How, not just how much: Bidirectional associations between social media use and internalizing psychopathology

Vasileia Karasavva; Adri Khalis; Amori Mikami

doi:10.29329/jsomer.107

Authors

Vasileia Karasavva University of British Columbia, Canada
Adri Khalis University of British Columbia https://orcid.org/0000-0001-7801-7572
Amori Mikami University of British Columbia https://orcid.org/0000-0001-5821-0674

DOI:

https://doi.org/10.29329/jsomer.107

Keywords:

Social Media, Facebook, Instagram, Internalizing Symptoms, Mental Health

Abstract

The impact of social media use on mental health is hotly debated. Considerably less research has investigated the impact of mental health on social media use. This longitudinal study aimed to bridge these gaps by examining the bidirectional relationships between Instagram (IG) and/or Facebook (FB) use and internalizing psychopathology in young adults. We considered participants’ quantity of use, as well as the cognitions and emotions they experience when using IG/FB, using both self-reported measures and observational data. Participants were 399 young adults with elevated psychopathology who were daily IG/FB users and who felt that their social media use had at least some negative impact on their lives. Every 2 weeks for 6 weeks, we measured participants’ internalizing psychopathology and multiple aspects of their IG/FB use. Analyses were conducted using Random Intercept Cross-Lagged Panel Modelling (RI-CLPM), a statistical procedure used in longitudinal data to estimate the directional pathways between one variable and a different variable across time. Using RI-CLPM we found that three different measures of higher quantity of IG/FB use (β = .08 - .32), and posting positive content (β = .28 - .40), were associated with more internalizing psychopathology at subsequent timepoints. More internalizing psychopathology was associated with making more upward social comparisons on IG/FB at subsequent timepoints (β = -.24 to -.19). There were bidirectional associations between higher internalizing psychopathology and a greater number of social comparisons at a subsequent time point (β = .14 - .16), and vice versa (β =.13 - .19). Our work highlights how young adults’ mental health may influence, and also be influenced by, different facets of social media use.

Author Biographies

Vasileia Karasavva, University of British Columbia, Canada

Vasileia Karasavva,MA is a PhD candidate at the University of British Columbia. Her research focuses on issues of digital citizenship, or in other words, how we interact with the online world and the ways this impacts our lives. She is working on three inter-connected research streams (1) e-health literacy and health information seeking online (2) online sexual communication and consent, and (3) technology-facilitated sexual violence (e.g., deepfake/AI pornography, non-consensual intimate image dissemination).

Adri Khalis, University of British Columbia

Dr. Adri Khalis, PhD, received his PhD in Clinical Psychology from the University of British Columbia. His research examines the impacts of social media and digital technology on psychological well-being. He is a registered clinical psychologist in Nova Scotia.

Amori Mikami, University of British Columbia

Dr. Amori Yee Mikami, PhD is a Professor in the Department of Psychology at the University of British Columbia, where she holds a Canada Research Chair in Clinical Child Psychology and is a registered clinical psychologist in British Columbia. Her research focuses on children’s and adolescents’ social relationships, with a particular interest in how peer group norms, stigma, and broader social contexts shape inclusion and exclusion among youth, especially those with attention-deficit/hyperactivity disorder (ADHD). Through her work, Dr. Mikami develops and evaluates interventions aimed at improving social belonging, wellbeing, and access to mental health support with a strong equity, diversity, and inclusivity perspective.

References

Adamis, D., Flynn, C., Wrigley, M., Gavin, B., & McNicholas, F. (2022). ADHD in adults: A systematic review and meta-analysis of prevalence studies in outpatient psychiatric clinics. Journal of Attention Disorders, 26(12), 1523–1534. https://doi.org/10.1177/10870547221085503

Adams, S. H., Schaub, J. P., Nagata, J. M., Park, M. J., Brindis, C. D., & Irwin, C. E., Jr. (2022). Young adult anxiety or depressive symptoms and mental health service utilization during the COVID-19 pandemic. Journal of Adolescent Health, 70(6), 985–988. https://doi.org/10.1016/j.jadohealth.2022.02.023

Alarachi, A., McNeely, H., Rowa, K., & McCabe, R. E. (2026). A qualitative investigation of the lived experiences of adults with anxiety and related disorders and ADHD: Interconnectedness of symptoms and implications for improving care. British Journal of Clinical Psychology, 1–19. https://doi.org/10.1111/bjc.70048

Allan, S., & Gilbert, P. (1995). A social comparison scale: Psychometric properties and relationship to psychopathology. Personality and Individual Differences, 19(3), 293–299. https://doi.org/10.1016/0191-8869(95)00086-L

Alonzo, R., Hussain, J., Stranges, S., & Anderson, K. K. (2021). Interplay between social media use, sleep quality, and mental health in youth: A systematic review. Sleep Medicine Reviews, 56, 101414. https://doi.org/10.1016/j.smrv.2020.101414

Anderl, C., Hofer, M. K., & Chen, F. S. (2024). Directly measured smartphone screen time predicts well-being and feelings of social connectedness. Journal of Social and Personal Relationships, 41(5), 1073–1090. https://doi.org/10.1177/02654075231158300

Aubry, R., Quiamzade, A., & Meier, L. L. (2024). Depressive symptoms and upward social comparisons during Instagram use: A vicious circle. Personality and Individual Differences, 217, 112458. https://doi.org/10.1016/j.paid.2023.112458

Bailey, E. R., Matz, S. C., Youyou, W., & Iyengar, S. S. (2020). Authentic self-expression on social media is associated with greater subjective well-being. Nature Communications, 11, 4889. https://doi.org/10.1038/s41467-020-18539-w

Baricevic, M. (2021). The impact of constant connectivity: Examining the relationships between social media, loneliness, anxiety and avoidant behaviors (Publication No. 1761) [Bachelor’s thesis, Scripps College]. Scholarship@Claremont. https://scholarship.claremont.edu/scripps_theses/1761

Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: a practical and powerful approach to multiple testing. Journal of the Royal statistical society: series B (Methodological), 57(1), 289-300. https://doi.org/10.1111/j.2517-6161.1995.tb02031.x

Brailovskaia, J., & Margraf, J. (2024). From fear of missing out (FoMO) to addictive social media use: The role of social media flow and mindfulness. Computers in Human Behavior, 150, 107984. https://doi.org/10.1016/j.chb.2023.107984

Brailovskaia, J., Schillack, H., & Margraf, J. (2020). Tell me why are you using social media (SM)! Relationship between reasons for use of SM, SM flow, daily stress, depression, anxiety, and addictive SM use—An exploratory investigation of young adults in Germany. Computers in Human Behavior, 113, 106511. https://doi.org/10.1016/j.chb.2020.106511

Branigan, K. (2026). What is the quality of ADHD content on TikTok, and how might this affect self-diagnosis? A systematic literature review. Educational Psychology in Practice, 42(3), 253–269. https://doi.org/10.1080/02667363.2026.2644889

Calvert, E., Cipriani, M., Dwyer, B., Lisowski, V., Mikkelson, J., Chen, K., Flathers, M., Hau, C., Xia, W., & Castillo, J. (2025). Social media detox and youth mental health. JAMA Network Open, 8(11), e2545245. https://doi.org/10.1001/jamanetworkopen.2025.45245

Capraro, V., Globig, L., Rausch, Z., Rathje, S., Wormley, A., Olson, J., Ross, R., Aşçı, S., Bouguettaya, A., Burnell, K., Choukas-Bradley, S., Fardouly, J., Kowert, R., Lopez, R., Maheux, A., Mirea, D.-M., Ozimek, P., Selterman, D., Thiagarajan, T., … Van Bavel, J. J. (2025). A consensus statement on potential negative impacts of smartphone and social media use on adolescent mental health. Social Science Research Network. https://doi.org/10.2139/ssrn.5256747

Chkhaidze, A., Millar, B. M., Revenson, T. A., & Mindlis, I. (2024). Scrolling your sleep away: The effects of bedtime device use on sleep among young adults with poor sleep. International Journal of Behavioral Medicine, 1–6. https://doi.org/10.1007/s12529-024-10326-x

Clerkin, E. M., Smith, A. R., & Hames, J. L. (2013). The interpersonal effects of Facebook reassurance seeking. Journal of Affective Disorders, 151(2), 525–530. https://doi.org/10.1016/j.jad.2013.06.038

Crocker, J. (2002). The costs of seeking self-esteem. Journal of Social Issues, 58(3), 597–615. https://doi.org/10.1111/1540-4560.00279

Curran, P. J., & Hancock, G. R. (2021). The challenge of modeling co-developmental processes over time. Child Development Perspectives, 15(2), 67–75. https://doi.org/10.1111/cdep.12401

de Segovia Vicente, D., Van Gaeveren, K., Murphy, S. L., & Vanden Abeele, M. M. (2024). Does mindless scrolling hamper well-being? Combining ESM and log-data to examine the link between mindless scrolling, goal conflict, guilt, and daily well-being. Journal of Computer-Mediated Communication, 29(1), zmad056. https://doi.org/10.1093/jcmc/zmad056

Desjarlais, M. (2024). Subtle momentary effects of social media experiences: An experience sampling study of posting and social comparisons on connectedness and self-esteem. Journal of Computer-Mediated Communication, 29(3), zmae004. https://doi.org/10.1093/jcmc/zmae004

Dinh, T. C. T., & Lee, Y. (2025). Understanding the psychological drivers of online self-presentation: A survey study on social media exposure, social comparison, social network type and FOMO. BMC Psychology, 13, 781. https://doi.org/10.1186/s40359-025-03117-w

Escobar-Viera, C. G., Shensa, A., Bowman, N. D., Sidani, J. E., Knight, J., James, A. E., & Primack, B. A. (2018). Passive and active social media use and depressive symptoms among United States adults. Cyberpsychology, Behavior, and Social Networking, 21(7), 437–443. https://doi.org/10.1089/cyber.2017.0668

Fassi, L., Ferguson, A. M., Przybylski, A. K., Ford, T. J., & Orben, A. (2025). Social media use in adolescents with and without mental health conditions. Nature Human Behaviour, 9(6), 1283–1299. https://doi.org/10.1038/s41562-025-02134-4

Fassi, L., Thomas, K., Parry, D. A., Leyland-Craggs, A., Ford, T. J., & Orben, A. (2024). Social media use and internalizing symptoms in clinical and community adolescent samples: A systematic review and meta-analysis. JAMA Pediatrics, 178(8), 814–822. https://doi.org/10.1001/jamapediatrics.2024.2078

Faverio, M., & Sidoti, O. (2024, December 12). Teens, social media and technology 2024. Pew Research Center. https://www.pewresearch.org/internet/2024/12/12/teens-social-media-and-technology-2024/

Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7(2), 117–140. https://doi.org/10.1177/001872675400700202

Gerson, J., Plagnol, A. C., & Corr, P. J. (2017). Passive and active Facebook use measure (PAUM): Validation and relationship to the reinforcement sensitivity theory. Personality and Individual Differences, 117, 81–90. https://doi.org/10.1016/j.paid.2017.05.034

Gibbons, F. X., & Buunk, B. P. (1999). Individual differences in social comparison: Development of a scale of social comparison orientation. Journal of Personality and Social Psychology, 76(1), 129–142. https://doi.org/10.1037/0022-3514.76.1.129

Godard, R., & Holtzman, S. (2024). Are active and passive social media use related to mental health, wellbeing, and social support outcomes? A meta-analysis of 141 studies. Journal of Computer-Mediated Communication, 29(1), zmad055. https://doi.org/10.1093/jcmc/zmad055

Granic, I., Morita, H., & Scholten, H. (2020). Beyond screen time: Identity development in the digital age. Psychological Inquiry, 31(3), 195–223. https://doi.org/10.1080/1047840X.2020.1820214

Hall, J. A. (2024). Ten myths about the effect of social media use on well-being. Journal of Medical Internet Research, 26, e59585. https://doi.org/10.2196/59585

Hames, J. L., Hagan, C. R., & Joiner, T. E. (2013). Interpersonal processes in depression. Annual Review of Clinical Psychology, 9, 355–377. https://doi.org/10.1146/annurev-clinpsy-050212-185553

Hamaker, E. L., Kuiper, R. M., & Grasman, R. P. (2015). A critique of the cross-lagged panel model. Psychological Methods, 20(1), 102–116. https://doi.org/10.1037/a0038889

Hodes, L. N., & Thomas, K. G. (2021). Smartphone screen time: Inaccuracy of self-reports and influence of psychological and contextual factors. Computers in Human Behavior, 115, 106616. https://doi.org/10.1016/j.chb.2020.106616

Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55. https://doi.org/10.1080/10705519909540118

Huang, C. (2017). Time spent on social network sites and psychological well-being: A meta-analysis. Cyberpsychology, Behavior, and Social Networking, 20(6), 346–354. https://doi.org/10.1089/cyber.2016.0758

Iskric, A. J. (2019). The impact of cognitive distortions on negative social comparisons and depressive symptoms: Six-month longitudinal study [Master’s thesis, University of Regina]. Faculty of Graduate Studies and Research. https://ourspace.uregina.ca/server/api/core/bitstreams/a5a719bc-6413-472c-a6c5-66a8728438a1/content

Ivie, E. J., Pettitt, A., Moses, L. J., & Allen, N. B. (2020). A meta-analysis of the association between adolescent social media use and depressive symptoms. Journal of Affective Disorders, 275, 165–174. https://doi.org/10.1016/j.jad.2020.06.014

Joiner, T. E., Jr. (1995). The price of soliciting and receiving negative feedback: Self-verification theory as a vulnerability to depression theory. Journal of Abnormal Psychology, 104(2), 364–374. https://doi.org/10.1037/0021-843X.104.2.364

Kim, B., & Kim, Y. (2017). College students’ social media use and communication network heterogeneity: Implications for social capital and subjective well-being. Computers in Human Behavior, 73, 620–628. https://doi.org/10.1016/j.chb.2017.03.033

Kiplagat, B., & Dudkiewicz, L. (2025, April 3). 75+ latest Meta statistics & facts for 2025. Cropink. https://cropink.com/meta-statistics

Kross, E., Verduyn, P., Sheppes, G., Costello, C. K., Jonides, J., & Ybarra, O. (2021). Social media and well-being: Pitfalls, progress, and next steps. Trends in Cognitive Sciences, 25(1), 55–66. https://doi.org/10.1016/j.tics.2020.10.005

Lee, R. M., & Robbins, S. B. (1998). The relationship between social connectedness and anxiety, self-esteem, and social identity. Journal of Counseling Psychology, 45(3), 338–345. https://doi.org/10.1037/0022-0167.45.3.338

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U

Mahalingham, T., McEvoy, P. M., & Clarke, P. J. (2023). Assessing the validity of self-report social media use: Evidence of no relationship with objective smartphone use. Computers in Human Behavior, 140, 107567. https://doi.org/10.1016/j.chb.2022.107567

McCarthy, P. A., & Morina, N. (2020). Exploring the association of social comparison with depression and anxiety: A systematic review and meta-analysis. Clinical Psychology & Psychotherapy, 27(5), 640–671. https://doi.org/10.1002/cpp.2452

McComb, C. A., Vanman, E. J., & Tobin, S. J. (2023). A meta-analysis of the effects of social media exposure to upward comparison targets on self-evaluations and emotions. Media Psychology, 26(5), 612–635. https://doi.org/10.1080/15213269.2023.2180647

Meier, A., Gilbert, A., Börner, S., & Possler, D. (2020). Instagram inspiration: How upward comparison on social network sites can contribute to well-being. Journal of Communication, 70(5), 721–743. https://doi.org/10.1093/joc/jqaa025

Mikami, A. Y., Khalis, A., & Karasavva, V. (2025). Logging out or leaning in? Social media strategies for enhancing well-being. Journal of Experimental Psychology: General, 154(1), 171–189. https://doi.org/10.1037/xge0001668

Mikami, A. Y., Szwedo, D. E., Khalis, A., Jia, M., & Na, J. J. (2019). Online social interactions predict academic and emotional adjustment in the transition to university. Journal of Research on Adolescence, 29(1), 210–224. https://doi.org/10.1111/jora.12377

Mougharbel, F., Chaput, J.-P., Sampasa-Kanyinga, H., Hamilton, H. A., Colman, I., Leatherdale, S. T., & Goldfield, G. S. (2023). Heavy social media use and psychological distress among adolescents: The moderating role of sex, age, and parental support. Frontiers in Public Health, 11, 1190390. https://doi.org/10.3389/fpubh.2023.1190390

Ng, J. X. (2025). Downward social comparison and state anxiety: The role of self-relevance anxiety. Canadian Undergraduate Journal of Cognitive Science, 8. https://doi.org/10.21810/cujcs.v8i1.7177

Orben, A., & Przybylski, A. K. (2019). The association between adolescent well-being and digital technology use. Nature Human Behaviour, 3(2), 173–182. https://doi.org/10.1038/s41562-018-0506-1

Orosz, G., Tóth-Király, I., & Bőthe, B. (2016). Four facets of Facebook intensity—The development of the multidimensional Facebook intensity scale. Personality and Individual Differences, 100, 95–104. https://doi.org/10.1016/j.paid.2015.11.038

Paiva, U., Cortese, S., Flor, M., Moncada-Parra, A., Lecumberri, A., Eudave, L., Magallón, S., García-González, S., Sobrino-Morras, Á., Piqué, I., Mestre-Bach, G., Solmi, M., & Arrondo, G. (2025). Prevalence of mental disorder symptoms among university students: An umbrella review. Neuroscience & Biobehavioral Reviews, 175, 106244. https://doi.org/10.1016/j.neubiorev.2025.106244

Pomery, E. A., Gibbons, F. X., & Stock, M. L. (2012). Social comparison. In V. S. Ramachandran (Ed.), Encyclopedia of human behavior (2nd ed., pp. 463–469). Elsevier. https://doi.org/10.1016/B978-0-12-375000-6.00332-3

Primack, B. A., Shensa, A., Sidani, J. E., Escobar-Viera, C. G., & Fine, M. J. (2021). Temporal associations between social media use and depression. American Journal of Preventive Medicine, 60(2), 179–188. https://doi.org/10.1016/j.amepre.2020.09.014

Quinn, K. (2021). Social media and social wellbeing in later life. Ageing & Society, 41(6), 1349–1370. https://doi.org/10.1017/S0144686X19001570

Reer, F., Tang, W. Y., & Quandt, T. (2019). Psychosocial well-being and social media engagement: The mediating roles of social comparison orientation and fear of missing out. New Media & Society, 21(7), 1486–1505. https://doi.org/10.1177/1461444818823719

Roberts, J. A., & David, M. E. (2023). On the outside looking in: Social media intensity, social connection, and user well-being: The moderating role of passive social media use. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 55(3), 240–250. https://doi.org/10.1037/cbs0000323

Samra, A., Warburton, W. A., & Collins, A. M. (2022). Social comparisons: A potential mechanism linking problematic social media use with depression. Journal of Behavioral Addictions, 11(2), 607–614. https://doi.org/10.1556/2006.2022.00023

Schimmele, C., Fonberg, J., & Schellenberg, G. (2021). Canadians’ assessments of social media in their lives. Economic and Social Reports, 1(3). Statistics Canada. https://doi.org/10.25318/36280001202100300004-eng

Sewall, C. J., Goldstein, T. R., Wright, A. G., & Rosen, D. (2022). Does objectively measured social-media or smartphone use predict depression, anxiety, or social isolation among young adults? Clinical Psychological Science, 10(5), 997–1014. https://doi.org/10.1177/21677026221078309

Sokolova, K., Kefi, H., & Dutot, V. (2022). Beyond the shallows of physical attractiveness: Perfection and objectifying gaze on Instagram. International Journal of Information Management, 67, 102546. https://doi.org/10.1016/j.ijinfomgt.2022.102546

Statista. (2025). Average time spent on selected social media platforms daily among adults in the United States in February 2024, by age group. https://www.statista.com/statistics/1484565/time-spent-social-media-us-by-age/

Tang, S., Werner-Seidler, A., Torok, M., Mackinnon, A. J., & Christensen, H. (2021). The relationship between screen time and mental health in young people: A systematic review of longitudinal studies. Clinical Psychology Review, 86, 102021. https://doi.org/10.1016/j.cpr.2021.102021

Taylor, Z., Yankouskaya, A., & Panourgia, C. (2024). Social media use, loneliness and psychological distress in emerging adults. Behaviour & Information Technology, 43(7), 1312–1325. https://doi.org/10.1080/0144929X.2023.2209797

Terlizzi, E. P., & Villarroel, M. A. (2020). Symptoms of generalized anxiety disorder among adults: United States, 2019 (NCHS Data Brief No. 378). National Center for Health Statistics. https://stacks.cdc.gov/view/cdc/255833

Tibbs, M., Deschênes, S., van der Velden, P., & Fitzgerald, A. (2025). An investigation of the longitudinal bidirectional associations between interactive versus passive social media behaviors and youth internalizing difficulties: A within-person approach. Journal of Youth and Adolescence, 54(4), 849–862. https://doi.org/10.1007/s10964-024-02093-5

Usami, S., Todo, N., & Murayama, K. (2019). Modeling reciprocal effects in medical research: Critical discussion on the current practices and potential alternative models. PLOS ONE, 14(9), e0209133. https://doi.org/10.1371/journal.pone.0209133

Valkenburg, P. M., van Driel, I. I., & Beyens, I. (2022). The associations of active and passive social media use with well-being: A critical scoping review. New Media & Society, 24(2), 530–549. https://doi.org/10.1177/1461444821106542

Verduyn, P., Gugushvili, N., & Kross, E. (2022). Do social networking sites influence well-being? The extended active-passive model. Current Directions in Psychological Science, 31(1), 62–68. https://doi.org/10.1177/09637214211053637

Verduyn, P., Lee, D. S., Park, J., Shablack, H., Orvell, A., Bayer, J., Ybarra, O., Jonides, J., & Kross, E. (2015). Passive Facebook usage undermines affective well-being: Experimental and longitudinal evidence. Journal of Experimental Psychology: General, 144(2), 480–488. https://doi.org/10.1037/xge0000057

Verduyn, P., Ybarra, O., Résibois, M., Jonides, J., & Kross, E. (2017). Do social network sites enhance or undermine subjective well-being? A critical review. Social Issues and Policy Review, 11(1), 274–302. https://doi.org/10.1111/sipr.12033

Vogels, E. A., & Gelles-Watnick, R. (2023, April 24). Teens and social media: Key findings from Pew Research Center surveys. Pew Research Center. https://www.pewresearch.org/short-reads/2023/04/24/teens-and-social-media-key-findings-from-pew-research-center-surveys/

Wakeling, S., Stukas, A. A., Wright, B. J., & Evans, L. (2020). Negative feedback seeking and excessive reassurance seeking behavior and depression: A meta-analytic review. Journal of Social and Clinical Psychology, 39(9), 788–823. https://doi.org/10.1521/jscp.2020.39.9.788

Wang, J.-L., Gaskin, J., Rost, D. H., & Gentile, D. A. (2018). The reciprocal relationship between passive social networking site (SNS) usage and users’ subjective well-being. Social Science Computer Review, 36(5), 511–522. https://doi.org/10.1177/0894439317721981

Wang, L., Zhou, X., Song, X., Gan, X., Zhang, R., Liu, X., Xu, T., Jiao, G., Ferraro, S., & Bore, M. C. (2023). Fear of missing out (FOMO) associates with reduced cortical thickness in core regions of the posterior default mode network and higher levels of problematic smartphone and social media use. Addictive Behaviors, 143, 107709. https://doi.org/10.1016/j.addbeh.2023.107709

Yoo, J. H., & Jeong, E. J. (2017). Psychosocial effects of SNS use: A longitudinal study focused on the moderation effect of social capital. Computers in Human Behavior, 69, 108–119. https://doi.org/10.1016/j.chb.2016.12.011

Yoon, S., Kleinman, M., Mertz, J., & Brannick, M. (2019). Is social network site usage related to depression? A meta-analysis of Facebook–depression relations. Journal of Affective Disorders, 248, 65–72. https://doi.org/10.1016/j.jad.2019.01.026

Zanon, C., Brenner, R. E., Baptista, M. N., Vogel, D. L., Rubin, M., Al-Darmaki, F. R., Gonçalves, M., Heath, P. J., Liao, H.-Y., Mackenzie, C. S., Topkaya, N., Wade, N. G., & Zlati, A. (2021). Examining the dimensionality, reliability, and invariance of the Depression, Anxiety, and Stress Scale–21 (DASS-21) across eight countries. Assessment, 28(6), 1531–1544. https://doi.org/10.1177/1073191119887449

Zheng, X., Yang, M., Li, R., Li, W., Lis, N., & Lin, H.-C. (2026). Reciprocal relationships among youth social media use, internalizing symptoms, and substance use. Drug and Alcohol Dependence, 278, 113018. https://doi.org/10.1016/j.drugalcdep.2025.113018

Zywica, J., & Danowski, J. (2008). The faces of Facebookers: Investigating social enhancement and social compensation hypotheses; predicting Facebook and offline popularity from sociability and self-esteem, and mapping the meanings of popularity with semantic networks. Journal of Computer-Mediated Communication, 14(1), 1–34. https://doi.org/10.1111/j.1083-6101.2008.01429.x