Social media use in adolescents with and without mental health conditions

Concerns about the relationship between social media use and adolescent mental health are growing, yet few studies focus on adolescents with clinical-level mental health symptoms. This limits our understanding of how social media use varies across mental health profiles. In this Registered Report, we analyse nationally representative UK data (N = 3,340, aged 11–19 years) including diagnostic assessments by clinical raters alongside quantitative and qualitative social media measures. As hypothesized, adolescents with mental health conditions reported spending more time on social media and were less happy about the number of online friends than adolescents without conditions. We also found hypothesized differences in social media use by condition type: adolescents with internalizing conditions reported spending more time on social media, engaging in more social comparison and experiencing greater impact of feedback on mood, alongside lower happiness about the number of online friends and lower honest self-disclosure. In contrast, those with externalizing conditions only reported higher time spent. These findings emphasize the need to consider diverse adolescent mental health profiles in policy and clinical practice.