{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:55:48Z","timestamp":1790751348680,"version":"4.1.0"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000025","name":"National Institute of Mental Health","doi-asserted-by":"publisher","award":["R01MH134886"],"award-info":[{"award-number":["R01MH134886"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100022111","name":"Huo Family Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100022111","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Child Adolesc. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Acquisition of the first smartphone represents a major developmental transition. However, evidence on its effects on adolescent health and behavior remains limited. We assessed associations between first smartphone acquisition around age 12 and changes in mental health, environmental and lifestyle (exposomic) factors, and examined potential pathways underlying these associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed longitudinal data from 3,486 participants in the U.S. Adolescent Brain Cognitive Development (ABCD) Study who did not have a smartphone by age 12 (2-year assessment wave). We tested the association between smartphone acquisition (exposure) between age 12 to 13 (the 2- and 3-year assessments) and age 13 self-reported mental health (Brief Problem Monitor [BPM]) and exposomic outcomes including digital (screen time, social media, gaming, streaming, cyberbullying) and offline (sleep duration, school performance, exercise, bullying and reading) measures. Mixed-effects regression models accounted for sociodemographic, family, and developmental covariates. To reduce confounding, models additionally adjusted for pre-exposure measures of each outcome assessed at age 12, prior to smartphone acquisition. Mediation models examined indirect effects of smartphone acquisition on mental health through total screen time, social media account ownership, and bedtime media use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with youth who remained smartphone-free at age 13 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,940), smartphone acquisition (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091,546) was associated with worse BPM internalizing, attention, and total scores (all p's \u2264 0.003), more screen time, greater odds of having a social media account, less sleep, and more frequent bedtime use of social media, video games, and streaming (all p's\u2009&amp;lt;\u20090.001). Smartphone acquisition was not associated with differences in externalizing symptoms, academic performance, exercise, or bullying\/cyberbullying (all p's\u2009&amp;gt;\u20090.05). Mediation analyses suggested indirect associations between smartphone acquisition and mental health through total screen time, social media account ownership, and bedtime media use (all indirect effects\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.002); collectively, these factors accounted for most of the association, with social media use contributing the largest indirect effect.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Smartphone acquisition is associated with several environmental and lifestyle changes in the following year, particularly around bedtime. These changes may represent mechanisms linking smartphone acquisition to mental health symptoms. Findings provide insight into potential behavioral pathways associated with smartphone acquisition and adolescent mental health and may inform future intervention studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frcha.2026.1940646","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:01:45Z","timestamp":1790748105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Smartphone acquisition as an inflection point in early adolescence digital exposome: relevance to mental health"],"prefix":"10.3389","volume":"5","author":[{"given":"Ziv","family":"Bren","sequence":"first","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children\u2019s Hospital of Philadelphia (CHOP)","place":["Philadelphia, PA, United States"]},{"name":"Lifespan Brain Institute of CHOP and Penn Medicine","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate T.","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children\u2019s Hospital of Philadelphia (CHOP)","place":["Philadelphia, PA, United States"]},{"name":"Lifespan Brain Institute of CHOP and Penn Medicine","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Clinton","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elina","family":"Visoki","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children\u2019s Hospital of Philadelphia (CHOP)","place":["Philadelphia, PA, United States"]},{"name":"Lifespan Brain Institute of CHOP and Penn Medicine","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lani A.","family":"Tran","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadine","family":"Michel","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler M.","family":"Moore","sequence":"additional","affiliation":[{"name":"Lifespan Brain Institute of CHOP and Penn Medicine","place":["Philadelphia, PA, United States"]},{"name":"Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel D.","family":"Pimentel","sequence":"additional","affiliation":[{"name":"Department of Statistics, UC Berkeley","place":["Berkeley, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ran","family":"Barzilay","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children\u2019s Hospital of Philadelphia (CHOP)","place":["Philadelphia, PA, United States"]},{"name":"Lifespan Brain Institute of CHOP and Penn Medicine","place":["Philadelphia, PA, United States"]},{"name":"Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania","place":["Philadelphia, PA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"B1","author":"Rideout","year":""},{"key":"B2","volume-title":"Teens, Social media and technology 2024.","author":"Faverio","year":"2024"},{"key":"B3","volume-title":"Teens, Social Media and Technology 2022.","author":"Vogels","year":"2022"},{"key":"B4","volume-title":"Adolescent Mental and Behavioral Health, 2023.,\u2019 National Survey of Children\u2019s Health Data Briefs","author":"Sappenfield","year":"2018"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e2025072941","DOI":"10.1542\/peds.2025-072941","article-title":"Smartphone ownership, age of smartphone acquisition, and health outcomes in early adolescence","volume":"157","author":"Barzilay","year":"2026","journal-title":"Pediatrics"},{"key":"B6","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1001\/jama.2018.8931","article-title":"Association of digital media use with subsequent symptoms of attention-deficit\/hyperactivity disorder among adolescents","volume":"320","author":"Ra","year":"2018","journal-title":"JAMA"},{"key":"B7","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1111\/jpc.13462","article-title":"Clinical and psychological effects of excessive screen time on children","volume":"53","author":"Domingues-Montanari","year":"2017","journal-title":"J Paediatr Child Health"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e023191","DOI":"10.1136\/bmjopen-2018-023191","article-title":"Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews","volume":"9","author":"Stiglic","year":"2019","journal-title":"BMJ Open"},{"key":"B9","doi-asserted-by":"publisher","first-page":"S240","DOI":"10.1139\/apnm-2015-0630","article-title":"Systematic review of sedentary behaviour and health indicators in school-aged children and youth: an update","volume":"41","author":"Carson","year":"2016","journal-title":"Appl Physiol Nutr Metab"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/15388220.2025.2596991","article-title":"Bullying victimization and suicide among US high school adolescents: the mediating role of depressive symptoms and the moderating effects of physical activity and sex","author":"Luis","year":"","journal-title":"J Sch Violence"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e2218746","DOI":"10.1001\/jamanetworkopen.2022.18746","article-title":"Association of cyberbullying experiences and perpetration with suicidality in early adolescence","volume":"5","author":"Arnon","year":"2022","journal-title":"JAMA Netw Open"},{"key":"B12","doi-asserted-by":"publisher","first-page":"E136","DOI":"10.1503\/cmaj.190434","article-title":"Smartphones, social media use and youth mental health","volume":"192","author":"Abi-Jaoude","year":"2020","journal-title":"CMAJ"},{"key":"B13","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1080\/02673843.2019.1590851","article-title":"A systematic review: the influence of social media on depression, anxiety and psychological distress in adolescents","volume":"25","author":"Keles","year":"2020","journal-title":"Int J Adolesc Youth"},{"key":"B14","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.eclinm.2018.12.005","article-title":"Social media use and adolescent mental health: findings from the UK millennium cohort study","volume":"6","author":"Kelly","year":"2018","journal-title":"eClinicalMed"},{"key":"B15","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1001\/jamapediatrics.2026.0253","article-title":"Screens and youth sleep","volume":"180","author":"Hale","year":"2026","journal-title":"JAMA Pediatr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1202","DOI":"10.1001\/jamapediatrics.2016.2341","article-title":"Association between portable screen-based media device access or use and sleep outcomes: a systematic review and meta-analysis","volume":"170","author":"Carter","year":"2016","journal-title":"JAMA Pediatr"},{"key":"B17","doi-asserted-by":"publisher","first-page":"497","DOI":"10.1016\/j.sleh.2023.02.005","article-title":"Bedtime screen use behaviors and sleep outcomes: findings from the adolescent brain cognitive development (ABCD) study","volume":"9","author":"Nagata","year":"2023","journal-title":"Sleep Health"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e90153","DOI":"10.2196\/90153","article-title":"The digital exposome: a life course framework for health in the digital age","volume":"28","author":"Petit","year":"2026","journal-title":"J Med Internet Res"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.1158\/1055-9965.EPI-05-0456","article-title":"Complementing the genome with an \u2018exposome\u2019: the outstanding challenge of environmental exposure measurement in molecular epidemiology","volume":"14","author":"Wild","year":"2005","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"B20","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1108\/MHDT-03-2025-0020","article-title":"A narrative theoretical review of research on factors associated with media use and mental health among adolescents and emerging adults","volume":"3","author":"Luis","year":"2025","journal-title":"Mental Health and Digital Technologies"},{"key":"B21","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s44277-024-00006-9","article-title":"Probing the digital exposome: associations of social media use patterns with youth mental health","volume":"2","author":"Pagliaccio","year":"2024","journal-title":"NPP\u2014Digit Psychiatry Neurosci"},{"key":"B22","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1001\/jama.2025.7829","article-title":"Addictive screen use trajectories and suicidal behaviors, suicidal ideation, and mental health in US youths","volume":"334","author":"Xiao","year":"2025","journal-title":"JAMA"},{"key":"B23","doi-asserted-by":"publisher","first-page":"116523","DOI":"10.1016\/j.psychres.2025.116523","article-title":"Adolescent smartphone use, sleep, and physical activity: daily associations between sensor-based measures in the adolescent brain cognitive development (ABCD) study","volume":"349","author":"Alexander","year":"2025","journal-title":"Psychiatry Res"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1401","DOI":"10.1002\/jad.12367","article-title":"Family factors related to adolescent screen media use and mental health outcomes: a systematic review and recommendation for practices","volume":"96","author":"Liu","year":"2024","journal-title":"J Adolesc"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1598","DOI":"10.1186\/s12889-021-11640-9","article-title":"Electronic media use and sleep in children and adolescents in western countries: a systematic review","volume":"21","author":"Lund","year":"2021","journal-title":"BMC Public Health"},{"key":"B26","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.smrv.2014.07.007","article-title":"Screen time and sleep among school-aged children and adolescents: a systematic literature review","volume":"21","author":"Hale","year":"2015","journal-title":"Sleep Med Rev"},{"key":"B27","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1038\/s41562-018-0506-1","article-title":"The association between adolescent well-being and digital technology use","volume":"3","author":"Orben","year":"2019","journal-title":"Nat Hum Behav"},{"key":"B28","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s11920-024-01481-9","article-title":"The impact of social media use on sleep and mental health in youth: a scoping review","volume":"26","author":"Yu","year":"2024","journal-title":"Curr Psychiatry Rep"},{"key":"B29","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1057\/s41599-026-06609-1","article-title":"Excessive screen time is associated with mental health problems in US children and adolescents: physical activity and sleep as parallel mediators","volume":"13","author":"Dai","year":"2026","journal-title":"Humanit Soc Sci Commun"},{"key":"B30","doi-asserted-by":"publisher","first-page":"e031161","DOI":"10.1136\/bmjopen-2019-031161","article-title":"Social media use and adolescent sleep patterns: cross-sectional findings from the UK millennium cohort study","volume":"9","author":"Scott","year":"2019","journal-title":"BMJ Open"},{"key":"B31","doi-asserted-by":"publisher","first-page":"605","DOI":"10.3389\/fpsyg.2017.00605","article-title":"Smartphones and cognition: a review of research exploring the links between mobile technology habits and cognitive functioning","volume":"8","author":"Wilmer","year":"2017","journal-title":"Front Psychol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1533327","DOI":"10.3389\/fpubh.2025.1533327","article-title":"The relationship and mechanism of screen time and academic performance among adolescents: an empirical study based on CEPS","volume":"13","author":"Feng","year":"2025","journal-title":"Front Public Health"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e0256591","DOI":"10.1371\/journal.pone.0256591","article-title":"Screen time and early adolescent mental health, academic, and social outcomes in 9- and 10- year old children: utilizing the adolescent brain cognitive development SM (ABCD) study","volume":"16","author":"Paulich","year":"2021","journal-title":"PLoS One"},{"key":"B34","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1080\/1047840x.2020.1820219","article-title":"Adolescent development in the digital media context","volume":"31","author":"Nesi","year":"2020","journal-title":"Psychol Inq"},{"key":"B35","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/jcpp.13190","article-title":"Adolescent mental health in the digital age: facts, fears and future directions","volume":"61","author":"Odgers","year":"2020","journal-title":"J Child Psychol Psychiatry"},{"key":"B36","doi-asserted-by":"publisher","first-page":"858","DOI":"10.1001\/jamapediatrics.2026.2118","article-title":"Smartphone acquisition and use at age 13 years and health outcomes at age 14 years","volume":"180","author":"Bren","year":"2026","journal-title":"JAMA Pediatr"},{"key":"B37","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1038\/s41386-020-0736-6","article-title":"The ABCD study: understanding the development of risk for mental and physical health outcomes","volume":"46","author":"Karcher","year":"2021","journal-title":"Neuropsychopharmacol"},{"key":"B38","doi-asserted-by":"publisher","first-page":"805","DOI":"10.1097\/EDE.0b013e3181577511","article-title":"Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration","volume":"18","author":"Vandenbroucke","year":"2007","journal-title":"Epidemiology"},{"key":"B39","first-page":"33","volume-title":"Manual for the ASEBA Brief Problem Monitor (BPM)","author":"Achenbach","year":"2011"},{"key":"B40","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1111\/pcn.12188","article-title":"Reliability and validity the brief problem monitor, an abbreviated form of the child behavior checklist","volume":"68","author":"Piper","year":"2014","journal-title":"Psychiatry Clin Neurosci"},{"key":"B41","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1016\/j.jaacop.2026.02.003","article-title":"Social media usage and its association with the social media addiction questionnaire scale among early adolescents","volume":"4","author":"Hermann","year":"2026","journal-title":"JAACAP Open"},{"key":"B42","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1207\/S15374424JCCP3004_05","article-title":"Overt and relational aggression in adolescents: social-psychological adjustment of aggressors and victims","volume":"30","author":"Prinstein","year":"2001","journal-title":"J Clin Child Psychol"},{"key":"B43","doi-asserted-by":"publisher","first-page":"2158244015573169","DOI":"10.1177\/2158244015573169","article-title":"The relationship between cell phone use and academic performance in a sample of U.S. College students","volume":"5","author":"Lepp","year":"2015","journal-title":"Sage Open"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1542\/peds.2014-2251","article-title":"Mobile and interactive media use by young children: the good, the bad, and the unknown","volume":"135","author":"Radesky","year":"2015","journal-title":"Pediatrics"},{"key":"B45","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1177\/0748730402239679","article-title":"Life between clocks: daily temporal patterns of human chronotypes","volume":"18","author":"Roenneberg","year":"2003","journal-title":"J Biol Rhythms"},{"key":"B46","doi-asserted-by":"publisher","first-page":"105727","DOI":"10.1016\/j.psyneuen.2022.105727","article-title":"Association between racial\/ethnic discrimination and pubertal development in early adolescence","volume":"140","author":"Argabright","year":"2022","journal-title":"Psychoneuroendocrinology"},{"key":"B47","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1037\/ppm0000203","article-title":"Trends in U.S. Adolescents\u2019 media use, 1976\u20132016: the rise of digital media, the decline of TV, and the (near) demise of print","volume":"8","author":"Twenge","year":"2019","journal-title":"Psychol Pop Media Cult"},{"key":"B48","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/s00431-016-2823-6","article-title":"Adolescents with a smartphone sleep less than their peers","volume":"176","author":"Schweizer","year":"2017","journal-title":"Eur J Pediatr"},{"key":"B49","doi-asserted-by":"publisher","first-page":"814","DOI":"10.1001\/jamapediatrics.2024.2078","article-title":"Social media use and internalizing symptoms in clinical and community adolescent samples: a systematic review and meta-analysis","volume":"178","author":"Fassi","year":"2024","journal-title":"JAMA Pediatr"},{"key":"B50","doi-asserted-by":"publisher","first-page":"496","DOI":"10.3109\/07420528.2013.872121","article-title":"Does one hour of bright or short-wavelength filtered tablet screenlight have a meaningful effect on adolescents\u2019 pre-bedtime alertness, sleep, and daytime functioning?","volume":"31","author":"Heath","year":"2014","journal-title":"Chronobiol Int"},{"key":"B51","doi-asserted-by":"publisher","first-page":"832","DOI":"10.1177\/1745691615596788","article-title":"Seven fears and the science of how mobile technologies may be influencing adolescents in the digital age","volume":"10","author":"George","year":"2015","journal-title":"Perspect Psychol Sci"},{"key":"B52","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1177\/0956797616678438","article-title":"A large-scale test of the Goldilocks hypothesis: quantifying the relations between digital-screen use and the mental well-being of adolescents","volume":"28","author":"Przybylski","year":"2017","journal-title":"Psychol Sci"}],"container-title":["Frontiers in Child and Adolescent Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frcha.2026.1940646\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:01:47Z","timestamp":1790748107000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frcha.2026.1940646\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":52,"alternative-id":["10.3389\/frcha.2026.1940646"],"URL":"https:\/\/doi.org\/10.3389\/frcha.2026.1940646","relation":{},"ISSN":["2813-4540"],"issn-type":[{"value":"2813-4540","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"article-number":"1940646"}}