Systematic review (PRISMA/Cochrane) of 42 studies (N = 46,912; mean age 16.8 years) examining the association between short-form video (SFV) platform use — specifically TikTok, Instagram Reels, and YouTube Shorts — and neurocognitive, emotional, and behavioural outcomes in individuals ≤25 years, covering literature from 2015–2025.
Heavy SFV use (typically ≥4 h/day) was consistently linked to: small-to-moderate rises in inattention (β ≈ 0.30) and impulsivity (β ≈ 0.25); moderate drops in working-memory span (β ≈ −0.75) and self-regulation (β ≈ −0.45); moderate increases in anxiety (β ≈ 0.35), depression (β ≈ 0.48), and stress (β ≈ 0.32); and a moderate-to-large surge in addiction symptoms (β ≈ 0.60). Neuroimaging and EEG findings showed grey-matter differences in orbitofrontal cortex/cerebellum and reduced P300 amplitude in heavy users. Protective factors included algorithm literacy, structured digital routines, active parental mediation, regular exercise, and supportive school relationships.
- 88% of studies were cross-sectional and 76% were from China, severely limiting causal inference and international generalisability. - All exposure data were self-reported; no study used objective metrics (e.g., device logs or in-app analytics). - At least 15 different addiction scales were used with no uniform definition of 'excessive' use, complicating cross-study comparisons.
Clinicians should ask about SFV use patterns — especially daily duration and loss-of-control symptoms — as part of routine adolescent mental health and attention assessments. Practical guidance can target algorithm literacy, structured screen routines, and active parental co-viewing while awaiting stronger causal evidence.
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