Are Physical Activity, Screen Time, and Mental Health Related During Childhood, Preadolescence, and Adolescence?

11-Year Results From the German Motorik-Modul Longitudinal Study

Claudio R. Nigg; Kathrin Wunsch; Carina Nigg; Claudia Niessner; Darko Jekauc; Steffen C. E. Schmidt; Alexander Woll

Disclosures

Am J Epidemiol. 2021;190(2):220-229. 

In This Article

Results

Descriptive Results

Descriptive results for PA, ST, and MH at the 3 measurement points are presented by sex in Table 1.

Taken together, PA decreases with increasing age in all participants, whereas ST increases. These findings are independent of sex. The decrease in PA is higher in females than in males (−1.49 days from T1 to T3 in males vs. –1.64 days in females), as is combined ST (i.e., TV/video time plus PC/Internet time; 162.4 minutes from T1 to T3 in males vs. 216.23 minutes in females). Regarding SDQ scores, males and females differ significantly at all time points, with males showing higher scores at younger ages. However, this pattern changes at T3, as males show lower MH scores than females in adolescence.

Path Panel Prediction Model Results

The structural equation model results for each of the SDQ subscales and the SDQ total scale score are presented by sex in Figures 1 and 2. The fit indices all revealed good model fits (comparative fit index > 0.97; root mean square error of approximation < 0.03).

Figure 1.

Models of the associations among physical activity (PA), television (TV) and video viewing (shown as "TV"), personal computer (PC) and Internet use (shown as "PC"), and mental health indicators at time 1 (T1), time 2 (T2), and time 3 (T3) for females, Motorik-Modul Longitudinal Study, 2003–2017. (Note: Within-time-point correlations of the behavioral indicators and explained variances are not shown in the model.) A) Emotional symptoms (ES); B) conduct problems (CP); C) hyperactivity/inattention (H/I); D) peer relationship problems (PR); E) prosocial behavior (PB); F) overall Strengths and Difficulties Questionnaire (SDQ) score. a P < 0.05; b P < 0.01; c P < 0.001.

Figure 2.

Models of the associations among physical activity (PA), television (TV) and video viewing (shown as "TV"), personal computer (PC) and Internet use (shown as "PC"), and mental health indicators at time 1 (T1), time 2 (T2), and time 3 (T3) for males, Motorik-Modul Longitudinal Study, 2003–2017. (Note: Within-time-point correlations of the behavioral indicators and explained variances are not shown in the model.) A) Emotional symptoms (ES); B) conduct problems (CP); C) hyperactivity/inattention (H/I); D) peer relationship problems (PR); E) prosocial behavior (PB); F) overall Strengths and Difficulties Questionnaire (SDQ) score. a P < 0.05; b P < 0.01; c P < 0.001.

Female Results. Results for females (n = 379) are shown in Figure 1. Stability coefficients were stronger from T1 to T2 than from T2 to T3. Regarding the interbehavioral relationships (between PA and ST variables), TV time positively predicted PC time from T1 to T2 and from T2 to T3; and PA at T2 negatively predicted TV time at T3. Regarding the MH and behavior relationships, the MH variables negatively predicted PA from T1 to T2 (except for prosocial behavior); T1 TV time positively predicted T2 emotional symptoms, peer relationship problems, SDQ score, and T3 conduct problems; T1 PC time positively predicted T2 hyperactivity/inattention and T3 conduct problems; T2 TV time positively predicted T3 emotional symptoms, hyperactivity/inattention, and SDQ score; T1 PA negatively predicted T2 prosocial behavior; and T2 PA positively predicted T3 prosocial behavior.

Male Results. Results for males (n = 307) are shown in Figure 2. Stability coefficients were stronger from T1 to T2 than from T2 to T3 for the behavioral variables, but not necessarily for the MH variables. Regarding the interbehavioral relationships (between PA and ST variables), TV time positively predicted PC time from T1 to T2 and from T2 to T3, and PC time positively predicted TV time from T1 to T2. Regarding the MH and behavior relationships, T1 PC time positively predicted T2 emotional symptoms, T1 PA positively predicted T2 prosocial behavior, and T1 emotional symptoms and SDQ score negatively predicted T2 PA. Four out of 6 T2 MH indicators (conduct problems, hyperactivity/inattention, peer relationship problems, and SDQ score) positively predicted both T3 TV time and T3 PC time.

Separate analyses were conducted by socioeconomic status, which resulted in no significant differences between socioeconomic status groups (data not shown). In addition, because of lower-than-expected Cronbach's α coefficients for some of the SDQ subscales, we reran the analyses using the average scores; this resulted in the same model conclusions (data not shown).

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