Adolescents around the world are part of a distinct generation. They are maturing in a society where social media is not only intensive and widespread but also increasingly incorporated into their everyday lives (Valkenburg & Piotrowski, 2017). The swift uptake of these technologies, particularly among the youth, has sparked concerns among scholars, policymakers, educators and the general public globally about the potential negative effects social media may have on adolescent health and well-being (Valkenburg et al., 2022). These worries are primarily driven by two notable trends: a marked rise in the amount of time teenagers spend online and an increase in symptoms of depression and anxiety among adolescents (Twenge et al., 2022). Simultaneously, substantial evidence indicates that adolescents' experiences with social media engagement, social media risks, and associated health outcomes vary significantly, underscoring the issue of equity in young people's opportunities to safe and secure social media use (Kickbusch et al., 2021).

The evidence on the role of social media in explaining adolescent health has thus far been conflicting. On the one hand, numerous reviews have established a connection between social media use and negative health outcomes among adolescents (Ivie et al., 2020). On the other hand, a recent umbrella review concluded that the association between social media use and adolescent health is 'weak' and 'inconsistent' (Valkenburg et al., 2022). Calls have been made for research to shed light on these conflicting findings, focusing on the mechanisms that could make social media harmful to adolescents' health (Beyens et al., 2020; Twenge et al., 2022; Valkenburg et al., 2022). Encounters with social media threats have been proposed as one such mechanism (Smahel et al., 2020). Social media threats are defined as harmful, provocative or dangerous situations arising from the use of social media (Ognibene et al., 2022) and include, but are not limited to, cyberbullying, sexual harassment, racism, and misinformation (Smahel et al., 2020).

Realizing that the use of social media is a multifaceted and complex phenomenon, one of the limitations of earlier scholarly has been the insufficient attention given to the user's individual characteristics and social contexts (Beyens et al., 2020; Twenge et al., 2022; Valkenburg et al., 2022). This is particularly relevant when considering disparities, vulnerabilities, inequities, and opportunities, such as skills (e.g., emotional intelligence) (Davies et al., 2010) and resources (e.g., social support) (Smahel et al., 2020) for safe and secure social media use.

Therefore, in order to shed light on the conflicting findings of the previous research on adolescent social media use and health, this study investigated the prevalence of the nine social media threats: 1) cyberbullying, 2) sexual harassment, 3) racism, 4) unauthorized distribution of sensitive material, 5) phishing attempts, 6) misinformation, 7) the sale or distribution of drugs, 8) harmful or dangerous social media challenges, 9) content causing appearance pressures and their association with self-rated health, depressive feelings, and anxiety symptoms. Bearing in mind inequities (i.e., social media use differs from adolescent to adolescent) (Beyens et al., 2020), the study also investigated how individual (e.g., gender, age, emotional intelligence) and social factors (e.g., family affluence, family support, friend support) are associated with social media threats. Furthermore, to investigate whether vulnerabilities begets vulnerabilities in the digital world, the associations between adolescent problematic social media use (indicated by addiction-like symptoms such as preoccupation and tolerance) (Boer et al., 2022) and online communication with strangers were considered. Theoretical support was derived from The Differential Susceptibility to Media Effects Model (DSMM) (Valkenburg & Peter, 2013).

Internationally comparative (collected in 51 countries) and nationally representative Health Behaviour in School-aged Children (HBSC) data from Finland encompassed 2288 respondents aged 11, 13, and 15 years (M = 2.13, SD = 0.81). Data was gathered using standardized questionnaires voluntarily completed by adolescents as part of a school-based survey. Data collection adhered to the guidelines set out by the HBSC research protocol and utilized a stratified random cluster sampling methodology. The University of Jyväskylä’s institutional ethics committee granted ethical clearance for the study’s procedures. Measures. (1) Social media threats: Encounters with cyberbullying, sexual harassment, racism, unauthorized distribution of sensitive material, phishing attempts, misinformation, the sale or distribution of drugs, harmful or dangerous social media challenges, and content causing appearance pressures were examined. The response options ranged from 1 (daily) to 5 (never). Response options 2 (more than once a week) and 3 (at least once a week) were combined to represent weekly exposure. 2) Individual factors: Gender (boy, girl) and age (11, 13, 15) were studied by asking respondents to choose the correct alternative. Emotional intelligence was measured using a 10-item Brief Emotional Intelligence Scale (Davies et al., 2010). 3) Social factors: The Family Affluence Scale III (FAS) was used to measure the family’s socioeconomic position (Torsheim et al., 2016). Family and friend support were measured via Zimet et al.’s (1988) Multidimensional Scale of Perceived Social Support. 4) PSMU was measured via nine items of the Social Media Disorder Scale (Boer et al., 2022). 5) Online communication with strangers was assessed using an adapted item from the EU Kids Online Survey (Mascheroni et al., 2014). 6) Health outcomes: Self-rated health (SRH) was measured via a single question on the individual’s evaluation of their health (Kaplan & Camacho, 1983). Depressive feelings and anxiety were measured as part of the HBSC symptoms checklist (Ravens-Sieberer et al., 2008). Multiple imputation was used to deal with the missing data. The associations between individual and social factors, PSMU online communication with strangers and social media threats were examined using fixed effects multinomial logistic regression analyses and reported as odds ratios (ORs). Fixed effects binary logistic regression analyses were conducted to investigate the association between social media threats and health outcomes, adjusted for age, gender and family affluence. The analyses were performed via IBM SPSS Statistics 28.0 (IBM Corp, 2021).

At a daily level, the most prevalent social media threats were misinformation (12.9%) and content causing appearance pressures (9.1%). At a weekly level, misinformation (44.2%) and harmful social media challenges (22.3%). The study found a systematic link between daily and weekly exposure to social media threats and poor self-rated health (Daily OR range 2.02-5.12; Weekly OR range 1.65-3.37), as well as frequent depressive feelings (Daily OR range 3.15-8.89; Weekly OR range 1.86-3.32) and anxiety symptoms (Daily OR range 2.99-6.69; Weekly OR range 2.72-4.94). Furthermore, exposure to any of the nine social media threats, even as infrequently as once a month, heightened the probability of experiencing at least one negative health outcome. Generally, the odds ratios for negative health experiences rose with the frequency of exposure to social media threats. Individual and social factors are differently associated with social media threats. Girls were more likely to report content causing appearance pressures daily, weekly and monthly. In contrast, seven out of the nine threats (e.g., cyberbullying, racism) were more likely reported by boys at a daily level. Adolescents aged 15 were more likely to report social media threats than 11-year-olds. Higher levels of emotional intelligence and family support appeared to protect adolescents from social media threats, for example, daily cyberbullying and sexual harassment. In conclusion, our study highlights the need for education, as well as intervention and health promotion efforts to mitigate adolescent exposure to social media threats and ensuing negative health consequences. Such efforts should consider adolescents in vulnerable situations in order to reduce digital inequity. Our study provides support for the key objectives of the European Strategy for a Better Internet for Kids (Niestadt et al., 2022) and the EU Strategy on the Rights of the Child (European Commission, 2021) to ensure safe and secure social media for adolescents across Europe.

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