Children and Screens: A Little Can Do A Lot of Damage

Marcia Frellick

November 07, 2018

Children's psychological well-being starts to deteriorate after an average 1 hour of screen viewing per day, according to a study of more than 40,000 children aged 2 to 17 years.

In the study, Jean Twenge, PhD, professor of psychology at San Diego State University in California, and W. Keith Campbell, PhD, professor of psychology at the University of Georgia in Athens, used a 2016 random sample through the National Survey of Children's Health to gather information on the children.

The children's caregivers were surveyed to get comprehensive measures of the the children's daily screen time, including use of cell phones, computers, electronic devices, games, and television. The caregivers were also asked about a wide variety of the children's behaviors.

Well-being did not vary significantly between young people who spent no time and those who spent an hour a day watching screens.

After 1 hour, however, more screen time "was generally linked to progressively lower psychological well-being," the authors write.

The findings were published online October 18 in Preventive Medicine Reports.

High Users at Twice the Risk for Lower Well-being

High users (at least 7 hours a day) had twice the relative risk (RR) for low well-being as low users (1 hour a day).

Low well-being in the study included less curiosity, less self-control and emotional stability, more distractibility, more difficulty making friends, and being more difficult to care for.

The effects were more pronounced in adolescents (aged 14 to 17 years) than in younger children, the authors write.

Among adolescents, the high users (compared with the low users) were more than twice as likely to have been diagnosed with depression (RR, 2.39; 95% confidence interval [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 year.

Moderate use (4 hours a day) was also linked to lower psychological well-being, but with lower effect sizes. Moderate users had a greater risk for depression (RR, 1.61; CI, 1.03 - 2.52) and diagnoses of anxiety (RR, 1.52; CI, 1.06 - 2.18) in the 14- to 17-year-old group but not in those aged 11 to 13 years.  

The authors speculate that reasons the effects were stronger in adolescents might include that adolescents are much more likely to have social media accounts and spend time online. Because relationships with peers are particularly important in adolescents, if social media is subbing for face-to-face conversations, that may affect well-being more.

Adolescents may be much more likely to have their own smartphones, the researchers note, and taking their smartphones to bed may affect the length and quality of their sleep, which may also affect their well-being.

The authors say that to their knowledge few to no previous studies have examined the links between screen time and diagnoses of anxiety or depression or reports of professional treatment for mental health issues. They included tablets, television, gaming, smartphones, and computers when calculating screen time. Previous studies also have offered conflicting results on a connection between screen time and psychological well-being.

Average Screen Time Increased With Age

Screen time averaged 3.2 hours a day (standard deviation, 2.40) and increased with age. The biggest jump in screen time happened between elementary and middle school. By high school, adolescents averaged 4 hours and 35 minutes a day with screens, according to reports by caregivers.

The cross-sectional study is not able to indicate whether screen time leads to low well-being or the other way around.

"However, several longitudinal studies have found that increases in recreational screen time precede lower psychological well-being among children and adolescents," they write.

In every household, one child was randomly selected for the survey, which was taken either online or on paper. The response rate was 40.7%. The study excluded children who had at least one of these eight conditions: autism, blindness, cerebral palsy, deafness, Down syndrome, developmental delay, epilepsy, or intellectual disability.

The study population was 49.8% male and 71% white, 16% Hispanic, 6% black, and 7% other. Family income was widely distributed.

The authors have disclosed no relevant financial relationships.

Preventive Medicine Reports. Published online October 18, 2018. Full text

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