The Association Between Negative Online Behaviours and Problematic Social Media Use in Adolescents: Comparing Psychiatric Inpatients and Community Participants.

Objectives: The U.S. Surgeon General's Advisory recently highlighted (2023) the urgency to better understand the impacts of social media on youth mental health, emphasizing the need to distinguish normative from problematic social media use (PSMU). This study aims to investigate specific online behaviours in adolescents, examining their association with PSMU, depressive symptoms and past abuse. Methods: 247 adolescents (ages 12-17) completed online questionnaires; 124 were part of the community group (CG) and 123 were psychiatric inpatients (Hospitalized Group, HG). The Bergen Social Media Addiction Scale (BSMAS) and PHQ-9 were used to evaluate PSMU and depressive symptoms. Additionally, participants reported on cyberbullying victimization, sexting, accessing self-harm content online and past abuse. Logistic regression analyses were used to measure the strength of association of different score predictors (BSMAS, PHQ-9, abuse) on negative behaviours. Results are presented as odds ratios (OR) with 95% confidence intervals (CI). Results: The prevalence rates of negative online behaviours were similar to those in the existing literature for cyber bullying victimization (20.5%), sexting (20.4%) and self-harm content seeking (27.6%). They were all more frequent in the hospitalized group. They were also associated with PSMU: cyber bullying victimization (OR 4.54, 95% CI [1.95-10.54]), sexting (OR 5.47, 95% CI [2.37-12.81]), and self-harm content seeking (OR 4.71, 95% CI [2.07-11.09]). Moreover, negative behaviours were associated with depressive symptoms as well as past physical and sexual abuse. Conclusions: Problematic social media use (PSMU) is associated with multiple negative online behaviours. Mental health professionals should include questions about social media use and online behaviours in their clinical assessment of adolescents.