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This study aimed at determining whether adolescents and young adults use music as an agent of consolation when dealing with daily sorrow and stress. We furthermore tested whether three aspects of music listening, i.e., the music itself, its lyrics, and experiences of closeness to artists and fans, were experienced as comforting. Third, we explored whether consolation through music listening was related to music use and psychological problems. Overall, 1,040 respondents, age 13–30 years (M = 20.3, 70.7% female), responded to items measuring listening hours, music importance, music preferences, positive and negative affects elicited by music (PANAS), internalizing and externalizing problems, and consolation through music. Slightly over 69% reported that they (definitely) use music as a source of consolation. Furthermore, female respondents and respondents with higher levels of anxiousness/depression and lower levels of aggression sought consolation by music more often. The same result emerged for respondents with a preference for chart pop music, for those who found music important, and for those with stronger emotional reactions to music. Music’s consoling effects were reported as resulting particularly from the sound and texture of the music itself, from attribution of personal meaning to music’s lyrics, and, to a lesser extent, from perceptions of closeness to artists and other listeners. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate to what extent alcohol-specific parenting practices relate to adolescents’ alcohol use, binge drinking, and alcohol-related problems, and whether these associations are moderated by socioeconomic status (SES), i.e. parents’ education level and family income. The present data were collected within the framework of a representative study on alcohol use among Dutch students. The present findings are based on data from respondents who had been drinking in the past year (81.5%), and of whom one of the parents had filled out a short questionnaire including SES characteristics (52%). The sample consisted of 1,344 adolescents. Adolescents were approached in a school setting; parents received a short questionnaire at the home address. The results show that applying strict rules about alcohol use and having qualitative good conversations about drinking alcohol seem to prevent adolescents from heavy drinking patterns, whereas parental alcohol use seems to promote adolescents’ drinking. A positive association was found between frequency of alcohol communication and availability of alcohol at home on the one hand and adolescents’ drinking on the other. Some moderating effects of SES were found. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Several studies have shown that the prevalence of smoking among adolescents with asthma is similar or even higher than among non-asthmatic adolescents. To design effective interventions, the predictors of smoking among adolescents with asthma need to be identified. This is the first study investigating the theory of planned behaviour (TPB) among adolescents with asthma. An extended TPB model, also including risk perceptions and perceived prevalence of smoking, was tested in a national, cross-sectional sample of 713 adolescents with (self-reported) current asthma and 7140 non-asthmatic controls. No differences in the level of smoking-specific cognitions were found (except for perceived risk of lung affections). However, the effect of having pro-smoking cognitions (e.g. a positive attitude) on smoking was stronger for adolescents with asthma than for non-asthmatic adolescents. Therefore, smoking prevention programs based on the TPB, designed for changing cognitions, could be of extra importance for adolescents with asthma. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to gain insight into the prevalence of asthma, allergic rhinitis, and eczema among Dutch early adolescents, and to study the impact of several social demographic and individual risk factors. Methods: Cross-sectional survey study using the self-report questionnaires of the International Study of Asthma and Allergies in Childhood (ISAAC). In January 2003, 10 087 12- to 14-year-old students from 33 secondary schools in four regions of the Netherlands participated in this study. Results: Of all participants, 52.6% reported that they had an allergic disease at least once in their lifetime. The 12 months prevalence of wheezing, rhinitis, and itchy rash was 12.3%, 28.3%, and 13.5%, respectively. Several social demographic and individual factors (gender, age, education levels, ethnicity, body mass index, and residential area) were significantly associated with the atopic symptoms and diseases. Conclusion: This study showed that allergic conditions are common in the Netherlands. Several social demographic and individual risk factors were related to the atopic diseases and symptoms. [ABSTRACT FROM AUTHOR]

Background:It has frequently been suggested that adolescents are more likely to start smoking when they hold favorable social images or prototypes of smoking peers. Although empirical evidence supports the role of smoker prototypes in predicting smoking, little is known about the relative contribution of smoker prototypes, in comparison to more well-established social cognitive factors. Therefore, the present study investigated the relative impact of smoker prototypes, in comparison to factors of the theory of planned behavior, in predicting smoking among adolescents. Methods: A three-wave prospective study was conducted among 612 Dutch 8th grade students (aged 12–13 years). Questionnaires were administered and adolescents were followed during one year. Results: The results indicate that smoker prototypes are predictive of adolescent smoking behavior. Adolescents who believe that smoking peers are sociable more frequently engage in smoking behavior. Moreover, adolescents who hold the image that smoking peers are rebellious are less inclined to engage in smoking. These prototype factors predict a significant proportion of variance in smoking status, over and above the components of the theory of planned behavior. Conclusion: The findings of the present study are interesting because they suggest that intervening on the level of smoker prototypes may contribute to the effectiveness of current programs aiming at the prevention of adolescents’ smoking behavior. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The objective of this research was to assess the predictive power of various Internet applications on the development of compulsive Internet use (CIU). The study has a two-wave longitudinal design with an interval of 1 year. The first measurement contained 447 adult heavy Internet users who used the Internet at least 16 h per week and had Internet access at home for at least 1 year. For the second measurement, all participants were invited again, of whom 229 responded. By means of an online questionnaire, the respondents were asked about the time spent on various Internet applications and CIU. On a cross-sectional basis, gaming and erotica seem the most important Internet applications related to CIU. On a longitudinal basis, spending a lot of time on erotica predicted an increase in CIU 1 year later. The addictive potential of the different applications varies; erotica appears to have the highest potential. [ABSTRACT FROM AUTHOR]

Objectives. To identify factors related to alcohol use among Turks and Moroccans living in the Netherlands. Furthermore, to reveal methodological problems related to research among Turks and Moroccans in general and to alcohol research among these groups in particular. Design. Individual face-to-face interviews were carried out with Dutch researchers (n=9), Turkish and Moroccan (health) practitioners working in the field with Turks (n=4) or Moroccans (n=2), and members of the target population with a Turkish (n=3) or a Moroccan background (n=2). Furthermore, focus-group interviews were held with Turkish women (n=4), Turkish men (n=3), Moroccan women (n=4) and Moroccan men (n=3) working as health professionals. Results. Alcohol use seems prevalent particularly among second-generation Turks and Moroccans and is related to: upbringing, influence of peer groups, integration and the degree in which Islamic rules are practised. Written questionnaires seem more appropriate for second-generation Turks and Moroccans, because they have fewer language problems and are more familiar with Western bureaucratic society. However, both generations may prefer face-to-face interviews since both groups fear that 'written' answers about the sensitive subject 'alcohol use' may somehow become known among community members. Similarly, an interviewer with a Dutch background may elicit more reliable answers about alcohol use than an interviewer with a Turkish or Moroccan background. Conclusion. In alcohol research special attention should be paid to second-generation Turks and Moroccans. Although it is probably easier to conduct alcohol studies in this group than in first-generation Turks and Moroccans, quantitative research is needed to test the hypothesis that written questionnaires elicit more reliable answers about alcohol use than face-to-face interviews. Furthermore, the influence of ethnic matching on response and data quality should be tested further. [ABSTRACT FROM AUTHOR]

Besides nicotine, other chemicals in tobacco smoke, such as norharman, may contribute to the addictive properties of cigarettes. More specifically, elevated blood plasma levels of norharman may reduce feelings of craving among tobacco-dependent individuals. To test this hypothesis, plasma concentrations of norharman were measured in 38 male smokers (at least 15 cigarettes per day) at three time-points on 3 different days spread over a 4-month period. The first measurement (T0) was conducted in the morning at 8.30 a.m., after 12 hours of smoking abstinence. The T1 and T2 measurements were conducted at 13.00 p.m. and 16.30 p.m., during a period of ad libitum smoking (after the T0 measurement, participants were not restricted in their smoking behaviour). At each of the nine time-points, craving was assessed by means of a shortened version of the Questionnaire of Smoking Urges. The Fagerström Test of Nicotine Dependence was used to obtain an indication of nicotine dependence. The results showed that, after a period of smoking abstinence, craving was stronger in those with a high tobacco dependence than in those with a low tobacco dependence. After resumption of smoking, craving declined to a similar low level in both low and high dependent smokers. Measurements during periods of ad libitum smoking indicate that plasma levels of norharman are related negatively to craving among low nicotine-dependent smokers, but not among high dependent smokers. [ABSTRACT FROM AUTHOR]

The article provides information on a study that examines the predictors of the intention to use condoms with new sexual partners. For this purpose, a sample of heterosexual adult females and males was recruited through various channels. Most of the adults in the sample had engaged in risky sexual behavior. The study notes that women, compared with men, were in general more aware of the risks of AIDS and perceived fewer barriers to using condoms, but they also perceived less support for condom use among potential new partners. For subjects with a risk factor for HIV infection, various types of barriers, absolute and comparative self-efficacy, and three types of social norms were independently related to the intention to use condoms. When including all relevant predictors, self-efficacy, anticipated regret, and descriptive norms in the reference group, were independent predictors of condom use motivation among both men and women. The article finally discusses implications for prevention.

A correction to the article "Bidirectional Within-Family Effects of Restrictive Mediation Practices and Adolescents' Problematic Social Media Use" that was published in the June 17, 2024 online issue is presented.

Psychometric characteristics were investigated of an Implicit Association Test to assess implicit endorsement of the sexual double standard (SDS-IAT) in emerging adults. The reliability of the SDS-IAT was investigated focusing on internal consistency across different phases of the test. Convergent validity of the SDS-IAT was evaluated against the Scale for the Assessment of Sexual Standards in Youth, an explicit measure of SDS, and against gender investment. Divergent validity was evaluated against the personality characteristics of extraversion, neuroticism, and social desirability proneness. Gendered patterns were examined. Attenuation-corrected alphas demonstrated acceptable internal consistency, with alphas ranging for.65–.70. A modest level of explicit SDS endorsement was found in both female and male participants. In line with their explicit SDS level, a modest level of implicit SDS endorsement was found in male participants, whereas a reverse implicit SDS was found among young women. In agreement with our theoretical expectations, we found low convergent validity in multitrait-multimethod analysis of the SDS-IAT with a measure of explicit SDS endorsement, and with general level of investment in gender ideals. Similarly, divergent validity analysis revealed absence of significant correlations with the conceptually unrelated concepts of extraversion, neuroticism, and social desirability proneness, except for extraversion in female participants. The present findings suggest that implicit SDS endorsement can be assessed using the SDS-IAT. The finding that explicit and implicit SDS approvals differ in young female participants, while they align in young male participants, warrants further research. [ABSTRACT FROM AUTHOR]

Research on the social determinants of Problematic Social Media Use (PSMU) among adolescents is scant and focused on proximal contexts and interpersonal relationships. This study examines the relation of PSMU with economic inequality, measured at country, school and individual levels. It also evaluated the moderating role of family and peer support in these associations. The 2017/18 Health Behavior in School-aged Children (HBSC) study measured PSMU in 179,049 adolescents aged 11-, 13- and 15-year-olds in 43 countries and sub-regions of Belgium (Flanders and Wallonia) and the United Kingdom (England, Scotland, and Wales). Associations between inequality and PSMU were tested using multilevel logistic regression analyis. Results showed that adolescents who were relatively more deprived than their schoolmates and attended more economically unequal schools had a higher likelihood of reporting PSMU. In addition, school wealth inequality was more closely related to PSMU among adolescents with lower levels of peer support. A similar effect of country income inequality was found, but only in adolescents who reported low family support. Our findings expand the existing literature on the detrimental impact of inequalities in different social contexts on adolescent wellbeing by showing the role of inequalities in the engagement in PSMU. [ABSTRACT FROM AUTHOR]

This research longitudinally explored adolescent pornography (porn) consumption and its association with sexual development in early and middle adolescence. A four-wave design with half-year intervals investigated pornography consumption and different (sexual) activities, such as masturbation, French kissing, petting, giving/receiving manual and oral sex, and intercourse, among 630 respondents (47.9% female, mean age 13.7 years; SD = 0.48) years at T1). A latent growth mixture analysis of pornography consumption revealed two groups with relatively low pornography (LP; 51.8% of the boys, 91.4% of the girls) versus high pornography (HP; 48.2% of the boys; 8.6% of the girls) consumption across time. At T1, HP boys on average watched pornography less than once a month, but more than once a year at T1. At T4, their average pornography use had increased to almost one to two times a week. LP boys never watched pornography at T1. At T4, their average pornography use was still less than once a year. At T1, HP girls never watched pornography, but consumption increased to almost one to three times a month at T4. Across waves of the study, LP girls (almost) never watched pornography. A discrete-time survival mixture analysis of sexual developmental patterning indicated that, compared to their LP peers, both girls and boys in the HP groups showed accelerated development of masturbation, petting, and receiving manual sex. Girls in the HP group were also more inclined to receive oral sex, whereas boys in the HP group also showed earlier and more frequent manual sex and intercourse. Thus, whereas the HP group of boys was substantially larger compared to that of girls, pornography consumption was related to accelerated development of sexual activities for both genders across early and middle adolescence. The discussion deliberates on pornography as a driving force in adolescent sexual development versus pornography as a medium of choice for sexually advanced adolescents. [ABSTRACT FROM AUTHOR]

The Internet offers adolescents unique opportunities to actively shape their own sexual media environment. The aim of this study was to gain in-depth insight into Dutch adolescents’ motives, perceptions, and reflections toward Internet use for (a) finding information or advice related to romance and sexuality; (b) searching for and viewing pornographic or erotic material; and (c) romantic and sexual communication (i.e., cybersex/sexting). Data were collected through 12 Web-based focus groups (36 adolescents aged 16 to 19 years, 72.2% girls) and analyzed through three stages of open, axial, and selective coding. The themes that emerged from the focus-group discussions suggest that sex-related Internet use is a complex and ambivalent experience for adolescents. Sex-related Internet use seems an increasingly normalized and common phenomenon. Participants perceived the Internet as a useful source of sexual information, stimulation, inspiration, and communication. Yet they discussed a range of negative consequences and risks related to sex-related online behaviors, particularly concerning pornography’s potential to create unrealistic expectations about sex and sexual attractiveness. Participants generally believed they had the necessary skills to navigate through the online sexual landscape in a responsible way, although they believed other young people could be influenced inadvertently and adversely by sex-related online content. [ABSTRACT FROM AUTHOR]

Much remains unknown about whether restrictive mediation is an effective parenting strategy to prevent or reduce problematic social media use among adolescents. Therefore, this study examined bidirectional within-family effects between two restrictive mediation practices (rule-setting and reactive restrictions) and problematic social media use using random-intercept cross-lagged panel modeling. Three-wave survey data collected among Dutch adolescents (T1: N = 1928, M age  = 13.31 years, SD = 0.91, 43.3% girl) with a 1 year-interval were used. Results showed that within-family changes in problematic social media use symptoms predicted subsequent within-family changes in perceived parental restrictive mediation. More specifically, an increase in symptoms predicted a decrease in rule-setting and an increase in reactive restrictions 1 year later. Within-family changes in perceived parental restrictive mediation practices did not predict within-family changes in problematic social media use symptoms, suggesting that the relation is unidirectional. However, concluding that limiting adolescents' Internet use is ineffective to prevent problematic social media use would be premature. Future research should investigate whether it may be an effective parenting strategy for a certain subgroup of adolescents or under certain circumstances., (© 2024. The Author(s).)

In this viewpoint, we introduce the term 'screenwashing', which describes the phenomenon whereby social media platforms, such as TikTok and Instagram, pretend to be more socially responsible than they actually are. That is, social media platforms pretend to be thoughtful about children's health and the prevention of problematic social media use, but this often turns out to be nothing more than "a lick of paint". We describe how features like the one-hour notification on TikTok and Instagram are considered screenwashing and why we believe so. Screenwashing, an unethical practice, has the potential to mislead parents and young users. Consequently, we advocate for increased government intervention to protect our youth from the potential hazards associated with problematic social media use.

Although both Internet-specific and general parenting have been linked to adolescents' problematic social media use, until now they have been investigated as separate predictors of this behavior. As specific parenting practices occur in the broader general parenting context, this study examined how different Internet-specific parenting practices (Internet-specific rule setting, reactive restrictions towards Internet use, and co-use) and general parenting dimensions (responsiveness and autonomy-granting) co-occur, and act together in predicting adolescents' problematic social media use. Four-wave data of 400 adolescents (T1: M age = 13.51 years, SD = 2.15, 54% girls) were used. Latent profile analysis identified three parenting profiles: Limiting and less supportive (13.5%), Tolerant and supportive (25.5%), and Limiting and supportive (60.8%). Membership to Tolerant and supportive predicted lower scores on prospective problematic social media use than membership to the other profiles. Besides, membership to Limiting and supportive predicted lower scores on problematic social media use than membership to Limiting and less supportive. No robust moderation effects of adolescents' age and gender were found. These findings suggest that a supportive general parenting context rather than Internet use restrictions should be the focus when considering the prevention of adolescents' problematic social media use., (© 2023. The Author(s).)

Objective: Over the past decade, concurrent with increasing social media use (SMU), there has been a shift toward poorer sleep among adolescents in many countries. The purpose of this study was to examine the cross-national associations between adolescent SMU and sleep patterns, by comparing 4 different categories of SMU (nonactive, active, intense, and problematic use)., Design, Setting, and Participants: Data were from 86,542 adolescents in 18 European and North American countries that participated in the 2017/18 Health Behaviour in School-aged study., Measurements: Mixed-effects linear regression models were used to examine cross-national associations between 4 SMU categories and adolescent sleep duration, bedtime and social jetlag derived from self-reported data., Results: For all countries combined, nonactive SMU was associated with longer sleep, earlier bedtimes, and less social jetlag, compared to active SMU, although the differences were minor. By comparison, intense and problematic SMU were associated with less sleep and later bedtimes on both school and nonschool days, and greater social jetlag, compared to active SMU. While findings were relatively consistent between countries, some differences were observed, suggesting that the national and cultural context may be important in interpreting results., Conclusions: These findings suggest that both intense and problematic SMU are associated with poorer sleep patterns in adolescents across most countries. Further research is needed to identify effective policies, programs, and messaging to promote the healthy use of social media and prevent potential negative impacts on adolescent sleep., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Adolescents growing up with a chronic condition might experience more social vulnerabilities compared to their healthy peers as an indirect result of their conditions. This can lead to a relatedness need frustration for these adolescents. Consequently, they might spend more time playing video games compared to their peers. Research shows that both social vulnerability and gaming intensity are predictors for problematic gaming. Therefore, we investigated if social vulnerability and gaming intensity are more pronounced in adolescents that have a chronic condition compared to the general population; and if these levels reflect the levels of a clinical group being treated for Internet Gaming Disorder (IGD)., Methods: Data on peer problems and gaming intensity were compared from three separate samples: a national representative sample of adolescents, a clinical sample of adolescents that are undergoing treatment for IGD, and a sample of adolescents diagnosed with a chronic condition., Results: No differences were found on either peer problems or gaming intensity between the group of adolescents that have chronic conditions and the national representative group. The group with chronic conditions scored significantly lower on gaming intensity than the clinical group. No significant differences were found between these groups on peer problems. We repeated the analyses for boys only. Similar results were found for the group with chronic conditions compared to the national representative group. The group with chronic conditions now scored significantly lower on both peer problems and gaming intensity than the clinical group., Conclusion: Adolescents growing up with a chronic condition appear similar in their gaming intensity and peer problems compared to their healthy peers., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Alexandridis, Nijhof, van der Rijst, van der Neut, Spijkerman, Stevens, Bakkes, Lesscher, van den Eijnden, van der Ent, van den Berg and Peeters.)

Aim: This study aimed to enhance knowledge on which aspects of the family context are most relevant in identifying at-risk/problematic social media users among adolescents. Therefore, we examined the relative contribution to adolescents' at-risk/problematic social media use (SMU) of general and Internet-specific family factors related to three different family (sub)systems: parent-child (Internet-specific rule-setting, reactive restrictions towards Internet use, co-use, adolescents' involvement in rule-setting and positive parenting), parent (parental screen time, phubbing, stress, anxiety and depression) and family (family functioning, family intactness and SES) (sub)system., Methods: Questionnaire data came from 403 adolescents (M = 13.51, SD = 2.15) and 396 parents (M = 46.59, SD = 5.29) who participated in wave 1 of the Dutch 'Digital Family project'., Results: Logistic regression analyses showed that only factors related to the parent-child subsystem remained significant in predicting being an at-risk/problematic social media user when examining predictors related to the parent-child, parent and family (sub)system simultaneously. Specifically, general and Internet-specific parenting practices contributed to the prediction above and beyond each other. Positive parenting and Internet-specific rule-setting seem protective, while parental reactive restrictions towards Internet use could be a risk factor. Positive parenting showed the largest effect size., Conclusion: The results suggest that parental behaviors directed towards the child should be a focus of attention in prevention of adolescents' problematic SMU. In addition, our findings highlight the importance of untangling restrictive mediation (impulsive, in the moment, attempts to limit SMU versus communicating clear rules in advance) when examining its effects., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background and Aims: There is currently no cross-national validation of a scale that measures problematic social media use (SMU). The present study investigated and compared the psychometric properties of the social media disorder (SMD) scale among young adolescents from different countries., Design: Validation study., Setting and Participants: Data came from 222 532 adolescents from 44 countries participating in the health behaviour in school-aged children (HBSC) survey (2017/2018). The HBSC survey was conducted in the European region and Canada. Participants were on average aged 13.54 years (standard deviation = 1.63) and 51.24% were girls., Measurement: Problematic SMU was measured using the nine-item SMD scale with dichotomous response options., Findings: Confirmatory factor analyses (CFA) showed good model fit for a one-factor model across all countries (minimum comparative fit index (CFI) and Tucker-Lewis index (TLI) = 0.963 and 0.951, maximum root mean square error of approximation (RMSEA) and standardized root mean square residual (SRMR) = 0.057 and 0.060), confirming structural validity. The internal consistency of the items was adequate in all countries (minimum alpha = 0.840), indicating that the scale provides reliable scores. Multi-group CFA showed that the factor structure was measurement invariant across countries (ΔCFI = -0.010, ΔRMSEA = 0.003), suggesting that adolescents' level of problematic SMU can be reliably compared cross-nationally. In all countries, gender and socio-economic invariance was established, and age invariance was found in 43 of 44 countries. In line with prior research, in almost all countries, problematic SMU related to poorer mental wellbeing (range β STDY  = 0.193-0.924, P < 0.05) and higher intensity of online communication (range β STDY  = 0.163-0.635, P < 0.05), confirming appropriate criterion validity., Conclusions: The social media disorder scale appears to be suitable for measuring and comparing problematic social media use among young adolescents across many national contexts., (© 2021 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

This qualitative study provides insight into the role of parents' self-interest in digital media use of children in different age groups. We conducted 31 semi-structured interviews with fathers/mothers of children aged 3-16 years who were recruited via targeted sampling. A deductive and inductive content analysis was applied. Results show that parents' self-interest in letting children use digital media includes being able to do other tasks without being bothered, having some me-time, managing children's behavior, avoiding discussions, having moments to use digital media themselves and spending quality-time together. In addition, we found that the manner in which parents let children use digital media out of self-interest seems to depend on age. With younger children, parents initiate digital media use or set times at which children are allowed to use digital media. With older children, parents use a passive manner by omitting restrictive responses to their children's media use. Current findings can be used to inform interventions aimed at reducing children's screen time., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) 2021.)

The popularity of social media use among adolescents has raised concerns about the potentially harmful effects of social media use on adolescents' sleep. Since longitudinal research considering this relationship is scarce, the present two-wave longitudinal study of 2021 secondary school students (M age = 13.86, SD = 1.25) examined whether frequency of social media use and problematic social media use predicted adolescents' bedtime and quality of sleep. Moreover, the protective role of parental rules regarding Internet and smartphone use one hour before sleep was examined. The findings indicated that strict parental rules about Internet and smartphone use before sleep might prevent negative consequences of social media use on bedtime and sleep quality, but only among less engaged social media users. Once adolescents are highly engaged social media users, strict parental rules do not seem to prevent negative media influences on sleep. This implies that limiting Internet accessibility before bedtime can help prevent adolescents' sleep problems, but that regulation is less effective for adolescents who are already highly involved in social media use.

Purpose: This study examined (1) whether intense and problematic social media use (SMU) were independently associated with adolescent well-being; (2) whether these associations varied by the country-level prevalence of intense and problematic SMU; and (3) whether differences in the country-level prevalence of intense and problematic SMU were related to differences in mobile Internet access., Methods: Individual-level data came from 154,981 adolescents (mean age  = 13.5) from 29 countries that participated in the 2017/2018 Health Behaviour in School-aged Children (HBSC) survey. Intense SMU was measured by the time spent on social media, whereas problematic SMU was defined by symptoms of addiction to social media. Mental (life satisfaction and psychological complaints), school (school satisfaction and perceived school pressure), and social (family support and friend support) well-being were assessed. Country-level data came from aggregated individual-level data and data from the Organisation for Economic Co-operation and Development (OECD) on Internet access., Results: Two-level regression analyses indicated that in countries with a lower prevalence of intense SMU, intense users reported lower levels of life satisfaction and family support and more psychological complaints than nonintense users. In contrast, in countries with a higher prevalence of intense SMU, intense users reported higher levels of family support and life satisfaction than nonintense users, and similar levels of psychological complaints. In all countries, intense users reported more friend support than nonintense users. The findings regarding problematic SMU were more consistent: In all countries, problematic users reported lower well-being on all domains than nonproblematic users. Observed differences in country-level prevalence rates of intense and problematic SMU could not be explained by mobile Internet access., Conclusions: Adolescents reporting problematic SMU are particularly at risk of lower well-being. In many countries, intense SMU may be a normative adolescent behavior that contributes positively to specific domains of their well-being., (Copyright © 2020. Published by Elsevier Inc.)