More screen time links with lower psychological well-being in children

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Higher amounts of screen time are linked t0 heightened levels and diagnoses of anxiety or depression in children as young as age two, according to a US study.

Even after only one hour of screen time daily, children and teens may begin to have less curiosity, lower self-control, less emotional stability and a greater inability to finish tasks, reports San Diego State University psychologist Jean Twenge and University of Georgia psychology professor W Keith Campbell.

Twenge and Campbell were particularly interested in associations between screen time and diagnoses of anxiety and depression in youth, which has not yet been studied in great detail. Their findings provide broader insights at a time when youth have greater access to digital technologies and are spending more time using electronic technology purely for entertainment, and also as health officials are trying to identify best practices for managing technology addiction.

“Previous research on associations between screen time and psychological well-being among children and adolescents has been conflicting, leading some researchers to question the limits on screen time suggested by physician organizations,” Twenge and Campbell wrote in their paper.

The National Institute of Health estimates that youth commonly spend an average of five to seven hours on screens during leisure time. Also, a growing body of research indicates that this amount of screen time has adverse effects on the overall health and well-being of youth.

Also timely: the World Health Organisation this year decided to include gaming disorder in the 11th revision of the International Classification of Diseases. The organisation is encouraging “increased attention of health professionals to the risks of development of this disorder” as gaming addiction may now be classified as a disease.

Utilising National Survey of Children’s Health data from 2016, Twenge and Campbell analysed a random sample of more than 40,300 surveys from the caregivers of children aged 2 to 17. The nationwide survey was administered by the US Census Bureau by mail and online and inquired about topics such as: existing medical care; emotional, developmental and behavioural issues; and youth behaviours, including daily screen time. Twenge and Campbell excluded youth with conditions such autism, cerebral palsy and developmental delay, as they may have impacted a child’s day to day functioning.

Twenge and Campbell found that adolescents who spend more than seven hours a day on screens were twice as likely as those spending one hour to have been diagnosed with anxiety or depression – a significant finding. Overall, links between screen time and well-being were larger among adolescents than among young children.

“At first, I was surprised that the associations were larger for adolescents,” Twenge said. “However, teens spend more time on their phones and on social media, and we know from other research that these activities are more strongly linked to low well-being than watching television and videos, which is most of younger children’s screen time.”

Among other highlights of Twenge and Campbell’s study: moderate use of screens, at four hours each day, was also associated with lower psychological well-being than use of one hour a day; among pre-schoolers, high users of screens were twice as likely to often lose their temper and 46% more likely to not be able to calm down when excited; among teens aged 14-17, 42.2% of those who spent more than seven hours a day on screens did not finish tasks compared with 16.6% for those who spent one hour daily and 27.7% for those engaged for four hours of screen time; and about 9% of youth aged 11-13 who spent an hour with screens daily were not curious or interested in learning new things, compared with 13.8% who spent four hours on screen and 22.6% who spent more than seven hours with screens.

The study provides further evidence that the American Academy of Paediatrics’ established screen time limits – one hour per day for those aged 2 to 5, with a focus on high-quality programmes – are valid, Twenge said.

The study also suggests that similar limits – perhaps to two hours a day – should be applied to school-aged children and adolescents, said Twenge.

In terms of prevention, establishing possible causes and outcomes of low psychological well-being is especially important for child and adolescent populations. “Half of mental health problems develop by adolescence,” Twenge and Campbell wrote in their paper.
“Thus, there is an acute need to identify factors linked to mental health issues that are amenable to intervention in this population, as most antecedents are difficult or impossible to influence,” they continued. “Compared to these more intractable antecedents of mental health, how children and adolescents spend their leisure time is more amenable to change.”

Abstract
Previous research on associations between screen time and psychological well-being among children and adolescents has been conflicting, leading some researchers to question the limits on screen time suggested by physician organizations. We examined a large (n = 40,337) national random sample of 2- to 17-year-old children and adolescents in the U.S. in 2016 that included comprehensive measures of screen time (including cell phones, computers, electronic devices, electronic games, and TV) and an array of psychological well-being measures. After 1 h/day of use, more hours of daily screen time were associated with lower psychological well-being, including less curiosity, lower self-control, more distractibility, more difficulty making friends, less emotional stability, being more difficult to care for, and inability to finish tasks. Among 14- to 17-year-olds, high users of screens (7+ h/day vs. low users of 1 h/day) were more than twice as likely to ever have been diagnosed with depression (RR 2.39, 95% CI 1.54, 3.70), ever diagnosed with anxiety (RR 2.26, CI 1.59, 3.22), treated by a mental health professional (RR 2.22, CI 1.62, 3.03) or have taken medication for a psychological or behavioral issue (RR 2.99, CI 1.94, 4.62) in the last 12 months. Moderate use of screens (4 h/day) was also associated with lower psychological well-being. Non-users and low users of screens generally did not differ in well-being. Associations between screen time and lower psychological well-being were larger among adolescents than younger children.

Authors
Jean M Twenge, W Keith Campbell

San Diego State University material
Preventative Medicine Reports abstract


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