Cyberbullying and lack of sleep and physical activity may be to blame for the ties between social media use and poor mental health and well-being in teen girls, researchers found.

They studied nearly 10,000 adolescents in England over three years starting in 2013 when participants were 13 or 14 years old. The teens were asked about frequency of social media use, their psychological health, cyberbullying, sleep, physical activity and well-being.

By the third year, 69% of boys and 75% of girls were very frequent social media users, defined as multiple times per day, according to the study published Tuesday in The Lancet Child & Adolescent Health.

About 28% of girls who used social media very frequently reported psychological distress compared to 20% of those using it weekly or less. The most frequent users also had lower life satisfaction and happiness and greater anxiety. Researchers found that cyberbullying and reduced sleep and physical activity play a significant role in explaining these findings.

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