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The present study explored the associations between orthorexia nervosa, social media addiction, emotion regulation difficulties, perfectionism and BMI with four facets of mindful eating, using path analysis to assess these relationships. A sample of 551 students (127 males, 424 females, mean age = 22.6 years) completed an online self-report questionnaire evaluating these constructs. Analyses revealed that mindful eating contributed to emotion dysregulation and orthorexia nervosa and was related to social media addiction. Significant indirect paths were identified from mindful eating, social media addiction and adaptive perfectionism through emotion dysregulation to maladaptive perfectionism. While no direct paths were observed between mindful eating and perfectionism, a direct path was found between adaptive perfectionism and orthorexia nervosa. These findings suggest a more nuanced understanding of eating behaviours is required. Individuals susceptible to eating disorders should approach mindful eating with caution and seek support from healthcare providers to ensure it is used in a way that supports overall wellbeing. Future research should aim to replicate and further clarify these associations to reveal the long-term effects of mindful eating.

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In the present era, the rapidly growing social media trends of the digital age have the potential to affect the psychological well-being of individuals. In this context, understanding how Social Media Addiction (SMA) interacts with various factors is important to understanding its potential impact on individuals' psychosocial health. In particular, the prevalence of SMA and its strong relationship with important variables such as anxiety, depression, stress, academic self-efficacy, general belongingness, and life satisfaction have received considerable attention from researchers and the society. This research aims to address the relationship between SMA and these variables in a holistic manner. The research further explored the relationship between life satisfaction and depression, anxiety, academic self-efficacy, and general belongingness. The research is based on a study conducted with 616 students (388 female and 228 male; 17-32 age range) at a state university in the Southeast of Turkey. Personal information form, Smartphone Addiction Scale, Depression Anxiety Stress Scale, Academic Self-Efficacy Scale, General Belongingness Scale, and Life Satisfaction Scale were used as data collection tools. Using a structural equation modeling approach, the research not only examined the significant relationships but also examined the mediating and moderating effects in more detail. According to the research results, SMA significantly affects academic self-efficacy, general belongingness, depression, stress and anxiety. Academic self-efficacy and general belongingness both impact life satisfaction. However, SMA does not have a significant effect on life satisfaction. Moreover, it is revealed general belongingness play effective roles in the relationship between SMA and life satisfaction. As a result of the research, it was revealed that gender plays a moderating role in the relationship between SMA and life satisfaction. It has been observed that gender has a moderating role in the relationships between academic self-efficacy, general belongingness, depression, anxiety and stress and life satisfaction. Conversely, there is no moderating influence of gender on the impact of SMA on academic self-efficacy, general belongingness, depression, anxiety, or stress. Consequently, the relationships between SMA and other variables play an important role in understanding their effects on individuals' mental health.

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Background: Cyberbullying and excessive social media use are emerging issues among medical students, with potential implications for mental health. This study aimed to investigate the prevalence of cyberbullying, social media addiction, and their associated mental health conditions, as well as to explore the associated factors among medical students. Methods: A cross-sectional study was conducted among 418 medical students in Gujarat using a self-administered questionnaire. Cyberbullying was assessed using the Revised Cyberbullying Inventory (RCI-R), social media addiction was measured using the Bergen Social Media Addiction Scale (BSMAS), and mental health issues were evaluated using the Depression Anxiety Stress Scale (DASS-21). Descriptive statistics and binary logistic regression analyses were performed. A P value of <0.05 was considered significant. Results: The prevalence of cyberbullying, social media addiction, depression, anxiety, and stress among participants was 27.5% (95% CI: 23.4%-31.9%), 32.1% (95% CI: 27.8%-36.7%), 37.6% (95% CI: 33.1%-42.2%), 41.9% (95% CI: 37.3%-46.6%), and 46.2% (95% CI: 41.6%-50.9%), respectively. Factors associated with increased risk of being a cyber victim included older age, female gender, later years of study, increased daily mobile and social media usage, social media as the preferred mobile usage, and social media addiction. Factors associated with being a cyberbully were similar, except for the male gender. Both cyber victimization and social media addiction were significantly associated with higher odds of depression [aOR-2.5 (1.6-3.9) and 2.1 (1.4-3.2)], anxiety [aOR-2.2 (1.4-3.4) and 1.9 (1.3-2.8)] and stress [aOR-2.8 (1.8-4.3) and 2.4 (1.6-3.6)]. Conclusions: Cyberbullying, social media addiction, and mental health issues are prevalent among medical students. Targeted interventions addressing excessive social media use, promoting responsible online behaviour, and supporting mental well-being are crucial for this population. Further research is needed to establish causal relationships and develop effective prevention and support strategies.

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The number of social media users has increased dramatically in recent years. Common correlates of social media use may be poor mental and sleep health which are pressing issues among emerging adults and Hispanic groups. This study investigated the relationships between five different forms of social media use and mental and sleep health in Hispanic university emerging adults. Hispanic university emerging adults (n = 358) completed a survey assessing sociodemographics, overall social media use frequency, nighttime in-bed social media use, social media addiction, social media self-control failure, emotional investment in social media, depression, anxiety, stress, and sleep quality. Findings demonstrated that social media addiction and social media self-control failure were positively associated with stress and poor sleep quality. Emotional investment in social media was positively associated with depression. Findings may suggest that Hispanic university emerging adults may use social media emotionally and problematically to cope with negative affect and poor sleep quality, or that negative affect and poor sleep quality stem from using social media emotionally and problematically. The clinical implications of these results are discussed. Prospective studies are warranted to assess temporality.

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Objective: Being bullied is a profoundly distressing experience for children and adolescents, with the potential for adverse mental and behavioral outcomes throughout their adult years. This study aims to explore the association between juvenile bullying, self-esteem, loneliness, and social media addiction among men across three generational cohorts: X, Y, and Z. Method: The study utilized an online survey, administering structured questionnaires to 797 men aged 18-58 divided into three generational cohorts: 142 individuals from Gen X (born between 1965 and 1980), 275 from Gen Y (born between 1981 and 1996), and 380 from Gen Z (born between 1997 and 2005). Results: The findings demonstrate that across all three generations, there was a positive correlation between experiencing bullying in one's youth and social media addiction in adulthood. Among Gen X, self-esteem did not act as a mediator in this relationship, nor did loneliness moderate the links between bullying and social media addiction, or between self-esteem and social media addiction. However, for Gen Y and Z, self-esteem was found to mediate the relationship between bullying and social media addiction. Loneliness moderated the association between self-esteem and social media addiction in Gen Y and the association between bullying and social media addiction in Gen Z. Conclusion: The differences observed among generational cohorts can be attributed to changes in masculinity norms, the evolution of bullying types, and the rapid development of social media platforms, catering to the distinct needs and gratifications of each generation.

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OBJECTIVE: Traumatic experiences and stressful life events have crippling outcomes on individuals' psychiatric disorders and are also frequently comorbid with addictive behaviors. This study aims to propose a mediation model to examine the association between coronavirus disease-2019 (COVID-19)-related post-traumatic stress disorder (PTSD) and social media addiction (SMA) among university students, and the mediating role of fear of missing out (FoMO). METHODS: A cross-sectional study with 856 university students (mean age 19.2 years; 67.9% female) was conducted in China. The COVID-19-related PTSD scale, the FoMO scale, and the Bergen Social Media Addiction Scale were used, in addition to an online questionnaire addressing participants' sociodemographic information. Descriptive statistics and correlations were conducted with SPSS 21.0. The Structural Equation Model (SEM) with AMOS 21.0 was performed to assess the hypothesized mediation mode. The bootstrap with the 95% confidence interval (CI) was computed to test the significance of the mediating effect. RESULTS: SEM demonstrated that COVID-19-related PTSD symptoms significantly and negatively influenced SMA (ß=0.247, p<0.001), FoMO significantly and positively affected university students' SMA (ß=0.341, p<0.001), and FoMO partially mediated the association between COVID-19-related PTSD symptoms and SMA. The mediation effect of FoMO was 0.176, with bootstrapping 95% CI=0.123, 0.235. CONCLUSION: The main effects of COVID-19-related PTSD symptoms and FoMO on SMA among university students were identified, providing intervention strategies for mental health professionals on how to reduce the risk of SMA when confronting future traumatic events and public health crises.

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OBJECTIVE: Previous research has explored a variety of mental disorders associated with Internet Gaming Disoder (IGD) and Social Media Addiction (SMA). To date, few studies focused on the network characteristics and investigated mood and sleep symptoms across SMA and IGD of adolescence at a group-specific level. This study aims to identify different characteristics of IGD and SMA and further determine the group-specific psychopathology process among adolescents. METHODS: We conducted a cross-sectional study to recruit a cohort of 7,246 adolescents who were scored passing the cutoff point of Internet Gaming Disorder Scale-Short Form and Bergen Social Media Addiction Scale, as grouped in IGD and SMA, or otherwise into the control group. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-item, and Pittsburgh Sleep Quality Index were assessed for the current study, and all assessed items were investigated using network analysis. RESULTS: Based on the analytical procedure, the participants were divided into three groups, the IGD group (n=789), SMA group (n=713) and control group (n=5,744). The edge weight bootstrapping analysis shows that different groups of networks reach certain accuracy, and the network structures of the three groups are statistically different (pcontrol-IGD=0.004, pcontrol-SMA<0.001, pIGD-SMA<0.001). The core symptom of SMA is "feeling down, depressed, or hopeless", while IGD is "feeling tired or having little energy". CONCLUSION: Although IGD and SMA are both subtypes of internet addiction, the psychopathology processes of IGD and SMA are different. When dealing with IGD and SMA, different symptoms should be addressed.

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Introduction: We aimed to evaluate social media addiction in Romanian undergraduate nursing students and its association with academic performance, depression, and anxiety. Methods: We used a cross-sectional online survey to collect data among nursing undergraduate students enrolled at the University of Medicine and Pharmacy "Iuliu Hatieganu", Cluj-Napoca, Romania. The Social Media Addiction Scale-Student Form (SMAS-SF), Beck Depression Inventory (BDI), and State-Trait Anxiety Inventory (STAI) were used to assess social media addiction, depression, and anxiety, respectively. Results: A total of 90 nursing students participated in the study, of which 82 (91.1%) were females and 81 (90%) were of Romanian ethnicity. The median age of participants was 21 years (18-40). Males showed higher BDI total scores, SMAS-SF total scores, and STAI scale A state anxiety compared to females, and females showed higher STAI scale A trait anxiety compared to males, although these results were not statistically significant. Also, we found no significant difference in these variables between participants from different study years. Participants with no or mild depression had a significantly higher academic performance (p-value = 0.001), lower SMAS-SF (p-value = 0.004), and lower STAI scores (p-value < 0.001) compared to participants with borderline, moderate, or severe depression after performing multivariate regression analysis. Conclusions: Our study demonstrated that depression was significantly associated with social media addiction, anxiety, and lower academic performance in Romanian undergraduate nursing students.

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Introduction: Mobile social media is a new type of online media that is participatory, open, and communicative, among other characteristics. Due to the increasing popularity of social media, this technology has become an indispensable part of people's social lives. This study aims to examine the relationship between childhood psychological maltreatment and social media addiction among university students as well as the mediating role of fear of missing out and the moderating effect of left-behind experience in this context. Material and methods: A voluntary anonymous online survey of 1694 university students was conducted using the Childhood Psychological Maltreatment Scale, the Fear of Missing Out Scale, and the Social Media Addiction Scale. Results: First, significant positive correlations were observed between childhood psychological maltreatment and both fear of missing out and social media addiction among university students. Fear of missing out partially mediated the relationship between childhood psychological maltreatment and social media addiction. Second, left-behind experience was found to moderate the direct path from childhood psychological maltreatment to social media addiction as well as the first half of the mediating effect of missed anxiety. Conclusions: Childhood psychological maltreatment can predict social media addiction among university students not only directly but also indirectly through the mediating role of missed anxiety. The direct effect of childhood psychological maltreatment on social media addiction is moderated by left-behind experience. The first half of the mediating role of missed anxiety is also moderated by left-behind experience.

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Background: Unwarranted internet use can lead to a multiplicity of issues in personal, social, and professional spheres. This phenomenon is known as internet addiction. Between 1989 and 2020, the number of internet users increased from 500000 to 4.83 billion, suggesting a rising trend in the figure of persons who are digitally savvy. India had more than 718 million subscribers as of June 2020, second only to China, according to TRAI. The ground of this study is to scrutinize the magnitude of addiction, its impact, and related factors in universities located in the districts of Chhattisgarh's judicial capital, Bilaspur, and state capital, Raipur. Methods: The "Personal Information Form" was used to gather data, which also contained synopses of internet usage, Young's "Internet Addiction Test (IAT)," and a questionnaire the researcher created called the "Impact Scale of Internet Addiction." findings: Out of 937 professionals from different socio-economic backgrounds, 495 (52.82%) were male and 442 (47.18%) were females. The subject's mean age was 21.34 (SD 2.34). The study's findings indicate that the mean IAT score for IA among users was 67.15. Out of the total, 222 (23.69%) respondents were found to be severely addicted, 587 (62.64%) to be possible addicts, and 122 (13.02%) to be mildly addicted, respectively. Only six (0.64%) out of 937 people were considered to be completely safe or addiction-free. Comparing males' and females' outcomes in terms of social media usage, academic performance, tendencies, and purpose has proven to be highly significant. Conclusion: Discuss the probability of addiction, protective factors, and preventive techniques based on these facts.

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OBJECTIVE: In the present work we investigate how individual differences in at least occasionally using distinct social media platforms is linked to social networks use disorder (SNUD) tendencies. A final sample of n = 2200 participants filled in the AICA-C-9 measure to get insights into individual differences in overuse of social media and participants also indicated which platforms they used at least once a month. RESULTS: The analysis revealed a robust positive association between number of at least occasionally used social media apps and SNUD tendencies (r = .44, p < .001). Further, platforms differed in terms of their "addictive potential", if one takes associations between frequency of distinct platforms use and SNUD tendencies as a proxy for this (and of course the actual descriptive statistics of the SNUD scale for the (non-)frequent user groups of the different platforms). In this regard, at least occasionally using some platforms (here Tumblr, Twitter and TikTok) was associated with highest SNUD tendencies. Moreover, largest differences in terms of effect sizes between the occasional and non-occasional user groups regarding SNUD scores could be observed for Instagram, WhatsApp, and TikTok. The present work bases on data from a larger project investigating associations between SNUD and tobacco use disorder.

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Social media addiction is a behavioral dependency characterized by excessive and compulsive use of social media platforms, leading to negative impacts on various aspects of an individual's life. Bibliometric analysis is a research method used to quantitatively analyze academic literature, such as articles, books, and conference papers. It involves the application of statistical and mathematical tools to study the patterns and trends in scientific publications. This bibliometric study provides a comprehensive analysis of the literature on social media addiction, revealing patterns and dynamics within the field. Utilizing Web of Science for bibliographic data, the study employs advanced bibliometric tools like Biblioshiny and CiteSpace to map the scientific landscape. Annual scientific production, top contributing authors, key sources, trending topics, and thematic maps were identified using Biblioshiny. Additionally, network visualizations, such as co-citation networks of authors, time zone network visualizations of keyword co-occurrence, and timeline network visualizations of country collaborations, were created using CiteSpace. Our findings present an increasing trend in publications over the years, highlighting a growing recognition of social media addiction's significance. We detail the most relevant authors and sources, pinpointing key contributors and influential journals that shape the discourse. Trend topics analysis uncovers the prevalent themes, with "internet addiction" and "adolescents" at the forefront, reflecting the field's concentration on the younger population. The thematic map categorizes the research into motor themes (driving research areas), basic themes (fundamental and well-established areas), and niche themes (specialized and emerging topics), providing insight into the central and evolving topics. The study also delves into the co-occurrence of all keywords and the co-citation of authors, illustrating the interconnected nature of the research community. A timeline network visualization of country collaborations underscores the global scope of research efforts. Importantly, the study identifies critical research gaps such as underexplored demographics and emerging digital concerns and discusses practical implications, including the need for targeted intervention programs and informed policy-making. Collectively, this study charts the trajectory of social media addiction research and lays a foundation for future explorations to address identified lacunae.

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Introduction: The negative effects of post-COVID-19 restrictions have been detected in students' mental well-being due to internet addiction, changing habits, despair and uncertainty. Students' academic success is expected to be affected by social media addiction, loneliness, depression, life satisfaction, problem solving skills and academic self-efficacy factors. This study aimed to determine the level of social media addiction and the effects of these factors on the academic success of university students and define their interactions with each other. Methods: Four hundred nineteen questionnaires were collected between October-December 2022 at Bingöl University, Türkiye. Descriptive statistics, independent t-test, One-Way ANOVA, correlation and multiple linear regression methods were used to analyze data with the help of the SPSS 22 software. Results: Middle level grade (GPA) average (71,17 ± 9,69 out of 100), low level social support from friends and family members (34,6%), spending more than 4 h on social media (42,5%), middle level social media addiction, moderate depression level (51,31%-PHQ > 10), mild loneliness and slight dissatisfaction with life were found among students. Furthermore, high academic self-efficacy, moderate agreement with academic performance and good problem-solving skills were indicated in the survey results. Significant differences, such as higher life satisfaction among males and higher depression among females, were measured. Academic self-efficacy scale, problem solving skills and satisfaction with life had a negative correlation with social media addiction and depression, while a positive correlation with academic performance measures. Problem solving skills, satisfaction with life, fourth class vs. others and living alone vs. others were positive predictors of the academic self-efficacy. Meanwhile, loneliness was a negative predictor of the academic self-efficacy, while higher problem-solving skills and being female were positive factors leading to a higher GPA. Discussion: The fact that the participants were only students from Bingöl University limits the ability to generalize the results. Policymakers could implement social and problem-solving skills training to develop better academic programs and cognitive-behavioral therapy for students' academic success.

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OBJECTIVE: The purpose of this study was to determine the predictors of social appearance anxiety and social media addiction on objectified body consciousness among adolescents. METHOD: This descriptive and cross-sectional study included 502 adolescents. The Child and Family Information Form, Social Appearance Anxiety Scale, Objectified Body Consciousness Scale-Youth Form, and Social Media Addiction Scale for Adolescents were used to collect data. Mann-Whitney U test, Kruskal Wallis H test and regression analysis were used. RESULTS: In the study, being female, being pleased with one's weight, and following and being influenced by influencers all increase levels of self-objectification. It was found that social media addiction, social appearance anxiety, and self-objectification all have an effect on one another. CONCLUSION: It was concluded that social media usage characteristics, social media addiction, social appearance anxiety affect self-objectification.

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OBJECTIVE: Social media (SM), with its addictive nature and the accompanying psychosocial challenges such as stress, anxiety, and depression, is the primary factor exacerbating mental health problems and adversely impacting individuals' wellbeing. Our study's goal was to determine how SM affects employees' psychosocial behaviours and assess the various factors that contributed to the employee's excessive use of SM. METHODS: A cross-sectional correlational analysis was conducted. Using a relevant questionnaire on employees, the study was assessed to establish the relationship or association between SM addiction and psychosocial disorders like depression, anxiety, and stress. 200 people with a minimum age of 24 were enrolled in the study. The questionnaire contained the social networking addiction scale (SNAS) and the depression, anxiety, and stress-21 (DASS-21) scales; the data were statistically assessed. RESULTS: The association between SM addiction and psychosocial behaviours has been examined using statistical tools including descriptive statistics and the Chi-square analysis. SM addiction has a strong, statistically significant correlation with depression (p = 0.001), stress (p = 0.001), and anxiety (p = 0.001). CONCLUSION: This study discovered a connection between SM use and depression, stress, and anxiety among working employees, raising questions regarding worries about overuse and addiction to SM. Various factors influencing excessive usage included revealed that employees also majorly over used SM for entertainment, boredom avoidance, constant knowledge sharing, and relationship-building.

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Background: Several studies focused on the escalating prevalence of Problematic Use of Internet (PUI) and its consequential impact on mental health globally. This study investigates the relationship between PUI and associated psychological variables across different cultural contexts in Italy, Spain, Ecuador, and Peru. Method: A total of 675 participants, aged 18 to 54 (M = 22.73; SD = 4.05), completed measures assessing Internet addiction, social media addiction, Fear of Missing Out, Internet Gaming Disorder, and Phubbing. Results: Significant cultural variations were found, with Italian participants showing higher levels of Internet addiction but lower levels of social media addiction compared to other countries. Fear of Missing Out was higher in Italy, while the Italian sample exhibited lower Internet Gaming Disorder levels compared to Peru. As regards the communication disturbance caused by Phubbing, the Italian sample demonstrated significantly higher scores than the Peruvian sample. Linear regression analyses revealed distinct predictors for problematic Internet use in each country, emphasizing the importance of considering the cultural context in understanding this phenomenon. Conclusions: These findings contribute valuable insights into the interplay of cultural factors, psychological variables, and problematic Internet use, guiding future research and interventions.

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BACKGROUND: Social media addiction (SMA) is an increasing problem, especially among young adults. Little is known about university students' SMA and family functioning. This study aimed to explore the mediating effect of depressive symptoms and the moderating effect of peer support in the relationship between family functioning and SMA among young adults. METHODS: A sample of 1862 Chinese university students completed an online survey including the Bergen Social Media Addiction Scale (BSMAS), Family APGAR, the Patient Health Questionnaire (PHQ-9), peer support, and demographic characteristics. Hierarchical regression and moderated mediation analysis were used to test the effects and pathways among them. RESULTS: Of the 1840 participants, 30.11% experienced SMA, 38.80% had family dysfunction and 15.98% had depressive symptoms. Hierarchical multiple regression showed better family functioning significantly predicted less SMA (ß = -0.26, p < 0.001) and lower depressive symptoms (ß = -0.58, p < 0.001), after adjusting for covariates. Mediation analysis verified that depressive symptoms mediated the effect of family functioning on SMA (indirect effect = -0.22, 95%CI[-0.28, -0.17]). Furthermore, the interaction of family functioning and peer support was negatively related to depressive symptoms (ß= -0.03, 95% CI[-0.05, -0.01]) and the interaction of depressive symptoms and peer support was positively related to SMA (ß = 0.01, 95%CI[0.004, 0.02]). Additional analysis further confirmed that peer support decreased depressive symptoms among young adults from dysfunctional families, and increased SMA behaviors in individuals with depressive symptoms. CONCLUSION: Better family functioning and lower depressive symptoms may contribute to less social media addiction among Chinese university students. Peer support could moderate the mediating role of depressive symptoms on social media addiction in individuals with family dysfunction.

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This study aimed to examine the mediating role of phubbing and social media addiction in the correlation between satisfaction levels of basic psychological needs in romantic relationships and relationship satisfaction. The participants were 958 students from various universities in Türkiye. The research utilized demographic information form for personal information of the participants, the Satisfaction of Basic Psychological Needs in Romantic Relationships Scale, the Generic Scale of Phubbing, the Social Media Addiction Scale-Adult Form, and the Relationship Satisfaction Scale. It was concluded in the research that social media addiction and phubbing had a mediating role in the correlation between the needs for love/belonging ß = 0.05, power ß = 0.03, and freedom ß = -0.08 and the relationship satisfaction. The bootstrapping method performed in the study showed that indirect effect of the need for fun on the relationship satisfaction was significant, but in the Sobel test, social media addiction and phubbing was not found to have a mediating role in this correlation (p > 0.05). It was concluded that phubbing had a mediating role for all needs other than the need for fun in the correlation between satisfaction of basic psychological needs in romantic relationships and social media addiction. Finally, social media addiction was found to have a mediating role in the correlation between phubbing and relationship satisfaction. These findings were discussed in line with the literature. As shown by the findings, it was observed that satisfaction of basic psychological needs in romantic relationships affected the relationship satisfaction, and social media addiction and phubbing had a mediating role in that correlation.

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BACKGROUND: Social anxiety has been shown to affect college students' academic performance. However, the role of social media addiction and academic engagement in this association is unclear. METHODS: A total 2661 college students completed a self-report questionnaire including Liebowitz Social Anxiety Scale, the Bergen Social Media Addiction Scale, the Utrecht Student Work Engagement Scale for Students, and the grade point average. Hayes' PROCESS macro for SPSS was employed to test the serial mediation effect. RESULTS: Results indicated that social anxiety was negatively related to academic performance, only academic engagement played a single mediating role in the relationship between social anxiety and academic performance, meanwhile social media addiction and academic engagement acted as serial mediators between social anxiety on academic performance. CONCLUSIONS: Social media addiction and academic engagement can explain the potential mechanisms of the association between social anxiety and academic performance, which have implications for devising intervention strategies to enhance the mental health and academic outcomes of college students.

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PURPOSE: This study examined time trends in significant child and adolescent psychological symptoms and explored the association of frequent and problematic social media use with these symptoms. METHODS: Time trends in psychological symptoms were assessed using data from five waves of the international survey of Health Behavior in School-aged Children (HBSC), conducted between 2001 and 2018 (N = 1,036,869). The associations of frequent and problematic social media use with significant psychological symptoms were assessed by hierarchical multinomial logistic regression using data from 2001-2002 and the 2017-2018 survey waves. The direction of effect between social media use variables and psychological symptoms was explored using Linear Non-Gaussian Acyclic Models (LiNGAM). RESULTS: Prevalence of more severe psychological symptoms increased from 6.7% in 2001-2002 to 10.4% in the 2017-2018 survey waves. The increase was especially large among 15-year old and older girls: from 10.9 to 19.1%. The higher prevalence of more severe psychological symptoms in 2017-2018 compared with 2001-2002 was eliminated after adjusting the model for problematic social media use. LiNGAM analysis supported the direction of effect going from social media use and problematic social media use to psychological symptoms. CONCLUSIONS: The findings suggest that frequent and problematic use of social media contribute to the increasing trend of psychological symptoms in adolescents in recent years.