Engagement with Algorithm-curated Short-form Video Content and Its Association with Non-suicidal Self-harm and Personality Traits.

The rapid expansion of algorithm-curated short-form video (ACSFV) platforms has raised concerns about their potential association with youth mental health, particularly through personalized content streams that may amplify psychological vulnerabilities and exposure to harmful material. This study examined the relationship between ACSFV use and self-harm behaviors, probable borderline personality disorder (BPD) traits indicators, and anxious personality traits among Saudi adolescents and young adults. It also examined associations with depression, anxiety, stress, and sociodemographic factors. A cross-sectional study was conducted among Saudi individuals aged 12-30 years, utilizing self-reported data on social media use. The Taylor Manifest Anxiety Scale-50 (TMAS-50) was used to assess anxious personality traits, and the Self-Harm Inventory (SHI) was used to screen for BPD traits indicators and evaluate the lifetime history of self-harm. The questionnaire also included the Depression, Anxiety, and Stress Scale-21 (DASS-21). Among the 566 participants (74% female, 51.8% aged 19-25 years), daily engagement with ACSFV content was frequent, with 22.5% using it for 3-4 h and 15.3% for more than 4 h per day. The most frequently used platforms were TikTok (84.2%), Snapchat (80.0%), and Instagram (70.0%). Self-harm behaviors (37.5%), BPD indicators (9.5%), and severe / very severe anxious traits (31.0%) were prevalent. Self-harm correlated with age category 15-25 years, depression, and stress. Anxious traits were associated with extensive engagement with ACSFV content in unadjusted analysis, while Facebook use and higher depression and anxiety scores remained significant in adjusted analysis. BPD indicators were independently associated with psychiatric consultations and stress levels. This study highlights high rates of self-harm, anxious traits, and BPD indicators among Saudi adolescents and young adults, emphasizing the complex associations between social media use and psychological distress and the need for culturally tailored interventions, school-based programs, and further research.