Depression precedes problematic video streaming in adolescents: Prevalence trends and cross-lagged associations from a four-wave population-based study
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Background
In the age of TikTok, YouTube, and Netflix, video streaming (VS) is highly popular among adolescents. Yet, risky to addiction-like viewing patterns (i.e., problematic (P)VS ) may adversely affect well-being. Prevalence estimates based on established criteria and etiological understanding of this phenomenon remain scarce. It is associated with depression, a major issue within the youth mental health crisis. However, causality remains unclear. This study investigated prevalence trends of adolescent PVS and its temporal relationship with depression.
Methods
Population-based data were drawn from four annual waves (2022-2025) of a representative online survey among 3,477 German adolescents (aged 10-17 years). Weighted annual PVS prevalence estimates were calculated based on standardized measures applying ICD-11 criteria of behavioural addictions distinguishing pathological from hazardous behavioural patterns. A cross-lagged panel analysis examined the reciprocal relationship between PVS and depression over four years.
Results
Prevalence of pathological VS ranged between 2 to 4% across waves. Hazardous VS prevalence was 13-14% from 2022 to 2024, before increasing to 25% in 2025. Up to 81% of adolescents with pathological VS (21% with hazardous VS ) showed clinically relevant symptoms of depression, versus 8-9% of non-affected adolescents. Depression significantly predicted PVS in two of three lags (β w1-w2 =0.233, β w2-w3 =0.155), but not vice versa.
Conclusions
Prevalence rates and their divergent associations with depression support distinguishing hazardous from pathological VS and underline the clinical relevance of PVS. Depression preceded PVS, pointing to the role of maladaptive coping. This has direct implications for effective intervention measures. Future research should clarify the mechanisms underlying this relationship.
