Adolescent depression is a worldwide public health concern and has contributed to significant socioeconomic burden. Investigating the association between time spent on social media (TSSM) and depression may provide guidance toward the prevention and intervention of adolescent depression. However, related literature reported mixed findings in terms of the relationship between TSSM and depression in adolescents. Hence, we conducted a comprehensive dose–response meta-analysis to clarify this issue. We conducted a systematic title/abstract and topic search of the relative terms in Web of Science, PubMed, PsycINFO databases through 9 January 2022. Odd ratios (ORs) were used to examine the pooled effect size of the association between TSSM and risk of depression. Dose–response analysis was evaluated by a generalized least squares trend estimation. Twenty-one cross-sectional studies and five longitudinal studies including a total of 55,340 participants were included. Overall, more TSSM was significantly associated with a higher risk of depression symptoms (OR = 1.60, 95%CI: 1.45 to 1.75) with high heterogeneity (Q₍₂₉₎ = 105.9, p < 0.001; I² = 72.6%). The association was stronger for adolescent girls (OR = 1.72, 95%CI: 1.41 to 2.09) than boys (OR = 1.20, 95%CI: 1.05 to 1.37). Five studies with seven reports were included in dose–response analysis. There was a linear dose–response association of TSSM and risk of depression. The risk of depression increased by 13% (OR = 1.13, 95%CI: 1.09 to 1.17, p < 0.001) for each hour increase in social media use in adolescents. TSSM is associated with depression in a linear dose–response and gender-specific manner, which suggests the need for better monitoring of adolescent social media use. However, motivation, content, and engagement on and exposure to social media use may also be important contributing factors, making it necessary to interpret the current findings with caution. Therefore, further research is required to clarify not only the causal link between TSSM and depression by randomized control studies but also the influence of other factors, such as active vs. passive social media use or different types of engagement or environments in which social media is used.

Background: Patterns of suicide rates in China differ in many ways from those in the West. This study aimed to identify the risk factors characteristic for young rural Chinese suicides.Method: This was a case-control psychological autopsy (PA) study. The samples were suicides and living controls (both aged 15–34 years) from 16 rural counties of China. We interviewed two informants for each suicide and each control with pretested and validated instruments to estimate psychosocial, psychiatric and other risk factors for suicides.Results: The prevalence of mental disorders was higher among the young Chinese who died by suicide than among the living controls, but was lower than among suicides in the West. Marriage was not a protecting factor for suicide among young rural Chinese women, and never-married women who were involved in relationships were about three times more likely to commit suicide than single women who were unattached. Religion/religiosity was not a protecting factor in Chinese suicide, as it tended to be stronger for suicides than for controls. Impulsivity was significantly higher for suicides than for controls. Psychological strain, resulting from conflicting social values between communist gender equalitarianism and Confucian gender discrimination, was associated significantly with suicide in young rural Chinese women, even after accounting for the role of psychiatric illness.Conclusions: Risk factors for suicide in rural China are different from those in the West. Psychological strain plays a role in suicide. Suicide prevention programs in China should incorporate culture-specific considerations.

The Chinese version of Scale for Suicide Ideation (SSI; Beck, Kovacs, & Weissman, 1979 Beck , A. T. , Kovacs , M. , & Weissman , A. ( 1979 ). Assessment of suicidal intention: The scale for suicide ideation . Journal of Consulting and Clinical Psychology , 47 , 343 – 352 . [Crossref], [PubMed], [Web of Science ®] , [Google Scholar] ) was examined with high school students (n = 292) in rural China. Results indicated that the SSI had high internal reliability and high item-total correlations. The SSI was highly correlated with measures of trait anxiety, hopelessness, and favorable attitude towards suicide. These findings indicated that the Chinese version of the SSI has excellent psychometric properties for measuring suicidal ideation in Chinese populations.

Suicide is a global public health problem, but very few theories have been developed for its etiology and effective prevention. Presented in this article is a comprehensive and parsimonious theory explaining the socio-psychological mechanism prior to suicidal behavior. Strain, resulting from conflicting and competing pressures in an individual’s life, is hypothesized to precede suicide. The strain theory of suicide (STS) proposes four sources of strain leading to suicide: (1) value strain from differential values; (2) aspiration strain from the discrepancy between aspiration and reality; (3) deprivation strain from the relative deprivation, including poverty; and (4) coping strain from deficient coping skills in the face of a crisis. This new model is built on previous notions of anomie (Durkheim, 1897/1951 ), strain theories of deviance (Merton, 1957 ) and crime (Agnew, 1992 ), although suicide is not a major target for explanation in those theories. Future research with rigorous quantitative data needs to be conducted to further test STS on a more comprehensive level.