Large meta-analysis links TikTok and Instagram Reels to poorer cognitive and mental health
A new systematic review and meta-analysis indicates that engaging with short-form videos on platforms like TikTok, Instagram Reels, and YouTube Shorts is associated with poorer mental health and cognitive functioning. The findings suggest that high levels of engagement with this content are linked to deficits in attention and increased feelings of anxiety, stress, and depression. This comprehensive synthesis of existing literature was published in Psychological Bulletin.
Short-form videos have rapidly become a dominant force in digital media. These clips typically last from a few seconds to a few minutes and are served to users through algorithms designed to maximize engagement.
While originally popularized for entertainment, this format has expanded into education, news, and commerce. Despite their ubiquity, the psychological and neurological effects of consuming this content have been debated. Some earlier investigations suggested negative impacts, while others found no significant harm or even potential benefits.
Lan Nguyen, a researcher at the School of Applied Psychology at Griffith University, led a team to address these inconsistencies. The researchers aimed to consolidate the fragmented evidence base to provide a clearer picture of how these platforms relate to user health.
They sought to determine if the mixed results in previous studies could be explained by different measurement methods or user demographics. By statistically combining data from dozens of studies, the team hoped to identify robust patterns that individual studies might have missed.
The research team conducted a systematic search of major academic databases to identify relevant quantitative studies. They ultimately selected 71 studies for the qualitative review and 70 for the meta-analysis. These studies included a total of 98,299 participants.
The majority of the research was conducted in Asia, with a smaller portion coming from North America and Europe. The sample included both youths and adults, allowing the researchers to see if age played a role in the observed effects.
To assess the impact of the videos, the researchers categorized outcomes into two main domains. The first was cognition, which included measures of attention, memory, executive functioning, and language processing. The second was mental health, which encompassed depression, anxiety, stress, loneliness, sleep quality, body image, and self-esteem. They also looked at how video engagement was measured, distinguishing between simple duration of use, frequency of checking, and scores on addiction scales that measure compulsive behavior.
The analysis revealed a moderate negative association between short-form video engagement and cognitive performance. The data showed that higher levels of use were most consistently linked to poorer attention span and reduced inhibitory control. This means that frequent users tended to display more difficulty focusing on tasks and suppressing impulsive reactions.
The authors utilized a theoretical framework known as the dual theory of habituation and sensitization to explain these cognitive findings. This theory suggests that repeated exposure to fast-paced, highly stimulating content may desensitize users to slower, more effortless tasks.
Activities that require sustained concentration, such as reading or complex problem-solving, may become more difficult as the brain adapts to the rapid-fire rewards of the video feed. Simultaneously, the algorithmic rewards of the platforms may sensitize users to impulsive engagement, reinforcing a cycle of seeking instant gratification.
Regarding mental health, the study found a small but significant negative correlation. Greater engagement with short-form videos was associated with higher levels of anxiety, depression, and stress. The researchers also observed a link between video consumption and sleep disturbances. The fast-paced nature of the content is thought to cause physiological arousal that can delay sleep onset. Additionally, the infinite-scrolling design of these apps can displace time that would otherwise be spent sleeping.
The researchers analyzed whether the type of measurement influenced the strength of these associations. They found that studies using addiction scales reported stronger negative links to health outcomes than studies that simply measured the time spent on the apps. This suggests that the compulsive nature of the usage, rather than the duration alone, is a primary factor in the associated health declines.
The review did not find a significant overall association between short-form video use and body image or self-esteem. The researchers noted that these results were mixed across the individual studies. Some users may experience negative social comparisons, while others might find body-positive communities that bolster their self-perception. This variability suggests that the specific content a user consumes plays a larger role in body image issues than the medium itself.
These findings align with and expand upon recent neuroscientific research into how digital media shapes the brain. For instance, a separate study published in NeuroImage by Yuanyuan Gao and colleagues investigated the neural substrates of short-video addiction.
Their magnetic resonance imaging scans of college students revealed structural changes in the brains of those with high addiction scores. Specifically, they found increased gray matter volume in the orbitofrontal cortex and cerebellum. These regions are heavily involved in reward processing and emotional regulation.
Gao’s team also identified functional differences in brain activity. Users with addiction symptoms showed heightened activity in the dorsolateral prefrontal cortex. This pattern suggests that the brains of addicted users may be working harder to maintain cognitive control or are experiencing alterations in how they process rewards. This neurobiological evidence supports the cognitive deficits identified in Nguyen’s meta-analysis.
Further research has illuminated how specific types of usage affect attention. A study published in Neuropsychologia by Guanghui Zhai and associates distinguished between active users, who like and comment, and passive users who simply watch.
They found that high levels of active engagement were linked to a reduction in the brain’s “alerting” network efficiency. This network is responsible for maintaining a state of readiness to respond to incoming information. Their functional imaging data showed that active use was associated with specific connectivity patterns between the prefrontal cortex and the posterior cingulate cortex, hinting at a trade-off between social interaction and attentional readiness.
The link between addiction symptoms and impulsive decision-making has also been corroborated by behavioral experiments. A study by Chang Liu and colleagues, published in NeuroImage, used a gambling task to measure loss aversion.
They found that individuals with symptoms of short-video addiction were less sensitive to financial losses. This reduced sensitivity was mediated by decreased activity in the precuneus, a brain region involved in self-reflection and evaluating risks. This aligns with Nguyen’s finding that inhibitory control is negatively associated with heavy usage.
While Nguyen’s meta-analysis did not find a global link to body image issues, experimental work suggests that specific content is harmful. A study by Rachel Hogg and Madison Blackburn in PLOS One demonstrated that women exposed to pro-anorexia content on TikTok experienced immediate declines in body satisfaction. Even exposure to neutral content in that experiment led to some negative effects, potentially due to the presence of people in the videos triggering unconscious social comparisons.
The authors of the Psychological Bulletin review acknowledged some limitations to their study. The majority of the studies analyzed were cross-sectional, meaning they captured data at a single point in time. This design prevents researchers from establishing causality. It is possible that individuals with pre-existing anxiety, depression, or attention deficits are more likely to overuse these platforms as a coping mechanism or distraction.
Additionally, the review noted that many studies relied on self-reported measures of video usage, which can be inaccurate. The dominance of English-language studies in the review process may also mean that relevant data from non-English speaking regions was missed. The researchers also pointed out that few studies accounted for general social media use, making it difficult to isolate the specific effects of the short-form video format from broader internet usage.
Future research is needed to track users over long periods to determine if reducing video consumption leads to improvements in health. The researchers emphasize the need for longitudinal designs that can better tease apart cause and effect.
They also suggest that future studies should focus on the specific content users engage with, as this likely moderates the impact on mental health. Understanding the nuances of how different users interact with these algorithms will be essential for developing effective public health guidelines.
The study, “Feeds, Feelings, and Focus: A Systematic Review and Meta-Analysis Examining the Cognitive and Mental Health Correlates of Short-Form Video Use,” was authored by Lan Nguyen, Jared Walters, Siddharth Paul, Shay Monreal Ijurco, Georgia E. Rainey, Nupur Parekh, Gabriel Blair, and Miranda Darrah.

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