6, Patient Cronbach’s
Psychosocial factors Health Questionnaire, alpha = 0.80
Chinese version of the and 0.82,
Generalized Anxiety Depressive
Disorder Scale; 3) symptoms:
Whether participants Cronbach’s
became sick with Covid alpha =0.88 and
or were suspected sick 0.91, Anxiety
in their vicinity, severity symptoms: 7
of the pandemic in their items,
region, exposure to Cronbach’s
social media; 4) Scale alpha = 0.92

of Perceived Social and 0.93

Support, role of family
14 Chambonniere SCREEN Screen time Media hours spent Nr O,P LIFESTYLE 1) Physical activity; 2) 1) Hours of physical Nr O,P
et al. (51) before and during Sedentary hours activity before and
the lockdown during lockdown; 2)
Sedentary activities
before and during the
lockdown, what they
did before the
lockdown
(Continued)
Marciano et al.
TABLE 5 | Continued
15 Islam et al. ADDICTION, 1) Duration of 1) Average hours 9 items, O LIFESTYLE Lifestyle-related Smoking status, 4 items P
(52) SCREEN internet use; 2) spent on the Cronbach’s behaviors Sleeping hours,
Problematic internet; 2) What alpha: 0.85 Physical exercise,
internet use participants did on Doing household
the internet, chores
IDS9-SF
16 Parker et al. SCREEN Use of digital Frequency and Nr P LIFESTYLE Compliance with How many days per Nr O
(53) platforms for duration of use of recommendations week in the past
physical activity digital physical regarding physical month, for 30/60 min,
activity platforms, activity whether at home or in
What type of the gym before the
online platform pandemic
17 Dragun et al. SCREEN Screen time Computer/tablet/cell 3 items P LIFESTYLE, 1) Dietary habits; 2) 1) Mediterranean diet 1) 3 items; 2) 4 O
(54) phone/TV hours WELLBEING, Sleeping habits; 3) adherence, items; 3) Si; 4) 6
usage per day ILLBEING Sedentary activity; 4) consumption of sweet items; 5) 7 items
Psychological drinks and processed
well-being; 5) Lifestyle meat/fish, frequency of
habits breakfast consumption,
snacking habits while
studying/TV; 2) Wake
17
up time and when you

go to bed, how you feel
after waking up; 3)
Sedentary activities
and frequency of
physical activity; 4)
Perceived Stress Scale,
happiness, anxiety and
optimism about the
future; 5) Consumption
of fruits and
vegetables, body
weight,...

18 Fumagalli et SOCIAL 1) Screen time; Trace data of total Nr P SOCIAL 1) FOMO; 2) 1) 3-item measure; 2) 1) 3 items, O
al. (36) 2) Social media time spent on the Loneliness; 3) UCLA Loneliness Cronbach’s
use smartphone, time Personality Scale; 3) 7-point scale alpha =0.39; 2)
using apps of characteristics 8 items,
various categories, Cronbach’s
time spent on a alpha = 0.82; 3)
single installed 10 items
application, set a
limit for a certain
app or not
(Continued)
TABLE 5 | Continued
Marciano et al.
19 Magis- SOCIAL, 1) Social media 1) Online social 1) 11 items, P SOCIAL 1) Loneliness; 2) 1) UCLA Loneliness 1) Cronbach’s O
Weinberg et SCREEN experience; 2) experience Cronbach’s Perceived family Scale; 2) alpha =0.79; 2)
al. (55) Screen time measure; 2) Hours alpha pos = support Multidimensional Scale 12 items,
spent from 0 to 8 0.85, of Perceived Social Cronbach’s
with video games, Cronbach’s Support alpha =
watching TV, pc or alpha =0.79; 2) 0.88,0.90,0.86,0.90
cell phone 1 item
20 Rens et al. SOCIAL Social media use Daily social media 2 items P SOCIAL, 1) Mental distress; 2) 1) General Health 1) 12 items; 2) 3 O
(56) usage in hours COVID, Social support; 3) Questionnaire; 2) Oslo items; 3) Si; 4)
LIFESTYLE Exposure to Covid-19; Social Support Scale, Nr; 5) 5 items; 6)
4) Home activities; 5) 3) Have/had Covid, 3 items
Change in everyday life; has/had a relative with
6) Experiencing Covid; 4) Change in
loneliness time spent at home
before and during the
pandemic; 5) Visiting
friends and relatives,
going out to drink and
eat, physical activity,
hobbies and activities
at home; 6) UCLA
3-item Loneliness Scale
18
21 Xiao et al. (57) SCREEN Screen time Hours spent online 2 items P SOCIAL, 1) Mood state; 2) 1) Chinese version of 1) Nr; 2) Nr; 3) Si O
for school and ILLBEING, Physical activity; 3) the Mood Profile, Total
other reasons LIFESTYLE Conflicts with parents Mood Disorder; 2)
Questions about leisure
exercise; 3) Number of
conflicts with parents
22 Nomura et al. SOCIAL 1) Social media Communication Si P SOCIAL, 1) Social support; 2) 1) Presence of 1) 2 items; 2) Si; O
(58) use; 2) Social through text, audio LIFESTYLE, Exercise; 3) Depressive someone to talk to 3) 9 items
media disorder and video on ILLBEING symptoms about your concerns;
various social 2) Measurement of the
networks intensity of physical
activity performed, how

long in minutes,...; 3)
Japanese version of
PHQ-9
23 Hudimova et SOCIAL, Social media use Social media Cronbach’s P WELLBEING, Psychological Sleep changes, worry, Nr O
al. (59) ADDICTION disorder scale, alpha = 0.82 LIFESTYLE, well-being tolerance, feeling
Experience using ILL-BEING connected during
social media, Time quarantine, avoidance
spent on social behaviors, conflict,
media per day, loneliness,
Social media Warwick-Edinburgh
disorder scale, Mental Wellbeing Scale
Number of profiles
(Continued)
TABLE 5 | Continued
Marciano et al.
24 Cauberghe et SOCIAL Social media use Brief-coping 14 items, MED WELL-BEING, 1) Happiness; 2) 1) Three items of the 1) 3 items; 2) 7 O, P
al. (60) scales, How social Cronbach’s ILLBEING, Anxiety; 3) Loneliness; Center for items,
media used to alpha = 0.722, SOCIAL 4) Epidemiological Cronbach’s
manage crisis, 0.765 Happiness/depression Studies Depression alpha = 0.868;
Coping strategies Scale; 2) General 3) 6 items,
to manage lack of Anxiety Disorder Scale, Cronbach’s
social relationships 3) 6-item scale alpha = 0.768;
and manage mood (RULS-6); 4) Feelings of 4) 3 items,
sadness/happiness Cronbach’s
alpha =0.811
25 Pigaiani et al. SOCIAL 1) Video games; 1) Playing video Si P WELLBEING, 1) Subjective 1) Difficulty staying at Nr O
(61) 2) Social media games; 2) Using LIFESTYLE well-being; 2) Lifestyle home, impact of the
use social networks to and coping skills pandemic experience
stay in touch with on the person, changes
family, acquiring in psychological well
new skills through being, anxiety about
social networks the situation, sleep
abstinence; 2)
organization of the day,
activities performed
and how they have
changed, relationship
19
with family, distance

learning
26 Islam et al. ADDICTION 1) Problematic 1) Bergen Social 1) 6 items, O ILLBEING, 1) Depressive 1) Patient Health 1) 9 item, O
(52) social media Media Addiction Cronbach’s LIFESTYLE symptoms; 2) Anxiety Questionnaire (PHQ-9); Cronbach’s
use; 2) Scale (BSMAS); 2) alpha = 0.80; 2) symptoms; 3) Lifestyle 2) Generalized Anxiety alpha =0.89; 2)
Problematic Smartphone 6 items, Measures; 4) Home Disorder (GAD-7); 3) 7 item,
smartphone use Application Based Cronbach’s Quarantine Activities Items measuring sleep, Cronbach’s
Addiction Scale alpha =0.85 Measures during physical exercising, alpha =0.91; 3)
(SABAS) Covid-19 smoking cigarettes, Nr; 4) Nr
and alcohol
consumption; 4) Items
on the engagement in

frequent activities
during the pandemic,

including home
quarantine
regular/frequent
activities (i.e.,
academic/other
studies, social-media
use, watching
television, household
chores, and
professional activities).
(Continued)
Marciano et al.
TABLE 5 | Continued
27 Chen et al. ADDICTION, 1) Social media 1) Bergen Social 1) 6 items, O, MED ILLBEING Psychological distress Depression, Anxiety, 21 item, P
(62) SCREEN addiction; 2) Media Addiction Cronbach’s (symptoms of anxiety, Stress Scale-21 Cronbach’s
Smartphone Scale (BSMAS); 2) alpha =0.875; 2) depression, and stress) (DASS-21) alpha =0.820,
addiction; 3) Smartphone 6 items, 0.778, 0.813
Gaming Application-Based Cronbach’s
addiction; 4) Addiction Scale alpha =0.882; 3)
Time spent in (SABAS); 3) 9 items,
online activities Internet Gaming Cronbach’s
Disorder alpha =0.922; 4)
Scale-Short Form si
(IGDS-SF9); 4) Ad
hoc questions
28 Fung et al. ADDICTION 1) Social media 1) Bergen Social 1) 6 items, P ILLBEING Psychological distress Depression, Anxiety, 21 items, O
(63) addiction; 2) Media Addiction Cronbach’s (symptoms of anxiety, Stress Scale-21 Cronbach’s
Smartphone Scale (BSMAS); 2) alpha =0.83, depression, and stress) (DASS-21) alpha =0.93,
addiction Smartphone 0.88, 0.89; 2) 6 0.91, 0.93
Application-Based items,
Addiction Scale Cronbach’s
(SABAS) alpha =0.78,
0.90, 0.88
29 Hayran et al. SOCIAL 1) Time they Ad-hoc scales 10 items, 2 P ILLBEING FOMO State and trait FOMO 10 items, O
(64) engaged in items, 2 items, 4 Cronbach’s
20
online social items alpha =0.82

activities (such
as virtual
gatherings with
family and
friends, watching
real-time
Instagram
concerts or
interviews) since
the beginning of
the pandemic; 2)
Whether the

time they spent
on social media
increased during
the pandemic
30 Siste et al. ADDICTION 1) Internet Internet Addiction 44 items, O ILLBEING 1) Psychopatological 1) Strengths and 1) 25 items, P
(65) addiction Diagnostic Cronbach’s problems; 2) Sleep Difficulties Cronbach’s
Questionnaire alpha =0.979 problems Questionnaire; 2) alpha =0.773; 2)
Pittsburgh Sleep 24 items,
Quality Index Cronbach’s
alpha =0.79
Media (SCREEN, screen time in general; ADDICTION, Internet, social media, smartphone addiction; SOCIAL, social media use); Reliability (number of items/inter-item correlation/Cronbach’s alpha; nr, not reported; si, single item scale);
Media and Mental health in the model (P, Predictor, Med, Mediator, Mod, Moderator, O, Outcome); Mental health (WELLBEING, in a positive sense such as self-esteem, life satisfaction; ILLBEING, anxiety, depression, other symptoms;
COVID, stress related to Covid-19; SOCIAL, social well-being; LIFESTYLE, physical activity, food, sleep, etc.).
TABLE 6 | Description of results.
ID Author and Brief description of results

Year
1 Arend et al. (37) Results showed that participants reported increased screen use during leisure time, mostly social media and television watching,
followed by news consumption, other internet usage, and gaming. Experienced work confinements were positively associated
with social media usage. Further, work confinements were positively associated with gaming in males and with news
consumption, especially in individuals living alone. Social confinements were positively associated with watching television
especially in younger participants and with social media consumption in younger participants. Higher experienced day structure
was related to less television watching, gaming, and internet surfing but more news consumption.
2 Ellis et al. (40) Frequency of social media use increased during the pandemic and physical activity decreased. Social media use increased, with
48% of participants using social media for more than 5 hours. Although social media use is nearly universal among youth (95% of
teens reported at least 30 min per day), results showed a substantial increase in the time spent using a variety of social media
platforms (e.g., Instagram, Snapchat, TikTok,) during the initial call to stay at home. Shockingly, over 12% of adolescents reported
using social media more than 10 hrs a day. Analyses showed virtual time with friends related to higher depression but lower
loneliness, beyond reported COVID-19 stress.
3 Li et al. (41) Most youth reported: worsening family stress, decreased/maintained physical activity, higher technology use. 93% say they have
some level of worry about the future and 40.1% show clinical symptoms of illness anxiety. Participants with previously diagnosed
anxiety or depression showed lower levels of physical activity, higher technology use, worse sleep quality, higher levels of
loneliness and uncertainty, lower levels of psychological stress, lower levels of mental well-being, and anxiety about health. Use of
technology to feel with other people is associated with better overall well-being and lower levels of loneliness.
4 Liu et al. (42) The results indicate that the perceived COVID-19 information overload on social media increased social media fatigue and fear of
COVID-19.The enormous amounts of complex information related to COVID-19 exceeded the information-processing capacity of
the members of Gen Z and further hindered their ability to develop an unbiased assessment of COVID-19, which led to a higher
level of fear of the coronavirus pandemic. Results suggest that fear of missing out acts as a moderator that weakens the
associations between the inner psychological states of Gen Z social media users (i.e., social media fatigue and fear of COVID-19)
and their social media discontinuance intention. Users who are high in FoMO tend to derive more benefits from social media use,
particularly during the time of lockdown.
5 Zhao et al. (43) The results showed that COVID-19 stress was positively associated with tendencies toward addictive SMU. Path analyses
revealed that this relationship was significantly serially mediated by active use and social media flow, with SMU time being
controlled. Our findings suggest that individuals who experience more COVID-19 stress are at increased risk of addictive SMU
that may be fostered by active use and flow experience. Therefore, the significant indirect path from COVID-19 stress to addictive
SMU via active use implies that excessive active use acts as a maladaptive coping strategy in the time of the COVID-19 crisis.
6 Arslan et al. (44) Higher experience of coronavirus anxiety was associated with lower college belongingness and higher psychological adjustment
problems. Adjustment via college belongingness only occurred when social media addiction was low and moderate.
Unsurprisingly, the moderating effect of social media addiction did not occur when it was high. When they are highly engaged in
social media, they may find an opportunity to meet their sense of belongingness with their peers in the virtual environment.
7 Zhen et al. (45) The results demonstrated a complicated relationship between online self-disclosure and perceived stress. Specifically, we found a
positive relationship between the levels of disclosing oneself to a small group of people and the levels of perceived stress. This
positive relationship potentially indicates that college students are more likely to turn to their online friends through social media
channels during stressful times. We also found that the willingness to disclose personal information to a selected group of people
on social media moderates the negative impact of life disruptions such as schedule changes, moving, and selfisolating. However,
the results did not show that peripheral selfdisclosure, such as updating SNS casually, helps relieve the stress.
8 Dong et al. (46) In the present study, 2.68% and 33.37% of the participants were classified as addicted and possibly addicted to the Internet. The
results also showed that IA grew with age. This study discovered that the frequency and duration of recreational electronic
devices use, the frequency of electronic devices use after midnight, and the self-score of addiction to electronic products were all
significantly higher than those before the epidemic in all the groups. Our data showed that a number of participants experienced
significant depression, anxiety, and stress during the outbreak. In this particular period, due to the suspension of schools, the
closure of living environments, the reduction of outdoor activities, and the increase of epidemic pressure, the mental health of
school-age children and adolescents were threatened.
9 Vall-Roqué The frequency of use of Instagram was positively associated with body dissatisfaction, drive for thinness and low self-esteem.
et al. (47) However, effect sizes were very small, hence these results should be interpreted with caution. Following appearance-focused
accounts on Instagram was found to be associated with drive for thinness in both age groups, and the effect size in this case was
stronger, even though still small. Taking into consideration the lockdown’s associated changes in SNS use stated above, these
results might have significant implications, as they might indicate that the detrimental effects of SNS could have been
exacerbated during the pandemic, and COVID-19 might be linked to increased drive for thinness and risk for eating disorder
behaviors relative to media effects.
10 Sheoran et al. The total number of uncontrolled users of internet (moderately and severely addicted combined) constitute about two thirds
(48) (66.7%) of the sample population. There were, however, no significant gender differences in Internet Addiction among the male
and female adolescents. In case of Psychological Distress, more than one third of the sample population (35.3%), was in
moderate range and another 36.3 % population was found to be in the severe range. The female adolescents seem to be at a
higher risk of Psychological Distress as compared to male adolescents though the differences with respect to gender are not
statistically significant. The current study established significant positive correlation between Psychological Distress and Internet
Addiction among adolescents.
(Continued)

TABLE 6 | Continued

Year
11 Hong et al. (49) EMS and covid info do not directly predict psychological distress. When college students read massive amounts of stressful news
from various media platforms (e.g., WeChat), increased perceptions of COVID-19 as a severe health threat may lead to fear,
anxiety, and depression. Thus, college students who are frequently exposed to COVID-19 information on social media are likely to
report increased levels of anxiety and depression. Second, SME was positively associated with rumination, which in turn was
positively associated with psychological distress in these college students, supporting the integrated model of ruminative
response style. During this pandemic, exposure to COVID-19 information serves as a stressor, which may activate cognitive
processes and increase ruminative thoughts. Mindfulness significantly moderated the first stage of the mediating process in these
college students. Specifically, SME was positively associated with rumination among students who reported low levels of
mindfulness, whereas this association was not significant among students who reported high levels of mindfulness.
12 Magson et al. The pre-pandemic to intra-pandemic increase in depressive symptoms and anxiety, and decrease in life satisfaction. The finding
(38) that girls are experiencing greater declines in mental health than boys during the COVID-19 crisis. The present results also
showed that feeling socially disconnected during the pandemic was associated with higher levels of anxiety and depressive
symptoms and lower levels of life satisfaction.
13 Li et al. (50) Acute stress levels decreased over time while levels of possible depression and anxiety significantly increased. During second
survey fewer participants said they use social media often and worry about their family or that they might get sick. Probability of
developing symptoms related to acute stress increased in students with higher levels of depression and anxiety during initial
spread of covid, higher exposure to social media, and anxiety about getting sick from covid.
14 Chambonniere 68.9% of adolescents reported an increased screen time. A higher proportion of children and adolescents who complied with the
et al. (51) recommendations before lockdown reported an increase in their screen time (65.0% and 78.7% respectively) compared to those
who exceeded the 2h/day of screen time before the lockdown (respectively 47.8% and 64.8%). A higher proportion of
adolescents who had a sitting time > 6h/day before the lockdown declared an increase of their screen time during lockdown
(70.3%) compared to those who showed a sitting time < 6h/day before the lockdown (57.6%) (p < 0.001). All declared an
increase in their screen time during the lockdown but the higher proportion of children and adolescents who lived in urban areas
reported an increase in their time spent in front of screen (respectively 66.4% and 70.6%) compared 56.7% and 67.4% of those
who lived in the countryside respectively. Higher proportions of children and adolescents who had not access to an outdoor
before the lockdown admitted to increasing their screen time. A total of 64.2% of initially inactive adolescents before the
lockdown reported an increase of their screen time during lockdown against 75.8% of the initially active participants (p < 0.001).
15 Islam et al. (52) Problematic Internet use was significantly associated with being younger in age, having a bachelor degree level of education,
being unmarried, being a member of a nuclear family, having middle-income socioeconomic status, living in an urban area, being
a cigarette smoker, being a heavier sleeper, being physically inactive, not engaging in household chores, and having higher
engagement with online activities (e.g., playing video games, social media use, and online recreational activities).
16 Parker et al. Among adolescents, just 7% met guidelines for moderate-to-vigorous physical activity (MVPA), which was slightly lower than the
(53) Australian average of 10% of 15- to 17-year-olds. Using platforms that promote physical activity determined that on average
participants who used it added movement recommendations more often. 26.5% (255/963) of adolescents reported using digital
platforms for physical activity. Adolescents’MVPA (OR 2.4, 95% CI 1.3-4.3), MSE (OR 3.1, 95% CI 2.1-4.4), and combined (OR
4.3, 95% CI 2.1-9.0) guideline adherence were also higher among users of digital platforms relative to nonusers.
17 Dragun et al. We found no substantial differences in dietary pattern between pre-lockdown and lockdown periods, including the overall
(54) Mediterranean diet (MD) adherence. MD adherence was positively correlated with QoL and study time, and negatively with TV
and mobile phone use in pre-lockdown period (all p < 0.001). Interestingly, higher MD adherence was correlated with less
perceived hardship and greater happiness and QoL during lockdown. The most prominent difference in sedentary activity
corresponded to the time spent on computer/tablet. This kind of activity was reported to average three hours per day during
COVID-19 lockdown, which is two hours more than before due to the online learning (p < 0.001). As many as 78.4% of
secondary school students increased their computer time during lockdown period. subjective health rating was negatively
correlated with daily sitting time, stress score, and anxiousness, while it showed a positive correlation with the MD adherence,
sleep duration, quality of life, happiness and optimism during both study periods.
18 Fumagalli et al. Results showed that only social network usage increased in the initial stage of confinement as a function of lockdown initiation.
(36) Additionally, social network app usage was associated with increased feelings of loneliness, and this relation was mediated by
fear of missing out (FOMO). In contrast, messaging app usage was associated with decreased feelings of loneliness, and was
unrelated to FOMO. These results suggest that technology may be useful for mitigating the impact of loneliness during social
isolation but that it is necessary to promote usage of messaging and VoIP apps, rather than social networking apps, because
they are directly associated with decreases in loneliness without increasing FOMO.
19 Magis- Positive and negative online experiences were more frequent for older students, and females experienced more negative online
Weinberg et al. experiences than males. Greater positive online experiences related to lower loneliness, with the reverse pattern for negative
(55) online experiences. Our results suggest that positive online experiences may mitigate loneliness during physical isolation. Lower
loneliness was associated with lower negative experiences and also higher positive experiences.
20 Rens et al. (56) The results indicate that about two thirds (65.49%) experienced mental distress. In the multivariable regression model, significant
(p < 0.01) predictors of mental distress were female gender (OR = 1.78), low social support (OR = 2.17), loneliness (OR = 5.17),
a small (OR = 1.63), or large (OR = 3.08) increase in social media use, a small (OR = 1.63) or large (OR = 2.17) decrease in
going out for drinks or food, and a decrease in doing home activities (OR = 2.72).
(Continued)

TABLE 6 | Continued

Year
21 Xiao et al. (57) Physical activity, particularly of at least 150 minutes’ duration each week, significantly decreased the likelihood of negative mood
among adolescents during lockdown. Screen time, specifically other than that spent on online study, had a negative association
with mood, after controlling for the relevant variables (i.e., physical activity and body mass index). Less screen time and
accumulating 150 minutes of physical activity were associated with fewer conflicts with parents. An additional 1 hour of screen
time that was not online study was associated with an increase of 1.6 to 1.8 points in participants’ mood disturbance scores.
22 Nomura et al. Multivariable logistic regression analyses showed that risk factors for depression included being a woman, smoking, alcohol
(58) consumption, and social network communication using either video or voice. For suicide-related ideation, alcohol consumption
was the only risk factor. Exercise and having someone to consult about worries were associated with decreased risk of both
depressive symptoms and suicide-related ideation. Conclusions: Negative lifestyles of smoking and drinking, and being a woman,
may be important risk factors for depressive symptoms, whereas exercise and having someone to consult about worries may be
protective factors.
23 Hudimova et al. The study proves that young people spend almost all day online due to the obsessive pattern of social media involvement and/or
(59) procrastination, which often provokes withdrawal syndrome upon the attempt to distract from them. The lack of controlled time
spending on social media during self-isolation provokes an exacerbation of anxiety, apathy, depressed mood, and a sense of
isolation from social reality.
24 Cauberghe Participants who were feeling lonely were more inclined to use social media to cope with lacking social contact. However, this
et al. (60) coping strategy was not significantly related to their happiness feelings. Humorous coping was positively related with feelings of
happiness, but not influenced by loneliness or anxiety. An analysis of the indirect effects showed that the effect of anxiety on
happiness is positively mediated by social media (active) coping. A higher feeling of loneliness among the participants predicted
social media use to keep in touch with peers and family, but it was not associated with happiness. Anxious participants indicated
to use social media more often to actively seek for a manner to adapt to the current situation, and to a lesser extent as a way to
keep in touch with friends and family. The indirect effect of anxiety on happiness through active coping was significantly positive
25 Pigaiani et al. When assessing the impact of adolescents’ lifestyle behaviors and coping strategies on their psychological wellbeing, a number
(61) of variables predicted a significant change. “Active” and planning” adaptive coping strategies associated with a significant change
in wellbeing included doing physical activity and engaging in different activities than before, including media use.
26 Islam et al. (52) Problematic social media sue (PSMU) was positively associated with irregular physical exercise, poor engagement with academic
studies, social media use, watching television, ignoring earning activities, anxiety, and depression. Similarly, PSMU was positively
associated with lower age, poor sleep, alcohol consumption, social media use, anxiety, and depression. Moreover, according to
the hierarchical regression analyses conducted, individuals with irregular physical activity were found to exhibit higher levels of
PSPU than physically active individuals. The present study found that PSPU was significantly associated with poor study
engagement. Moreover, the results of this study found that depression, and anxiety were positively associated with PSPU. In the
hierarchical regression analysis conducted, reporting with less sleep (<7 h/day) were more prone to PSMU. Another important
finding was that alcohol consumption and PSMU were positively associated.
27 Chen et al. (62) In the present study, the problematic use of gaming, social media, and smartphones showed mediating effects in the associations
between psychological distress (including depression, anxiety, and stress) and screen time use among Chinese primary
schoolchildren during their school hiatus due to the COVID-19 outbreak. However, the fear of being infected by COVID-19 did not
impact on any noticeable changes concerning increased time or problematic gaming, problematic social media use, and
problematic smartphone use given the weak significant correlations with small effect sizes. In contrast, children who increased
their time reading/studying or exercising showed less problematic use of Internet-related activities and less psychological distress
during school hiatus.
28 Fung et al. (63) We found that problematic smartphone use (PSU) was significantly higher during the COVID- 19 outbreak, However, there was
no significant difference in PSMU across the three waves. we found positive associations between PSU/PSMU and psychological
distress. However, their associations changed direction across the three waves. Specifically, the association between PSU and
depression/anxiety decreased from before, during, to post-lockdown; however, association between PSMU and
depression/anxiety increased from before, during, to post-lockdown. The diminished associations between PSU and
depression/anxiety may be due to the recently designed mental health apps. Although we did not ask whether our participants
used such apps, it could be possible that participants used apps to cope with their depression and anxiety. The exacerbated
associations between PSMU and depression/anxiety may be due to the rumors and frightening news or information on COVID-19
in the social media.
29 Hayran et al. With two studies conducted at the beginning and towards the end of the pandemic, we tried to uncover the triggers and the
(64) accompanying well-being effects of university students’ FOMO experiences resulting from this digital overuse. Our results reveal
that during the pandemic, even when socially distancing at home, individuals continued to experience FOMO. During this time,
there has been a major shift in the type and amount of digital information individuals consumed. Our findings show that FOMO
has been commonly experienced due to the difficulty of catching up with real-time social media content, others’ posts and
videos, newly released movies and series on videostreaming platforms such asNetflix, and virtual gatheringswith family and
friends. Especially individuals who are more prone to FOMO as a personality characteristic reported feeling it more intensely about
digital content. We find that like a vicious cycle, higher involvement in virtual activities feeds into experiencing higher levels of
FOMO, which then leads to increased engagement with social media.
30 Siste et al. (65) This study observed a point prevalence of 19.3% for suspected Internet addiction among Indonesian adolescents during the
COVID-19 outbreak. Our findings showed that internalization and externalization problems were correlated to higher KDAI scores.
This finding corresponded with other studies about this issue on adolescents

FIGURE 4 | Forest plot of the meta-analysis of social media use and ill-being.
FIGURE 5 | Forest plot of the meta-analysis of media addiction and ill-being.
including 1,64,101 Chinese college students at the onset of existing evidence on the association between (addictive) screen
the Covid-19 in February 2020 and 68,685 participants at the media use and mental health in adolescents during the Covid-
follow-up assessment - about 2.5 months later - highlighted 19 pandemic.
that acute stress diminished. However, depressive and anxiety The key message of the present review is that not all uses of
symptoms augmented, and social media exposure was a risk digital media had negative consequences on adolescents’ mental
factor, especially when participants spent more than 3 h per day health during the pandemic. In particular, our results suggested
with these platforms. that social media use was helpful in mitigating the feeling of
loneliness during Covid-19, but only when a one-to-one or one-
DISCUSSION to-few communication (e.g., use of VoIP apps), rather than
a general social media use, was promoted. Likewise, online
During the Covid-19 pandemic, especially during the lockdown, disclosure in the context of reciprocal friendship was found
social distancing measures and the associated disruption of to relieve stress rather than a one-to-all peripheral disclosure
everyday activities and social contacts threatened the mental on social media. In addition, good online experiences like
health of adolescents (6, 68). To alleviate the negative experiences receiving positive feedback augmented social connection and
of social distancing measures, young people spent more time reduced loneliness during the lockdown, and using social media
online. Lockdown and distancing measures began not long as a humorous coping tool (i.e., using humor to cope with
ago, but researchers have studied whether and how the time the pandemic) increased happiness. These findings align with
spent in front of screens affected mental health. However, a the Theory of Compensatory Internet Use, according to which
comprehensive synthesis of the literature published so far was “negative life situations can give rise to a motivation to go online
still missing. Based on a systematic search and screening process, to alleviate negative feelings” [(69), p. 352], although time online
the present review qualitatively and quantitively summarized the can have both positive and negative outcomes. In the present

review, positive outcomes included better self-reported (social) due to the immaturity of the prefrontal cortex, younger age
well-being and less ill-being in terms of loneliness and stress. groups were even more at risk of developing symptoms of media
Although some studies underlined the positive side of social addiction during the pandemic, which was further facilitated
media use, the majority reported that digital media use was by the instantaneous and easy-to-access gratifying contents that
associated with diminished well-being. Firstly, detrimental effects (social) media platforms convey (65, 71). According to the
of social media may derive from the overload of Covid-19- Interaction of Person-Affect-Cognition-Execution Model (72),
related information, which was frequently negatively valenced the experience of psychological distress, such as the one created
and included much misinformation augmenting feelings of by the Covid-19 lockdown, likely contributed to the development
worry, fear of the pandemic, and FoMO, thus diminishing well- of addictive Internet use. As previously stated, social media,
being [e.g., (42)]. It is likely that, when dealing with high levels of and screen media in general, could be used as a coping tool
stress and uncertainty, online communication and posts’ sharing for self-regulating negative emotions deriving from stress, fear,
among adolescents fostered rumination on negative feelings and uncertainty, and lifestyle changes due to the pandemic. That
involuntarily intensified these concerns. Not surprisingly, older would end up in the experience of negative emotions due to
participants, who better understood the pandemic’s severity, were the loss of control over online activities and the search for
more affected by the negative consequences of social media more frequent gratifications online (62). This would explain
contents’ exposure. the sizeable meta-analytic correlation found between media
Secondly, young people used social media as a coping tool addiction measures and ill-being.
to disconnect from negativity, avoid boredom, displace time To conclude, although overall digital media use was related
for homework, get entertained and follow social media content to lower adolescents’ well-being during Covid-19, some kind of
without getting directly involved. However, as reported by social media use (i.e., one-to-one communication and online
previous literature reviews, passive and compensatory social mutual relationships, the experience of funny and positive
media use led to increased ill-being (59), including feelings of contents) improved social and mental well-being and helped
depression, anxiety, loneliness, and low self-esteem due to social adolescents to deal with the lack of in-person social experiences
comparison as well as body-related concerns (47). The latter during the pandemic. That said, our findings contribute to a
result is in line with a general risk of increased eating disorders growing body of evidence highlighting that the quality rather
during the pandemic (70). Although many of the studies included than the quantity of online interactions and experiences are
in this review used a correlational design, the results indicated crucial in determining potential influences on young people’s
a detrimental effect of social media use during the Covid-19 mental health. Thus, the positive aspects of online activities
pandemic, especially in adolescents who were less involved in should be promoted. At the same time, awareness should be
online activities and those who already experienced mental health raised about the detrimental effects of addictive media use and
problems before the pandemic. adverse mechanisms such as social comparison, FoMO, and the
While mechanisms such as social comparison, FoMO or exposure to negative content during online activities, which can
exposure to negative Covid-19-related information are one happen more frequently in times of pandemic, social isolation,
possible explanation for the detrimental effect of social media, and confinement.
another mechanism is that social media, and screen time in
general, replaced lifestyle activities promoting mental health.
For example, more time in front of screens was associated with
sleep problems, leading to even more screen time during night LIMITATIONS AND FUTURE DIRECTIONS
hours and determining irritability and anxiety. Likewise, physical
activity was reduced, and a more sedentary lifestyle was adopted, This review does not come without limitations. We included only
including a poorer diet and greater use of substances like alcohol peer-reviewed articles; hence, pre-prints and gray literature were
and cigarettes, which were subsequently associated with more left out, which may have introduced some biases. Also, in some
screen time [e.g. (54)] and a more frequent engagement in cases, we did not have enough effect sizes to conduct a meta-
alcohol-related social media usage [e.g., (66)]. analysis on all of the associations of interest or to run meta-
Additionally, youth who spent more time in front of screens to regression and sub-group analyses. Additionally, heterogeneity
deal with Covid-19 stressful situations also tended to fall into “an levels of the effect sizes varied largely, suggesting a significant
immersed pleasant state through repeated use”, which eventually variance that other factors should likely explain. Also, more
led to the development of media addiction symptoms (43). Yet, studies are needed to conclude on more reliable results.
the prevalence of these addictive symptoms varied considerably Eventually, the findings of our systematic review may be biased
across the included studies, ranging from 20 to 70 per cent. because the included studies looked mainly at detrimental effects
In particular, during home quarantine, social media use was of screen time and social media use, including addictive use,
the only way to meet and socialize, thus contributing to longer with only a few focusing on a positive conceptualization of
time spent online and more frequently reported symptoms of mental well-being. Likewise, causality claims, i.e., whether screen
social media addiction, especially when adolescents experienced time and social media use impact mental health or whether
FoMO, thus diminishing well-being (64) - in particular, FoMO the latter is a driver of certain usage behaviors, could only
proneness was higher at the early stage of the pandemic (64). be made with caution since most reviewed studies relied on a
Given that adolescents’ self-control skills are still underdeveloped cross-sectional design.

We encourage researchers to focus on the positive side funny online experiences mitigated feelings of loneliness and
of mental health for future research, including hedonic and stress during Covid-19. These positive aspects of online activities
eudaimonic well-being measures. Furthermore, given the strong should be promoted. Youth’s access to psychological support
focus and predominance of studies measuring the quantity services to provide measures for and promote healthy coping
of (social) media use in terms of duration and frequency, mechanisms during the ongoing Covid-19 pandemic should be
future studies should move beyond these holistic measures facilitated (68).
and disentangle the type and quality of (social) media use.
Furthermore, researchers should invest time and effort in DATA AVAILABILITY STATEMENT
longitudinal studies, although we are confident that more
longitudinal findings will be published in the upcoming months. The original contributions presented in the study are included
Researchers should include longer time ranges when conducting in the article/supplementary material, further inquiries can be
longitudinal studies and use a rigorous statistical procedure to directed to the corresponding author/s.
differentiate between- and between-person effects.
AUTHOR CONTRIBUTIONS
CONCLUSIONS
LM and MO contributed to developing the main research
To conclude, the present systematic review and meta-analysis question, carrying out the literature search, collecting the
first summarizes the existing evidence from 30 studies on the included studies’ information, and describing the results. LM
link between mental health and digital media use in adolescents performed the meta-analysis and wrote the first draft of
during Covid-19. Results showed that adolescents augmented the manuscript. A-LC contributed to developing the main
their social media use, including general screen time. Also, research question and revised the manuscript. PS revised the
higher levels of digital media addiction were reported during manuscript. All authors contributed to the article and approved
the pandemic. In general, higher social media use and media the submitted version.
addiction were related to higher ill-being. Hence, adolescents
are particularly at risk of experiencing mental health problems
due to the augmented exposure to screen time and social FUNDING
media during the pandemic. However, not all types of digital
media use had a negative consequence. In particular, one-to-one This research was in part funded by the Swiss National Science
communication, mutual online friendship, and positive and Foundation (Grant No. 175874).
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SYSTEMATIC REVIEW

published: 01 February 2022

Digital Media Use and Adolescents’

The Covid-19 physical distancing measures had a detrimental effect on adolescents’

Frontiers in Public Health | www.frontiersin.org 1 February 2022 | Volume 9 | Article 793868

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Population: adolescent* OR teen* OR tween* OR young* Dimension Description

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Introduction Methods Results Discussion

Well-Being and Media Use During COVID-19

FIGURE 1 | PRISMA flowchart.

Meta-Analytic Procedure RESULTS

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FIGURE 2 | Graphic representation of well-being investigated constructs.

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FIGURE 3 | Graphic representation of digital media use investigated constructs.

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Media Addiction and Mental Health During

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TABLE 4 | Summary of the included studies.

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10 Sheoran Prevalence of India C online 300 C 50% 15.57 –

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Well-Being and Media Use During COVID-19

Margraf; 3) alpha = 0.82, 4)

Well-Being and Media Use During COVID-19

Well-Being and Media Use During COVID-19

China Distress Scale Cronbach’s

week on social LIFESTYLE to Covid-19 epidemic activity; 2) Impact of items,

Well-Being and Media Use During COVID-19

of Perceived Social and 0.93

up time and when you

Well-Being and Media Use During COVID-19

Well-Being and Media Use During COVID-19

with family, distance

Well-Being and Media Use During COVID-19

during the pandemic,

online social items alpha =0.82

Well-Being and Media Use During COVID-19

TABLE 6 | Description of results.

ID Author and Brief description of results

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ID Author and Brief description of results

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ID Author and Brief description of results

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FIGURE 5 | Forest plot of the meta-analysis of media addiction and ill-being.

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REFERENCES first outbreak of equine influenza. BMC Public Health. (2008)

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