{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:55:28Z","timestamp":1790916928913,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:00:00Z","timestamp":1790899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This cross-sectional study examined the prevalence of problematic social media use (PSMU) among Saudi adolescents and its associations with digital health literacy (DHL) and psychological distress (depression, anxiety, and stress).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 330 Saudi adolescents (170 male, 160 female) aged 13\u201318\u202fyears from intermediate and secondary schools in Madinah, Saudi Arabia, completed validated Arabic versions of the Bergen Social Media Addiction Scale (BSMAS), the Digital Health Literacy Instrument (DHLI), and the Depression, Anxiety, and Stress Scale (DASS-21). Multivariate logistic regression analyses were performed to identify factors associated with PSMU and its mental health correlates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The prevalence of PSMU was 34.8% (95% CI: 29.7\u201340.2%), with significantly higher rates among females compared to males (41.9% vs. 28.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.009). Low DHL was independently associated with PSMU (adjusted OR\u202f=\u202f2.79, 95% CI: 1.70\u20134.58,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Participants with PSMU had significantly higher mean scores on all DASS-21 subscales compared to non-problematic users (depression: 14.1\u202f\u00b1\u202f5.5 vs. 8.6\u202f\u00b1\u202f4.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; anxiety: 12.7\u202f\u00b1\u202f5.0 vs. 7.8\u202f\u00b1\u202f3.9,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; stress: 15.5\u202f\u00b1\u202f5.7 vs. 10.0\u202f\u00b1\u202f4.6,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). PSMU was significantly associated with moderate-to-severe depression (aOR\u202f=\u202f3.18, 95% CI: 1.88\u20135.38), anxiety (aOR\u202f=\u202f2.90, 95% CI: 1.72\u20134.89), and stress (aOR\u202f=\u202f2.64, 95% CI: 1.56\u20134.47).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PSMU is highly prevalent among Saudi adolescents in Madinah and is strongly associated with low digital health literacy and adverse mental health outcomes. These cross-sectional findings demonstrate associations between PSMU, low digital health literacy, and adverse mental health outcomes, suggesting the potential value of school-based digital literacy interventions and mental health screening programmes. However, longitudinal studies are needed to establish causal relationships before definitive intervention recommendations can be made.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1926618","type":"journal-article","created":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:35:00Z","timestamp":1790915700000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Problematic social media use, digital health literacy, and psychological distress in Saudi adolescents"],"prefix":"10.3389","volume":"14","author":[{"given":"Khaled A.","family":"Shahat","sequence":"first","affiliation":[{"name":"Department of Women and Child Health, College of Medicine, Taibah University","place":["Madinah, Saudi Arabia"]},{"name":"Al-Rayan National College of Medicine","place":["Madinah, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,10,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1038\/s41390-023-02567-9","article-title":"Media use, dietary intake, and diet quality of adolescents in Saudi Arabia","volume":"94","author":"Mumena","year":"2023","journal-title":"Pediatr Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"100960","DOI":"10.1016\/j.chbr.2026.100960","article-title":"Prevalence of social media disorder and internet gaming disorder among high school students in Saudi Arabia\u2014a national school-based survey","volume":"21","author":"Thrul","year":"2026","journal-title":"Comput Hum Behav Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.pedn.2024.03.007","article-title":"The relationship between internet addiction and stress, anxiety, and depression in adolescents in Saudi Arabia","volume":"77","author":"Ismail","year":"2024","journal-title":"J Pediatr Nurs"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"233","DOI":"10.4103\/jnsm.jnsm_207_24","article-title":"Social media addiction: prevalence, determinants, and correlation with self-esteem and loneliness among young adults in Saudi Arabia","volume":"8","author":"Alateeq","year":"2025","journal-title":"J Nat Sci Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e51125","DOI":"10.7759\/cureus.51125","article-title":"Digital health literacy and web-based health information-seeking Behaviors in the Saudi Arabian population","volume":"15","author":"Alhur","year":"2023","journal-title":"Cureus"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"673","DOI":"10.15537\/smj.2021.42.6.20210012","article-title":"Exploring the predictors of depression among Saudi adolescents: time for urgent firm actions","volume":"42","author":"AlYousefi","year":"2021","journal-title":"Saudi Med J"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"28","DOI":"10.3928\/02793695-20250107-04","article-title":"Prevalence of mental illness among middle adolescents in Jeddah, Saudi Arabia","volume":"63","author":"Yaghmour","year":"2025","journal-title":"J Psychosoc Nurs Ment Health Serv"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"886","DOI":"10.15537\/smj.2021.42.8.20210310","article-title":"Physical inactivity and its predictors among adolescents in Saudi Arabia: a cross-sectional comparison between cities with and without a healthy cities program","volume":"42","author":"Alasqah","year":"2021","journal-title":"Saudi Med J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"94","DOI":"10.15537\/smj.2020.1.24761","article-title":"Does the poor sleep quality affect the physical activity level, postural stability, and isometric muscle strength in Saudi adolescents? 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