Research on Child and Adolescent Psychopathology (2021) 49:241–253

https://doi.org/10.1007/s10802-020-00715-7

Social Media and Depression Symptoms: a Meta‑Analysis

Simone Cunningham1 · Chloe C. Hudson1 · Kate Harkness1

Accepted: 29 September 2020 / Published online: 6 January 2021

© Springer Science+Business Media, LLC, part of Springer Nature 2021

Abstract
Social Networking Sites (SNS) have close to 3 billion users worldwide. Recently, however, SNS have come under media
scrutiny for their potential association with depression. Two previous meta-analyses failed to find evidence for a robust
concurrent association between SNS use and depression symptoms. However, these analyses focused primarily on the time
spent using SNS. The current meta-analysis is the first to consider the multi-dimensional nature of SNS use, and examines
separately the quantitative associations of depression symptoms to SNS use in three types of SNS studies examining three
distinct constructs of SNS use: time spent using SNS, intensity of SNS use, and problematic SNS use. Sixty-two studies
(N = 451, 229) met inclusion criteria. Depression symptoms were significantly, but weakly, associated with time spent using
SNS (r = 0.11) and intensity of SNS use (r = 0.09). However, the association of depression symptoms to problematic SNS
use was moderate (r = 0.29), was significantly higher than for time spent using SNS (Qbetween = 35.85, p < 0.001) or intensity
of SNS use (Qbetween = 13.95, p < 0.001), and was not significantly moderated by age, gender, year of study publication, or
mode of recruitment. These results suggest that future research examining causal models of the relation of SNS use and
depression, as well as research on intervention and prevention, should focus in more detail on individuals who are engaging
in a pattern of problematic SNS use.

Keywords Depression symptoms · Social networking sites · Problematic social media use

Social Networking Sites (SNSs) are a worldwide platform
for communication (Kaplan and Haenlein 2010). In March
2020, Facebook was estimated to have over 2.6 billion users
worldwide, and Instagram recently surpassed 1 billion users
(Clement 2020). Because of the rise of SNSs we now have
unparalleled opportunities for information exchange and
discovery, as well as easy and instantaneous connection
with people all over the world. Some research has touted
the advantages of SNS use at the individual level, includ-
ing benefits on mood, cognitive function, and social support
(Ellison et al. 2007; Myhre et al. 2017; Park et al. 2009; Patel
et al. 2015; Primack and Escobar-Viera 2017). At the same
time, SNSs have come under intense scrutiny in recent years
for their negative aspects, including the potential to promote
Electronic supplementary material The online version of this
article (https​://doi.org/10.1007/s1080​2-020-00715​-7) contains
supplementary material, which is available to authorized users.
* Simone Cunningham
0scc6@queensu.ca
1
Department of Psychology, Queen’s University, 62 Arch
Street (Humphrey Hall), Kingston, ON K7L 3L3, Canada
negative social comparison and cyber-bullying (e.g.,
Kırcaburun et al. 2019). A growing body of research sug-
gests that SNS use is associated with symptoms of depres-
sion, anxiety, low self-esteem, and loneliness (Saiphoo et al.
2019; Vannucci et al. 2017), with a recent high-impact report
suggesting that this association in adolescents may be causal
(Twenge et al. 2018).
The potential relation between SNS use and depression is
particularly concerning. Depression affects over 300 million
people worldwide and is the leading global cause of dis-
ability (World Health Organization 2018). It typically first
onsets in adolescence or young adulthood (Weissman et al.
2006), which is both the developmental period associated
with the highest SNS use (Smith and Anderson 2018), and
the age cohort in which rates of depression have been stead-
ily rising (Twenge 2015; Twenge et al. 2018). Very few pro-
spective or experimental studies exist testing causal models
of the relation between SNS use and depression. However,
the studies that do exist appear to point to the possibility of
a bi-directional relation; that is, high levels of SNS use have
been found to prospectively predict increases in depression
(e.g., Vernon, Modecki, & Barber, 2016), and individuals

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with depression appear to be more vulnerable to the nega-
tive impacts of SNS use (Vernon et al., 2016). Qualitative
reviews of the much larger number of studies examining the
cross-sectional association between depression and SNS use
reveal that this relation has been inconsistently replicated
and is complex, likely varying as a function of a number of
methodological and sample moderators (Baker and Algorta
2016; Blease 2015; Frost and Rickwood 2017; Seabrook
et al. 2016). Therefore, the time is ripe for a rigorous meta-
analysis to quantify the strength of the concurrent relation
between SNS use and depression symptoms, and to identify
key moderators that can be used to inform much-needed
studies designed to test causation.
Prior Research on the Relation Between SNS
Use and Depression Symptoms
To the best of our knowledge, only two meta-analytic studies
have quantitatively examined the average effect sizes of the
concurrent relation between SNS use and depression symp-
toms (Huang 2017; Yoon et al. 2019). Both meta-analyses
included studies conducted in North America, Europe, Asia,
and Australia. First, in separate meta-analyses, Yoon and
colleagues (Yoon et al. 2019) reported small positive cor-
relations between depression symptoms and time spent on
SNSs (e.g., minutes using SNSs per day, hours using SNSs
per week; 33 articles; r = 0.11) and SNS checking frequency
(e.g., number of times SNSs were checked per day or per
week; 12 articles; r = 0.10). Age (adults versus adolescents/
children) and gender (percent of the sample who identified
as female) were not significant moderators in either case.
Second, in a meta-analysis of 61 studies, Huang (2017)
reported that the relations of time spent using SNSs (e.g.,
minutes per day, hours per week) to overall psychological
wellbeing was negative, but small (r = −0.07). When the
negative indicators of psychological well-being (i.e., lone-
liness and depression) were considered separately, they were
also weak (rs = −0.08, −0.11, respectively). Age and gender
were again not significant moderators of these relations. The
meta-analytic knowledge to date, then, suggests that there
is a statistically significant, but potentially not a clinically
meaningful, concurrent association between depression
symptoms and SNS use when use is defined as time spent
using SNSs or checking frequency.
There are many different ways to operationalize and
assess SNS use beyond time spent using SNS and frequency
of checking SNS. For example, some studies have specifi-
cally compared active versus passive use (e.g., Escobar-
Viera et al. 2018), or the extent to which SNSs involve social
comparison (e.g., Avery 2018). However, research on these
more specific constructs is still at an early stage, and, thus,
for many of them there are not enough studies to permit
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Research on Child and Adolescent Psychopathology (2021) 49:241–253
separate meta-analytic investigation. Another, larger, set of
studies has focused more broadly on the emotional invest-
ment, or “intensity,” of use, as well as the extent to which
SNS use has become addictive or problematic. While these
latter studies may not address the very specific features of
SNSs, they do address the general ways in which individuals
use SNSs that may be associated with negative outcomes. In
this quantitative review we focus on three distinct operation-
alizations of SNS use that have received the most attention
in the literature and, thus, are frequent enough to permit
meta-analytic investigation: (a) time spent using SNSs; (b)
the “intensity” of SNS use; and (c) problematic SNS use.
It is important to note that there is no agreed-upon con-
sensus operationalization of the above three constructs in the
literature, and studies vary, sometimes widely, in the ways
in which these constructs are operationalized and assessed.
In general, however, time spent using SNSs is typically
assessed with a small number of items querying about the
amount of time (e.g., minutes, hours) per day or per week
spent on social media (e.g., Baker et al. 2016; Lin et al.
2016; Tandoc et al. 2015). Examples include, “Indicate in
hours and minutes (e.g., 3 h and 6 min) how much time you
spend social networking each day” (Baker et al. 2016) and
asking participants to estimate their “total time per day on
social media for personal use” (Lin et al. 2016).
Intensity of SNS use is a heterogeneous construct that
is typically assessed with SNS intensity scales, such as the
Facebook Intensity Scale (FIS; Ellison, Seinfeld, & Lampe,
2007). These scales are designed to measure users’ emo-
tional connectedness to SNSs, as well as the extent to which
SNS use is integrated into their day-to-day life (Avery 2018;
Daniels 2014; Ellison et al., 2007). These scales generally
yield a total score based on multiple features of SNS use,
and may include items assessing time spent on SNSs (e.g.,
minutes or hours per day or week), number of followers and/
or friends, number of posts (e.g., number of posts per day or
per week), feelings of connectedness with SNS communities
(e.g., “I feel I am part of the Facebook community”; Ellison
et al., 2007), and the extent to which SNSs have become
integrated into individuals’ daily routine (e.g., “Facebook
has become a part of my daily routine”; Ellison et al., 2007).
Therefore, the ‘intensity’ construct includes time spent on
SNSs in its definition and assessment, but also goes beyond
this to include other distinct features of SNS use.
The construct of problematic SNS use has also been
variously defined in the literature, but, in general, reflects
a pattern of use that is characterized by behavioral and
psychological features of addiction (e.g., Andreassen et al.
2017; Bányai et al. 2017; Kırcaburun et al. 2019). Most
recently, problematic SNS use has been situated in the
biopsychosocial model of addiction and, like other behav-
ioral addictions, has been theorized to involve a compul-
sion to engage in a non-substance related behavior despite
Research on Child and Adolescent Psychopathology (2021) 49:241–253
the potential negative consequences (Kırcaburun et al.
2019). Thus, problematic SNS use is often determined by
assessing whether there is high frequency of SNS use in
combination with a variety of addiction symptoms, such
as dependence, tolerance, and withdrawal (Bányai et al.
2017). Problematic SNS use has been assessed with a vari-
ety of self-report questionnaires (e.g., Andreassen et al.,
2012; Andreassen et al. 2017; Elphinston and Noller 2011;
Jung and Kim 2014). One of the most commonly used
scales, the Bergen Social Media Addiction Scale (BMAS;
Andreassen et al. 2017), includes items such as “You have
tried to cut down on the use of social media without suc-
cess” and “You use social media so much that it has a
negative impact on your job/studies,” rated on a scale from
1 (very rarely) to 5 (very often).
As noted above, the meta-analyses by Huang (2017)
and Yoon and colleagues (Yoon et al. 2019) found sta-
tistically significant, but very small, concurrent associa-
tions between depression symptoms and both time spent
on SNSs and frequency of checking SNSs. However, to
date, there does not exist a meta-analytic summary of the
relation between depression symptoms and the extent to
which SNS use is emotionally consuming (i.e., intensity
of SNS use) and potentially addictive. Theoretically, an
intense or problematic pattern of SNS use may be more
strongly associated with depression than non-problematic
use, regardless of total time spent using SNSs, because
of the potential for addictive behavior, in general, to fuel
emotions of guilt, shame, and loneliness (e.g., Bilevicius
et al. 2018). Similarly, already depressed individuals may
be more likely than non-depressed individuals to become
emotionally invested in SNSs, and to engage in prob-
lematic SNS use, given the strong association between
depression and addictive behavior, in general (Edgerton
et al. 2018; Swendsen and Merikangas 2000). Therefore,
examination of the intensity and addictive nature of SNS
use is a crucial step in better understanding the potential
relation between SNS use and depression symptoms. Fur-
ther, given the significant costs associated with disorders
like depression (World Health Organization 2018), under-
standing this relation is crucial from a prevention and pub-
lic health perspective as it may highlight more clinically
meaningful intervention targets.
Overall, the inconsistent findings in the qualitative litera-
ture regarding the concurrent relation between depression
symptoms and SNS use, and the weak meta-analytic correla-
tions between depression and time spent using SNSs, specifi-
cally, highlight the need to broaden the operationalization
of SNS use. The current meta-analysis represents the first to
our knowledge to quantitatively examine and compare the
concurrent relations between depression symptoms and SNS
use in studies that have assessed (a) time spent using SNSs;
(b) intensity of SNS use, and (c) problematic SNS use.
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Moderators of the Relation Between
Depression Symptoms and SNS Use
Age Adolescents are higher users of SNSs than adults (Per-
rin 2015), and many of the negative aspects of SNS use,
including cyber-bullying, negative social comparison, and
‘fear of missing out’ (FOMO) have been examined primar-
ily in adolescent samples (e.g., Kırcaburun et al. 2019).
Because adolescence is a critical period of transition in
terms of identify formation, peer and romantic relationship
building, and neuro-emotional development, generally, ado-
lescents have been theorized to be especially vulnerable to
the depressogenic aspects of SNS use (Shapiro and Mar-
golin 2014). Indeed, in a recent large-scale study, Twenge
and colleagues (Twenge et al. 2018) suggest that increases
in rates of depression and suicidality in teens observed in
the period since 2010 are directly attributable to increases
in SNS use by this age group over this period. As noted
above, age was not a significant moderator of the concur-
rent relation between time spent using SNSs and depression
symptoms in the two previous meta-analyses (Huang 2017;
Yoon et al. 2019). However, it is not known whether age
moderates the relation of depression symptoms to potentially
more depression-relevant indices, including the intensity and
problematic use of SNSs.
Gender Adolescent and adult women have been reported
to spend more time on SNS than men, and are more likely
to use SNSs for relational purposes, whereas men are more
likely to use SNSs for general information-seeking (Brooks
and Longstreet 2015; Krasnova et al. 2017). Further, the
prevalence of depression is at least twice as high in women
compared to men, and this gender gap is even more pro-
nounced in adolescents (Salk et al. 2017). Some studies
have, indeed, found that the relation between depression
symptoms and SNS use is stronger in women than men (e.g.,
Brooks and Longstreet 2015). Further, a recent longitudi-
nal study with a large sample found that SNS use predicted
depression symptoms only in adolescent girls, not boys (Hef-
fer et al. 2019). However, other studies have failed to find
evidence of a gender difference in SNS use (Baker et al.
2016; Barry et al. 2017). Further, as noted above, gender
was not a significant moderator of the concurrent relation
between depression symptoms and time spent using SNSs
or frequency of checking SNSs in the two previous meta-
analyses (Huang 2017; Yoon et al. 2019). However, it is not
known whether gender moderates the relation of depression
to potentially more depression-relevant constructs of SNS
use, including the intensity and problematic use of SNSs.
Year of Publication Over the past several years, the num-
ber of individuals who use SNSs on a regular basis has
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drastically increased. For example, in March 2012 Face-
book had approximately 901 million active users. By
March 2020, Facebook had an estimated 2.6 billion users
(Clement 2020). Further, increased use of handheld, port-
able electronic devices such as smartphones has likely
improved the accessibility of SNSs and the way that SNS
is used and integrated into individuals’ daily routines.
Because of these changes and their potential impact on
SNS research data, we examined studies’ year of publica-
tion as a moderator in the relation between SNS use and
depression symptoms.
Design Characteristics We examined two important design
features that may moderate the focal association of SNS
use and depression. First, we examined whether the study
included versus excluded non-SNS users, as we reasoned
that the exclusion of non-users may fail to capture an impor-
tant part of the SNS use distribution. Second, we examined
whether or not a study’s participants were recruited solely
through advertisements placed on SNSs, as we reasoned that
participants who respond to SNS advertisements may use
SNSs more frequently than those who do not, potentially
resulting in a less representative sample. Studies also differ
widely in terms of the specific SNS examined (e.g., Face-
book vs. Instagram vs. a combination, etc.). Unfortunately,
given the vast heterogeneity across studies on this variable,
it was not possible for us to include site as a moderator,
although descriptions of the SNSs included in each study
are provided.
The Current Study
The goal of this meta-analysis is to quantitatively summa-
rize and compare three types of studies that assessed the
concurrent relations between depression symptoms and: (a)
time spent using SNSs, (b) intensity of SNS use, and (c)
problematic SNS use. We hypothesized that all three groups
of studies would show significant effect sizes in association
with depression symptoms. However, we expected the aver-
age effect size to be significantly greater among studies that
assessed intensity of use and problematic SNS use compared
to studies that assessed time spent using SNSs.
This meta-analysis focuses on depression symptoms, and
not the diagnosis of a depressive disorder, for two main rea-
sons. Most pragmatically, there were not sufficient studies to
permit comparison of effect sizes between studies of symp-
toms versus diagnosis. More conceptually, however, depres-
sion symptoms are an important correlate in and of them-
selves: Depression is a dimensional phenomenon in nature
(Kotov et al. 2017); subthreshold symptoms are much more
common in the population than a depression diagnosis and
are associated with a similar level of functional impairment
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Research on Child and Adolescent Psychopathology (2021) 49:241–253
(e.g., Karsten et al. 2010); and subthreshold symptoms are
the strongest prospective risk factor for the future develop-
ment of a full-blown depressive disorder and, thus, are an
important indicator of risk (Shankman et al. 2009).
In terms of moderating variables, we hypothesized that
the relation between depression symptoms and SNS use
would be stronger (a) in studies that included participants
under the age of 18 than in studies that only included adults;
(b) in studies that included a higher proportion of female
participants; (c) in studies that excluded versus included
non-SNS users; and (d) in studies that recruited participants
exclusively through SNSs relative to using more diverse
recruitment strategies.
Methods
Literature Search Strategy
We used the following databases to identify articles: PSY-
CInfo, PubMed, Web of Science, and ProQuest Dissertations
and Theses. For all databases, we searched for the follow-
ing string in titles, keywords, and abstracts: “(depress* or
dysthym*) and (social media or social network* or Face-
book or Twitter or Instagram or Snapchat or LinkedIn)”.
Searches were conducted in January 2019. In addition to our
main search, we also performed backward searches (exam-
ining the references section of eligible studies) and forward
searches (examining articles that had cited eligible studies).
The searches initially yielded 4118 articles (see Fig. 1). Of
these, 1013 duplicates were detected and removed, leaving
3105 articles for initial examination.
During the first stage of the search examination, we
screened the titles and abstracts of all articles and excluded
those that were (1) not quantitative; (2) not written in Eng-
lish; (3) did not assess depression symptoms, or (4) did not
assess any kind of SNS use. Studies were deemed eligible for
inclusion as long as they included a measure of depression
symptoms, whether self-report or clinician-rated.1 Studies
that included participants who met diagnostic criteria for a
depressive disorder were not excluded as long as they also
included a measure of depression symptoms.
A total of 288 articles were identified as potentially eli-
gible for inclusion. During the second stage of examina-
tion, the full texts of articles were fully reviewed by the first
and second authors. During this second stage, articles were
excluded if (1) it became apparent that they did not meet
the inclusion criteria from the first stage; (2) they did not
1
The vast majority of studies utilized self-report measures of depres-
sion. Therefore, it was not possible to include mode of assessment
(i.e., self- vs. clinician-report) as a moderator.
Research on Child and Adolescent Psychopathology (2021) 49:241–253 245

Articles identified through database Articles identified through forward

searches (k = 4118) and backward searches (k = 135)

Articles screened after

duplicates removed (k = 3105)

Articles excluded based on

title and abstract (k = 2817)

Full-text articles assessed for

reliability (k = 288)

Articles excluded based on

full text (k = 225)

Articles included in meta-analysis

(k = 62)

Studies that reported Studies that reported SNS Studies that reported
time spent using SNS (k intensity (k = 6)1 problematic use (k = 20)1
= 44)1

Fig. 1  Study flowchart. 1Note that these numbers do not add up to 62 articles included analyses for depression and more than one construct
because they account for a instances where there were separate stud- of SNS use
ies with different participants within an article and b because some

measure at least one of time spent using SNSs, intensity of
SNS use, or problematic SNS use, and (3) they assessed only
nighttime use, in-bed use, active use, or passive use. These
studies were not included as they assessed only a specific
subset of individuals’ total SNS use, and, thus, may not be
representative of participants’ overall SNS use.
If more than one study used participants that were part of
the same larger study, the study with the larger sample was
included in the meta-analysis. In instances in which a paper
included more than one study with different samples, the
two studies were coded independently. Finally, when stud-
ies appeared to meet inclusion criteria but did not report the
relevant statistics required for the meta-analysis, the corre-
sponding author was contacted and unpublished data were
requested. If the author did not respond or could not provide
the information, the study was excluded. In total, there were
10 authors contacted. Of these, three responded. However,
only one author was able to provide the relevant statistics.
The second stage of examination that included a full text
review resulted in 62 articles that were eligible for inclusion.
Appendix C provides a summary of all 62 studies included
in the meta-analyses.
Study Coding and Inter‑Rater Reliability
All articles were coded by the first and second authors and
inter-rater reliability was assessed separately for initial
screening, eligibility screening, and for data extraction.
Inter-rater reliability was high for the initial screening, with
consensus on the status of 2981 of the 3105 articles screened
(96% agreement). Similarly, inter-rater reliability was high
for study inclusion versus exclusion, with consensus on the
status of 282 of the 288 potential studies (98% agreement).
Finally, inter-rater was high for data extraction. Eleven data

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points were extracted for each of the 62 studies included
in the meta-analysis (see Appendix C), resulting in a total
of 682 data points extracted. There was initial agreement
on 646 data points (95% agreement). Disagreements for the
initial screening, eligibility screening, and data extraction
were discussed and a consensus reached.
The moderator variables were coded as follows: Age
was assessed as mean age and age category. Age category
categorized studies as including 0-only individuals under
age 18 (children and adolescents), 1-only individuals age
18 or older (adults), or 2-both. Gender was coded as the
proportion of the sample that was female.2 Year of publi-
cation was included as a continuous variable ranging from
2012 to 2018. Exclusion of non-SNS users was coded as
0-including participants who did not use SNSs at all or
1-excluding non-SNS users. Finally, study recruitment was
coded as 0-recruited participants through SNSs or 1-did
not recruit participants through SNSs.
Data Analysis
The meta-analyses were performed using the Compre-
hensive Meta-Analysis software (Borenstein et al. 2005).
Three sets of analyses were performed to examine studies
that reported on the relation between depression symptoms
and (a) time spent using SNSs, (b) intensity of SNS use,
and (c) problematic SNS use. Random effects models were
used for all analyses because they better manage outliers
in effect sizes and sample sizes compared to fixed-effect
models and, thus, results are more generalizable (Card
2012). To test for heterogeneity in the variation in effect
sizes across studies, we calculated Q and I2 statistics. For-
est plots were used to visualize the extent of heterogeneity
across studies. Further, a fourth set of analyses were con-
ducted to statistically compare the effect sizes across the
three types of studies. Several studies included in the pre-
sent meta-analysis reported the relation between depres-
sion symptoms and more than one measurement of SNS
use (e.g., both time spent using SNSs and problematic
SNS use; see Appendix C). Although all of these studies
were included within the initial three meta-analyses, they
were excluded from final analyses comparing the effect
sizes between the three types of studies in order to retain
independent samples.
Continuous moderators (mean age of sample, proportion
of sample that was female, and year of publication) were
analyzed using a meta-regression, which involves a weighted
2
Many studies included in the present meta-analysis assessed gen-
der through self-report items and did not appear to specifically query
about biological sex. Thus, we use the term “gender” throughout the
present paper as opposed to sex.
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Research on Child and Adolescent Psychopathology (2021) 49:241–253
regression of effect sizes onto the continuous moderator
(Card 2012). In this case, a significant meta-regression
indicates that the moderator changes the relation between
depression symptoms and SNS use.
Categorical moderators (age category of participants,
exclusion of non-SNS users, and recruitment through SNSs)
were analyzed using the Qbetween statistic. The Qbetween sta-
tistic assesses whether between-group heterogeneity was
greater than expected (Card 2012). In this case, a signifi-
cant Qbetween statistic indicates that the effect size for the
relation between depression symptoms and SNS use varies
significantly for different levels of the categorical moderator.
In cases where there was a significant Qbetween statistic for
a moderator with more than two levels, follow-up analyses
were conducted comparing across levels of the moderator.
Publication bias was assessed by examining the fun-
nel plots for each of the three meta-analyses (time spent
using SNSs, intensity of SNS use, and problematic SNS
use). If significant funnel plot asymmetry was detected,
suggesting publication bias, the “trim and fill method”
(Duval 2005; Duval and Tweedie 2000) was used to
determine the number of missing studies due to publica-
tion bias. Specifically, studies that contributed to fun-
nel plot asymmetry were temporarily “trimmed” until
the funnel plot was symmetrical. Next, trimmed studies
were reinstated and studies that fell within the under-
represented section were imputed, which allowed for
more accurate estimation of the mean effect size. Funnel
plots for the present paper are included in electronic sup-
plementary material. Publication bias was also assessed
quantitatively using Egger’s weighted regression analysis
(Egger et al. 1997).
Results
Depression and Time Spent Using SNSs
Across the 44 studies that assessed the relation between
depression symptoms and time spent using SNSs, the
pooled effect size expressed as a correlation was 0.11
(95% CI = 0.086 – 0.13), p < 0.001. The results were het-
erogeneous, I2 = 96.65, Q = 2091.52, p < 0.001. A forest
plot for the meta-analysis of depression symptoms and
time spent using SNSs is depicted in Fig. 2.
The relation between depression symptoms and
time spent using SNSs was not significantly moder-
ated by mean age (regression coefficient = 0.002, 95%
CI = −0.002 – 0.007, p = 0.321) or gender (regres-
sion coefficient = 0.001, 95% CI = −0.003 – 0.002,
p = 0.173). When age was modelled as a categorical
variable, however, the pooled effect size between depres-
sion symptoms and time spent using SNSs was greater
Research on Child and Adolescent Psychopathology (2021) 49:241–253
Fig. 2  Forest plot of depression
symptoms and time spent using
SNS
as a trend in studies that used only adults (mean effect
size = 0.11, k = 24) compared to studies that used only
children or adolescents (mean effect size = 0.02, k = 6),
Q between(1) = 3.40, p = 0.065. Year of publication did not
significantly moderate the relation between depression
symptoms and time spent using SNSs (regression coef-
ficient = 0.01, 95% CI = −0.005 – 0.02, p = 0.203).
There was a trend for the effect size between depression
symptoms and time spent using SNSs to be higher in stud-
ies that only included SNS users in the analyses (pooled
effect size = 0.14, k = 15) compared to studies that also
included non-SNS users (pooled effect size = 0.09, k = 29),
Q between (1) = 3.34, p = 0.067. The effect size between
depression symptoms and time spent using SNSs was
247
significantly higher in studies that recruited participants
through SNSs (pooled effect size = 0.21, k = 6) compared
to studies that did not (pooled effect size = 0.10, k = 38),
Qbetween(1) = 4.94, p = 0.027.
The funnel plot was asymmetrical, suggesting that publica-
tion of studies of the relation between depression symptoms
and time spent using SNSs is biased towards reporting higher
effect sizes. The quantitative measure of publication bias also
was significant (Egger’s weight regression analysis, p < 0.001).
The trim and fill method imputed that approximately 14 stud-
ies might be missing due to publication bias. After adjustment
for publication bias, the effect size of the relation between
depression symptoms and time spent using SNSs was 0.06
(95% CI = 0.04 – 0.08).
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Fig. 3  Forest plot of depres-
sion symptoms and intensity of
SNS use
Fig. 4  Forest plot of depres-
sion symptoms and problematic
SNS use
Depression and Intensity of SNS Use
Across the six studies that assessed the relation between
depression symptoms and intensity of SNS use, the
pooled effect size expressed as a correlation was 0.09
(95% CI = −0.003 – 0.18), p = 0.058. The results were
heterogeneous, I 2 = 75.06, Q = 20.05, p < 0.01. A forest
plot for the meta-analysis of depression symptoms and
SNS use intensity is depicted in Fig. 3. Moderator analy-
ses were not conducted for intensity of SNS use as, with
only 6 studies total, there was not adequate coverage of
the varying areas or levels of the moderator variables
(see Card 2012).
The funnel plot was symmetrical, suggesting no pub-
lication bias. Similarly, the quantitative assessment of
publication bias was not significant (Egger’s weighted
regression analysis, p = 0.154).
13
Research on Child and Adolescent Psychopathology (2021) 49:241–253
Depression and Problematic SNS Use
Across the 20 studies that assessed the relation between
depression symptoms and problematic SNS use, the
pooled effect size expressed as a correlation was 0.29 (95%
CI = 0.23 – 0.35), p < 0.001. The results were heterogeneous,
I2 = 95.49, Q = 421.61, p < 0.001. A forest plot is depicted
in Fig. 4.
Of the studies that assessed problematic SNS use, only
one had a sample comprised of individuals under age
18. However, the relation between depression symptoms
and problematic SNS use was not systematically related
to age when examined continuously (regression coeffi-
cient = −0.002, 95% CI = −0.011 – 0.008, p = 0.715). Fur-
ther, the relation between depression symptoms and prob-
lematic SNS use was not significantly moderated by gender
(regression coefficient = 0.001, 95% CI = −0.004 – 0.004,
Research on Child and Adolescent Psychopathology (2021) 49:241–253
p = 0.871). Year of publication did not significantly mod-
erate the relation between depression symptoms and time
spent using SNSs (regression coefficient = −0.01, 95%
CI = −0.05 – 0.03, p = 0.524).
The effect size of the relation between depression symp-
toms and problematic SNS use was not significantly different
in studies that exclusively included SNS users in the analy-
ses (pooled effect size = 0.32, k = 8) compared to studies
that also included non-SNS users (pooled effect size = 0.27,
k = 12), Qbetween(1) = 1.18, p = 0.277. Only two studies exclu-
sively recruited participants through SNSs. Thus, no mod-
erator analyses were conducted on this variable.
The funnel plot was relatively symmetrical, suggesting
no publication bias. Similarly, the quantitative assessment
of publication bias was not significant (Egger’s weighted
regression analysis, p = 0.102).
Comparing Time, Intensity, and Problematic Use
of SNSs
The omnibus comparison of effect sizes across the total time,
intensity, and problematic nature of SNS use was significant,
Qbetween(2) = 31.61, p < 0.001. As hypothesized, the mean
effect size of studies that assessed problematic SNS use
(pooled effect size = 0.29, k = 15) was significantly greater
than that of studies assessing time spent using SNSs (pooled
effect size = 0.11, k = 38; Qbetween(1) = 35.88, p < 0.001)
and intensity of SNS use (pooled effect size = 0.09, k = 5;
Qbetween(1) = 13.92, p < 0.001), while the latter two effect
sizes did not differ significantly, Qbetween(1) = 0.18, p = 0.666.
It is noteworthy that the pooled effect sizes in these analy-
ses, which excluded several studies that reported more than
one type of SNS use measurement, did not differ from the
pooled effect sizes for each meta-analysis that included these
studies.
Discussion
The goal of this meta-analysis was to statistically synthesize
and compare effect sizes in the existing literature for the con-
current relation between depression symptoms and SNS use
across three types of studies examining distinct constructs
of SNS use: (a) time spent using SNSs; (b) intensity of SNS
use; and (c) problematic use of SNS. The findings suggest
that, in general, greater SNS use is significantly associated
with elevated depression symptoms. Further, partially con-
sistent with hypotheses, the effect size for studies that specif-
ically examined a pattern of problematic SNS use indicated
a moderate strength of effect (r = 0.29) that was significantly
higher than the effect for studies that assessed either time
spent using SNSs or intensity of SNS use. Although the
pooled effect sizes for studies examining time spent using
249
SNSs (r = 0.11) and SNS intensity (r = 0.09) were statisti-
cally significant or approaching statistical significance, the
effect sizes were small, suggesting that these may not be
clinically meaningful relations. Although this was expected
for time spent using SNSs, we had hypothesized that inten-
sity of SNS use, similar to problematic SNS use, would have
a stronger association with depression symptoms than time
spent using SNSs.
The current meta-analytic results suggest that problem-
atic SNS use may be the primary construct driving the rela-
tion between SNS use and depression, more so than time
spent using SNSs or intensity of SNS use more generally.
If so, this finding has important implications for identify-
ing individuals who are most at risk for negative outcomes,
regardless of the directionality of this relation, and provides
a research target for future longitudinal studies examining
the transactional relations between depression symptoms
and SNS use, as well as mediators of this relation, over time.
For example, if problematic SNS use prospectively predicts
depression, then future research could investigate inter-
ventions for the addictive behaviors associated with SNS
use as a means of preventing the emergence of depression
symptoms and disorder. Similarly, if depression symptoms
prospectively increase the likelihood of problematic SNS
use, then existing prevention and intervention strategies for
depression could be amended to include modules that spe-
cifically target teaching more adaptive ways to use SNSs.
A possible alternative explanation for the above associa-
tion between problematic SNS use and depression symptoms
is construct overlap in these cross-sectional studies. As noted
previously, problematic SNS use is characterized by symp-
toms of behavioral addiction and, by definition, negatively
impacts functioning. Thus, it is not surprising that individ-
uals who endorse elevated levels of depression symptoms
would also endorse items on scales of measures of prob-
lematic SNS use (e.g., “used [SNSs] to reduce feelings of
guilt, anxiety, helplessness, and depression,” “used [SNSs]
to forget about personal problems” from the BSMAS). This
possibility points, again, to the importance of prospective,
longitudinal research that attempts to determine the causal
and transactional associations between SNS use and symp-
toms of psychopathology, including depression.
The observation of a small pooled effect size for the rela-
tion between SNS use intensity and depression symptoms
was unexpected. One possible explanation for this finding
is that although some items included in intensity scales
may overlap with features associated with problematic use
(e.g., frequent use; high integration into one’s daily routine),
some items may also be assessing more positive or protec-
tive aspects of use. For example, individuals who endorse
the FIS item “I feel I am part of the Facebook community”
(Ellison et al., 2007) may also experience more social sup-
port and more positive interactions on SNSs, which has in
13
250
turn been associated with positive outcomes (e.g., Davila
et al., 2012). Therefore, it is possible that the heterogeneity
in items on SNS intensity scales may have resulted in a small
pooled effect size in the relation between intensity of SNS
use and depression symptoms.
In addition to showing the largest effect size, the relation
of depression and problematic SNS use was not significantly
moderated by age, gender, year of study publication, or
design characteristics. It should be noted that only one study
assessed problematic SNS use in adolescents. As a result,
age was examined as a continuous moderator in what were
primarily adult samples. Therefore, our review highlights
the need for more research in adolescents examining the
specific construct of problematic SNS use. Nevertheless, the
moderation findings indicate that the relation of problematic
SNS use to depression is no stronger in younger adults (e.g.,
college-age, who are the next highest users after adoles-
cents) than older adults. Further, problematic SNS use was
not significantly moderated by gender. These null findings
are important as they suggest that despite different use pat-
terns and rates of depression across ages and genders, if use
rises to the level of being problematic, its association with
depression is consistent. An intriguing and important area
for future research in this area is to examine in a more fine-
grained manner the specific ways in which younger versus
older individuals’ or men’s versus women’s problematic use
of SNSs differ (e.g., addictive on-line gaming versus addic-
tive scrolling through posts promoting social comparison)
in order to determine whether the content of intervention
and prevention strategies should differ across these impor-
tant demographic groups. Finally, although the prevalence
and modes of SNS use (i.e., increased smartphone use) have
undergone drastic changes over the last several years, the
year of study publication was not a significant moderator
in the relation between depression symptoms and SNS use.
These null findings may suggest that changes in SNS use
over time are not a relevant factor in the potential association
between SNS use and depression; however, year of publi-
cation is ultimately a proxy for changes in the way SNSs
are used over time. Future research that more specifically
examines these changes and their association with depres-
sion symptoms warrants further attention. Overall, however,
our results suggest that problematic SNS use may have a
more stable and consistent relation to depression symptoms
than time spent using SNSs or intensity of SNS use, one that
is not altered by, or dependent upon, other factors.
In contrast, the relation between depression symptoms
and time spent using SNSs was significantly moderated
by mode of recruitment. Specifically, studies that exclu-
sively recruited participants through SNSs had a signifi-
cantly larger pooled effect size than studies that relied on
other recruitment methods. Indeed, the effect size for the
relation of time spent using SNSs to depression in studies
13
Research on Child and Adolescent Psychopathology (2021) 49:241–253
recruited through SNS advertisements (r = 0.21) was similar
in strength to the overall effect size for problematic SNS
use. This finding suggests that there may be important dif-
ferences between individuals who respond to research study
advertisements on SNSs versus individuals recruited from
other sources and signals a need to be aware of sample bias
in future studies. It is possible that individuals who respond
to advertisements on SNSs are also high-frequency users,
thus resulting in a restricted range on the variable of time
spent using SNSs. Further, to the extent that time spent
using SNSs is correlated with problematic use, it is possi-
ble that samples recruited solely from SNS advertisements
may include a disproportionate number of problematic SNS
users, which could spuriously inflate the effect sizes for time
spent using SNSs. Therefore, the current results highlight a
need for future studies to ensure that samples are representa-
tive of the population to which they would like to general-
ize, and that studies examine the intersection of total time,
intensity, and problematic SNS use.
Finally, there was a trend for the pooled effect sizes of the
relation of time spent using SNSs and depression symptoms
to be significantly larger in studies of adults than in stud-
ies of children or adolescents. It should be noted, however,
that both effect sizes were small (r = 0.11, r = 0.02, respec-
tively), thus is it unlikely that this difference is clinically
meaningful. Further, the small number of studies examining
the younger age group (k = 6) collapsed across studies of
children and adolescents. Therefore, this highlights again
the importance of more research on the relation of SNS use
and depression in adolescents specifically.
The results of this meta-analysis should be interpreted
in light of the following limitations. First, although there
were 62 studies included overall, there were smaller sam-
ple sizes for each of the three SNS use groups, particularly
the intensity of SNS use group (k = 6). This small sample
size prevented us from examining any of the moderators
within the intensity of SNS use group, and in the other two
groups of studies we were not able to examine interactions
among our moderator variables. Further, there are a number
of potentially important mechanisms may moderate the rela-
tion of SNS use and depression that we could not examine
due to an insufficient number of studies. For example, some
studies have found that passive social media use (e.g., scroll-
ing through other individual’s posts) is more strongly associ-
ated with depression symptoms than active social media use
(e.g., posting photos or status updates, commenting on other
posts, etc.; e.g., Escobar-Viera et al. 2018). Other research
has found that time of day may be relevant, with nighttime/
in-bed SNS use associated with depression symptoms more
strongly than daytime use (Becker and Lienesch 2018;
Woods and Scott 2016). These potential moderators may
also be of relevance to the statistically significant hetero-
geneity (i.e., significant I2 values) across studies examining
Research on Child and Adolescent Psychopathology (2021) 49:241–253
all three constructs of SNS use. As more research exam-
ining these specific factors of SNS use becomes available,
meta-analytic research will be useful in further specifying
the nature of the relation between depression and SNS use.
Second, the current meta-analyses only included studies
that reported bivariate correlational statistics for the con-
current relation between depression symptoms and SNS
use. The purpose of this inclusion criterion was to create
more homogeneity within our groups of studies, as we rea-
soned that including studies that dichotomized continuous
variables (e.g., created depression groups based on symptom
scale scores) would alter the nature of the research question.
However, our inclusion criterion resulted in the exclusion
of several studies relevant to the topic of the present meta-
analysis. Assessing the relation of a categorical depression
variable and SNS use thus represents an important area of
investigation.
Finally, as with all meta-analyses, the results of the cur-
rent study were limited by what was available in the existing
published literature. In this meta-analysis we detected evi-
dence for a “file drawer” effect for studies that assessed time
spent using SNSs, such that the published literature may
overestimate the strength of the relation between depres-
sion symptoms and SNS use. However, we were only able
to include published studies in the meta-analysis (includ-
ing theses published on ProQuest), and did not include any
unpublished data or data from the grey literature (e.g., con-
ference presentations, theses not available on ProQuest).
Therefore, the current findings of publication bias may be
an underestimate of the true publication bias present in this
field. Further, and importantly, of the studies included in this
meta-analysis did not include information on participants’
ethnicity or cultural background. As a result, we were not
able to examine the potential moderating role of ethnicity
on the relation between depression symptoms and SNS use.
Further, most studies did not clarify whether they assessed
gender or biological sex, and few studies reported the inclu-
sion of participants who identified as anything other than
male or female. Future research that investigates sex, gen-
der, ethnicity, and their intersection are necessary to further
clarify the relation between SNS use and depression.
The results of the current meta-analysis indicate a sig-
nificant association of depression symptoms and all three
constructs of SNS use examined (time spent using SNSs,
intensity of SNS use, or problematic SNS use). Nevertheless,
associations with time spent using SNSs and intensity of use
were weak, suggesting that they may not be clinical mean-
ingful. Further, for time spent using SNSs, this association
rose to moderate size only when studies included partici-
pants recruited exclusively from SNSs, raising the potential
of a confounding between time spent using SNSs and prob-
lematic use. In contrast, the association of problematic SNS
251
use and depression symptoms was moderate in size, and was
not significantly moderated by age, gender, or design char-
acteristics, suggesting that this relation may be more stable
and universal. An important implication of these results is
that future work with the goal of establishing the directional-
ity of the association between depression and SNS use, and
mediators and moderators of this association, may want to
focus in more detail on problematic SNS use. Further, we
suggest that prevention and intervention strategies to lessen
the functional impact of SNS use may be most cost-effective
if they target individuals who are engaging in problematic
or addictive use.
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