Paeds · adolescent-and-young-adult-medicine
Digital media, gaming and cyberbullying
Also known as Screen time and adolescent mental health · Problematic internet use · Internet gaming disorder · Cyberbullying and online victimisation · Sexting and online sexual solicitation · Social media harm reduction
A fellowship approach to the digital life of young people: how to ask about screen time, social media, gaming, cyberbullying and online sexual risk; how to separate normative use from the use that harms; and how to build a harm-reduction plan that keeps a young person safe and engaged rather than lectured into silence.
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Target exams
Red flags
- Cyberbullying with suicidal ideation, plan, intent or recent attempt
- Disclosure of online grooming, sexual exploitation, sextortion or trafficking
- Acute mental-health crisis driven by online events (mass harassment, leaked images)
- Severe sleep deprivation, weight loss or school refusal from compulsive use
- Non-consensual sharing of intimate images of a minor (a safeguarding and legal event)
- Signs of disordered gaming with neglect of food, hygiene, education or relationships
Life stages
Care settings
Clinical exam formats
Board mappings
- General and Community Paediatrics
- Adolescent health, digital media and online safety
- Current 2026 PREP curriculum — Learning Objective 1.2.1: Communicate with a child or young person in a way which is appropriate to the position of that child within their own culture
- Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment – essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 6: Clinical management – essential general paediatrics
- Renewed curriculum for first-year trainees from 2027 — Learning goal 12: Communication with patients, families, and health professionals
- Renewed curriculum for first-year trainees from 2027 — Learning goal 15: Essential general paediatrics
- Clinical Applications
- Adolescent medicine, digital media and cyberbullying
- Long Cases
- Short Cases
- Communication stations
- 2. Professional skills and knowledge: Communication
- 4. Professional skills and knowledge: Patient management
- 5. Health promotion and illness prevention
- 11. Adolescent health
- General Paediatrics: Assesses digital-media, gaming and cyberbullying risk and applies harm-minimisation and safeguarding principles for young people
- Foundation of Practice (FOP)
- Applied Knowledge in Practice (AKP)
- Adolescent health, safeguarding and online risk
- History
- Communication
- Clinical
- General Pediatrics Content Outline — Domain 1: Preventive Pediatrics/Well-Child Care
- General Pediatrics Content Outline — Domain 11: Adolescent Medicine and Gynecology
- General Pediatrics Content Outline — Domain 16: Mental and Behavioral Health
- General Pediatrics EPA: Counselling families on media use, screen time and online safety
- Patient Care 5: Patient Management
- Interpersonal and Communication Skills 1: Patient- and Family-Centered Communication
- Systems-Based Practice 3: System Navigation for Patient Centered Care – Coordination of Care
- Professionalism 1: Professional Behavior and Ethical Principles
- Communicator
- Health Advocate
- Professional
- Pediatrics: Foundations EPA — Assessing and providing care for adolescents including digital-media and online-safety risk
- Pediatrics: Core EPA — Providing preventive care, media counselling and safeguarding
Overview & Definition
A registrar sees a 14-year-old for acne. The phone never leaves the teenager's hand. "Sleep's fine," they say, dark-eyed at noon. The visit closes in seven minutes. Three weeks later the same young person is in the emergency department after taking pills because a group chat turned on them. The missed work was not a rare diagnosis. It was an online life that nobody asked about. [4] [8]
Digital media is now a developmental environment, not an accessory. Screen time, social media, gaming and online interaction are where adolescents form identity, build peer relationships, seek information about health and sexuality, and explore risk. The American Academy of Pediatrics frames media use as a health topic that paediatricians must discuss at every well-child visit from infancy onward, shifting the question from "how much screen time" to "what is the content, context and consequence of the use." [1] [2]
Digital-media harm is the cluster of mental-health, sleep, developmental and safety harms that arise when exposure meets vulnerability: depression and anxiety linked to heavy or comparative social-media use, sleep loss from night-time device use, compulsive or disordered gaming, and the psychological injury of cyberbullying and online sexual exploitation. The defining clinical point is that the same technology is benign for most and harmful for a vulnerable few, so the task is targeted assessment rather than blanket prohibition. [12] [5]
Cyberbullying is aggression — harassment, humiliation, threats, exclusion or rumour — delivered through digital channels, distinguished from offline bullying by its reach, permanence, perceived anonymity, and the fact that it follows the young person home and into the bedroom. [3] [4]
Core sequence of a digital-media risk encounter
- 1
Screen all
Ask every adolescent about use, content, contacts, cyberbullying, sleep and mood — without judgement.
- 2
Assess function
Impairment, mood/sleep effects, compulsive-use signs, victimisation, coercion.
- 3
Classify
Normative use vs use causing impairment, danger or instability.
- 4
Brief intervention
Motivational interviewing, personalised feedback, a family media plan.
- 5
Harm-reduction plan
Sleep-protective schedule, blocking/privacy, safer-use, parental controls.
- 6
Red-flag exit
Suicidality, exploitation, leaked images, crisis → acute safety and safeguarding.
References12ShowHide
- [1]Council on Communications and Media Media Use in School-Aged Children and Adolescents. Pediatrics, 2016.PMID 27940794
- [2]Council on Communications and Media Media and Young Minds. Pediatrics, 2016.PMID 27940793
- [3]Selkie EM, Fales JL, Moreno MA Cyberbullying Prevalence Among US Middle and High School-Aged Adolescents: A Systematic Review and Quality Assessment. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2016.PMID 26576821
- [4]John A, Glendenning AC, Marchant A, Montgomery P, Stewart A, Wood S, Lloyd K, Hawton K Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review. Journal of medical Internet research, 2018.PMID 29674305
- [5]Boers E, Afzali MH, Newton N, Conrod P Association of Screen Time and Depression in Adolescence. JAMA pediatrics, 2019.PMID 31305878
- [6]Primack BA, Shensa A, Sidani JE, Whaite EO, Lin LY, Rosen D, Colditz JB, Radovic A, Miller E Social Media Use and Perceived Social Isolation Among Young Adults in the U.S. American journal of preventive medicine, 2017.PMID 28279545
- [7]Madigan S, Ly A, Rash CL, Van Ouytsel J, Temple JR Prevalence of Multiple Forms of Sexting Behavior Among Youth: A Systematic Review and Meta-analysis. JAMA pediatrics, 2018.PMID 29482215
- [8]Livingstone S, Smith PK Annual research review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age. Journal of child psychology and psychiatry, and allied disciplines, 2014.PMID 24438579
- [9]Greene-Colozzi EA, Winters GM, Blasko B, Jeglic EL Experiences and Perceptions of Online Sexual Solicitation and Grooming of Minors: A Retrospective Report. Journal of child sexual abuse, 2020.PMID 33017275
- [10]Schneider LA, King DL, Delfabbro PH Family factors in adolescent problematic Internet gaming: A systematic review. Journal of behavioral addictions, 2017.PMID 28762279
- [11]Nagata JM, Testa A, Ganson KT, Baker FC Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study. BMC public health, 2024.PMID 39370520
- [12]Odgers CL, Jensen MR Annual Research Review: Adolescent mental health in the digital age: facts, fears, and future directions. Journal of child psychology and psychiatry, and allied disciplines, 2020.PMID 31951670