Evidence map›Paper›PMID 42337729›Full record

ArticleBMC public health2026

Algorithmic recommendation and adolescent mental health: a grounded theory study of social and commercial determinants.

Lizzy Winstone, James Parsonage, Lauren Cross, Cassey Muir, Amie Randhawa, Georgie MacArthur, Emma Garavini, Evangelina Asiedu-Addo

Abstract read
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Lizzy WinstonePopulation Health Sciences, University of Bristol, Bristol, UK. lizzy.winstone@bristol.ac.uk.
James ParsonagePopulation Health Sciences, University of Bristol, Bristol, UK.
Lauren CrossMRC Epidemiology Unit, University of Cambridge, Cambridge, UK.
Cassey MuirPopulation Health Sciences Institute, Newcastle University, Newcastle, UK.
Amie RandhawaSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Georgie MacArthurPopulation Health Sciences, University of Bristol, Bristol, UK.
Emma GaraviniThe McPin Foundation Young People's Network, The McPin Foundation, London, UK.
Evangelina Asiedu-AddoThe McPin Foundation Young People's Network, The McPin Foundation, London, UK.

Funding

National Institute for Health and Care Research (NIHR) 20400School for Public Health Research NIHR 204000
6 · The paper itself

Abstract

backgroundExisting digital mental health research tends to frame social media in individualistic terms, emphasising screen-time, self-control, or personal vulnerability. Less attention has been given to the role of algorithmic recommendation systems in population mental health. We aimed to develop a grounded theory of how adolescents experience algorithmically curated feeds and how these experiences relate to mental health and wellbeing.

methodsWe conducted semi-structured, photo-elicitation interviews with 27 UK young people aged 14-19 years. Participants shared screenshots from their TikTok 'For You' and Instagram 'Explore' pages to support discussion of algorithmically recommended content. Data were analysed using constructivist grounded theory, with iterative coding, memo-writing, and theoretical sampling.

resultsWe identify algorithmically structured exposure as a central mechanism through which engagement-driven recommendation systems shape young people's digital mental health. Algorithms organised what content participants encountered, how frequently, and with what emotional intensity, within broader socioecological contexts. Three interlocking processes sustained exposure; algorithmic reinforcement of engagement, emotional feedback loops between mood and recommendations, and a persistent sense of limited control despite high awareness. Although participants developed adaptive strategies and algorithmic literacy, these were unevenly distributed and often insufficient within engagement-driven, profit-oriented systems.

conclusionsDigital mental health may be produced through interactions between individual capacities, social environments, and commercially driven platform design. Protecting population mental health therefore requires multi-level action, including developmentally appropriate social media and algorithmic literacy education alongside structural reforms to recommendation systems, transparency, and platform governance.

Indexed as

AlgorithmsMental HealthSocial MediaAdolescentDigital MediaFemaleGrounded TheoryHumansInterviews as TopicMaleQualitative ResearchUnited KingdomYoung AdultAdolescent mental healthAlgorithmic recommendationCommercial determinants of healthGrounded theorySocial mediaSocioecological model

Identifiers

PMID42337729
PMCPMC13540923

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.