Background: Published systematic reviews provide evidence linking positive and negative digital experiences to adolescent mental health. However, these reviews focus on the general public rather than the digital experiences of adolescents with different pre-existing mental health conditions and so may be limited in their clinical relevance. We review publications relating to anxiety, depression, eating disorders and nonsuicidal self-injury to identify common and condition-specific digital experiences and how these may be implicated in the origins and maintenance of these mental health conditions. Methods: A systematic literature search using a combination of mental health, digital experience (including social media use), and age of the target population terms was conducted on four databases. Detailed findings from the included studies were summarised using a combination of thematic and narrative methods. Results: Five qualitative and 21 quantitative studies met the eligibility criteria for inclusion (n = 5021). Nine studies included adolescents with depression, one with eating problems, two with nonsuicidal self-injury and 14 with multiple emotional health conditions. The review identified six themes related to the target populations' digital experiences: (a) social connectivity and peer support; (b) escape and/or distraction; (c) social validation and social comparison; (d) accessing/creation of potentially harmful content; (e) cyberbullying; and (f) difficulties with self-regulation during engagement with digital media. Conclusions: Digital practices of adolescents with pre-existing clinical vulnerabilities are complex and encompass a range of positive and negative experiences, which appear to have common elements across different clinical populations. The literature is currently too limited to identify disorder-specific practices, with too few direct or indirect comparisons between conditions. Key practitioner message• Digital technologies have redefined how adolescents learn, work, play and socialise. These digitally related changes in adolescent lifestyles coincide with a consistent trend of an increase in adolescent mental health problems. • The digital world provides psychologically vulnerable adolescents with opportunities for social connection and support and allows distraction from their mental health problems. • However, some young people find it difficult to self-regulate their digital engagement and their digital experiences can exacerbate psychological difficulties or lead to the normalisation of pathological behaviour.• Future research should be designed in a way to better understand the more nuanced impact of a multiplicity of digital experiences and how these might differ for specific clinical groups.

As Information and Communication Technologies (ICT), such as the internet and mobile phones, facilitate the spread of knowledge and interactions across borders in previously unimagined ways, questions are being asked about whether the benefits of this digitization process are equally distributed between and within countries. Motivated by the way technology adoption and usage patterns may differ in the Arab Middle East, this paper examines how the Kuwaiti context shapes people’s understanding of a survey instrument used for evaluating digital inequalities, as they relate to access, skills and engagement, and outcomes of ICT use. Specifically, it discusses the adaptation and validation of the survey measures of socio-digital inequalities through a process of cognitive interviewing and provides insight into the theoretical and empirical linkages between cultural conceptions of digital and traditional inequalities in ways that explore both their universal and contextual aspects, or denotative and connotative meanings. Evidence suggests that important cross-cultural complications relate to language issues, socio-economic conditions, citizenship, and differing perceptions of social desirability. These findings offer important considerations for improving the reliability and validity of future survey-scale adaptations in the broader MENA region, especially in countries containing significant multicultural populations. Simultaneously, they call into question the extent to which global conceptualizations of digital inequalities and their measures reflect complex local realities.

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