Are public social interactions on Twitter associated with mental health outcomes?

It has been suggested that active use of social media (i.e. direct interactions with other users) is associated with improved mental health. Active use could help build relationships, and lead to feelings of social and emotional support. However, evidence is inconsistent, potentially because active use comprises many different behaviours. The impact of active use may depend on whether individuals are targeting specific users and the feedback they receive from others. Our study explored the relationship between the public active use Twitter users performed and received, and mental health outcomes. We linked Twitter data from 2020 to 2022 to self-reported measures of mental health from the Avon Longitudinal Study of Parents and Children. We generated variables capturing the type of active use each participant performed, and the feedback they received from other users. We produced models predicting mental health from these variables, using data from 310 adults. We found little to no evidence that engaging in more targeted interactions or receiving greater amounts of feedback on Twitter was linked to better mental health outcomes. Likewise, there was limited evidence that the amount of feedback received influenced the relationship between targeted interactions and mental health. We also found no evidence that posting more nontargeted Tweets (i.e. those not directed at any specific user) was related to mental health. However, this relationship was influenced by the amount of feedback received. As feedback increased, the relationship between nontargeted Tweets and mental wellbeing became more negative. Given that Twitter is primarily designed for information sharing purposes, social interactions on this platform may often result in weak relationships that do not provide meaningful social or emotional benefit.