THE MEDIATING ROLE OF BODY IMAGE DISTORTION IN THE ASSOCIATION BETWEEN SMARTPHONE SCREEN TIME AND MENTAL HEALTH AMONG KOREAN ADOLESCENTS
Author(s)
seoyeon lee, .1, Minseol Jang, PharmD2, Hae Sun Suh, MA, MS, PhD3.
1Kyunghee University, Seoul, Korea, Republic of, 2PhD Student, Kyung Hee University, Seoul, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of.
1Kyunghee University, Seoul, Korea, Republic of, 2PhD Student, Kyung Hee University, Seoul, Korea, Republic of, 3Kyung Hee University, Seoul, Korea, Republic of.
OBJECTIVES: Excessive smartphone use has been associated with poor mental health in adolescents, potentially through body image distortion. This study aimed to examine the associations of screen time and mental health and to evaluate the mediating role of body image distortion in these relationships among adolescents.
METHODS: This cross-sectional study utilized data from the Korean Youth Risk Behavior Survey of 2020-2025, and 238,269 adolescents were included in the analysis. Smartphone screen time was categorized as low-use group (<2 h/day), moderate-use group (2-4 h/day), high-use group (4-6 h/day), and excessive-use group (>6 h/day). The low-use group served as the reference category. Mental health outcomes included depression, suicidal ideation, and suicide attempts. Body image distortion, defined as overestimation of body shape relative to BMI, was evaluated as the potential mediator between smartphone screen time and mental health outcomes. Mediation analyses was conducted according to the Baron and Kenny framework using complex-sample logistic regression models with adjustment for potential confounder, and indirect effects were estimated using bootstrap resampling.
RESULTS: The mediation effects of body image distortion varied by smartphone screen-time level. Significant negative mediation effects were observed in moderate-use group for depression (β=-0.009, 95% CI -0.016--0.003), suicidal ideation (β=-0.015, 95% CI -0.027--0.004), and suicide attempts (β=-0.020, 95% CI -0.036--0.005). In contrast, excessive-use group (4 to less than 6 hours) showed significant positive mediation effects for depression (β=0.017, 95% CI 0.011-0.024), suicidal ideation (β=0.029, 95% CI 0.018-0.041), and suicide attempts (β=0.038, 95% CI 0.023-0.054), whereas no significant mediation effects were identified in high-use group.
CONCLUSIONS: In this study, the mediating role of body image distortion varied non-linearly across smartphone screen-time levels. Body image distortion was associated with adverse mental health outcomes with excessive smartphone use, suggesting that interventions addressing body image may be beneficial in these high-risk adolescents.
METHODS: This cross-sectional study utilized data from the Korean Youth Risk Behavior Survey of 2020-2025, and 238,269 adolescents were included in the analysis. Smartphone screen time was categorized as low-use group (<2 h/day), moderate-use group (2-4 h/day), high-use group (4-6 h/day), and excessive-use group (>6 h/day). The low-use group served as the reference category. Mental health outcomes included depression, suicidal ideation, and suicide attempts. Body image distortion, defined as overestimation of body shape relative to BMI, was evaluated as the potential mediator between smartphone screen time and mental health outcomes. Mediation analyses was conducted according to the Baron and Kenny framework using complex-sample logistic regression models with adjustment for potential confounder, and indirect effects were estimated using bootstrap resampling.
RESULTS: The mediation effects of body image distortion varied by smartphone screen-time level. Significant negative mediation effects were observed in moderate-use group for depression (β=-0.009, 95% CI -0.016--0.003), suicidal ideation (β=-0.015, 95% CI -0.027--0.004), and suicide attempts (β=-0.020, 95% CI -0.036--0.005). In contrast, excessive-use group (4 to less than 6 hours) showed significant positive mediation effects for depression (β=0.017, 95% CI 0.011-0.024), suicidal ideation (β=0.029, 95% CI 0.018-0.041), and suicide attempts (β=0.038, 95% CI 0.023-0.054), whereas no significant mediation effects were identified in high-use group.
CONCLUSIONS: In this study, the mediating role of body image distortion varied non-linearly across smartphone screen-time levels. Body image distortion was associated with adverse mental health outcomes with excessive smartphone use, suggesting that interventions addressing body image may be beneficial in these high-risk adolescents.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EPH124
Topic
Clinical Outcomes, Epidemiology & Public Health
Disease
Mental Health (including addiction), Pediatrics