Maltese teenagers ranked the second highest out of 44 countries for addiction-like social media use with girls at higher risk than boys, according to a new international study into children’s health.

Results showed that almost one in four Maltese adolescents - aged 11, 13 and 15 - show an addictive-like pattern of social media use with girls more at risk.

In Malta, 28% of 13-year-old girls and 24% of 15-year-old girls showed problematic social media use, compared to 14% and 13% of boys respectively. This dropped to 18% of girls and 11% of boys for 11-year-olds.

The study also showed that Maltese teens ranked the highest, out of 13 countries, for risk of problematic gaming with boys more at risk.

The Health Behaviour in School-aged Children (HBSC) collected data on the health behaviours, health outcomes and the social environments of adolescents aged 11, 13 and 15. Over 280,000 children were surveyed in 2021/2022 across 44 countries and regions in Europe, Central Asia, and Canada.

This large school-based survey is carried out every four years in collaboration with the WHO Regional Office for Europe. Consistent with previous research, the results suggested that girls tend to use social media more often than boys to contact friends and others.

The prevalence of problematic social media use was higher among girls than boys, and the gender difference widened with age. Boys tended to engage in digital gaming more frequently than girls, with girls being more likely to be non-gamers. 

SOCIAL MEDIA USE

The method

Adolescents were asked how often they had online contact through social media with four categories of people: close friends, friends from a larger friend group, friends they had met through the Internet, and other people (such as teachers, siblings, classmates and parents). 

The research also looked at problematic social media use. Adolescents were asked to report about symptoms of problematic (addictive-like) use, using a nine-item measure to which respondents answered with yes or no. Responses were classified across four categories computed by combining the frequency of online contact and problematic use measures. These were:

• Non-active users - having weekly or less frequent online contact with others and non-problematic use.
• Active users - having online contact with others daily but not all the time and non-problematic use.
• Intense users - having online contact with others almost all the time throughout the day and non-problematic use.
• Problematic users - having six or more symptoms of problematic use regardless of the online contact with other.

The results

Data showed that a quarter (26%) of adolescents across all countries reported having continuous online contact with close friends, 12% with friends from a larger friend group, 7% with friends they met online and 16% with people other than friends.

Continuous online contact with close friends increased with age for both genders but remained stable across age groups for the other friendship categories.

In Malta 8% were non-active users, 38% were active users, 36% were intense users and 18% were problematic users. Meanwhile, 46% of 11-year-old girls and 41% of boys reported continuous online contact with friends, which increased to 55% and 44% respectively for 13-year-olds.

Problematic use

Romania had the highest prevalence of problematic use (22%), followed by Malta (18%) and Bulgaria (17%). The lowest prevalence was found in the Netherlands (5%).

Overall, 11% of adolescents reported problematic social media use (SMU) . The prevalence of problematic use showed a slight increase since 2018 (from 7%).

“Although previous studies have found that intense SMU is not necessarily associated with negative mental or physical health outcomes and can even be beneficial, there is a well-established association between problematic SMU and problematic gaming in adolescence, with adverse mental, social and physical health outcomes. The increasing prevalence of problematic SMU and problematic gaming implies that a growing number of adolescents are at risk of experiencing social, school and emotional problems in their daily lives as a result of these phenomena, and policy-makers and practitioners should give careful consideration to the issues this raises,” the report said.

GAMING AND TEENS

The method

Adolescents reported on their frequency of gaming by responding to two questions: how often do you play games?; and, on a day that you play games, about how much time do you spend gaming?

Adolescents also reported on their symptoms of problematic (addictive-like) gaming by answering a dichotomous nine-item scale.  

Three categories of gaming were computed by combining the frequency of gaming and problematic gaming measures:

• Non-gamers (responding that they never or almost never play digital games)
• Non-problematic gamers (having fewer than five symptoms on the scale and not responding that they never or almost never play digital games)
• At risk of problematic gaming (having five or more symptoms on the scale)

The results

Thirteen countries and regions included questions on online gaming in the 2021/2022 HBSC survey. Overall, a third (34%) of adolescents reported playing games every day and a fifth (22%) played for at least four hours on the days they played games.

In Malta 16% were non-gamers, 65% were non-problematic gamers and 19% were at risk of problematic gaming – placing Malta at the top for the problematic gaming category followed by the UK (15%).

While the report highlights the risks, it also underscores the benefits of responsible social media use. Adolescents who are heavy but non-problematic users reported stronger peer support and social connections.

Dr Natasha Azzopardi-Muscat, director for Country Health Policies and Systems at WHO/Europe, added: “This study reveals both the promise and the pitfalls of digital engagement for our young people. It’s crucial that we take steps to protect youth to navigate the digital landscape safely and equip them to make informed choices about their online activities, maximising the benefits while minimising the risks to their mental and social well-being. In short, they should rule social media, and not have social media ruling them.”

ACTION NEEDED

The study findings offer a roadmap for action. Key recommendations for policymakers, educators, and healthcare providers include:

• Invest in a health promoting school environment, in which digital literacy education is embedded
• Enhance mental health services
• Promote open dialogue
• Train educators and healthcare providers 
• Enforce platform accountability

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A parent's nightmare

Controlling the use of social media platforms for children and teenagers is one of the biggest challenges parents face today. Various issues come to play including the lack of knowledge about the constantly evolving platforms, lack of time and awareness and societal pressures.

How do you go about navigating this delicate situation? If you have some insight to share contact claudia.calleja@timesofmalta.com.