“In the case of substance abuse, decades of research established a taxonomy that is more nuanced than simply alcohol abuse vs use. The National Institute of Alcohol Abuse and Alcoholism has established different usage patterns that have been studied both for their independent effects on functioning and how each might ultimately lead to the clinical entity of alcohol use disorder (Table).
We propose an analogous taxonomy for digital media use that identifies patterns of use, irrespective of content, that could be problematic but, at a minimum, should be flagged as warranting further evaluation and potential remediation. Although in this Viewpoint we focus on children, the same approach could and should be applied to adults. Abnormal laboratory values or behavior are frequently defined by setting a cut point (often at the 95th percentile). A screening value that should be cause for concern is set below that threshold with an eye to trading off false-positive results for false-negative results. Although it is true that sometimes screening values represent a normal value or behavior that is a merely a statistical outlier, they are useful for identifying at-risk individuals. [..]
Given that teenagers should sleep for 8 to 10 hours per day and attend school for approximately 6 hours per day, those using their phones for 9 hours per day (the 85th percentile in our data) must be using them during school and/or forgoing sleep to do so. Simply put, any activity besides school or sleep performed for 9 hours per day should be cause for concern, if not intervention. However, these proposed screening cut points, as important as they are, may soon become obsolete themselves if wearable screens (eg, smart glasses) become more common, enabling, in effect, continuous screen use.”
Full article, DA Christakis and L Hale, JAMA, 2025.4.28