The relationship between suicidality and self-harming behaviors with problematic smartphone use in adolescents admitted to a psychiatric hospital

Document Type : Research Paper

Authors

1 Medical student of general medicine, Student of Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

2 General physician, Student of Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.

3 MSc. in clinical psychology, Mashhad University of Medical Sciences, Mashhad, Iran.

4 Professor of child and adolescent psychiatry, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

10.22038/JFMH.2025.90318.3272

Abstract

Introduction: Regarding the increasing rate of self-harming behaviors and suicidal ideations or attempts among adolescents, we assessed the relationship between suicidality, self-harming behaviors with problematic smartphone use in adolescents admitted to psychiatric hospital.
 
Materials and Methods: This cross-sectional study conducted on adolescents aged 12 to 18 years who were hospitalized in the Child and Adolescent Psychiatry Department of Ibn-e-Sina Hospital in Mashhad, Iran, during December 2022 to March 2023, who were selected through the convenient sampling method. Research instruments included a demographic checklist, Behavioral Features of Self-Harm Questionnaire, Beck Scale for Suicide Ideation, Self-Harm Inventory, and Cellphone Overuse Scale. We analyzed the data analysis using SPSS 16.0, descriptive indices, Chi-square test, t-test, and Pearson's correlation test.
 
Results: In this study, we assessed 158 adolescents (91 had a history of suicide and 67 had no history of suicide). The difference between the two groups in history of self-harm was significant (P< 0.001). The risk of suicide was more in the suicide group and this group had problematic use of mobile phone more than the group without suicidal attempt (P< 0.001). In the suicide group, the suicide risk was significantly associated with borderline personality disorder and problematic use of mobile phone (P< 0.001). Also, mobile phone use was significantly associated with borderline personality disorder in all adolescents (P< 0.001).
 
Conclusion: We revealed that the problematic use of mobile phone is associated with an increased risk of suicide attempt in adolescents

Keywords


  1. Marengo D, Fabris MA, Longobardi C, Settanni M. Smartphone and social media use contributed to individual tendencies towards social media addiction in Italian adolescents during the COVID-19 pandemic. Addict Behav 2022; 126: 107204.
  2. Shannon H, Bush K, Villeneuve PJ, Hellemans KG, Guimond S. Problematic social media use in adolescents and young adults: Systematic review and meta-analysis. JMIR Ment Health 2022; 9(4): e33450.
  3. Yang S-Y, Wang Y-C, Lee Y-C, Lin Y-L, Hsieh P-L, Lin P-H. Does smartphone addiction, social media addiction, and/or internet game addiction affect adolescents’ interpersonal interactions? Healthcare 2022; 10: 963.
  4. Paakkari L, Tynjälä J, Lahti H, Ojala K, Lyyra N. Problematic social media use and health among adolescents. Int J Environ Res Public Health 2021; 18: 1885.
  5. Bozzola E, Spina G, Agostiniani R, Barni S, Russo R, Scarpato E, et al. The use of social media in children and adolescents: Scoping review on the potential risks. Int J Environ Res Public Health 2022; 19: 9960.
  6. van den Eijnden RJJM, Geurts SM, ter Bogt TFM, van der Rijst VG, Koning IM. Social media use and adolescents’ sleep: A longitudinal study on the protective role of parental rules regarding internet use before sleep. Int J Environ Res Public Health 2021; 18: 1346.
  7. Pirdehghan A, Khezmeh E, Panahi S. Social media use and sleep disturbance among adolescents: A cross-sectional study. Iran J Psychiatry 2021; 16: 2: 137-45.
  8. Zubair U, Khan MK, Albashari M. Link between excessive social media use and psychiatric disorders. Ann Med Surg 2023; 85: 875-8.
  9. Ergün N, Özkan Z, Griffiths MD. Social media addiction and poor mental health: Examining the mediating roles of internet addiction and phubbing. Psychol Rep 2025; 128(2): 723-43.
  10. Vannucci A, Simpson EG, Gagnon S, Ohannessian CM. Social media use and risky behaviors in adolescents: A meta-analysis. J Adolesc 2020; 79: 258-74.
  11. Caner N, Efe YS, Başdaş Ö. The contribution of social media addiction to adolescent LIFE: Social appearance anxiety. Curr Psychol 2022; 41(12): 8424-33.
  12. Acar IH, Avcılar G, Yazıcı G, Bostancı S. The roles of adolescents’ emotional problems and social media addiction on their self-esteem. Curr Psychol 2022; 41(10): 6838-47.
  13. Zhu X, Griffiths H, Xiao Z, Ribeaud D, Eisner M, Yang Y, et al. Trajectories of screen time across adolescence and their associations with adulthood mental health and behavioral outcomes. J Youth Adolesc 2023; 52(7): 1433-47.
  14. Cayubit RF, Dimaculangan DM, Lim SM, Sanchez GM, Pazcoguin JM, Reyes ME. Social networking and depressive symptom: Predictors of non-suicidal self-injury among adolescents. Curr Psychol 2022; 42: 13084-92.
  15. da Silva NA, Rocha LC, Mano GB, Sampaio VC, Felix MC, Dias FD, et al. Excessive social media use and suicide in adolescents: Worst side of the coin. Research in social development 2024; 13(6): e4713641609.

16. Kefala A. Social media effects and self-harm behaviors among young people: Theoretical and methodological challenges. Journal of education, innovation and communication 2022; 3(2): 13-26.

  1. Moss C, Wibberley C, Witham G. Assessing the impact of Instagram use and deliberate self‐harm in adolescents: A scoping review. Int J ment Health Nurs 2023; 32(1): 14-29.
  2. Yang LS, Zhang ZH, Hao JH, Sun YH. Association between adolescent Internet addiction and suicidal behaviours. Chin J Epidemiol 2010; 31: 101115-9.
  3. Weinstein E, Kleiman EM, Franz PJ, Joyce VW, Nash CC, Buonopane RJ, et al. Positive and negative uses of social media among adolescents hospitalized for suicidal behavior. J Adolesc 2021; 87: 63-73.
  4. Shafi RM, Nakonezny PA, Romanowicz M, Nandakumar AL, Suarez L, Croarkin PE. Suicidality and self-injurious behavior among adolescent social media users at psychiatric hospitalization. CNS Spectr 2021; 26(3): 275-81.
  5. 21. Beck AT, Steer RA, Ranieri WF. Scale for Suicidal Ideation: Psychometric properties of a self-report version. J Clin Psychol 1988; 44(4): 499-505.
  6. 22. Esfahani M, Hashemi Y, Alavi K. Psychometric assessment of Beck Scale for Suicidal Ideation (BSSI) in general population in Tehran. Med J Islam Repub Iran 2015; 29: 268.
  7. Steine IM, Winje D, Krystal JH, Bjorvatn B, Milde AM, Grønli J, et al. Cumulative childhood maltreatment and its dose-response relation with adult symptomatology: Findings in a sample of adult survivors of sexual abuse. Child Abuse Negl 2017; 65: 99-111.
  8. Valinezhad A, Nemattavousi M, Rezabakhsh H, Kraskian Moujembari A. [The mediating role of perceived burdensomeness and suicidal ideation in the relationship between parent-adolescent conflict and non-suicidal self-injury]. Rooyesh-e-Ravanshenasi journal 2023; 12(1): 109-120. (Persian)
  9. Golmohammadian M, Yaseminejad P. [Normalization, validity and reliability of Cell-phone Over-use Scale (COS) among university students]. New findings in psychology 2011; 6: 37-52. (Persian)
  10. He X, Yu Q, Yang B, Yang P, Du N, Yue Y. Association between internet addiction and suicide and self-injury behavior in Chinese adolescents: A meta-analysis. Research square 2023. (preprint).
  11. Pastorino GMG, Operto FF, Buonaiuto R, Diaspro G, Coppola G. Social media use and mood, suicidal ideation and self-harm in adolescents. Brain 2020; 11(3): 31-40.
  12. Collins M, Grant JE. Social media addiction and borderline personality disorder: A survey study. Front Psychiatry 2025; 15: 1459827.
  13. Elias Balt E, Mérelle S, Robinson J, Popma A, Creemers D, van den Brand I, et al. Social media use of adolescents who died by suicide: lessons from a psychological autopsy study. Child Adolesc Psychiatry Ment Health 2023; 17: 48.
  14. Bye A, Carter B, Leightley D, Trevillion K, Liakata M, Branthonne-Foster S, et al. Cohort profile: The Social media, Smartphone use and Self-harm in Young People (3S-YP) study–A prospective, observational cohort study of young people in contact with mental health services. PLoS ONE 2024; 19(5): e0299059.
  15. Tørmoen AJ, Øverlien Myhre M, Kildahl AT, Walby FA, Rossow I. A nationwide study on time spent on social media and self‑harm among adolescents. Sci Rep 2023; 13: 19111.