Doomscrolling in the Clinic: Why Psychiatry Training Must Teach Problematic Social Media Use

When a Los Angeles jury found Meta and Google liable in March 2026 for harm associated with the addictive design of social media platforms, and for failing to warn users of the associated risks, the verdict did more than make legal history. It signaled that the mental health consequences of compulsive platform use are now being weighed by courts, clinicians, and researchers alike. Against that backdrop, a correspondence published in Academic Psychiatry by Aditya Thakur of Newcastle University School of Medicine and Lindsay P. Bodell of Western University makes a pointed argument: medical education, and psychiatric training in particular, has not kept pace with one of the most pervasive behavioral patterns of modern life. Their case rests on new preliminary data linking problematic social media use to depression, anxiety, and substance-related outcomes in young adults.

The authors begin with a term that most readers will recognize instantly. Doomscrolling describes prolonged, often compulsive scrolling through social media content, a behavior that has become a fixture of daily routine for adolescents and emerging adults. The related clinical concept, problematic social media use, refers to preoccupation with platforms and a compulsion to engage excessively despite negative consequences. A 2022 systematic review and meta-analysis in JMIR Mental Health found that such patterns are increasingly common among adolescents and young adults, and a 2026 scoping review on doomscrolling documented growing evidence of its influence on mental health. What has been missing, the authors contend, is a systematic way for healthcare professionals to recognize and assess these patterns in clinical settings.

Social media use warrants clinical attention precisely because its benefits and harms are reflected in everyday functioning. For many young people, platforms are a primary means of communicating with friends, connecting with communities, and consuming entertainment. Used well, this technology can positively influence mood, eating, sleep, self-esteem, and lifestyle behaviors. Used problematically, however, it may contribute to sleep disruption, compulsive checking, social comparison, exposure to harmful content, and difficulties with mood, anxiety, and academic functioning, particularly in vulnerable individuals. The clinical task, as the authors frame it, is twofold: recognize the harmful impacts of social media use on mental health and quality of life, and leverage the potential positive aspects of use to improve those same outcomes.

To gather evidence for their argument, the team conducted a secondary analysis of a previous study, exploring concurrent associations between problematic social media use and mental health symptoms. Their instrument was a clever adaptation. The CAGE questionnaire, a classic four-item screen for alcohol problems whose letters stand for Cut down, Annoyed, Guilty, and Eye-opener, was originally designed to assess problematic video game use in modified form. Thakur and Bodell modified it again, this time to target social media, and administered the adapted version to a sample of 273 emerging adults with a mean age of 18.30 years, a standard deviation of 1.14, 72.34 percent female participants, and 42.89 percent White participants. Participants screening positive on the modified social media CAGE, defined as two or more affirmative responses, were compared with those screening negative across a battery of validated mental health measures.

The results were statistically robust. Participants screening positive on the modified social media CAGE scored significantly higher on the Patient Health Questionnaire-8, a widely used depression screen, with a mean of 14.21 and standard deviation of 5.48, compared with a mean of 11.70 and standard deviation of 6.01 in the negative group, a difference yielding a Mann-Whitney U statistic of 10,338 and a p value below 0.001. Anxiety followed the same pattern. Generalised Anxiety Disorder-7 scores were higher in the positive group, with a mean of 12.54 and standard deviation of 5.54, versus a mean of 9.95 and standard deviation of 5.98 in the negative group, with U equal to 9,576 and p below 0.001. The positive group also had less favorable substance avoidance scores on the substance use section of the Lifestyle Habits Questionnaire, with a mean of 29.71 and standard deviation of 7.74, compared with a mean of 36.75 and standard deviation of 5.29, with U equal to 19,307 and p below 0.001.

Not every association survived the strictest statistical scrutiny. SCOFF scores, measured with a five-question screening tool for eating disorder risk, were higher in the positive-screen group, but the association did not remain significant after Bonferroni correction for four comparisons, which set the adjusted alpha at 0.0125; the observed p value was 0.025 with U equal to 12,697. Sensitivity analyses using a more stringent cutoff of three or more affirmative CAGE responses yielded the same overall pattern of results as the primary analysis. The authors are careful to note that their findings are cross-sectional, meaning they cannot establish direction of causation. Problematic social media use may worsen mental health symptoms, or distressed individuals may retreat into compulsive scrolling, or both processes may reinforce each other. Even so, the associations suggest that problematic social media use may be linked with clinically relevant mental health symptoms, highlighting the potential need to address it and support those who may benefit from intervention.

The practical proposals in the correspondence are refreshingly concrete. Training support for psychiatrists, pediatricians, family physicians, and other mental health providers in community care settings could improve recognition of problematic social media use. Education leaders and curriculum developers can treat the medical school curriculum, particularly mental health teaching, as a valuable starting point. Didactic teaching could include a section on social media consumption and its potential positive and negative impacts on health, placed alongside existing curricula on behaviors such as substance use, sleep, and psychosocial risk. One simple adaptation would be to add social media use as an item in social history-taking, the routine clinical interview that already asks about diet, exercise, and relationships. At the postgraduate level, psychiatry residents in child psychiatry and addictions rotations could be trained in the assessment and management of problematic social media use, and in how to leverage social media to improve psychological outcomes while minimizing risks of harm. For practicing psychiatrists, addressing concurrent clinical issues alongside identification and treatment would be another focus.

The authors argue that psychiatry as a specialty is particularly well positioned to identify and support individuals with problematic social media use, given its associations with mental health. History-taking is fundamental to the development of clinical skills, and a brief, structured screen could be introduced within psychiatry history-taking education across undergraduate, postgraduate, and continuing professional development contexts. Their preliminary findings suggest that the modified CAGE may represent a promising approach to screening, but the authors are explicit about the limits of the evidence. Further validity testing is needed to establish the reliability, sensitivity, specificity, and acceptability of the tool before supporting wider implementation of social media screening instruments in clinical education and practice. The four-item format has obvious appeal for busy clinics, but a screening question is only as good as the psychometric evidence behind it.

The broader context makes the timing of this argument significant. As concerning patterns of social media use are increasingly recognized by clinicians, researchers, and courts as a source of harm, the authors write, education curricula should evolve with changing social patterns to keep up to date with developing needs. The landmark ruling against Meta and Google, reported in the BMJ, involved harm to a child’s mental health and turned partly on questions of addictive design and failure to warn, issues that intersect directly with the clinical concepts of compulsion and preoccupation that define problematic use. Legal accountability and clinical recognition are converging on the same behavioral territory, yet most medical students still graduate without ever being taught to ask a patient about doomscrolling.

Ultimately, the correspondence is a call to raise awareness among healthcare professionals that problematic social media use may represent a meaningful and modifiable contributor to mental health difficulties. Education across undergraduate, postgraduate, and continuing professional development settings should equip clinicians to recognize problematic patterns of use early, assess their impact on mental health and functioning, and respond appropriately. The study received no specific grant from any funding agency, and all procedures were approved by the university’s Non-Medical Research Ethics Board with informed consent obtained from all participants. The authors report no conflict of interest. Whether the modified CAGE becomes a standard clinical screen or simply a teaching prompt, the underlying message is clear: the question of whether a patient has ever doomscrolled belongs in the psychiatric interview, and the skills to interpret the answer belong in the curriculum.

Subject of Research: Psychiatry and mental health education on problematic social media use

Article Title: “Have You Ever Doomscrolled?”: A Case for Teaching About Social Media Use in Psychiatric Education

Article References: Thakur, A., & Bodell, L. P. (2026). “Have You Ever Doomscrolled?”: A Case for Teaching About Social Media Use in Psychiatric Education. Academic Psychiatry. https://doi.org/10.1007/s40596-026-02457-y

Image Credits: AI Generated

DOI: 10.1007/s40596-026-02457-y

Keywords: doomscrolling, problematic social media use, psychiatric education, CAGE questionnaire, depression screening, anxiety, medical curriculum, adolescent mental health, Ever, Doomscrolled, Case, Teaching