Abstract

Technological developments in recent decades have increased young people’s engagement with screen-based technologies (screen time), and a reduction in young people’s contact with nature (green time) has been observed concurrently. This combination of high screen time and low green time may affect mental health and well-being. The aim of this systematic scoping review was to collate evidence assessing associations between screen time, green time, and psychological outcomes (including mental health, cognitive functioning, and academic achievement) for young children (<5 years), schoolchildren (5–11 years), early adolescents (12–14 years), and older adolescents (15–18 years). Original quantitative studies were identified in four databases (PubMed, PsycInfo, Scopus, Embase), resulting in 186 eligible studies. A third of included studies were undertaken in Europe and almost as many in the United States. The majority of studies were cross-sectional (62%). In general, high levels of screen time appeared to be associated with unfavourable psychological outcomes while green time appeared to be associated with favourable psychological outcomes. The ways screen time and green time were conceptualised and measured were highly heterogeneous, limiting the ability to synthesise the literature. The preponderance of cross-sectional studies with broadly similar findings, despite heterogeneous exposure measures, suggested results were not artefacts. However, additional high-quality longitudinal studies and randomised controlled trials are needed to make a compelling case for causal relationships. Different developmental stages appeared to shape which exposures and outcomes were salient. Young people from low socioeconomic backgrounds may be disproportionately affected by high screen time and low green time. Future research should distinguish between passive and interactive screen activities, and incidental versus purposive exposure to nature. Few studies considered screen time and green time together, and possible reciprocal psychological effects. However, there is preliminary evidence that green time could buffer consequences of high screen time, therefore nature may be an under-utilised public health resource for youth psychological well-being in a high-tech era.

Highlights

  • 1.1 BackgroundThe prevalence of mental illness among children and adolescents is increasing globally [1,2,3]

  • There is a pressing need to identify and address upstream determinants of mental health, focussing on the prevention of mental illness alongside the promotion of mental well-being. This scoping review focuses on two emerging determinants of interest: time spent engaging with screen-based technologies, referred to as ‘screen time’ (ST), and exposure to or time spent in nature, referred to as ‘green time’ (GT)

  • The literature search identified 8,369 studies; 8,179 studies were removed because they were either duplicates (n = 2,544) or did not meet the inclusion criteria based on information in the Screen time, green time, and youth psychological outcomes title (n = 4,709) or abstract (n = 926)

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Summary

Introduction

1.1 BackgroundThe prevalence of mental illness among children and adolescents is increasing globally [1,2,3]. Experiences of depressive and anxiety symptoms in childhood and adolescence are associated with an elevated risk of poor mental health in adulthood [8,9,10,11,12], suggesting enduring consequences of compromised mental health while young for wellbeing and functioning across the lifespan. Given these lifelong impacts, there is a pressing need to identify and address upstream determinants of mental health, focussing on the prevention of mental illness alongside the promotion of mental well-being. With widespread integration of digital technologies in school curricula [21], ST is no longer confined to recreational use, making it an inevitable part of young peoples’ lives

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