Exploring mediational roles for self-stigma in associations between types of problematic use of internet and psychological distress in youth with ADHD.
Self-stigma is the hidden path that turns social-media over-use into depression and anxiety for youth with ADHD.
01Research in Context
What this study did
Lee et al. (2023) asked 100 Taiwanese youth with ADHD about their phone, social media, and gaming habits.
They also measured how much the kids blamed themselves for their struggles and how anxious, sad, or stressed they felt.
The team then ran a mediation test to see if self-stigma links heavy screen use to mental distress.
What they found
Self-stigma acted like a bridge: more problematic social-media and phone use went in, more depression, anxiety, and stress came out.
Gaming hours did not travel through this bridge; only social media and general phone use mattered.
In plain words, when kids with ADHD feel ashamed of their screen habits, their mood sinks.
How this fits with other research
Fabio et al. (2026) reviewed 25 studies and saw the same social-media-to-inattention link, but they could not say which causes which. Kuan-Ying adds the missing piece: self-stigma is one reason the link exists.
Woodman et al. (2025) mapped heavy public stigma toward ADHD in Saudi Arabia. The new study flips the lens inward, showing that the shame kids carry about themselves—not just what others think—hurts mental health.
Williams et al. (2023) also used a mediation model with Indian teens who have learning disorders. They found self-concept boosts well-being, while Kuan-Ying shows self-stigma drags it down—two sides of the same self-image coin.
Why it matters
If you treat ADHD and screen over-use, add brief stigma probes to your intake. Ask, “Do you feel bad about yourself when you scroll?” A simple shame rating can flag kids whose mood may worsen even if screen hours drop. Pair parent training with self-compassion scripts or group sessions that normalize ADHD traits. Lowering self-stigma could unlock bigger gains from your standard time-management or token plans.
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02At a glance
03Original abstract
BACKGROUND: Several studies have linked the problematic use of the Internet (PUI) to psychological distress. Youth with attention deficit hyperactivity disorder (ADHD) are considered a particular disadvantaged population with a high risk of developing PUI, psychological distress, and self-stigma. Nonetheless, the interrelationships of PUI, self-stigma, and psychological distress in adolescents with ADHD are not well understood. AIMS: This study investigated whether self-stigma mediates relationships between different forms of PUI, such as problematic gaming (PG), problematic social media use (PSMU), problematic smartphone use (PSPU), and psychological distress (i.e., depression, anxiety, and stress), in children with ADHD. METHODS AND PROCEDURES: We recruited 100 youth with ADHD (mean age=10.80 [SD=3.07] years; 84 boys) from psychiatric outpatient clinics in Taiwan. All participants were assessed for PUI (via Internet Gaming Disorder-Short Form for PG, Bergan Social Medica Addiction Scale for PSMU, and Smartphone Application-Based Addiction Scale for PSPU), self-stigma (via Self-Stigma Short-Scale), and psychological distress (via Depression, Anxiety, Stress Scale). OUTCOMES AND RESULTS: The results of path and bootstrapping analyses indicated that self-stigma mediated the associations between PSMU and PSPU, but not PG, and depression, anxiety, and stress. CONCLUSIONS AND IMPLICATIONS: This study expands the extant literature by revealing that self-stigma mediates the association between specific forms of PUI and psychological distress in adolescents with ADHD. Interventions aimed at reducing self-stigma and PUI, particularly PSMU and PSPU, may help decrease psychological distress among adolescents with ADHD.
Research in developmental disabilities, 2023 · doi:10.1016/j.ridd.2022.104410