Supplementary file 1_Problematic social media use and psychosocial conditions.docx

BackgroundProblematic social media use (PSMU) is frequently associated with adolescent mental health problems, but the interpretive meaning of a high PSMU score in population surveys remains unclear. We examined whether elevated PSMU identifies adolescents with broader psychosocial difficulties or appears in multiple psychosocial contexts.
MethodsCluster analysis was conducted using data from the 2022 Health Behaviour in School-aged Children (HBSC) survey, including nationally representative samples of 15-year-old adolescents (mean age 15.80 years, SD 0.41) from five Nordic countries (N = 7,202).
ResultsAdolescents with high PSMU, psychosomatic complaints, and perceived stress showed the most adverse psychosocial profile, including cyberbullying involvement, negative school and peer experiences, loneliness, and low well-being. Adolescents with high psychosomatic complaints and perceived stress but average PSMU showed equal or greater difficulties, except for cyberbullying. A third group reported high PSMU without elevated perceived stress or psychosomatic complaints and did not show elevated psychosocial difficulties on the measured indicators.
ConclusionHigh PSMU scores occurred in heterogeneous psychosocial contexts. Adolescents with high PSMU were distributed across markedly different psychosocial profiles, and those with the most adverse stress-related conditions were often identified without elevated PSMU. These findings suggest that PSMU should be interpreted cautiously when used as a stand-alone indicator in adolescent population surveys and that its meaning depends on accompanying stress-related symptoms and social context.