The relationship between problematic social media use and psychological factors among university students with evaluation of ADHD, social anxiety and self-esteem

Medicine (Baltimore). 2026 Sep 18;105(38):e50740. doi: 10.1097/MD.0000000000050740.

ABSTRACT

Problematic social media use (PSMU) has been increasingly associated with various psychological vulnerabilities; however, findings remain mixed, particularly among university students and in non-Western contexts. This study aimed to examine the associations between PSMU and psychological factors including attention-deficit/hyperactivity disorder (ADHD) symptoms, social anxiety, and self-esteem among university students, as well as to explore the role of selected sociodemographic and usage-related characteristics. This cross-sectional study included 179 university students aged 18 to 25 years. Participants completed a sociodemographic and clinical information form, the Social Media Addiction Scale-Adult Form, Adult Attention-Deficit/Hyperactivity Disorder Self-Report Scale, Liebowitz Social Anxiety Scale, and Rosenberg Self-Esteem Scale-Short Form. Statistical analyses were conducted using SPSS v22.0. Spearman correlation analyses and group comparisons were performed, with statistical significance set at P < .05. Mean daily screen time was 352.29 ± 156.41 minutes, significantly higher than the global average. Social media addiction scale scores positively correlated with ADHD symptoms (r = 0.412, P < .001), social anxiety (r = 0.395, P < .001), and low self-esteem (r = 0.221, P = .03). Participants who found it easier to communicate on social media exhibited higher social anxiety scores. The use of social media with hidden identities or fake accounts was associated with increased screen time, social media addiction severity, and social anxiety. The findings indicate that problematic social media use among university students is closely associated with psychological vulnerabilities, particularly ADHD symptoms and social anxiety, whereas the role of self-esteem appears more nuanced. These results support the conceptualization of PSMU as a multidimensional phenomenon influenced by individual psychological traits and usage-related behaviors rather than by time spent online alone. By providing data from a non-Western university student population, this study contributes to the cultural generalizability of existing literature and highlights the importance of considering multiple psychological domains when addressing problematic social media use.

PMID:42760662 | DOI:10.1097/MD.0000000000050740