Problematic social media use and psychosocial conditions.

Background: Problematic social media use (PSMU) is frequently associated with adolescent mental health problems, but the interpretive meaning of a high PSMU score in population surveys remains unclear. We examined whether elevated PSMU identifies adolescents with broader psychosocial difficulties or appears in multiple psychosocial contexts. Methods: Cluster analysis was conducted using data from the 2022 Health Behaviour in School-aged Children (HBSC) survey, including nationally representative samples of 15-year-old adolescents (mean age 15.80 years, SD 0.41) from five Nordic countries ( Results: Adolescents with high PSMU, psychosomatic complaints, and perceived stress showed the most adverse psychosocial profile, including cyberbullying involvement, negative school and peer experiences, loneliness, and low well-being. Adolescents with high psychosomatic complaints and perceived stress but average PSMU showed equal or greater difficulties, except for cyberbullying. A third group reported high PSMU without elevated perceived stress or psychosomatic complaints and did not show elevated psychosocial difficulties on the measured indicators. Conclusion: High PSMU scores occurred in heterogeneous psychosocial contexts. Adolescents with high PSMU were distributed across markedly different psychosocial profiles, and those with the most adverse stress-related conditions were often identified without elevated PSMU. These findings suggest that PSMU should be interpreted cautiously when used as a stand-alone indicator in adolescent population surveys and that its meaning depends on accompanying stress-related symptoms and social context.