Abstract

This qualitative systematic review examines the complex connection between social media and that of adolescents and young adults aged 13-24 in United States. Utilizing a comprehensive approach, the assessment is meticulous in examining different opinions about social media's overarching impact.

It illuminates aspects of both positive and negative influence. The fact that numerous sources have been included and an extremely thorough literature search performed across several databases means the review is methodologically robust.

The use of the CASP Quality Assessment Tool gives an extra level of credibility to those studies included.Acknowledging possible confirmation biases and limitations, the findings constitute a critical summary relevant to the research question and objectives. The synthesis focuses on the distinctive qualitative impact of social media on psychological, social and developmental well-being.

The review summarizes with evidence-based suggestions for public health interventions appropriate to this population. Practical proposals for policymakers, educators and care providers It also offers strategies on safe social media use, digital literacy education as well a parental guidance.

Additionally, the review suggests directions for further treatment research: longitudinal studies and investigation of intervention strategies. This research has not only encouraged the development of academia but also led to a more refined understanding about the subject, and its meaning for young people in the information age.

Chapter1

INTRODUCTION

1.1. Background and Rationale

The advent of the digital age has precipitated the exponential growth of social media platforms, embedding them firmly within the fabric of everyday life. These platforms have rapidly transitioned from mere nascent online communities to ubiquitous entities, defining myriad aspects of human interaction, especially amongst the younger populace (Barry et al., 2017).

Today, it is not an exaggeration to assert that for many, particularly the youth, life is almost inconceivable without the shadow of social media looming over it. Whilst the proliferation of social media has undeniably facilitated unparalleled connectivity, fostering global communities and reshaping the very essence of communication, it also brings to the fore a plethora of concerns (Pantic, 2014).

The dual-edged nature of these platforms manifests in the benefits they offer on one hand, and the potential detriments they pose on the other. Benefits such as enhanced communication, instant information access, and global networking sit alongside detriments like misinformation, cyberbullying, and notably, mental health challenges (Coyne et al., 2020).

Adolescents, being in a transformative phase of their lives, are particularly susceptible to the latter, often grappling with issues of self-worth, identity, and societal acceptance, all of which are exacerbated in the high-pressure environment of social media.

The decision to focus on female young adults and adolescents in this systematic review is grounded in the current literature highlighting distinctive patterns of social media interaction and its potential repercussions on this demographic.

Body dissatisfaction is associated with viewing social media with unrealistically perfect images, according to research by Tamplin et al. (2018). They note that this is especially the case for young f women. In this situation, their research shows how social media knowledge can have an impact in lessening the bad effects of seeing such things only for women.

Heffer et al. (2019) looked into how social media use changes over time and connects with depression in people. They found that using more social media did not make someone depressed, but girls who were often depressed did end up spending a lot of their free time on the internet.

Choosing the United States as the main focus for this study was not just a random choice. The country is at the centre of technology changes and uses one of the most popular social media globally (Memon et al., 2018). The U.S., a big part of global technology trends, gives clues that could be useful within our own nation or over the world too.

Concentrating on kids from 13 to 24 years old is very important. This group, often called adolescents and young adults, is really at risk because they're still growing up (O’Reilly et al., 2018).

Going from being a child to an adult is full of bodily, mental and social changes. During this time, people are not only making up who they are but they are also more prone to facing mental health issues (O’Reilly et al., 2018). Their experiences on these websites, because they are still growing up, can affect their mind's health for a long time.

This study focuses on mental health because there is growing worry in the public health field. Recent proof shows a possible link between heavy use of social media and bad effects on mental health (Odgers and Jensen, 2020). Now, teenagers are reporting problems such as feeling sad or worried more often. Decreased happiness in life is also happening to them.

So it is very important to see how social media might be causing these worries and unhappiness for the young ones. Because mental health affects a person's overall wellbeing, school results and future chances in life so much, this study is not just needed right now but also very important (McCrae et al., 2017).

A study by Orben et al. (2022), in Nature Communications, found that how bad social media is for boys and girls changes with age. This means that these changes are affected by hormone or growth shifts happening during puberty, which happen later for boys than girls.

Some individuals may be particularly vulnerable to the impacts of social media throughout adolescence because of factors such as brain development and puberty, which are accompanied by significant cognitive, physiologic, and social changes. 

1.2 Research Question

The main enquiry driving this systematic review seeks to unravel the multifaceted impact of digital platforms on young individuals. Specifically, it poses the question: 
“What are the receptions regarding social media use and its influence the mental health of female adolescents and young adults aged 13-24 in the United States?” 

1.3 Relevance to Public Health

Adolescent mental health is not just a concern for the person or their close friends. It also affects society, money-making and how well families in communities do overall. The strength of adolescent’s minds directly affects how they will grow as grown-ups. So, if people have mental health problems it can be harmful for society. It might make their work worse and they may need more help from medical services which puts pressure on public hospitals (Reid et al., 2016).

It is very important to understand how using social media affects the mental health of young people in today's digital world. As the difference between online and everyday life gets harder to see, it is really important that public health people know how deal with this new world (Riehm et al., 2019).

This knowledge can greatly guide and create public health actions, making sure they are both quick and focused. It can give really useful information to people who make rules. This helps them create strong policies based on facts, which tackle problems from the digital age (Yonker et al., 2015). Education places can put this information into their lessons. This helps young people learn how to use the internet safely.

Knowing how social media and teen mental health connect could lead to big steps for helping young people. Understanding early and strong can stop problems from getting worse before they happen (Stockdale & Coyne, 2020). This not only reduces individual worry but also lessens the bigger effects of mental health issues on society.

So, knowing how it works is worth more than just for one person. It is really important because of public health and makes the big review needed in talk about public health too.

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1.4 Justification for a Systematic Review

The world of research is big, there are many methods made to fit the small details of each type of study. In these, the systermatic review is very important. This is especially true when looking into big and key topics. This method, as its name says, is careful and organized. It makes sure the review process can be repeated easily and covers everything needed (Papaioannou et al., 2016).

The in-depth study process is grounded on strictness. Unlike normal literature reviews that give a general view of a subject, systematic ones need strong rules. This rule sets out clear standards for including or excluding studies so that the review covers all important writing in a detailed way (Thomas et al., 2020). This way makes sure all the information is mixed well and helps repeat the review. This strengthens its trustworthiness.

One of the main advantages of systematic reviews is their ability to reduce biases. Since the rules for picking studies are decided beforehand and easy to understand, chances of choosing just certain kind of studies or accidently having biases are greatly reduced (Chen 2017). This organized method makes sure that the review's decisions are based on a thorough look at all the proof there is, not just part of it. So, the final result is a strong base on which advice based on facts can be made. This makes sure they are important and useful (Munn et al., 2018).

When comparing a systematic review to other kinds of research, it shows more and more benefits. This is especially important for topics like how social media affects the mental health of adolescents. Primary research, which is very important, often dives into the small details of a subject. Since there is already a lot of research done on this topic, it becomes very important to put all these parts together in a clear way. The big study is just right for this aim because it focuses on complete coverage and organized summary (Warburton and Bredin, 2017).

There is also a need for full understanding because the subject is multi-layered and complex. The way social media affects mental health is not the same for everyone. It relies on many different things like what one prefers and how often or in which ways they use it. A systematic review gives a big picture by bringing together different studies (Xiao and Watson, 2019).

The main goal is to take in a lot of information and make it simple, based on facts. These understandings can guide future studies or actions that help create rules. In short, because the subject is very important and there are already many studies on it, a detailed review is not just better but vital (Peters et al., 2015). It promises a serious study of the topic, making sure it is strong and important. This helps to add good knowledge about teen mental health during the time of technology.

1.5 Aim and Objectives of the Research

This study's main goal is to look at how American teen girls and young women (ages 13-24) use social media, as well as its impact on their mental health. This goal is supported by these specific goals:
1.    To comprehensively assess the overarching impact of social media on the mental health of this demographic, shedding light on both positive and negative influences.
2.    To delve deeper and identify specific qualitative effects of social media interactions, engagements, and exposures on their psychological, social and developmental well-being.
3.    To subsequently synthesise the findings and proffer evidence-based recommendations, aiming to inform and guide public health interventions tailored for this cohort.

1.6 Structure of the Systematic Review

The forthcoming systematic review is meticulously structured to offer readers a coherent, comprehensive exploration of the topic at hand. Following this introduction, the review will delve into a detailed literature search strategy. This section will elucidate the databases consulted, the search terms employed, and the criteria set for study inclusion and exclusion, ensuring transparency in the review's foundational stages.

After literature review, the method section will give a strong plan. It shows how they used different ways to study what they found from all these sources together correctly. In the results part, the researcher will talk about how using social media affects girls' and young women's mental health. It will have a brief of what scientists found out in their studies.

The discussion part will look at these outcomes with what is already known, showing important patterns and maybe why they happen. It also points to places needing more study in the future. The ending part of the review will cover main points, how they impact health for everyone and advice on what to do next in research or actions.

Chapter 2 – Literature Review

2.1. Introduction

In recent years, social media has changed the way young people connect and grow. It's become a big part of being an adolescent nowadays. Since social media is everywhere and it affects how teens grow mentally and with others, there is a need for a full study to clear up all the effects these platforms have.

Discussion about studies at this time shows that teen mental health can have good and bad effects. These different social results are seen in how teens feel mentally. It is clear that looking closely at a lot of literature is needed to understand the hidden meanings behind complex relationships.

2.2. Justification of the Topic

Social media's big effect on teenagers’ minds is a tricky thing. There is a need to take all parts into account and find out what the discourse still does not know about it while looking at how each impact works. Singleton et al.'s (2016) study talks about the difficult parts of social media. It shows how there is a strange mix between problems with judgment and connection all together for young users.

At the same time, Abi-Jaoude et al. (2020) point out that there is a link between young people using smartphones and social media more often with feeling unhappy, hurting themselves or thinking about suicide. This risk is much higher in girls. This study shows how bad social media can be for teen feelings about themselves and their friendships. This gets worse because of things like bullying on the internet or normalizing hurting themselves.

The study of the good things that come from using social media by Vaingankar, et al. (2022) is just as important. Their study found good mental health benefits like improved self-worth, better ways of handling tough times and increased happiness can come from joining different activities on social media. These may help global causes or family bonds grow stronger too. The different outcomes show there is a need for a investigation check to understand these mixed findings.

Dodemaide et al. (2021) state that there is not enough information about what it is really like for young people using social media sites, especially how they see the good and bad things from their use of these platforms. These people focus on different ideas, like using some platforms and needing to stay secret. This helps us understand how social media works in the lives of young adults better.

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2.3. Current discourse

2.3.1. Positive Impact of Social Media

Teens' mental health is affected both positively and negatively by social media. In a study by Vaingankar and others (2022), young people in Singapore joined 15 focus group discussions and interviews. They wanted to see how social media could make mental health better.

Three crucial aspects of social media use were found in the study: expressiveness, content, and connection. Good friendships and strong social ties keep your mind healthy. Thinking positive, feeling joyful and growing personally are five key parts of strong mental health. These things help with it.

With social media, making friends and building strong connections is simpler. The people said they use sites to stay in touch with friends and family, make them feel recognized, trusted and linked together. It also assists with emotions by providing a spot for folks to discuss what's on their mind and receive useful guidance from others. It also lets children be kind and helpful to others, which makes friendships stronger (Vaingankar et al., 2022).

The research also showed that social media lets people join groups with matching interests and connect further than their direct friends. Youth might share their own stories there and feel like they belong to a big, worldwide family. This feeling of shared ideas and values encourages people to join worldwide groups or trends. It makes them feel part of a team that sticks together (Vaingankar et al., 2022).

Social media websites are always there, giving chances to share and support each other. This helps in building friendships or connections between people. Adolescents use online platforms to look at themselves and improve their self-awareness and confidence. Looking at older posts can help them feel better about their body and accept yourself more. Getting support from friends on social networks makes them feel good about who they are (Vaingankar et al., 2022).

In a study done by Vaingankar et al. (2022), they learned that people use social media to feel good about themselves. They get information from it that motivates them to work on their hobbies or job goals.

This kind of action makes people more confident and better about themselves, which helps with their mental well-being. Social media is a place where one can unwind and feel happy without fear or blame, which makes it good for getting rid of troubles. Using social media for fun things like funny videos and hobbies helps them handle stress. It helps their mind forget issues and allows them to unwind better.

Vaingankar and team's (2022) study shows positive outcomes from using social media. But Popat and Tarrant (2023 looked at different results by focusing on teens aged 13 to 17 years old only. This study of 24 papers shows how hard it is to understand the link between teens using social media and their mental health or happiness.
Popat and Tarrant (2023) explained how important social media is for showing ourselves, getting likes.

Teens use these sites to express their feelings, get support and feel like they belong. This method could also make them feel better about themselves and their worth. Social media is a spot for talking with others and getting help from friends too. Teenagers can make buddies who might not live near them by chatting with people that like the same stuff or had similar happenings as them. This social media feature can help people dealing with certain health issues or other personal struggles a lot. It helps build support groups and talk spaces (Popat and Tarrant, 2023).

But the study mentions some possible problems too. These include having to fit into ideal body shapes and looks rules, worry about being judged harshly by others, and openness to online bullying from people on the internet. Several things can affect the mental health of teenagers. Social media has good and bad effects. Sometimes it helps us get support from others, but the discourse should also be careful about its negative sides (Popat and Tarrant, 2023).

2.3.2. Negative Impacts of Social Media

Teens face a hard situation, as shown by the study of bad mental feelings linked to social media done by Singleton et al. (2016) and de Felice et al. (2022). Singleton et al. (2016) studied how people their age with mental health problems saw online friendships on social networks. They also looked at the impact it made to overall wellbeing.

A Grounded Theory method was used along with semi-structured interviews to look at information from twelve young people getting mental health care. The research focused on "danger and judgment" aside from "connections and help." This showed a mixed action between the good parts as well as bad aspects of using social media.

Similarly, de Felice et al. (2022) did research on gender differences to learn more about whether or not it's good for teens in social networks. They also looked at the possible dangers too. 296 students from middle and high schools in Italy took part in the study.

They had 24 focus group discussions recorded, which were then studied using a method called grounded theory approach. This study shed light on the two primary risks associated with social networks: the wrong or nasty behavior shown on them and the need to become famous. Feeling safe and hiding behind a made-up person on social media encouraged these actions. This showed how hard it is for teenagers' minds because of online places like Facebook or Twitter.

These studies (de Felice et al., 2022; Singleton et al., 2016) together show that social media can be hard to understand. Young people may be in danger or hear bad words from it, while on the other hand they might go down a wrong path trying to become famous. The results show how important it is to understand these two parts. This will help meet the needs of young people's mental health in today's world where technology rules so much.

2.3.3. Adolescents Perspectives and Experiences

The study by Calancie et al. (2017) aimed to understand how social networking sites like Facebook affect teenagers with anxiety disorders. From studying what people talked about in focus groups, the study focused on finding big causes of stress like needing to be accepted.

Others are being scared someone will judge them and problems with others growing along with issues over keeping things private. Studies have shown that these things increase worry symptoms, showing the special problems teenagers with already existing anxiety issues face when they use social media (Calancie et al., 2017).

A qualitative meta-synthesis of feeling lonely among young people with depression was done by Achterbergh et al. (2020). After looking at fourteen studies, their results found themes like people feeling.separated because of mental health problems, how loneliness can make depression worse in a tricky way and then not telling others about being depressed leading to avoiding social interactions.

The study showed that sadness and loneliness often happen together. It taught how feeling alone because of depression can make a person feel even more lonely, which then makes them very sad.

These studies (Calancie et al., 2017; Achterbergh et al., 2020) show how social media can make problems like anxiety and loneliness worse, especially for teenagers who are not resilient. They stress the importance of thinking about how these sites might harm people's minds, especially those who already have problems with their mental health.

2.3.4. Unexplored Areas

The work of Campos-Castillo et al. (2021) and McLean & Griffiths (2019) shows there's need more research on some groups, like young Latin teens and female gamers. A study by Campos-Castillo et al. (2021) looks at how Latin teenagers react to their friends' posts on social media about mental health problems. This study interviewed 43 young Latin kids aged from 13-17 in Milwaukee, Wisconsin. There were more girls than boys. Most were from Mexico, but others came from different places too.

When a friend talked about mental health problems on social media, this study wanted to see how these young people looked for trustworthy adults. The research found that teenagers picked their moms and dads, also teachers plus other folks they were close with in feelings or body (Campos-Castillo et al., 2021).

There were concerns, though, about how experienced immigrant parents are and the emotional connection of some people. The research showed that young girls should be connected with trustworthy people who can help them, considering the distinct experiences of Latin teens. This is especially important for immigrant families and problems related to school watching over them too much.

McLean and Griffiths' (2019) study looks at what it's like to be a woman playing games on the internet. It especially focuses on bad treatment women get online and how other players help them out in these situations.

The study shows that women who play games face hard times, like worry and sadness due to bad behavior. This makes them need help by hiding their playing or joining then leaving gaming groups often. This research helps understand the different experiences of girl gamers. It also shows that more focused studies are needed in this area.

Samari et al. (2021) and Throuvala et al. (2021) both say that it is important to know more about how social media can affect mental health over a long time, because people aren't aware enough of these problems right now. The study by Samari et al. was carried out in Singapore and employed a qualitative methodology that included 25 semi-structured interviews and 11 focus group discussions with youth between the ages of 15 and 24.

The study investigated teens' negative social media usage experiences and harm mitigation tactics. Prominent adverse consequences encompassed adverse reactions stemming from upward comparisons, getting cruel remarks, encountering contentious issues, and the continuation of unfavourable emotions, activities, and ideas such as self-harm, bad eating habits, and ruminating.

To lessen these impacts, young people used techniques including information filtering, social media breaks, cognitive reframing, and self-affirmation. Although teens face negative consequences from social media, the study noted that they are highly media literate and use ways to lessen these impacts. This study offers recommendations for intervention study paths as well as insights for stakeholders to assist youngsters in navigating the risks associated with social media.

The knowledge of the long-term consequences of social media on mental health becomes more thorough when the findings from Throuvala et al. (2021) are taken into account. This research shows that more and more teenagers are using social media, internet, games too much in a bad way. This affects their feelings or emotions negatively.

It shows the need for studying that gives a full and balanced look from important groups like teachers, parents, and students on possible harmful things teenagers might experience. To really understand the different problems and risks connected to teens using social media, a more detailed way is needed.

When putting together what Samari et al. (2022) found with it, one can see how understanding the small details and opinions of people in this area is very important to make treatments friendly for youngsters and support groups they should get from others.

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2.4. Gaps 

2.4.1. Methodological Considerations

The works by Throuvala et al. (2021) and Hemberg et al. (2021) show that existing research ways do not do well in measuring the impact of using internet or social media on mental health, also highlighting a need for different methods.

Throuvala, et al. (2021) did a study that focused on the problems and bad impacts of using social media for teenagers in their online lives. In the UK, a study that included teachers and parents showed big gaps in what is known about these dangers from three different groups. The study looked at group conversations and one-on-one interviews using thematic analysis.

This helped understand how big the problems are for teenagers that have different levels of badness or severity. The study showed the importance of studying a wide range of possible mental issues and effects tied to drugs, including more than just addiction dangers.

In their research on being lonely for young adults and teenagers, Hemberg et al. (2022) tried to put together all the facts about many things that make someone feel loneliness they didn't want. Their research shows that loneliness is very complicated for this group because it's looked at in a psychological way. The way this study was done and what it studied helps learn more about how different personal things affect the mental health of teens and young adults.

Both studies by Throuvala et al. (2021) and Hemberg et al. (2023) show how important it is to use different ways of studying for fully understanding the complex mental health problems among young people, especially their use of online media like computers and phones.

They say it is very important to use ways of measuring that do not only focus on numbers. They add the thoughts and feelings from all people involved because understanding how social media and internet affects our minds is big deal for them. There is a need to create better treatments and help groups that really work for young people. This can be done using these methods.

Dodemaide et al. (2022) and Abi-Jaoude et al. (2020) studies show that we need to study social media's effects on people over longer times, as change happens often. Abi-Jaoude et al. (2020) studied how smartphone use on social media affects young people's mental health. Their research shows that young people, especially girls, using smartphones and social media more leads to greater stress in the mind.

This also results in harmful behaviors like hurting yourself and thinking about suicides. These finding are based on different types of studies over time with evidence behind them.

The study looked at how social media affects teenagers' views of themselves and their connections with others. It often leads to cyberbullying, where people are mean online, normalizing thoughts about harming oneself or ending your life.

The scientists said that doctors should talk to young people and families so they can reduce these problems. They suggested public education programs and social policy changes to help kids become strong in the digital age.

Dodemaide et al. (2023) looked at how using social media affects the mental health of youngsters in a study that used talking methods. The survey found many opinions about how much young people use social media.

They talked about wanting to stay hidden and judged if using some platforms is good or bad. This study looked at how younger people's life experiences are not valued enough on social media.

It offers information about the good and bad things happening there that we understand better for them. The study's findings show the need to understand better how young people use social media. These findings also add to what we know about helping others and other fields too.

Both studies show that social media's effect on mental health is complex and needs long term study to truly understand its lasting results. Dodemaide et al. (2022) pay more attention to understanding young people's experiences in the digital world.

Abi-Jaoude et al. (2020) think it is important to have a complete plan that mixes education with policy efforts. Together, these results show the need for a smart way of studying. This approach needs to consider how social media changes quickly and affects different groups in society differently.

2.5. Summary

In the end, looking at past research shows a complicated view of how social media can affect young people's mental health. It also highlights that there is a need to use different ways for long term studies on this topic in future. Studies by McLean and Griffiths (2019) and Campos-Castillo et al. (2021) showed the specific problems faced by groups like women who play games, and Latin teenagers. They also show a setting where facing online abuse and being close to trusted grown-ups can greatly affect mental wellness.

Samari et al. (2021) and Throuvala et al. (2021), built on this view to study how social media usually has negative effects in many areas related to our feelings and mental state. They say that to fully understand the different experiences and bad things, we need everyone's involvement.

As per the discussions in Throuvala et al.'s (2021) and Hemberg et al.'s (2023) papers, young people's experiences with social media need new ways to study them because it is not always easy or simple. These studies' quality ways help understand more deeply about how complicated loneliness is and its effects on the feelings inside.

In other words, two studies by Abi-Jaoude and Dodemaide show that understanding social media's impact over time is important. These findings reveal how mental stress might increase because of it along with the need to know what real experiences young adults have in their everyday lives.

Chapter 3 – Methodology

3.1. Introduction

The methods used in systematic reviews is very important for making sure the quality and reliability of research. This systematic review looks at how social media affects the mental health of American teenagers. Qualitative research is different from other kinds of study. So, it needs a detailed and careful way to do the method (Gerring, 2017).

The chosen way carefully collects, checks and combines information from different important studies. This is done to get a full understanding of the subject (Murphy, 2017). In this part, the chapter explains how the method was used for the systematic review. 

The main enquiry driving this systematic review seeks to unravel the multifaceted percpetions regarding impact of digital platforms on young individuals. Specifically, it poses the question: 
“What are the perceptions regarding social media use and its influence the mental health of female adolescents and young adults aged 13-24 in the United States?” 

The primary objective of this study is to analyse how American female teenagers and young adults (13–24 years old) use social media and how it affects their mental well-beng. This aim is underpinned by the following specific objectives:

4.    To comprehensively assess the overarching impact of social media on the mental health of this demographic, shedding light on both positive and negative influences.
5.    To delve deeper and identify specific qualitative effects of social media interactions, engagements, and exposures on their psychological, social and developmental well-being.
6.    To subsequently synthesise the findings and proffer evidence-based recommendations, aiming to inform and guide public health interventions tailored for this cohort.

3.2. Search Strategy

3.2.1. Databases Used

This detailed review picked special databases, which covered a lot of literature on how teen mental health connects to social media. The main source for health research, PubMed, is a helpful tool that gives old and new views on mental well-being. Williamson and Minter (2019) say that PubMed provides complete information about studies in psychiatry and psychology.

PsycINFO is a useful tool focused on behaviour and psychology studies. There is a lot of good quality study about teenagers who use social media and their mental health on PsycINFO (Rogers et al., 2018). Bramer et al. (2018) state that the social sciences are among many fields that used Scopus big library of research papers to help them get information from those studies done by researchers around the world.

This joining of databases lets you add many kinds of qualitative research. This makes the systematic review stronger. By using only free websites, the study process is open to everyone and easy. It follows the rules of sharing knowledge openly.

3.2.2. Search Terms and Keywords

The researcher worked meticulously to look at lots of information about how social media affects American teens' mind health. They put it all together in a detailed systematic review. As per, Bramer et al. (2018) the search method used a mix of words and special tools to narrow down or restrict what came up. In this study, the main words were "mental health," which means psychological well-being. Another term used was "social media" - these are online platforms and ways we talk on apps such as Facebook, Instagram or Snapchat (Ortiz-Ospina and Roser, 2023).

Then there's "adolescents" that refers to young people. To completely talk about these important words, the researcher added related ideas like "teens," "young people," "mental health" and online places. Atkinson and Cipriani (2018) say that Boolean operators were very important in improving the search. The word "AND" joined many ideas, such as "social media and mental health for teens in the United States".

This led to only getting back articles that related to each feature. To connect similar words like "teenagers" or "young people" with others such as “mental health” and “psychological well-being", the word 'OR' was used to make the search go deeper inside each idea. Big search questions were set up using brackets to make better mixes. They put together synonyms and related words (Galvan & Galvan, 2017). "(social media OR digital platforms) AND "(mental health OR psychological well-being)" & "adolescents, teens or youth".

Using a methodical way to pick keywords and use the Boolean logic, the researcher searched databases called PubMed, PsycINFO, and Medline. This gave the systematic review an important set of articles for our review in a simple form.

Table 1: Search Terms and Keywords
(Source: Developed by researcher)

3.2.3. Search Framework

The good detailed study on how social media affects American teens' minds was set up with the SPIDER method. The SPIDER model is different from the usual PICO map because it's better for work with thoughts and feelings. Eriksen and Frandsen (2018) say it means Sample, Important Thing to Look at, Design Process, Judgment Methods and Type of Study.

The 'Sample' part uses American teenagers. This helps us study this group better. The "Phenomenon of Interest" in this study is what the impact of social media on mental health was. Qualitative research was sure to give detailed and wide-ranging understanding because it was included in the 'Design' part.

Measuring mental health findings was handled by 'Evaluation', and picking qualitative studies depended on the type of research. The review used the SPIDER method to look at important literature. It focused on goals that needed quality research and details about the subject matter (Korstjens and Moser, 2017).

Table 2: Search Framework: SPIDER
(Source: Developed by researcher)

3.3. Inclusion and Exclusion Criteria

Table 3: Inclusion and Exclusion Criteria
(Source: Developed by researcher)

For this systematic, it is important to discuss clearly about how things will be checked. The researcher wanted to learn about opinions on how social media impacts the mental health of teens. So, the methodology only used qualitative studies in the study process. Qualitative study is important to understand what teenagers are feeling because it gives deep information about their lives (Hennink et al., 2020). This way matches the goal of looking into complex actions and feelings, which often is not properly shown by numerical data.

The researcher decided to only use titles in English for practical reasons. Concentrating on easy-to-get and clear literature for the study group helps them do their assessment. Even though this limitation makes the topic smaller, it doesn't reduce how much they need to think and understand correctly that qualitative research needs.

To keep up with social media and mental health that are changing all the time, a big period of 2013 to 2023 is picked. The way teens act and their mental health have been greatly affected by the fast growth of digital tech and social media during this time (Hausmann et al., 2017).

To get a better idea about what American teens think of using social media and its effects on their mental health, it is important to focus only on people in the U.S., considering cultural factors plus others from society and money matters (Twenge et al., 2019).

The United States is unique because it has many big social media companies and leads the world in innovation. This makes America a special place to study these dynamics (Kreski et al., 2021). This type of study may concentrate on certain cultural and social aspects that might not be important in other situations.

Using databases that are open to the public makes sure reviews use sources everyone can see. This increases how much other people can repeat research and it becomes clearer, says Bramer et al. (2018).

Also, famous databases like PubMed, PsycINFO and Medline help to collect all the related papers. This includes many different studies that could be missed if the researcher does not use them (Williamson and Minter; Rogers et al., 2018; Bramer et al., 2018). These rules help to finish the main goal of a careful look. This is to give full view on how social media affects American teens' mental health.

3.4. Quality Assessment

3.4.1. Quality Assessment Tool

The tool that helps with the CASP checklist is important for helping reviewers to do a systematic review of qualitative research. This includes studies about how social media can affect the mental health of American teenagers.

This solid tool is meant to check if the study's results are true (part A) and how they can be used in real life situations (part C). The first two questions on the list that they check, if answered yes, mean it is time to look more into the rest of them (Critical Appraisal Skills Programme - 2018).

The questions on the CASP checklist make sure people really think about what a study is trying to do. They want to look at whether it is correct for this kind of research and if the method worked well enough in reaching its goals. The list advises for a fair place and simple description of the gathering ways. It also makes check the search strategy to see if it matches our research goals and measures how carefully data was gathered (Critical Appraisal Skills Programme, 2018).

The study looks at any potential bias in the researcher-participant relationship. Also, ethical issues like getting permission and keeping things secret are very important too. The process of analyzing information is checked carefully. The results must be clearly stated, related to the goals in research and looked at closely for their truth value before adding them to what people know (Critical Appraisal Skills Programme 2018).

Long et al. (2020) say that the CASP checklist is the best way to make sure qualitative research in real life meets high standards and can be used effectively. It gives us information about the way and results of a study.

This helps to see studies like those on how social media affects young people in more detail. The checking process makes sure that the studies being looked at are not only done right, but also very important for understanding how social media affects feelings in young people (Williams et al., 2020).

Using the CASP checklist helps keep qualitative research honest. It also makes sure that results are true and can be trusted. This is important because the online world changes quickly, it affects how young people think about their mind health.

3.4.2. Application of the Tool

The systematic review examines how social media affected the mental health of teenagers in US. The program called Critical Appraisal Skills (CASP) was used to check the papers in reviewing. A full review was needed to ensure the results of the check were true and real.

Williams and team (2022) said that every chosen article was carefully looked at using rules made by CASP to be the best with it. The researcher first checked what goals the study was trying to reach, making sure it was simple and easy to understand. (Buccheri & Sharif 2017)

After that, the researcher looked at how each study collected their samples and data. This involved the way people were chosen, along with techniques used to gather details about their study type. This includes checking if the design properly tackled the research subject and making sure that picking people was fair and thorough (Majid and Vanstone, 2018).

The researcher also looked at the methods used for gathering data and how well they got correct, useful information. The study's second part focused on the ways data from research was examined. Looking at the papers, the researcher checked that they covered everything important and they could rely on their results. The person doing the research will make sure that every study followed good ethical rules for how to do right-minded work (Williams et al., 2020). The last step in the process was judging how important the research is, as said in these sentences. 

3.5. Data Extraction and Analysis

3.5.1. Data Extraction Table 

In the study review, getting information was very important in looking at how social media affects American teen's mind health. Pollock and Berge (2018) say this method was made to get all the right information from a chosen qualitative study. A table to get data was helpful in getting the details (Kim et al., 2017).

Study Characteristics:

This part had the main details from each study. They included who wrote them, what year they came out and where it happened - noting if only in America was studied specifically. Another thing to note was the kind of publication it came from (like a journal article or conference paper) and where you found it (PubMed, PsycINFO, Google Scholar etc.).

Research Aims and Objectives:

This group talked about the big goals and plans of each research project. It also gave details on what parts of teen social media use and mental well-being were being studied in these projects.

Methodology:

The method section explains how the study was set up, including use of interviews and focus groups. It also gives reasons for why those choices were made using things such as content analysis. This helped the researcher to understand how each study looked at studying the problem.

Participant Details:

Everyone's information, like how old they are and where they come from, was written down. This was important to understand the connection and importance of the results.

Key Findings:

Each study's main results and presented the most important findings about how social media affects girl teenagers' minds.

3.6. Summary

The researcher designed a careful way to review how social media affects American teenagers' mental health. This systematic review is done in the best possible manner and covers everything fully. The process began with a careful search that looked at different sites about social science and mental health, like PubMed, PsycINFO or Medline.

To make a big but focused set of literature and articles review, this method was used with more specific search words or keywords. The review used tools like SPIDER to organize its search and make sure that important qualitative studies were included. To include the newest and important research, special rules were set about what was included or not.

They focused on quality studies from 2013 to 2023. The review was very focused on being strong in its methodology. It showed this more by using CASP to check the quality of qualitative studies done. The results of how well each study was checked were given in a part at the end using this method. Once the data was carefully taken out, a table with important study parts, results and topics was made.

This let us do a full investigation and made sure we did not miss any important facts. Because the method was planned and set up very carefully, which was vital to get insights from lots of studies. Understanding how using social media affects young Americans' mental health has made great progress. 

Chapter 4: Results

4.1. Introduction

This chapter provides a detailed qualitative systematic review summary. The review examines the complex relationship between adolescents in the United States and social media use and mental health. In today's adolescent environment, social media is pervasive and may have negative effects on young minds. This chapter examines how adolescents' daily use of social media affects their mental health.

This evaluation uses qualitative analysis. It carefully collects and analyses data from many studies to understand this complex dynamic. The study methodology provides detailed and nuanced information on how social media affects adolescents' mental health. A rigorous methodology ensures the accuracy and reliability of this research, which benefits adolescent well-being stakeholders.

4.2. Results of Search Strategy and Study Selection

Here is a detailed description of the search strategy and research selection process. The discussion  will start with the PRISMA flow diagram. This search strategy was carefully designed to incorporate a wide range of studies with a focus on the effects of social media on the psychological health of adolescents in the United States.




First, Scopus, PubMed, and PsychINFO were searched. The databases were chosen for their extensive psychological literature coverage, ensuring a wide range of relevant research on the subject. Scopus contributed 263, PubMed 264, and PsychINFO 262, resulting in 789 search results.

Duplicate entry removal was crucial to the systematic review. The overlap of the databases allowed the extensive process of finding and eliminating duplicates, resulting in 349. After meticulous elimination, 440 unique records met screening criteria.

The process carefully followed the screening criteria. To ensure all research was relevant and met review objectives, this was done. Each of the 428 duplicate-free records was screened. The process first examined the papers' titles and abstracts to assess their quality, relevance to the problem, methodology, and audience.

420 of the screened records were unsuitable. These studies were excluded because they were unrelated to the research topic, lacked a sufficient design, or targeted a different population or location.

Next, the remaining 20 full-text publications were thoroughly assessed for eligibility. The qualitative nature of the research, its relevance to the study subject, and the unique setting of the United States were all taken into account throughout this procedure, which included a thorough evaluation against inclusion and exclusion criteria.

13 articles were rejected because 6 were not qualitative, 4 were not relevant to the research topic, and 2 were outside the intended geographical scope and 1 did not involve adolescents.

7 studies comprised the qualitative synthesis. A thorough and systematic search for papers that were highly relevant to the study issue and met high scientific rigour led to this final selection.

The PRISMA flow diagram is crucial to this chapter because it shows the meticulous process. It clearly describes the steps used to select studies for evaluation, starting with database search results. Any high-quality systematic review must be able to reproduce the results, and this graphic helps explain methodological rigour.

The researcher searched and selected studies using the highest methodological precision and completeness. This methodical selection of 7 studies lays the groundwork for future research into the complex relationship between social media and adolescents' mental health in the United States.

4.3. Results of Study Characteristics

The qualitative systematic review examines the characteristics of the research that qualified it for inclusion. The data extraction table lists these traits. This review evaluates each study's unique contribution to the overarching theme of how social media affects adolescents in the United States. Liang et al.'s 2023 study, uses a qualitative interview method. It uses a sample of 39 of adolescents aged 13 to 17 from all over the United States.

This study determined the experiences regarding how social media affects emotions and belonging during pandemic school closures. It highlights the growing reliance on social media to maintain connections and the wide range of emotional responses to social media engagement. Biernesser et al. (2020) examined Pittsburgh parents of depressed adolescents, mostly white and female, in a 2020 JMIR Paediatrics and Parenting study.

The qualitative study methodology illuminates parents' and children's perspectives on social media use and COVID-19 behaviour monitoring. This illuminates parental monitoring issues and how they affect parent-child relationships.

Escobar-Viera and colleagues conducted an online qualitative survey of LGBTQ adolescents aged 14 to 19 who live in rural areas of the United States for the 2022 project, which was published in Frontiers in Digital Health.

This study is unique because it examines people's opinions and experiences with social media and technology-based therapy to reduce social isolation. Success requires strong LGBTQ presence and relationships on social media. The 2022 International Journal of Environmental Research and Public Health study by de Felice and colleagues used a qualitative approach and included 13–18-year-old Italian adolescents.

The 296-person sample size and focus on how adolescents use social media, its risks, and gender disparities make it significant. This study illuminates gender differences in social network use and associated risks, advancing our understanding of online violence, self-image, and identity crises.

Each study adds a critical piece to the puzzle of understanding the complex relationship between social media use and adolescents' mental health with its own unique objective, methodology, and major theme. These interconnected elements must be distilled and shown to fully understand the issue.
 

4.4. Results of Study Quality Assessment

All selected studies were systematically reviewed using CASP Quality Assessment Tool provided in Appendix A. All studies used data collection methods tailored to the investigation to ensure thorough and relevant data. Such articles include Radovic et al. (2017) and Biernesser et al. (2021). Contact between researchers and study participants is crucial to qualitative research.

The ethical research that protected participants' rights and welfare showed that they understood this link. Liang et al. (2023) used precise data analysis and rational interpretation. Each study's findings were clear, helping the review understand how social media affects adolescents' mental health. The studies also showed how important the study was and how it affected theory and practice in this area.

This is significant given Escobar-Viera et al. (2022), which detailed rural LGBTQ youth experiences. The CASP quality review found that all selected research used rigorous methods. This makes this systematic review's findings more trustworthy and reliable.

Due to the breadth of this quality assessment, this review's conclusions will only be based on reliable qualitative research. This solid foundation may help better understand how social media affects the mental health of adolescents in the United States.  

However, there were a number of research papers, that had been limited with respect to the parameter of value of research. Namely, these were Biernesser et al. (2020), Escobar-Viera et al. (2022), and Biernesser et al. (2021). These can potentially impact the quality and reliability of the results obtained for the study.

4.5. Results of Synthesis

The systematic review synthesis followed a thorough thematic analysis. This method yields a thematic tree map, which depicts the major themes and subjects in the study. The following tree map shows the correlation between the different topics and ways in which social media can influence teenage mental health. 
 
In a nutshell, this is the beginning of an extended topic, “Mental Health and Social Media Use” where the relationship between adolescents’ mentally and social media use are examined. This theme is supported by Liang et al. (2023), considering adolescents’ “Varied Emotional Responses” to social media.

Based on the goal of the study the participants may feel energetic and sociable or nervous and tense. In particular, Biernesser et al. (2020) and Escobar-Viera et al. (2022) have also emphasized about the “Positive Use for Entertainment/Connection” component.

On the other hand, de Felice et al. (2022), as well as Laestadius (2021), point out the “Negative Aspects” of social media. This includes cyberbullying and self-comparison. As for the second major point in the presentation, “Role of Trusted adults and Monitoring,” its importance becomes more intense with each step taken.

The themes of ‘Help-seeking from Trusted Adults’, and ‘challenges in parental monitoring’, both backed by the research Biernesser et al. (2020) and Biernesser et al. (2021), have highlighted some important issues about using social media by both adolescence According to the theme of “Automated Alerts Perceptions”, Radovic, et al., 2017, teens find it hard to assess their reactions towards social media monitoring systems.

Third theme “influence of social and cultural factors” explains how the social and cultural contexts influence the use of social media among adolescents (Escobar-Viera et al., 2022; de Felice et al., 2022). Cultural background, social identity, and mental health on social media: these studies suggest that marriage is a very complex relationship. This theme involves gender inequality in social media use, lesbian, gay, bisexual, transgender, and queer youth, and latinx adolescents. Escobar-Viera et al. (2022), as well as Biernesser et al. (2021), defined this theme.

Some of these sub themes include “Automated Monitoring Acceptability,” “Attitudes towards interventions to reduce isolation,” and “Use of social media for positive representation.” This section includes four subthemes, each of which addresses various technological solution strengths and limitations. This approach combines a thematic tree map and synthesis to achieve an objective review of the selected artworks.

Through multiple studies, they illustrate the effect that social media has on the psyche of teens. Synthesizing a study’s data and situating it within a bigger research framework helps each study to have a greater impact. These results help light up this dynamic and complicated field.

4.6. Thematic Analysis

4.6.1. Mental Health and Social Media Use

This thematic analysis uses articles researched by Liang et al., (2023), on association between social media usage and psycho-emotional wellness of teenagers. The study by Liang et al. (2023) revealed heightened emotional engagement among adolescents during pandemic close-downs from schools. This situation meant so much for adolescences through the use of social media because this was the only way they could express their emotions.

Biernesser, et al., (2020) stated that one of the most discussed subject was titled “Positive Use for Entertainment/Connection”. The positive side of Social Media. Teenage social lives are marked by varied forms of expression that include an invaluable sense of belonging, actualization of potentials, and fulfillment. Positive engagement was beneficial to LGBTQ youths and participants in online communities recently reported by Escobar-Viera et al. (2021). This use shows that adolescents can express themselves through social media.

Cyberbullying is a “negative aspect” as well as making unfair comparisons with other people’s lives. The paper by De Felice and others (2022) investigates how use of social media could affect adolescents’ self-esteem. Such as social media platform where a person can be victim of cyberbullying or engaging in unhealthy comparison with other people photos.

According to Laestadius et al. (2021), posts by adolescents on self-harms and automated warning posts were investigated. This is an undesirable trait that is buttressed by scientific evidence. Instead, these findings suggest a more sophisticated approach of recognizing the risks that social media can pose to adolescents’ mental wellbeing.

This theme studies the interrelation between adolescent mental wellbeing and social media utilization. Notwithstanding this reality, it is necessary to recognize that these digital platforms can have both positive and negative effects in the mind of a child, whose emotions vary from one point to another.

Thus, these observations are significant for future studies and relevant actions concerning such an important topic, following previous works by Liang et al. (2023) and Biernesser, et al. (2021).
Indeed, these results exemplify how complex is the impact of social networking platforms upon teenage emotional well-being.

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4.6.2. Role of Trusted Adults and Monitoring

Through thematic analysis, the current theme of “Role of Trusted Adults and Monitoring” examine how adolescent’s social media usage is connected to adult surveillance, accessing websites and seeking help. This paper investigates the complex relationships among technologies, adult control, and trust in teenagers’ virtual worlds based on the work of Biernesser et al. (2020), Biernesser et al. (2021) and Laestadius et al. (2021). 

With respect to the theme, “Help-Seeking from Trusted Adults,” Biernesser et al. (2020) focused on adult presence in the world of social media, Internet, and mobile phone technology among today’s youth. The findings in the study show that adolescents turn to their trusted adults when they encounter troubling social media content or even events.

These people take on a role of a teacher for the children in both practical and emotional aspects regarding internet usage. It is suggested that this study should encourage close bonds to emerge among adults and adolescents such as teachers, parent and caregivers.

The theme “Challenges in Parental Monitoring” is founded on the work of Biernesser et al. (2021). As the authors observe, there should, be a balance between teens’ internet security and their privacy.

The study posits that parent’s should be aware of themselves, and find how they can observe their children and adolescents without controlling them. Such findings recommend innovative data-informed and team-based parental monitoring. Collaboration amongst all parties should be carried out with constant communication.

Laestadius et al. (2021) study was utilized as a foundation for the “Automated Alerts Perceptions” theme, which moves ahead with regard to the technological element involved in supervision of adults’ social media accounts.

Researchers investigate how adolescents read into rise in social media self-injury notices. It is not possible to compare all teens. There are some that encounter higher levels of anxiety compared to others. These results can help set up the base for other studies on the role of adult’s control over teens’ access to cyber environment with regard to their physical and mental health.

4.6.3. Influence of Social and Cultural Factors

According to the Thematic Analysis – Main Theme: Sexual Orientation, Gender, Ethnicity and Adolescent’s Experience in Social Media, Escobar-Viera et al. (2022), de Felice et al. (2022) and Laestadius (2021) studied how these factors influence the lives. These studies show that cultural and social identities affect social media use.
Male and female adolescents use social media differently, according to de Felice et al. (2022). These differences were documented in "Gender Differences" in social media use.

Their study found that girls and boys use social media differently, affecting their self-image and online violence exposure. This study emphasises gender-sensitive methods to fully understand social media's impact on adolescents' mental health. This study emphasises gender-sensitive techniques because society's gender norms and expectations are pervasive in digital contexts.

The study found that LGBTQ adolescents, especially rural ones, use social media as a refuge and a battleground. Escobar-Viera et al. (2022) use "Challenges for LGBTQ Youth" to discuss this. These networks give young users a sense of belonging, but they also risk marginalisation and harassment. This contrast makes it crucial to create online communities where LGBTQ youth can be themselves without harassment, bullying, or physical violence.

The cultural issues surrounding social media are put into context by Laestadius et al.'s (2021) "Experiences of Latinx Adolescents" theme. The study found that Latinx adolescents saw social media through the lens of their immigrant and cultural identities. As a result, comprehension suffers, particularly when delicate subjects like self-harm are brought up. The importance of cultural origins in the treatment of adolescents with mental illness was highlighted in this study. These strategies should be informed by the concerns of adolescents regarding social media.

Cultural and social factors have a significant impact on the social media use of adolescents, according to Escobar-Viera, de Felice, and Laestadius (2021). These implications include gender discrimination, civil rights for gay people, and multi-culturalism, which must be understood within this context. In digital era, there are various subgroups of adolescents who have their own problems, which help to create individual therapies and the special protection net works for each subgroup. The theme “Influence of Social and Cultural Factors” illustrates the effects of adolescent identity on social media use.

The exploration of the works of Escobar-Viera et al., (2021), de Felice et al. (2022) and Laestadius et al. (2021) offer a comprehensive exposition of this sophisticated interplay for the first time The said comments highlight the need for a diversity of opinions in social media and mental health interventions. Irrespective of gender, sexuality, or culture, all teenagers have to interact with receptive and comfortable online settings.

4.6.4. Technology-Based Interventions and Support

The thematic analysis of “technology-based intervention and support’ seeks to assess how technology could improve adolescent mental health based on the works of Escobar-Viera et al. (2022), Biernesser et al. (2021) and Radovic et al. (2017). The analysis will look at how peoples think about technological invasions, a good image of technologies through social networks, and advantages and disadvantages of automatic supervising.

Escobar-Viera et al. (2022) state that "Attitudes Towards Interventions" may lead to technologically-based therapies that enhance mental health and decrease isolation. If LGBTQ youth in rural regions have problems accessing mental health services, this project will look at how they can utilise social media to connect with others who understand. It is clear from the research that different subgroups of adolescents require individualised technological treatments. Importantly, these solutions must be made accessible while also respecting different cultures.

Technology has an impact on adolescents, according to Biernesser et al. (2021) with respect to the theme of "Use of Social Media for Positive Representation." Their research implies that social media platforms facilitate communication and group formation. These platforms help youth connect, share, and get support. The beneficial use of technology in mental health raises awareness by showing how it helps adolescents develop resilience, self-esteem, and belonging.

Radovic et al. (2017) study emphasizes with respect to the theme of "Automated Monitoring Acceptability" and social media stalking challenges. During their study, adolescents had mixed feelings about automated alerts for risky behaviours like self-harm. Even though some adolescents benefit from these alerts, others worry about privacy invasion and false alarms.

These findings demonstrate that adolescents' privacy and need for help require an all-encompassing automated monitoring framework.
Biernesser et al. (2021) and Escobar-Viera et al. (2022) noted that technology empowers people, but Radovic et al. (2017) noted the difficulties of creating effective and ethical technological therapies. Even though technology may improve adolescents' mental health, the study shows that young users' needs and perspectives must be considered.

Technology affects adolescents' mental health in complex ways, according to thematic analysis of "Technology-Based Interventions and Support". The perspectives offered by Escobar-Viera et al. (2022), Biernesser et al. (2021), and Radovic et al. (2017) have been combined to paint a more complex picture of how technology can help adolescents. This understanding may reveal issues and obstacles. This knowledge is essential for developing and implementing technology-based therapies that prioritise digital-native adolescents' rights and experiences. 

Chapter 5 - Discussion

5.1. Introduction

This systematic review examines in detail the complex effects of social media on young people's mental health. Setting out on the detailed search, it attempts to define this complex connection between teen well-being and digital socializing. The study pivots around several cardinal themes, notably: the bifurcated nature of social media as connectivity channel and mental stress source; adult mentorship in online use and its importance, yet influence on children's character building.

The power behind all these is human relations with their barbs of conflict hungry for attention; now technology infused into interventions leave room to question how much they aid healing. These themes together offer an integrated understanding, which is important for stakeholders in adolescent mental health.

5.2. Critical Appraisal of Included Studies

5.2.1. Methodological Rigour

The methodological approaches employed in these studies come together to form a mix of strengths and weaknesses that reflects the dynamic nature of qualitative research on adolescent mental health and social media. Although each study differs in method, collectively they contribute to the depth of the understanding gathered in this systematic review.

Thus, Liang et al. (2023) used the semi-structured interview--the bread and butter of qualitative research --which is flexible in nature and allows for in-depth line of questioning. Following this method allowed for more subtle readings of adolescents 'emotional reactions to social media, especially during the school shutdown. Yet the sample's diversity, while undeniably good news, cannot be said to fully reflect America 's teeming adolescent population. The generalisability of findings remains uncertain.

Biernesser et al. (2020) and their subsequent study in 2021 apply methodological rigor through dyadic analysis and thematic exploration. These methods allowed us to have a holistic grasp of the relationship between adolescents and their parents over social media use. Still, the heavy emphasis on a White and female population in Pittsburgh may not reflect all aspects of adolescents from various ethnic-racial and socioeconomic backgrounds--thus limiting what can be gleaned from this study.

This study, by Escobar-Viera et al. (2022), stands out for its examination of LGBTQ youth in rural areas as a gap not previously addressed within literature. This also showed for the first time that online qualitative survey methods can be used to target a difficult-to-reach demographic. Modern digital research is thus as much about methodology, after all. But the attainment of these deep and interpersonal conversions might be more difficult than face to-face interviews could have accomplished.

Focus groups are an effective way to gather the widest range of perspectives, even on sensitive topics such as body image and norms for social media. A group using this approach was employed by Burnette et al (2017). But this approach could well have had something to do with individual answers, depending on group psychology and resulting in conformity or suppression of differing views.

Both Laestadius et al. (2021) and Radovic et al. (2017) used semi-structured interviews, increasing the degree of detail in their understanding of youths 'attitudes. Laestadius et al.’s (2021) study, which was enriched by the community context taken into account in its methodological consideration (community organization recruitment), is excellent for this point.

5.2.2. Relevance and Representation

The value of the studies assessed here is also very much in line with the broad question that lies behind this review, exploring how precisely social media affects adolescent mental health at any given time. Every study brings its own unique perspective to this multi-faceted inquiry, increasing our knowledge of the topic as a whole. Responding directly to the crux of their review question, Liang et al. (2021) examine how social media use affects a range of adolescents in terms of emotion. Their time frame focuses on the period of pandemics, a particularly active one for social media since schools were closed. As such their findings have special relevance to current debate about digital wellbeing.

Biernesser et al. (2020) and their 2021 study further enrich the discourse by factoring in youth's parents which is critical to understanding the larger social system that affects teenagers 'social media usage. This dyadic approach provides valuable insights into family dynamics, a neglected but important aspect in studies of adolescent mental health.

Omitted from many studies, the group of LGBTQ youths living in more remote settings was highlighted by Escobar-Viera et al. (2022), which means a growing literature is finally turning its attention to this part of the population. Their findings provide a more comprehensive picture of the social media experiences of adolescents.

It is a very narrowly defined population: adolescent girls from a private school setting, as Burnette et al. (2017) note. Their ideas are very much in tune with debates about social media and weight, but the homogeneity of their sample restricts our ability to generalize from these results.

Laestadius et al. (2021). the authors is noted for its focus on Latinx adolescents, a group generally underrepresented in mental health research. Their study not only lends a cultural perspective to the review, it also suggests that we must approach understanding and dealing with mental health problems in culturally sensitive ways. This contribution by Radovic et al. (2017) provides an important viewpoint, focusing on adolescents diagnosed with depression; the review is thus spiced up with a little from the lives of those who already have mental health problems.

With regard to representation, although efforts have been made to take in all kinds of people there are also certain shortcomings. For example, some studies include mostly White populations. There is definitely a need in future research for more openness and inclusiveness. Furthermore, the different cultural and social backgrounds of participants in each study are important considerations when interpreting these findings. Recognizing these limitations, future research will have to go even farther afield in order properly to answer the question of whether this review is an evaluation.

5.3. Discussion of Main Findings

5.3.1. Mental Health and Social Media Use

It is a complicated and multifaceted problem. The results of Liang et al. (2023), Biernesser et al. (2020; 2021), Escobar-Viera et al. (2022). Burnette et al. (2017), Laestadius et al. (2021) and Radovic et al. (2017) can be regarded as a thorough framework in terms of insight provided.
This seems to be borne out by the surviving literature.

For example, works such as those of Barry et al. (2017), Schønning et al. (2020), Coyne et al. (2023), Boer et al. (2021), Lee et al. (2022); Petropoulos Petalas  et al. (2021); and Rutter et al. (2021). For instance, Barry et al. (2017), and Coyne et al. (2023) share theme of the other two studies studies (Liang et al., 2023; Escobar-Viera et al., 2022): social media can be a sword with two edges--it is both connective and supportive but also makes one feel lonelier and more anxious.

A Broader context is provided by Schønning et al. (2020) and Boer et al. (2021). This concurs with Biernesser et al. (2020, 2021), who stress the differentiated effects of social media which are mediated by family dynamic and parental surveillance.
The gender-specific nature of social media usage suggested by Coyne et al. (2023) is reflected in the studies done by Burnette et al. (2017) and Radovic et al. (2017).

Taken together, these studies suggest that gender identity is an important factor in how social media use influences mental health. This influence will have to be corrected by gender sensitivity.

Frequency and correlation with mental health problems: Lee et al. (2021), Petropoulos Petalas et al. (2021). Taken together, these studies give a good indication of the scale of social media use and they indicate that quantity as well as quality are important factors here (Laestadius et al., 2021). 

In addition, Rutter et al. (2021) clarify the mediating interrelationship between social media and physical activity in mental health symptoms. These factors add another level to the debate. It implies that individual lifestyle choices exert a significant mediating effect on the influence of social media upon this group's health.

In sum, these studies together with other literature give various impressions about the effect of social media on young people's mental health. These findings indicate that although social media can serve as a conducive environment for getting help and bringing people together, under certain situations it will function not only to cause problems but even exacerbate them.

This interplay of the individual, family and society further complicates this relationship. There is no doubt that to understand the mental health impact of children using social media we need a holistic approach.

5.3.2. Role of Trusted Adults and Monitoring

As the discussion of digital well-being has entered its own climate, trusted adultsCentered around parents and guardians have become an important element. There are many studies which echo this perspective. Such works as a whole reflect the complexity and significance of adult participation in adolescent online life.

As Hill et al. note (2016), it is recognized that media have both possibilities for benefits and risks in use. This points out the inconsistencies in modern times, emphasizing that parents struggle to monitor what their children watch. As with Kreski et al. (2021) and Cataldo et al, I would also suggest the development of a family “Media Use Plan.” These studies taken together stress indispensability of parental guidance in mediating the good and bad sides of social media.

For instance, Kreski et al.'s (2021) study on the relationship between social media use and depressive symptoms among children and adolescents shows that not all forms of networks are bad for health. It also means that parents' monitoring of and guidance for their children vary with the mental health profile associated with each adolescent, as Biernesser et al. (2020b) reported from a survey they did among parents on how much social media use was appropriate by their kids.

Cataldo et al.’s (2021) review, which focuses on the psychiatric problems that arise from excessive use of social media broadens this discussion still further. Thus situated, a trusted adult plays less the role of monitor than that of an understanding and speaking to adolescents 'psychological and developmental needs.

Meltzer et al. (2018) review the diverse social and economic roles played by trusted adults in young people's lives. According to their research, the effect of these older adults appears not limited simply to oversight, also including emotional encouragement and support. From this more expansive perspective, then we are able to understand the many roles played by trust adults in influencing social media.

Bekalu et al. (2019) do this research, and say that while ordinary use of social media are associated with good health outcomes, it's the emotional attachments to them which tend to be bound up in negative ones. This distinction highlights that trusted adults are part of their role in helping young people get emotionally involved with social media.

Stawarz et al. (2019) note that the technologies kids use to preserve their mental well-being are many and various. Pastoral care and moving plants Children learn about the children's portion This study stresses that trusted adults must know their way around this set just for kids. That will enhance such people 'ability to give realistic guidance.

To sum up, the results of these studies point to how whether social media has a positive impact or not depends on trusted adults. They suggest that effective monitoring and guidance must recognize the complexity of how social media is integrated with adolescent psychology. This is a landscape that even trusted adults must struggle through, not just as rule-makers but also counselors and cheerleaders to assist teenagers in our age of digital life.

5.3.3. Influence of Social and Cultural Factors

It is very important to look into the impact of social and cultural factors, such as gender, sexual orientation or ethnicity on using new media socially or suffering from mental-health problems. Adding together current research, the results chapter provides a comprehensive account of how these factors interact to influence teenagers 'use of cyberspace and mental health.

As Tao and Fisher (2022) describe, this social media racial discrimination comes at an enormous mental health cost for adolescents of colour. This study reveals that not only does racial discrimination exist in digital spaces, but it also hurts children of colour in terms of mental health.

It is also in line with Twenge’s (2020) judgment that the rising number of U.S, adolescents suffering poor mental health have a relationship to an increase in digital media use. Therefore, in order to think about the face of adolescent mental health we need a social space where cultural and racial energies are played out.

Boer et al. (2020) 's study of excessive and toxic social media use across countries indicates that culture is playing perhaps the biggest role in how absence or presence of any form affects adolescent psychology. So, in some countries deep involvement with social media isn't an aberration at all, but rather normal behavior for optimizing happiness.

But it does not function the same way everywhere: In fact, in some countries heavy internet exposure even lowers wellbeing. This shows the significance of accounting for these cultural norms and customs in defining that relationship between social media usage and mental health.

However, Riehm et al. (2019) study underscores the complexity of this relationship: Internalizing and externalizing problems are higher among U.S. youths who use social media more often. This suggests that cultural factors and the socio-digital environment moderate social media's effects on adolescent mental health.

Vidal et al.'s (2020) scoping review on social media use and depression in adolescents identifies four main themes: the quantity and quality of use, as well as social factors such ause disclosure. This review infers that social media influences depression and suicidality differently, depending on how adolescents can use the services provided, but also what is going on around them as they are using these sites.

Keles et al. (2020) also note in their systematic review that social media plays an important role when it comes to depression, anxiety and psychological distress among young people. This review categorizes the influence into four domains: This finding suggests that social media elements are intertwined and interacting with factors such as culture, society, etc. in influencing the mental health of teenagers.

Therefore, the effect of social and cultural forces upon the use by young people must be considered to be diverse in nature and deep-rooted. It includes, but is not limited to factors such as gender; sexual orientation; ethnicity and cultural background. Therefore, they determine how kids utilize social networks and affect their mental health.

Therefore future research and interventions will necessarily need to take account of these factors if mental health problems among adolescents are really going to be addressed in the age of digital technology.

5.3.4. Technology-Based Interventions and Support

Combining with the special conditions of this generation, treatment for mental health problems among teens is a rapidly growing field which involves technology. Similar studies, (Escobar-Viera et al. 2022; Biernesser et al., 2021) shed light on the likely shape of such interventions and some potential difficulties along these lines lining up with a wider trend reflected in other research

Adolescents, including those in public mental health settings, are especially computer-friendly and make a good companion for digital technologies to provide coaching on life management skills as wells as peer support. (Aschbrenner et al., 2019)

This is in line with Escobar-Viera et al. (2022), which demonstrated that social media can improve the mental health and normalize loneliness for rural LGBTQ youths.

The results of this study point to the necessity for technology interventions that are person-sensitive and culture specific, because there is such a vast difference in needs across adolescent subgroups.

As technology is so widely used among people with serious mental illness (including young adults), as described by Brunnette et al. (2019). This widespread situation provides rich soil for digital interventions, as Biernesser et al. (2021) put it in describing how social media can take us closer to one another and provide mutual support along the way. They also indicate that digital platforms can lead to dialogue and create social networks among youths, improving their resilience and sense of belonging.

In the view of Johnson et al., (2022), technological tools can be useful in promoting helpline and hotline advocacy for mental health issues. This coincides with the conclusions reached by Radovic et al. (2017) on different reactions to automated surveillance across social media platforms.

The review by Johnson et al. (2022) emphasizes that interventions must be devised not only to promote attitudes and intentions toward help-seeking, but also to contain those aspects of the intervention so as make them more readily accepted in low middle income countries.

Harvey et al. (2021) review in detail the growing role of technology for mental health assessment and treatment. Their examination of different technological approaches (e.g., virtual reality and ecological momentary assessment) rivals the difficulties that Radovic et al. (2017) notes in crafting effective, yet ethically sound digital interventions. The review argues for selective and critical evaluations of applications. Only those adapted to the special conditions faced by teens should be used for this population, it says.

Rai et al. (2023) evaluate the likely effect that technology-assisted interventions to promote mental health can have upon young people in low- and middle income countries. Looking at things from this angle, we enrich our understanding of how digital interventions can be implemented on different scales and in many cultural or socioeconomic contexts. This is a question that ought to interest anyone working towards the global applicability of such programs.

Jansen and Reid (2020), for instance, examine the use of communication technologies by carers of young people with mental health difficulties. These findings show that technology has much to offer caregivers: It can expand their knowledge, confidence and parenting skills. The narrative about the empowering potential of technology also goes along with that presented by Biernesser et al. (2021) and Escobar-Viera et al. (2022).

In sum, technology-based interventions in promoting adolescent mental health have great potential. Yet they face notable obstacles. These include guaranteeing privacy, the need to consider ethics and problems of methodology involved in making interventions relevant to cultural values, individualized needs or practical accessibility.

Because children and adolescents have special needs, a targeted approach is needed for guiding them through their mental health problems. A one-size fits all solution may not suit some youngsters.

5.4. Limitations of the Systematic Review

But although the systematic review process is extensive, it was hampered by several limitations which affect interpretation and generalization of its conclusions. The main problems with the selected studies arise from their methodological aspects.

Secondly, the inherently qualitative nature of these studies (e.g., Liang et al., 2023; Biernesser et al., 2020, 2021; Escobar-Viera et al., 2022; Burnette et al., 2017; Laestadius et al., 2021, and Radovic et al., 2017. Quantitative data are generally more scientific, and studies have larger sample sizes that may be extrapolated to the total population.

In some studies, such as the advertising of Instagram by Liang et al. (2023) or organizing through community organizations (Laestadius et al., 2021) have used recruitment approaches that may well introduce selection bias into research findings. However, this bias may well reduce the diversity of sampling and is not representative of all adolescents in the target age range.

The demographic skewness in some studies is another notable limitation. For example, Biernesser et al. (2020) largely involved White and female participants from Pittsburgh. This may not reflect well the experiences of adolescents with different racial, ethnic or geographical back- grounds. Likewise, Burnette et al. (2017) took a complete private school perspective, which may not capture the full range of teenagers' experiences with social media.

Most studies rely on self-reported data. This method is subject to potential bias and inaccuracy. Social desirability or a lack of self-awareness might also influence the way teenagers see themselves, as well as how they describe their use of social media and mental health. Finally, their cross-sectional design prevents the drawing of conclusions about cause and effect.

One can see these relationships between social media use and mental health, but there is no way to say which direction the relationship goes. Cause-and-effect relationships would have to be established through longitudinal studies.

In general, while the studies reviewed in this paper offer an illuminating look at how social media use affects adolescent mental health, their shortcomings involving sample composition, recruitment methods and sampling strategies; data collection via self-report questionnaires only (no objective measures); lack of attention to cause - effect reveal themselves upon closer scrutiny. These considerations imply a note of caution in interpreting the results and require additional research involving larger, more diverse samples as well as longitudinal designs.

Chapter 6 – Conclusion

6.1. Strengths of the Systematic Review

This systematic review, which examines how social media affects the mental health of teenage girls and young women in America, is a model for methodological rigor and thoroughness.

An important virtue is its strong emphasis on qualitative analysis: The demographic being investigated herein are not shallow, and neither should be the approach to understanding them. Its systematic method and thorough application of the PRISMA guidelines attest to the rigor employed by this review, which in turn enhances its reliability and validity.

The second characteristic of this review is the variety of sources. Much care was taken in the search of a wider range of databases including Scopus, PubMed and PsychINFO. A systematic search strategy like this therefore produced a vast amount of literature relevant to the problem, with different views and experiences.

Highlight: Collection of data There are Liang et al. (2023), Biernesser et al. (2020; 2021). These studies show that the varied kinds of populations from which such information was collected stretch all the way across general adolescent youths. To this, difference in types adds richness to this review's conclusions and provides a more comprehensive explanation as to how social media affect its target population.

CASP Quality Assessment Tool was also used on all selected studies, which adds credibility to the review. With the existence of this tool, each study could be strictly evaluated in terms of its quality. But research with weak methodologies and vague, insignificant results was excluded from the analysis.

The review's adherance to the highest academic and ethical standards is demonstrated in its strict enforcement of this quality control measure, which was applied uniformly across studies from Burnette et al. (2017) through Laestadius et al. (2021).

In sum, the systematic review has a high degree of methodological rigor. It is also comprehensive, picking from among high-quality and widely varying sources of information. They bring their combined strength to the table, making its findings robust and credible; Yet another significant addition to the field of adolescent mental health research..

6.2. Limitations of the Systematic Review

Although the methodology of this systematic review, which assesses the effect of social media on female adolescents 'and young adults ’ mental health in America has some strengths, there are several limitations to it arising from its design and that of included studies. The major restriction is that the research examples used are all in qualitative studies. For example, there are these qualitative studies by Liang et al. (2023) and Biernesser et al. (2020) as well as Biernesser et al. (2021).

These kinds of depths into personal experiences have insight that fundamentally is likely to reflect subjective bias rather than open up any trends in the entire population as a whole with which we can work conjointly together going In this qualitative approach, a heavy reliance on individual perceptions and experiences may inject biases into interpretation.

Moreover, some of the studies have distorted demographics that limit their general applicability. For example, Biernesser et al. (2020) mainly explored the experiences of predominantly White and female adolescents in Pittsburgh that may not resemble those experienced by other categories of teenagers across America. Likewise, Escobar-Viera et al. (2022) concentrated on rural youth from the LGBTQ community which is a particularly important insight as it relates to IG and social media experiences but may not necessarily reflect that of all adolescents

One other significant drawback is that many of the studies are based on self-reported data. Self-response runs the risk of introducing biases, such as recall bias or social desirability bias. For example, a study by Burnette et al. (2017) found that participants 'reflections on their use of social media and its effects might have been coloured by personal views or the wish to portray themselves in a particular light.

In addition, the cross-sectional design of studies such as Radovic et al. (2017) prohibits conclusions about causality in data analysis. Because there are no longitudinal data, it is difficult to say whether social media causes changes in mental health over time or vice versa.

In sum, although qualitative data from the systematic review provide useful perspective on how social media affects mental health among young females in America, there are potential biases owing to this selection of methods and introduction of these confounds. These limitations imply that it is necessary to be cautious in interpreting the findings, and suggest openings for future research into these gaps.

6.3. Conclusions

6.3.1. Summary of Findings

In this systematic review focused on assessing the various views about how social media impacts mental health among female adolescents and young adults, aged 13-24 in America today, a complex picture of the issue has emerged. The review has found a more balanced picture of how social networking affects this age group: not all good and not, alas, entirely bad.

The review found that social media can provide an effective means for interaction and self-expression, as certified by works such as Liang et al. (2023). Many are vital spaces for community building and support.

Especially at times of isolation, like the present COVID-19 crisis. This is one of the positive aspects about social media, because this creates a sense for kids that they belong to something. It helps them form an identity as well.

However, the review also provided darker sides of social media use. It could make mental health problems such as anxiety, depression and low self-esteem even worse--especially for the adolescent girl. This negative impact is often ascribed to reasons such as cyberbullying, or being exposed to unattainable beauty standards, and the pressure of maintaining a perfect online self.

These worries were crystallized by studies such as Burnette et al. (2017) and Biernesser et al. (2020; 2021), which indicate that a number of different psychological processes are manifesting themselves in these cases.

Secondly, the review showed that different subgroups of this demographic have very divergent experiences (Escobar Viera et al. 2022). This diversity indicates the need to study social media's role in different cultural and sociological settings. The impact society has had on mental health is further complicated, adding yet another facet.

6.3.2. Alignment with objectives

As this systematic review's findings are related to the set objectives, a detailed account arises regarding social media ' myriad influences on female adolescents and young adults ' psychological health in the United States.

Assessment of the Impact of Social Media on Mental Health:

The review carefully explored the double-edged sword of social media. On the plus side, for instance, Liang et al. (2023) revealed how social media makes it possible to connect with others and reveal oneself through interaction that can become a source of societal support and stimulus to community involvement precisely when people are kept apart by periods like the pandemic.

On the other hand, negative influences were also eminent. For instance, the research of Burnette et al. (2017) showed that anxiety and depression levels are aggravated by cyberbullying or social comparison, while self-esteem problems tend to be exacerbated due to online characters' pretensions.

Identification of Specific Qualitative Effects:

A qualitative analysis looked at the subtler psychological, social and developmental effects of using social media. They illuminated a range of experience, from empowering interactions and identity formation to psychic distress caused by negative online encounters.

As Escobar-Viera et al. (2022) note, thereby emphasizing varying effects on different subgroups of users, the social media use intersects with cultural and social identities.

Synthesis of Findings and Recommendations for Public Health Interventions:

Based on these insights the review concludes, proposing evidence-based recommendations. It advocates for the parallel building of targeted public health interventions, including educational campaigns promoting digital literacy, measures encouraging resistance to negative attitudes engendered by social media and policy changes that create a safer environment on line.

This adds that a multi-faceted strategy is needed in dealing with what appears to be an extraordinarily complex linkage between social media use and psychological wellbeing for these people.

Thus, the systematic review provides an overview of social media's impact on mental health. This is measured in extent, and understood qualitatively through depth. The existence of this effect provides an analytical foundation for a variety of public health interventions.

6.4. Recommendations for Practice

This qualitative systematic review provides concrete recommendations for policymakers, teachers and care providers in public health. Secondly, complex training programs in digital literacy need to be developed and completed.

As demonstrated by the study of Biernesser et al. (2021), research needs to be done so that young women can understand how social media causes psychological pressure on them. The programs available for this purpose are listed below: They should center on developing the ability to think critically and master online environments.

In addition, it's recommended that public health policymakers work together with social media companies to enhance online safety. According to different experiences, such as the studies of Escobar-Viera et al. (2022), it may mean that one can toughen up anti-cyberbullying legislation or perhaps rear psychological resources easily available for all students' use.

Most important of all are parental guidance programs. According to Laestadius et al. (2021), parents and caregivers must be provided with strategies for helping their teen on social media, as well assistance in effectively monitor use. But it means promoting open discussion about Internet life and drawing lines that ensure a healthy online-offline balance.

6.5. Recommendations for Research

With these findings, any future research into social media ’ s effect on female adolescents 'and young adults ’ mental health ought to be longitudinal.. In order to establish a connection between social media use and mental health outcomes, considered speculative in the cross-sectional analyses used by Radovic et al. (2017), longitudinal studies are especially needed. These kinds of studies would give us a better understanding about how long-term contact with social media affects mental health over time.

Also, more various demographic samples must enter the research. These studies, such as Escobar-Viera et al. (2014), suggest that the influences of social media differ greatly between different cultural and socioeconomic backgrounds. Broadening the scope of research to cover other ethnic groups, various socioeconomic backgrounds and a wider base in geographical locations should enable us not only get improved generalization but will also make our understanding more inclusive.

6.6. Self-Reflection

As a result, undertaking this systematic review has been an amazingly edifying journey for me. I have come to understand more about this very complex dance between social media and the mental health of young women.

The qualitative depth of this relationship has led me to alter my understanding: I've become more familiar with the multifaceted impact that social media can have on people. Now I realize that there is a delicate balance between its benefits and risks. This wasn't so clear to me early on when I began my research, however.

Over the course of this process, I have gradually gained a greater understanding and deeper empathy for difficulties we in today's digital age. But research is especially eye opening, revealing the varied ways in which social media intermeshes with the developmental and psychological environments of young people's lives.

My eyes have been opened not only academically but also in terms of the way I understand mental health among today's teenagers at a time when we are surrounded by digital technology. 

 

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References 

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Appendices

Appendix A – CASP Quality Assessment Table