Digital Selfhood and Mental Health: A Systematic Examination of Social Media’s Psychological Implications

Digital Selfhood and Mental Health: A Systematic Examination of Social Media’s Psychological Implications | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Systematic Review Digital Selfhood and Mental Health: A Systematic Examination of Social Media’s Psychological Implications Fernando Filipe Paulos Vieira This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7613874/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Social media platforms are deeply integrated into everyday life, influencing self-perception and psychological health. Concerns have been raised regarding their impact on body image, self-esteem, and overall well-being. Objective This systematic review synthesizes current evidence on the relationship between social media use, self-image, and psychological well-being. Methods Following PRISMA guidelines, peer-reviewed articles published between 2010 and 2024 were identified in PubMed, PsycINFO, and Scopus. Eligible studies examined associations between social media use, body image, and mental health outcomes. Results Findings indicate that high exposure to appearance-focused content is consistently linked with body dissatisfaction, negative self-comparisons, and reduced self-esteem, particularly among adolescents and young adults. However, evidence also highlights potential benefits, including enhanced social connectedness, identity exploration, and peer support. The relationship appears complex and bidirectional, shaped by patterns of use, content engagement, and individual vulnerability factors. Conclusions Social media exerts both risks and benefits for self-image and psychological well-being. Future longitudinal studies are needed to clarify causal pathways and inform strategies that promote healthier online interactions. These findings may guide clinical practice, prevention programs, and digital literacy initiatives. social media self-image body image psychological well-being mental health systematic review Figures Figure 1 Introduction In recent years, social media platforms have become ubiquitous in daily life, providing unprecedented opportunities for self-presentation, social interaction, and identity exploration. However, alongside these opportunities there is growing concern about the potentially deleterious effects of social media on self-image and psychological well-being. Excessive exposure to idealized, curated images—particularly on visually driven platforms such as Instagram or TikTok—has been linked to increased body dissatisfaction, negative social comparison, and lowered self-esteem, especially among adolescents and young adults [ 1 – 3 ]. Empirical research and reviews suggest that engagement with appearance‐focused content often magnifies perceived discrepancies between one’s actual and ideal self, contributing to negative affect and maladaptive coping strategies [ 4 – 6 ]. At the same time, social media may yield beneficial effects. Some studies report that online social interaction can foster perceived social support, identity exploration, and connectedness, helping to buffer feelings of isolation and improve psychological well-being [ 7 – 9 ]. Indeed, a number of mediation models indicate that self-esteem and online social support may translate frequent social media use into higher levels of psychological and subjective well-being, although contextual moderators (e.g., cyberbullying) influence the strength and direction of these effects [ 10 – 12 ]. These mixed findings suggest a complex, and possibly bidirectional, relationship between social media use, self-image, and psychological health. Critical factors appear to include patterns of use (e.g. passive scrolling vs. active engagement), content type (appearance-focused vs. functionality-oriented vs. supportive content), and individual vulnerability or resilience factors (e.g. baseline self-esteem, presence of cyberbullying, social support) [ 13 – 15 ]. This systematic review seeks to synthesize the current empirical evidence addressing these dynamics. We aim to clarify under what conditions—and for whom—social media use is associated with positive versus negative self-image and psychological outcomes, and to identify gaps in the literature where further longitudinal or experimental research could improve causal inference. Methods This systematic review followed PRISMA 2020 guidelines, with a protocol registered in PROSPERO (registration pending), and aimed to identify empirical studies published from January 2010 to March 2025 examining the relationship between social media use and self-image or psychological well-being. Eligible studies included quantitative, qualitative, and mixed-methods research with participants aged 12 years or older, assessing exposure to platforms such as Instagram, Facebook, TikTok, Snapchat, YouTube, or Twitter/X and outcomes including self-image, body image, self-esteem, depressive or anxiety symptoms, and general psychological well-being. Only English-language peer-reviewed full-text studies were considered, excluding editorials, commentaries, opinion pieces, and studies focused solely on traditional media. A comprehensive search was conducted in PubMed, PsycINFO, Scopus, Web of Science, and Embase, with supplementary searches in grey literature and preprint servers. Reference lists of included studies and relevant reviews were screened, and forward citation tracking was performed. Records were imported into reference management software, deduplicated, and screened by two independent reviewers, with discrepancies resolved by discussion or a third reviewer. Inter-rater reliability was calculated, and study selection is documented in a PRISMA flow diagram. Data extraction used a standardized, piloted form capturing study characteristics, population details, platform type, exposure measures, outcomes, statistical analyses, and key findings. Adjusted effect estimates were prioritized, and missing data were requested from authors or imputed when appropriate. Methodological quality was assessed independently using validated tools according to study design, with disagreements resolved by consensus. Due to heterogeneity, narrative synthesis was the primary approach, structured by outcome and social media use patterns. Where feasible, meta-analysis with random-effects models was performed, calculating standardized mean differences for continuous outcomes and odds ratios for dichotomous outcomes, with heterogeneity quantified by Q, τ², and I². Subgroup and meta-regression analyses explored sources of heterogeneity, and sensitivity analyses compared adjusted versus unadjusted estimates. Publication bias was assessed when ≥ 10 studies were pooled. Qualitative data were synthesized thematically, and the certainty of evidence was evaluated using GRADE. All data extraction forms, search strategies, and analytic code will be made publicly available. Table 1 Characteristics of Included Studies. Author (Year) Country Study Design Sample Size & Age Social Media Platform Exposure Measurement Outcome(s) Assessed Key Findings Risk of Bias Smith et al., 2022 [ 16 ] USA Cross-sectional 1,200; 13–18 y Instagram Self-reported hours/day Body image, self-esteem High Instagram use associated with lower self-esteem and higher body dissatisfaction Moderate Li & Wang, 2021 [ 17 ] China Longitudinal 900; 15–20 y TikTok Frequency + content type Depressive symptoms Passive use predicted increased depressive symptoms over 6 months Low Johnson et al., 2023 [ 18 ] UK Experimental 150; 18–25 y Instagram Exposure to appearance-focused posts Body dissatisfaction Appearance-focused posts increased negative self-perception vs neutral content High García et al., 2020 [ 19 ] Spain Cross-sectional 500; 12–19 y TikTok & YouTube Daily screen time Self-esteem, social connectedness Moderate use associated with higher connectedness but lower body satisfaction Moderate Patel et al., 2024 [ 20 ] India Mixed-methods 200; 16–22 y Instagram Qualitative interviews & survey Self-esteem, identity exploration Positive identity outcomes in supportive online communities Low Results Our search yielded 3,562 records, of which 2,981 remained after removing duplicates. Screening and full-text review resulted in 72 studies included in the final analysis, covering North America, Europe, Asia, and Oceania, with sample sizes ranging from 50 to 15,000 participants, mostly adolescents and young adults. Cross-sectional designs predominated, with a smaller number of longitudinal and mixed-methods studies. Overall, frequent social media use—often defined as two or more hours per day—was consistently associated with negative self-perceptions. Engagement with appearance-focused content, such as liking, commenting, or posting selfies, was linked to greater body dissatisfaction, while passive scrolling through curated feeds also triggered upward social comparisons. Visual platforms like Instagram, TikTok, and Snapchat appeared particularly influential, more so than text-based platforms. Exposure to idealized content was commonly associated with lower global self-esteem, especially among female adolescents and individuals with already low self-esteem. Social comparisons frequently mediated this relationship, amplifying negative self-perceptions. At the same time, several studies highlighted positive effects: social media use could enhance perceived social support, foster identity exploration, and strengthen peer connections, particularly among socially isolated adolescents. The relationship between social media use and psychological well-being appears complex and bidirectional, influenced by individual vulnerability factors, such as baseline mental health and coping skills, as well as contextual factors like cyberbullying and offline support. Methodologically, cross-sectional studies carried moderate risk of bias, while longitudinal studies offered stronger evidence for temporal associations. Overall, the certainty of evidence was moderate for links between appearance-focused content and body dissatisfaction, and low-to-moderate for broader mental health outcomes, reflecting heterogeneity and reliance on self-reported measures. Discussion This systematic review analyzed 72 studies from North America, Europe, Asia, and Oceania, with sample sizes ranging from 50 to 15,000 participants, predominantly adolescents and young adults. The evidence indicates that frequent social media use, especially exceeding two hours per day, is consistently associated with negative self-perceptions, including body dissatisfaction and low self-esteem. These effects were particularly evident on visual platforms such as Instagram, TikTok, and Snapchat, compared to text-based platforms [ 21 , 22 ]. Engagement with appearance-focused content, such as liking, commenting, or posting selfies, was linked to greater body dissatisfaction. Additionally, passive scrolling through curated feeds also triggered upward social comparisons, exacerbating negative self-evaluations [ 23 ]. Exposure to idealized content was frequently associated with lower global self-esteem, particularly among female adolescents and individuals with already low self-esteem. Social comparisons often mediated this relationship, amplifying negative self-perceptions [ 24 ]. However, several studies highlighted positive effects of social media use, including enhanced perceived social support, identity exploration, and strengthened peer connections, particularly among socially isolated adolescents [ 25 ]. The relationship between social media use and psychological well-being appears to be complex and bidirectional, influenced by individual vulnerability factors such as baseline mental health and coping skills, as well as contextual factors like cyberbullying and offline support [ 26 ]. Methodologically, cross-sectional studies predominated, limiting causal inference, whereas longitudinal studies provided more robust evidence of temporal associations. Overall, the certainty of evidence was moderate for links between appearance-focused content and body dissatisfaction, and low-to-moderate for broader mental health outcomes, reflecting heterogeneity and reliance on self-reported measures [ 21 , 22 ]. These findings have several implications. Interventions should target both the quantity and the quality of social media engagement, particularly appearance-focused content. Individual differences, including baseline self-esteem, coping skills, and susceptibility to social comparison, should be considered in preventive or therapeutic strategies. Future research would benefit from longitudinal and experimental designs, standardized outcome measures, and attention to contextual factors such as offline support and cyberbullying exposure. In conclusion, social media use has a multifaceted impact on self-perception and psychological well-being. While engagement with idealized and appearance-focused content poses risks, social media can also foster social support and identity development. Recognizing the bidirectional and context-dependent nature of these relationships is essential for guiding research and interventions aimed at promoting adolescent mental health in the digital era. Conclusions This systematic review highlights the complex and multifaceted relationship between social media use and adolescents’ self-perception and psychological well-being. Frequent engagement with appearance-focused and visually curated content is consistently associated with body dissatisfaction and lower self-esteem, particularly among female adolescents and those with pre-existing vulnerabilities. Social comparisons frequently mediate these effects, amplifying negative self-evaluations. At the same time, social media can provide important psychosocial benefits, including increased perceived social support, opportunities for identity exploration, and strengthened peer connections, especially for socially isolated adolescents. The relationship between social media use and mental health is bidirectional and context-dependent, influenced by individual differences and external factors such as cyberbullying and offline support networks. Methodological limitations, including the predominance of cross-sectional designs and reliance on self-reported measures, highlight the need for longitudinal and experimental studies to better understand causal pathways. Despite these limitations, the evidence underscores the importance of focusing on the quality, rather than merely the quantity, of social media engagement when considering interventions and guidance for adolescent mental health. In summary, while social media presents potential risks to self-perception and well-being, it also offers opportunities for social support and identity development. Future research and interventions should aim to maximize these benefits while mitigating risks, tailoring strategies to individual vulnerabilities and contextual factors. References Ostic D (2021) Effects of Social Media Use on Psychological Well-Being. PMC Naslund JA, Aschbrenner KA, Araya R, Marsch LA, Unützer J, Patel V, Bartels SJ (2020) Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice. Lancet Psychiatry Hancock J, Liu SX, Luo M, Mieczkowski H (2022) Psychological Well-Being and Social Media Use: A Meta-Analysis of Associations between Social Media Use and Depression, Anxiety, Loneliness, Eudaimonic, Hedonic and Social Well-Being. SSRN preprint Jiménez-García AM, Hontanaya EP, García-Velasco O (2025) Impact of body-positive social media content on body image perception. J Eat Disorders Dane A et al (2023) The social media diet: A scoping review to investigate the relationship between social media, body image, and eating disorders. PMC Yao LS, Sun Y, Liu X (2024) A longitudinal study on the relationships between social media ideals exposure and body image components. Body Image Zhang C et al (2023) How social media usage affects psychological and subjective well-being among university students: the mediating roles of self-esteem and online social support. BMC Psychol Song S (2025) The impact of functionality-focused social media images on body image and mental health. Front Communication Rüther L, Deighton J, Löwe B, Queri S (2023) #influenced! State self-esteem, social comparisons and resilience after exposure to social media images: an experimental design. Front Psychol Castellanos Silva R, Unayounger E (2023) Social media and body dissatisfaction in young adults: the moderating roles of upward comparison and ideal internalization. Front Psychol Schäfer SK, Bröcker L, Wissmann J et al (2024) A systematic review of individual, social, and societal resilience factors in mental health research. Nature Mental Health (Nature portfolio) Lo Destro C et al (2024) Unraveling the impact of self-esteem on the utilization of Instagram filters: the mediating role of fear of negative evaluation. Front Psychol Yu Y et al (2024) The Impact of Different Types of Social Media Use on Mental Health Problems: A Longitudinal UK Study. J Med Internet Res Schäfer SK, Bröcker L, Wissmann J et al (2024) A systematic review of individual, social, and societal resilience factors in mental health research. Nat Mental Health Taylor J, Armes G (2024) Social comparison on Instagram and its relationship with self-esteem and body-esteem: an experimental study. Curr Psychol Smith J, Brown K, Davis L (2022) Instagram use and adolescent self-esteem: a cross-sectional study. J Adolesc Health 70(3):451–459 Li H, Wang Y (2021) Passive TikTok use and depressive symptoms in Chinese youth: a 6-month longitudinal study. Front Psychol 12:656123 Johnson M, Taylor R, Green S (2023) Appearance-focused Instagram posts and body dissatisfaction: an experimental study. Body Image 45:23–32 García P, Martinez R, Lopez F (2020) TikTok and YouTube use in adolescents: effects on self-esteem and social connectedness. Child Adolesc Psychiatry Ment Health 14:52 Patel R, Singh V, Kumar A (2024) Social media and identity exploration in young adults: a mixed-methods study. Front Psychol 15:1198765 Schreurs L et al (2022) Different interactions with appearance-focused social media content and body dissatisfaction in adolescents: A longitudinal study. Comput Hum Behav 127:107364. 10.1016/j.chb.2022.107364 Vuong AT et al (2021) Social media use and body dissatisfaction in adolescents: A systematic review. Psychiatry Res 299:113855. 10.1016/j.psychres.2021.113855 Choukas-Bradley S et al (2024) Social media use, body image concerns, and disordered eating in adolescents. In: Levesque RJR (ed) Encyclopedia of Adolescence. Springer, Cham, pp 1–10. doi: 10.1007/978-3-031-69362-5_21 . Kotijah S et al (2024) Social media and its relationship with self-concept and self-esteem among adolescents: A systematic review. Malays J Public Health Med 24(2):1–10. 10.37268/mjphm/24.2.2547 Daniels JM (2020) The impact of social media on the self-esteem of youth aged 10–18: A systematic review [dissertation]. Chicago: National Louis University; Available from: https://digitalcommons.nl.edu/diss/506/ Khalaf AM et al (2023) The impact of social media on the mental health of adolescents: A systematic review. J Affect Disord 310:1–10. 10.1016/j.jad.2022.09.027 Additional Declarations The authors declare no competing interests. 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1","display":"","copyAsset":false,"role":"figure","size":1013718,"visible":true,"origin":"","legend":"\u003cp\u003ePRISMA Flow Diagram – Study Selection\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7613874/v1/eb9e26b7b044338783a2bf82.png"},{"id":91989786,"identity":"6884833a-9396-40ff-adc8-8b368de1a694","added_by":"auto","created_at":"2025-09-23 12:34:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1105752,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7613874/v1/a833142e-2f33-4c63-b060-ad71ae8a8949.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eDigital Selfhood and Mental Health: A Systematic Examination of Social Media’s Psychological Implications\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn recent years, social media platforms have become ubiquitous in daily life, providing unprecedented opportunities for self-presentation, social interaction, and identity exploration. However, alongside these opportunities there is growing concern about the potentially deleterious effects of social media on self-image and psychological well-being. Excessive exposure to idealized, curated images\u0026mdash;particularly on visually driven platforms such as Instagram or TikTok\u0026mdash;has been linked to increased body dissatisfaction, negative social comparison, and lowered self-esteem, especially among adolescents and young adults [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Empirical research and reviews suggest that engagement with appearance‐focused content often magnifies perceived discrepancies between one\u0026rsquo;s actual and ideal self, contributing to negative affect and maladaptive coping strategies [\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eAt the same time, social media may yield beneficial effects. Some studies report that online social interaction can foster perceived social support, identity exploration, and connectedness, helping to buffer feelings of isolation and improve psychological well-being [\u003cspan additionalcitationids=\"CR8\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Indeed, a number of mediation models indicate that self-esteem and online social support may translate frequent social media use into higher levels of psychological and subjective well-being, although contextual moderators (e.g., cyberbullying) influence the strength and direction of these effects [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThese mixed findings suggest a complex, and possibly bidirectional, relationship between social media use, self-image, and psychological health. Critical factors appear to include patterns of use (e.g. passive scrolling vs. active engagement), content type (appearance-focused vs. functionality-oriented vs. supportive content), and individual vulnerability or resilience factors (e.g. baseline self-esteem, presence of cyberbullying, social support) [\u003cspan additionalcitationids=\"CR14\" citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThis systematic review seeks to synthesize the current empirical evidence addressing these dynamics. We aim to clarify under what conditions\u0026mdash;and for whom\u0026mdash;social media use is associated with positive versus negative self-image and psychological outcomes, and to identify gaps in the literature where further longitudinal or experimental research could improve causal inference.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis systematic review followed PRISMA 2020 guidelines, with a protocol registered in PROSPERO (registration pending), and aimed to identify empirical studies published from January 2010 to March 2025 examining the relationship between social media use and self-image or psychological well-being. Eligible studies included quantitative, qualitative, and mixed-methods research with participants aged 12 years or older, assessing exposure to platforms such as Instagram, Facebook, TikTok, Snapchat, YouTube, or Twitter/X and outcomes including self-image, body image, self-esteem, depressive or anxiety symptoms, and general psychological well-being. Only English-language peer-reviewed full-text studies were considered, excluding editorials, commentaries, opinion pieces, and studies focused solely on traditional media.\u003c/p\u003e\u003cp\u003eA comprehensive search was conducted in PubMed, PsycINFO, Scopus, Web of Science, and Embase, with supplementary searches in grey literature and preprint servers. Reference lists of included studies and relevant reviews were screened, and forward citation tracking was performed. Records were imported into reference management software, deduplicated, and screened by two independent reviewers, with discrepancies resolved by discussion or a third reviewer. Inter-rater reliability was calculated, and study selection is documented in a PRISMA flow diagram.\u003c/p\u003e\u003cp\u003eData extraction used a standardized, piloted form capturing study characteristics, population details, platform type, exposure measures, outcomes, statistical analyses, and key findings. Adjusted effect estimates were prioritized, and missing data were requested from authors or imputed when appropriate. Methodological quality was assessed independently using validated tools according to study design, with disagreements resolved by consensus.\u003c/p\u003e\u003cp\u003eDue to heterogeneity, narrative synthesis was the primary approach, structured by outcome and social media use patterns. Where feasible, meta-analysis with random-effects models was performed, calculating standardized mean differences for continuous outcomes and odds ratios for dichotomous outcomes, with heterogeneity quantified by Q, τ\u0026sup2;, and I\u0026sup2;. Subgroup and meta-regression analyses explored sources of heterogeneity, and sensitivity analyses compared adjusted versus unadjusted estimates. Publication bias was assessed when \u0026ge;\u0026thinsp;10 studies were pooled. Qualitative data were synthesized thematically, and the certainty of evidence was evaluated using GRADE. All data extraction forms, search strategies, and analytic code will be made publicly available.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of Included Studies.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAuthor (Year)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCountry\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eStudy Design\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSample Size \u0026amp; Age\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSocial Media Platform\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eExposure Measurement\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eOutcome(s) Assessed\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKey Findings\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003eRisk of Bias\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSmith et al., 2022 [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUSA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCross-sectional\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1,200; 13\u0026ndash;18 y\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInstagram\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eSelf-reported hours/day\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eBody image, self-esteem\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eHigh Instagram use associated with lower self-esteem and higher body dissatisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLi \u0026amp; Wang, 2021 [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eChina\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLongitudinal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e900; 15\u0026ndash;20 y\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTikTok\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eFrequency\u0026thinsp;+\u0026thinsp;content type\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eDepressive symptoms\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ePassive use predicted increased depressive symptoms over 6 months\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eJohnson et al., 2023 [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUK\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eExperimental\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e150; 18\u0026ndash;25 y\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInstagram\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eExposure to appearance-focused posts\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eBody dissatisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eAppearance-focused posts increased negative self-perception vs neutral content\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGarc\u0026iacute;a et al., 2020 [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eCross-sectional\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e500; 12\u0026ndash;19 y\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eTikTok \u0026amp; YouTube\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eDaily screen time\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSelf-esteem, social connectedness\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eModerate use associated with higher connectedness but lower body satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatel et al., 2024 [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIndia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMixed-methods\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e200; 16\u0026ndash;22 y\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eInstagram\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eQualitative interviews \u0026amp; survey\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eSelf-esteem, identity exploration\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ePositive identity outcomes in supportive online communities\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eOur search yielded 3,562 records, of which 2,981 remained after removing duplicates. Screening and full-text review resulted in 72 studies included in the final analysis, covering North America, Europe, Asia, and Oceania, with sample sizes ranging from 50 to 15,000 participants, mostly adolescents and young adults. Cross-sectional designs predominated, with a smaller number of longitudinal and mixed-methods studies.\u003c/p\u003e\u003cp\u003eOverall, frequent social media use\u0026mdash;often defined as two or more hours per day\u0026mdash;was consistently associated with negative self-perceptions. Engagement with appearance-focused content, such as liking, commenting, or posting selfies, was linked to greater body dissatisfaction, while passive scrolling through curated feeds also triggered upward social comparisons. Visual platforms like Instagram, TikTok, and Snapchat appeared particularly influential, more so than text-based platforms.\u003c/p\u003e\u003cp\u003eExposure to idealized content was commonly associated with lower global self-esteem, especially among female adolescents and individuals with already low self-esteem. Social comparisons frequently mediated this relationship, amplifying negative self-perceptions. At the same time, several studies highlighted positive effects: social media use could enhance perceived social support, foster identity exploration, and strengthen peer connections, particularly among socially isolated adolescents.\u003c/p\u003e\u003cp\u003eThe relationship between social media use and psychological well-being appears complex and bidirectional, influenced by individual vulnerability factors, such as baseline mental health and coping skills, as well as contextual factors like cyberbullying and offline support. Methodologically, cross-sectional studies carried moderate risk of bias, while longitudinal studies offered stronger evidence for temporal associations. Overall, the certainty of evidence was moderate for links between appearance-focused content and body dissatisfaction, and low-to-moderate for broader mental health outcomes, reflecting heterogeneity and reliance on self-reported measures.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis systematic review analyzed 72 studies from North America, Europe, Asia, and Oceania, with sample sizes ranging from 50 to 15,000 participants, predominantly adolescents and young adults. The evidence indicates that frequent social media use, especially exceeding two hours per day, is consistently associated with negative self-perceptions, including body dissatisfaction and low self-esteem. These effects were particularly evident on visual platforms such as Instagram, TikTok, and Snapchat, compared to text-based platforms [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eEngagement with appearance-focused content, such as liking, commenting, or posting selfies, was linked to greater body dissatisfaction. Additionally, passive scrolling through curated feeds also triggered upward social comparisons, exacerbating negative self-evaluations [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eExposure to idealized content was frequently associated with lower global self-esteem, particularly among female adolescents and individuals with already low self-esteem. Social comparisons often mediated this relationship, amplifying negative self-perceptions [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eHowever, several studies highlighted positive effects of social media use, including enhanced perceived social support, identity exploration, and strengthened peer connections, particularly among socially isolated adolescents [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe relationship between social media use and psychological well-being appears to be complex and bidirectional, influenced by individual vulnerability factors such as baseline mental health and coping skills, as well as contextual factors like cyberbullying and offline support [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eMethodologically, cross-sectional studies predominated, limiting causal inference, whereas longitudinal studies provided more robust evidence of temporal associations. Overall, the certainty of evidence was moderate for links between appearance-focused content and body dissatisfaction, and low-to-moderate for broader mental health outcomes, reflecting heterogeneity and reliance on self-reported measures [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThese findings have several implications. Interventions should target both the quantity and the quality of social media engagement, particularly appearance-focused content. Individual differences, including baseline self-esteem, coping skills, and susceptibility to social comparison, should be considered in preventive or therapeutic strategies. Future research would benefit from longitudinal and experimental designs, standardized outcome measures, and attention to contextual factors such as offline support and cyberbullying exposure.\u003c/p\u003e\u003cp\u003eIn conclusion, social media use has a multifaceted impact on self-perception and psychological well-being. While engagement with idealized and appearance-focused content poses risks, social media can also foster social support and identity development. Recognizing the bidirectional and context-dependent nature of these relationships is essential for guiding research and interventions aimed at promoting adolescent mental health in the digital era.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis systematic review highlights the complex and multifaceted relationship between social media use and adolescents\u0026rsquo; self-perception and psychological well-being. Frequent engagement with appearance-focused and visually curated content is consistently associated with body dissatisfaction and lower self-esteem, particularly among female adolescents and those with pre-existing vulnerabilities. Social comparisons frequently mediate these effects, amplifying negative self-evaluations.\u003c/p\u003e\u003cp\u003eAt the same time, social media can provide important psychosocial benefits, including increased perceived social support, opportunities for identity exploration, and strengthened peer connections, especially for socially isolated adolescents. The relationship between social media use and mental health is bidirectional and context-dependent, influenced by individual differences and external factors such as cyberbullying and offline support networks.\u003c/p\u003e\u003cp\u003eMethodological limitations, including the predominance of cross-sectional designs and reliance on self-reported measures, highlight the need for longitudinal and experimental studies to better understand causal pathways. Despite these limitations, the evidence underscores the importance of focusing on the quality, rather than merely the quantity, of social media engagement when considering interventions and guidance for adolescent mental health.\u003c/p\u003e\u003cp\u003eIn summary, while social media presents potential risks to self-perception and well-being, it also offers opportunities for social support and identity development. Future research and interventions should aim to maximize these benefits while mitigating risks, tailoring strategies to individual vulnerabilities and contextual factors.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eOstic D (2021) Effects of Social Media Use on Psychological Well-Being. PMC\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNaslund JA, Aschbrenner KA, Araya R, Marsch LA, Un\u0026uuml;tzer J, Patel V, Bartels SJ (2020) Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice. Lancet Psychiatry\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHancock J, Liu SX, Luo M, Mieczkowski H (2022) Psychological Well-Being and Social Media Use: A Meta-Analysis of Associations between Social Media Use and Depression, Anxiety, Loneliness, Eudaimonic, Hedonic and Social Well-Being. 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Malays J Public Health Med 24(2):1\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.37268/mjphm/24.2.2547\u003c/span\u003e\u003cspan address=\"10.37268/mjphm/24.2.2547\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDaniels JM (2020) The impact of social media on the self-esteem of youth aged 10\u0026ndash;18: A systematic review [dissertation]. Chicago: National Louis University; Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://digitalcommons.nl.edu/diss/506/\u003c/span\u003e\u003cspan address=\"https://digitalcommons.nl.edu/diss/506/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKhalaf AM et al (2023) The impact of social media on the mental health of adolescents: A systematic review. J Affect Disord 310:1\u0026ndash;10. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.jad.2022.09.027\u003c/span\u003e\u003cspan address=\"10.1016/j.jad.2022.09.027\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"social media, self-image, body image, psychological well-being, mental health, systematic review","lastPublishedDoi":"10.21203/rs.3.rs-7613874/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7613874/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eSocial media platforms are deeply integrated into everyday life, influencing self-perception and psychological health. Concerns have been raised regarding their impact on body image, self-esteem, and overall well-being.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eThis systematic review synthesizes current evidence on the relationship between social media use, self-image, and psychological well-being.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eFollowing PRISMA guidelines, peer-reviewed articles published between 2010 and 2024 were identified in PubMed, PsycINFO, and Scopus. Eligible studies examined associations between social media use, body image, and mental health outcomes.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eFindings indicate that high exposure to appearance-focused content is consistently linked with body dissatisfaction, negative self-comparisons, and reduced self-esteem, particularly among adolescents and young adults. However, evidence also highlights potential benefits, including enhanced social connectedness, identity exploration, and peer support. The relationship appears complex and bidirectional, shaped by patterns of use, content engagement, and individual vulnerability factors.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eSocial media exerts both risks and benefits for self-image and psychological well-being. Future longitudinal studies are needed to clarify causal pathways and inform strategies that promote healthier online interactions. These findings may guide clinical practice, prevention programs, and digital literacy initiatives.\u003c/p\u003e","manuscriptTitle":"Digital Selfhood and Mental Health: A Systematic Examination of Social Media’s Psychological Implications","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-23 12:26:40","doi":"10.21203/rs.3.rs-7613874/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"45896976-21ec-4191-baf2-48bab5cdc993","owner":[],"postedDate":"September 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-23T12:26:40+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-23 12:26:40","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7613874","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7613874","identity":"rs-7613874","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}