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Update on ADHD and Screen Media Use

A bit of reassuring news in the time of COVID.

With public health authorities urging continued social distancing and holiday breaks here, screen media use is up and many parents worry about mental health effects on their children (and even on themselves). Hope is running high with vaccines on the horizon, but most of the country is still coping with modified operations and social distancing at a period of peak COVID caseloads that continue to rise. We have a ways to go. So I give an update on the screen media issue here in time for the rest of the holiday break.

It remains true that excessive screen time can be harmful, especially for very young children, whom it keeps from other developmentally important activities: Face-to-face time with parents is particularly crucial for small children. However, for older children and teens, when pandemics are not at hand, screens can interfere with playing outside, studies, hobbies, time with peers, physical activity, and sleep.

But concern has also historically been related to the screen time itself being potentially harmful when it is not educational, depending on the structure and content. These worries have increased in the past decade as the ubiquity of screens in daily life has skyrocketed. The American Academy of Pediatrics, in their updated 2016 guidelines, continues to express particular concern for infants and toddlers, and other risks pertaining to adolescent social development.

Screen time causing ADHD? Probably not.

I noted in a blog post two years ago that when it comes to commercial media use and ADHD symptoms, evidence remains fairly weak and continues to show only a small association based on a 2014 meta-analysis. A 2018 study tried to address this issue with more evidence. The authors note that since 2011 (the last study used in the 2014 meta-analysis), the kinds of social media kids use have changed dramatically, as has the amount of use.

The authors did find a reliable effect of screen media with ADHD symptoms, but the association, like in the meta-analysis, was very small. This suggests again that, yes, social media use plays some role in inattention and ADHD symptoms—but it is only a small part of the effect. ADHD results from the accumulation of multiple small factors, adding up over time or in succession. Removing any one can be helpful, but at the same time, any one by itself is only a small factor. So if other healthy steps can be taken, media use itself is not a major driver of ADHD problems.

Violent media and aggression and desensitization.

Much more concerning has been more consistent evidence that the wrong kind of media use–namely, seeing lots of violent media content either acted or cartoon illustrated–increases aggression in susceptible individuals. This concern was underscored by a special report from the American Psychological Association in 2015. However, a re-analysis this year questioned those conclusions and suggested effects are much smaller. While this is reassuring, especially when parents are pressed, I still would err on the side of caution here as much as possible. Other reviews have confirmed an association, and even this more skeptical review agreed that desensitization to violence occurs with viewing this type of media.

What about social media use and depression/suicide?

Likewise concerning have been preliminary findings that too much screen time and social media is associated with depression and irritability in teens. In the past couple of years, and accelerating with COVID, we have seen both an increase in digital media use and an increase in depression and suicide in youth.

Interestingly, the literature at the same time is engaged in dispute over the magnitude of association of teen social media use and the recent increase in depression symptoms and suicide rates among teenagers in the United States. Initial studies did provide some concerning evidence that the amount of social media use is associated with more depressive symptoms and unhappiness in teens. As with ADHD symptoms, the causal direction is difficult to disentangle on present evidence. However, a comprehensive review appearing this week in the Annual Review of Developmental Psychology suggests that evidence on the association between social media use and negative effects on adolescence remains too limited for firm conclusions.

Most importantly, while reliable associations with negative outcomes for teens are sometimes seen, these effects are still very small. That means many other factors in a teenager’s life are likely to be more important—and able to compensate for—any negative effects from using social media.

However, for parents of kids with ADHD, there was an important caveat: While social media use is not necessarily harmful for typically developing children, it does seem to be associated with worsening of mental health in children who already have some mental health problems.


ADHD probably involves an accumulation of multiple environmental risk factors on top of some degree of genetic liability. For sufferers and for parents, one strategy is to try to reduce the total amount of risk factor exposure—this is the stuff you can control.

That may mean, in part, putting reasonable limits on use of electronic media, keeping an eye on the effects of social media on your child’s mood, and monitoring exposure to violent imagery in video and other media, especially during childhood. In adolescence, for typically developing children, social media and other screen use is probably not a major mental health risk otherwise. However, for kids with ADHD or other mental health problems, keeping an eye on the degree to which social media may be fueling negativity remains important.

I should note, though, that many adolescents also report many positives from their social media use—this may be especially important now, during the isolation caused by the pandemic. Thus, the bottom line is to keep that communication channel open and keep an open mind as to potential harms or benefits from screen time and social media for teens.

Please note: Dr. Nigg cannot advise on individual cases for ethical, legal, and logistical reasons.


American Psychological Association (2015). APA Task Force on Violent Media: Technical report on the review of the violent video game literature. Retrieved from

Ferguson CJ, Copenhaver A, & Markey, P (2020). Reexamining the Findings of the American Psychological Association’s 2015 Task Force on Violent Media: A Meta-Analysis. Perspectives on Psychological Science, 15(6), 1423–1443.

Nikkelen SW, Valkenburg PM, Huizinga M, Bushman BJ. (2014). Media use and ADHD-related behaviors in children and adolescents: A meta-analysis. Dev Psychol. 50(9), 2228-2241.

Odgers CL, Schueller SM, Ito M (2020). Screen Time, Social Media Use, and Adolescent Development. Annual Review of Developmental Psychology, 2(1), 485-502

Ra CK, Cho J, Stone MD, et al (2018). Association of digital media use with subsequent symptoms of Attention-Deficit/Hyperactivity Disorder among adolescents. JAMA. 320(3), 255–263.

Twenge JM, Joiner TE, Rogers ML, Martin GN (2017). Increases in depressive symptoms, suicide-related outcomes, and suicide rates among US adolescents after 2010 and links to increased new media screen time. Clinical Psychological Science. 6(1), 3-17.