Profiling problematic digital use in adolescence: a clustering analysis from clinical settings

Abstract

Problematic digital technology use is a growing clinical concern among adolescents, given its close association with psychiatric symptoms. Despite its increasing relevance, limited research has addressed how psychiatric and psychosocial factors relate to patterns of digital overuse in clinical populations. This cross-sectional study aimed to identify natural psychosocial subtypes of adolescents based on psychiatric symptoms, emotional recognition abilities, and demographic variables, and to explore how these subtypes differ in problematic technology engagement. The sample consisted of 158 adolescents (M_age = 13.9 years, SD = 2.2; 59% female) recruited from outpatient child and adolescent psychiatry clinics. Psychiatric diagnoses were established through semi-structured interviews (K-SADS-PL) conducted by experienced child psychiatrists. Participants completed validated assessments of internalizing disorders, emotion recognition, and problematic digital behaviors (internet, gaming, smartphone, and social media use). A K-prototypes clustering analysis, which excluded technology use variables to avoid circularity, identified three distinct profiles: (1) Older Moderate-Risk Females, (2) High-Risk Internalizing Females with elevated emotion recognition and lower parental education, and (3) Young Low-Risk Males with Externalizing Features. The internalizing-dominant group showed significantly higher social media, smartphone, and internet overuse. Although problematic gaming did not significantly differ across clusters, the externalizing group displayed relatively higher gaming engagement compared to other digital domains. These findings highlight the importance of clinically informed, profile-based interventions that address the unique emotional and psychiatric vulnerabilities associated with problematic technology use.