Table 2. Unadjusted and Adjusted RRRs for Each Category of Social Media Use Associated With Internalizing and Externalizing Problems Among 6595 US Adolescents in the PATH Study, 2013-2016a.
| Variable | Internalizing Problems Alone | Externalizing Problems Alone | Comorbid Internalizing and Externalizing Problems | |||
|---|---|---|---|---|---|---|
| RRR (95% CI) | aRRR (95% CI) | RRR (95% CI) | aRRR (95% CI) | RRR (95% CI) | aRRR (95% CI) | |
| Time spent on social media per day during wave 2 | ||||||
| None | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| ≤30 min | 1.30 (0.94-1.78) | 1.23 (0.89-1.71) | 1.28 (0.98-1.67) | 1.18 (0.89-1.56) | 1.39 (1.06-1.82) | 1.27 (0.97-1.67) |
| >30 min to ≤3 h | 1.89 (1.36-2.64) | 1.37 (0.96-1.94) | 1.60 (1.16-2.21) | 1.37 (0.98-1.92) | 2.34 (1.83-3.00) | 1.59 (1.23-2.05) |
| >3 to ≤6 h | 2.47 (1.74-3.49) | 1.60 (1.11-2.31) | 1.36 (0.97-1.90) | 1.22 (0.86-1.72) | 3.15 (2.43-4.09) | 2.01 (1.51-2.66) |
| >6 h | 2.83 (1.88-4.26) | 1.78 (1.15-2.77) | 1.59 (1.07-2.37) | 1.40 (0.90-2.19) | 4.29 (3.22-5.73) | 2.44 (1.73-3.43) |
| Sex | ||||||
| Male | NA | 0.38 (0.30-0.47) | NA | 1.25 (1.03-1.53) | NA | 0.51 (0.43-0.61) |
| Female | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] |
| Race | ||||||
| White only | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] |
| Black only | NA | 0.65 (0.50-0.83) | NA | 0.86 (0.67-1.10) | NA | 0.70 (0.54-0.91) |
| Otherb | NA | 1.00 (0.73-1.36) | NA | 0.85 (0.67-1.09) | NA | 0.86 (0.68-1.09) |
| Parental educational level | ||||||
| Less than high school | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] |
| High school or equivalent | NA | 1.38 (1.05-1.82) | NA | 0.99 (0.75-1.31) | NA | 1.23 (0.93-1.63) |
| Some college or associate’s degree | NA | 1.17 (0.90-1.51) | NA | 1.29 (1.02-1.63) | NA | 1.37 (1.08-1.75) |
| Bachelor's degree | NA | 0.99 (0.72-1.34) | NA | 1.34 (0.99-1.81) | NA | 1.18 (0.89-1.57) |
| Advanced degree | NA | 0.89 (0.60-1.32) | NA | 1.69 (1.24-2.31) | NA | 1.28 (0.91-1.79) |
| Age, y | ||||||
| 12-14 | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] |
| 15-17 | NA | 0.94 (0.77-1.14) | NA | 0.94 (0.79-1.12) | NA | 0.82 (0.70-0.96) |
| BMI | NA | 1.00 (0.98-1.02) | NA | 0.99 (0.97-1.00) | NA | 1.00 (0.98-1.01) |
| Lifetime alcohol use | ||||||
| No | NA | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] |
| Yes | NA | 1.02 (0.84-1.25) | NA | 0.97 (0.82-1.14) | NA | 1.17 (1.00-1.36) |
| Lifetime marijuana use | ||||||
| No | NA | 1 [Reference] | NA | 1 [Reference] | NA | [1 [Reference] |
| Yes | NA | 0.94 (0.65-1.37) | NA | 0.67 (0.47-0.95) | NA | 0.71 (0.54-0.95) |
| Lifetime internalizing problems | NA | 1.57 (1.45-1.71) | NA | 1.00 (0.93-1.07) | NA | 1.48 (1.38-1.60) |
| Lifetime externalizing problems | NA | 0.97 (0.91-1.03) | NA | 1.43 (1.35-1.51) | NA | 1.36 (1.27-1.44) |
Abbreviations: aRRR, adjusted relative risk ratio; BMI, body mass index (calculated as weight in kilograms divided by height in meters squared); NA, not applicable; PATH, Population Assessment of Tobacco and Health; RRR, relative risk ratio.
a
The aRRRs are adjusted for all covariates listed in Table 1. The reference category is no internalizing or externalizing problems. All variables were measured during wave 1 except time spent on social media per day, which was measured during wave 2.
b
The other race category includes participants identifying as American Indian or Alaska Native, Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese, other Asian, Native Hawaiian, Guamanian or Chamorro, Samoan, and other Pacific Islander.