The relationship between social media addiction and metacognitions in patients with social anxiety disorder.

backgroundMental health problems including depression, eating disorders and anxiety disorders are associated with extensive social media use. The literature has examined the relationship between social anxiety and social media addiction; however, there is a lack of studies conducted in clinical patient populations. This study aimed to investigate the role of metacognitions related to social media addiction in individuals diagnosed with social anxiety disorder (SAD).

methodsIn this cross-sectional case-control study, 99 participants aged 18-65 years with social anxiety disorder and 113 control participants were recruited. One control participant with missing BSMAS data was excluded from all analyses, including sociodemographic comparisons; therefore, the final analytic sample included 99 SAD participants and 112 control participants without current psychiatric disorder. The SCID-5 was administered to participants in the SAD group to confirm the diagnosis of social anxiety disorder and to control participants to screen for current psychiatric disorders. No current psychiatric disorder was identified among control participants at the time of assessment. After written informed consent was obtained, all participants completed the Bergen Social Media Addiction Scale (BSMAS), Liebowitz Social Anxiety Scale (LSAS), and Metacognitions Questionnaire-30 (MCQ-30).

resultsSMA prevalence did not differ significantly between participants with SAD and control participants without current psychiatric disorder (52.5% vs. 46.4%; χ²=0.781, p = 0.377; φ = 0.06). Within the SAD group, SMA was associated with higher negative metacognitive beliefs, particularly uncontrollability of worry and the need to control thoughts, and BSMAS severity correlated with these metacognitive domains. Among participants meeting the operational SMA criterion, those with SAD showed higher MCQ-30 uncontrollability of worry scores than control participants. Sensitivity analyses using an alternative BSMAS threshold showed the same overall pattern (see Table 8).

conclusionSMA prevalence was comparable between participants with SAD and control participants without current psychiatric disorder; however, within SAD, problematic social media use was associated with negative metacognitive beliefs. These cross-sectional findings suggest that metacognitive beliefs may be treatment-relevant correlates of problematic social media use in SAD; longitudinal and interventional studies are needed. CLINICAL TRIAL NUMBER: Not applicable.