IMPORTANCE

In 2023, the US Surgeon General issued the Advisory on Social Media and Youth Mental Health, identifying critical research gaps that preclude evidence-based guidance given that most studies of social media and mental health have been cross-sectional rather than longitudinal and have focused on young adults or older adolescents rather than on younger adolescents.

OBJECTIVE

To evaluate longitudinal associations between social media use (time spent on social media) and depressive symptoms across 4 annual waves spanning a 3-year follow-up period from late childhood to early adolescence.

DESIGN, SETTING, AND PARTICIPANTS: In this prospective cohort study using data from the Adolescent Brain Cognitive Development Study across 21 study sites from October 2016 to October 2018, children aged 9 to 10 years at baseline were assessed across 4 waves (baseline, year 1, year 2, and year 3), with year-3 follow-up through 2022. Sample sizes varied across waves and measures due to attrition and missing data. Analyses retained all available data at each wave. Data were analyzed from January 2024 to March 2025.

EXPOSURES

Self-reported time spent on social media at baseline to 3-year follow-up.

MAIN OUTCOMES AND MEASURES

Reciprocal associations between social media use and depressive symptoms (Child Behavior Checklist) at baseline and at 1, 2, and 3 years of follow-up were assessed using longitudinal, cross-lagged structural equation panel models. Covariates included sex, race and ethnicity, household income, and parental educational level.

RESULTS

At baseline, the sample included 11 876 participants (mean [SD] age, 9.9 [0.6] years), of whom 6196 (52.2%) were male. After adjusting for stable between-person differences and covariates, within-person increases in social media use above the person-level mean were associated with elevated depressive symptoms from year 1 to year 2 (β, 0.07; 95% CI, 0.01-0.12; P = .01) and from year 2 to year 3 (β, 0.09; 95% CI, 0.04-0.14; P < .001), whereas depressive symptoms were not associated with subsequent social media use at any interval. The final random-intercept cross-lagged panel model demonstrated a good fit (comparative fit index, 0.977; Tucker-Lewis index, 0.968; root mean square error of approximation, 0.031 [90% CI, 0.029-0.033]). Between-person differences in social media use were not associated with depressive symptoms (β, -0.01; 95% CI, -0.04 to 0.02; P = .46) after accounting for demographic and family-level factors.

CONCLUSIONS AND RELEVANCE

In this cohort study of 11 876 children and adolescents, reporting higher than person-level mean social media use in years 1 and 2 after baseline was associated with greater depressive symptoms in the subsequent year. The findings suggest that clinicians should provide anticipatory guidance regarding social media use for young adolescents and their parents.