TOPLINE

More than 10% of US adolescents reported seeing violent imagery online in the preceding month, and more than half reported technology-associated sleep disruption. Exposure to content encouraging self-harm was more common online than offline.

METHODOLOGY

• Researchers conducted a cross-sectional pilot survey from February to December 2025 including 472 US adolescents (mean age, 14.9 years; 46.8% girls) to assess the prevalence of online, offline, and platform-based negative experiences.
• Participants reported their use of 20 internet-based communication platforms (Facebook, Instagram, TikTok, Snapchat, YouTube, and others) and the negative experiences they encountered on each platform in the previous 4 weeks.
• Harms assessed included harassment, exposure to violent content, and technology-related disruption in sleep, measured both online and offline.
• The weighted sample included adolescents from 47 states, with 96.1% using at least one social media platform.

TAKEAWAY

• Across digital and offline contexts, 44.7% of adolescents observed harassment and 29.8% reported encountering it personally within the preceding 4 weeks.
• Digital encounters surpassed offline exposure across multiple harmful exposures: viewing violent imagery (10.7% vs 1.6% of adolescents), content encouraging self-harm (9.7% vs 5.2% of adolescents), and unwanted sexual imagery (13.4% vs 2.0% of adolescents).
• Over half of the adolescents (51.5%) indicated experiencing disrupted sleep attributable to technology usage. 
• The prevalence of harms varied substantially according to the platform used; specifically, violent imagery viewing was reported by 9.1% of Instagram users vs 1.9% of YouTube users, and negative self-perception triggered by others' content was most common among Instagram users (16.6%) and TikTok users (13.4%).

IN PRACTICE

"Understanding the evolving experiences of US adolescents is essential to support evidence-based interventions to protect youth in an increasingly digital world," the authors wrote.

SOURCE

The study was led by Angela Y. Lee, PhD, of the School of Journalism and Mass Communication at the University of Wisconsin-Madison. It was published online on September 18 in JAMA Pediatrics.

LIMITATIONS

The participant number was small, which may have affected the precision for individual platforms and subgroup analyses, especially concerning infrequently utilized platforms or outcomes having low prevalence. Prevalence variations among platforms might partially represent demographic differences in users instead of platform design exclusively.

DISCLOSURES

The study was supported by the Stanford Center for Digital Health and the University of Southern California's Marshall Neely Center. One of the authors reported salary funded by the Center for Digital Health as a postdoctoral researcher. Several authors reported receiving consulting fees or honoraria, royalties, or advisory fees; holding advisory board or other positions; and providing expert witness services to various companies outside the submitted work. Some authors reported previous employment with technology companies such as Meta, YouTube, and Google. One of the authors continues to own Meta stock, and another author reported receiving grants from various sources during the conduct of the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.