Changes In Screen Time Research Articles

The Association Between Longitudinal Changes in Body Mass Index and Longitudinal Changes in Hours of Screen Time, and Hours of Physical Activity in German Children

ABSTRACTIntroductionThe association of screen time and physical activity with body weight in children has been investigated in cross‐sectional and prospective studies, as well as randomized controlled trials. The present study extends previous research by examining how longitudinal within‐person changes in screen time and physical activity relate to changes in Body Mass Index (BMI) in children, and how changes in screen time and physical activity relate to each other.MethodsThe data for the present study came from the PIER Youth Study. Data were collected from 971 children and their parents at two time points approximately 1 year apart. A multilevel modeling approach with measurement occasions nested within children was used to model changes in BMI across age.ResultsWithin a child, a change in daily hours of TV viewing was associated with a corresponding change in BMI, whereas a change in daily hours of physical activity was associated with an opposite change in BMI. Within‐person correlations between changes in screen time and physical activity were small but positive.ConclusionThe present findings have important implications for interventions to reduce and prevent childhood overweight and obesity. Specifically, interventions should focus on both reducing daily TV viewing and promoting physical activity.

How Screen Time and Social Media Hyperconnection Have Harmed Adolescents’ Relational and Psychological Well-Being since the COVID-19 Pandemic

Following the COVID-19 pandemic, the increase in screen time and hyperconnection on social media is raising significant concerns, with particular emphasis of their effects on the relational and psychological well-being of children and adolescents. The present study analyses data from two representative cross-sectional surveys conducted among Italian adolescents in 2019 and 2022. Through bivariate analyses and binary logistic regression models, the study examines changes in screen time on social media, identifies key socio-demographic predictors of hyperconnection, and explores its effects on both the relational and psychological well-being of young people. The findings reveal the profound impact of the pandemic on daily social media use, showing a significant increase across all social groups regardless of socio-demographic characteristics, with girls consistently exhibiting higher levels of hyperconnection. Additionally, the results indicate that hyperconnected individuals are 1.4 times more likely to experience negative psychological states compared to their peers. The effects of hyperconnection vary by gender, influencing both horizontal and vertical social interactions, reducing trust in adult figures, increasing the likelihood of cyberbullying victimisation, phubbing, and body image concerns, and fostering the belief that online relationships can replace offline ones. Overall, the study highlights the urgent need for more effective prevention, awareness, and educational strategies aimed at educators, parents, and adolescents.

Associations among screen time, sleep, mental health and cognitive functioning in school-aged children during the COVID-19 pandemic, November 2020 through to August 2022

ObjectiveTo examine children’s screen time use and sleep patterns over 2 years of the pandemic and the downstream associations with children’s executive functions and behavioural problems, as well as the moderating effects of parental factors. MethodThis longitudinal cohort study examined school-aged children’s lifestyle and behavioural changes over 2 years of the pandemic across 6 timepoints (November 2020 to August 2022). Latent growth modeling (LGM) was used to identify changes in screen time and sleep duration and multivariate LGM was used to determine how parental stress, positive parenting, changes in children’s screen time and sleep over time were associated with children’s executive functions and mental health outcomes at the final time point. ResultsA total of 198 parents (children’s mean age = 9.14 years) were recruited and followed up. Non-school screen time was elevated at the initial timepoint (3.6 ± 2.3 h). Positive parenting at the initial timepoint was associated with lower screen time use in children (β = −.19, p < .001; β = −.19, p < .001, in internalizing and externalizing models). Children whose screen time use was constant during the pandemic had shorter sleep durations (β = −.45, p < .05 in internalizing model). Executive function was predicted by sleep duration at the first timepoint (β = −.55, p < .001; β = .73, p < .001, in internalizing and externalizing models) and changes in screen time during the pandemic was associated with both internalizing and externalizing symptoms (β = .58, p < .05; β = .54, p < .05, in internalizing and externalizing models). ConclusionChildren’s screen time decreased slightly but remained significantly higher than Canadian and International guidelines during 2 years of the pandemic. Positive parenting styles can have a significant impact on children's screen time use. Reducing excessive screen time can help improve sleep patterns and, consequently, cognitive, and emotional well-being in children.

Does the Association between Changes in Health Behaviors and Weight Gain Differ by Race and Ethnicity During the (COVID)-19 Pandemic? Findings from a Population-based Study

Objectives: We examined racial and ethnic differences in the association between changes in lifestyle behaviors and weight gain during COVID-19. Methods: We obtained data from a 2020 national survey involving 2,709 adult Americans. The outcome of interest was self-reported weight change status; behavioral measures included changes in exercise time, screen time, fast food meals consumed, and alcohol and tobacco use. We performed weighted multivariable logistic regression analyses to examine the association. Results: Non-Hispanic (NH) black adjusted odds ratio (AOR) (AOR = 1.59, 95% CI: 1.21-2.10) and Hispanic respondents (AOR = 1.89; 95% CI: 1.48-2.42) were more likely to experience weight gain, relative to the NH white respondents. Among NH Whites, changes in exercise time (AOR = 0.93), screen time (AOR = 1.16), fast-food meals consumptions (AOR = 1.14), and being drinkers (AOR = 1.35) and smokers (AOR = 0.53) were associated with weight gain; while among Hispanics, only changes in exercise time (AOR = 0.92) and screen time (AOR = 1.14) were associated with weight gain. Changes in exercise time (AOR = 0.94) among NH Blacks and changes in screen time (AOR = 1.16) among NH Asians were associated with weight gain. Conclusions: Risk factors of weight gain differ across racial and ethnic groups during the COVID-19 pandemic. Tailored intervention strategies are warranted to address specific risk behaviors within each racial and ethnic group.

Mindfulness programs for problematic usage ofthe internet: A systematic review and meta-analysis.

Problematic usage of the internet (PUI) is an umbrella term for a range of uncontrolled, excessive, and potentially harmful online behaviors. Recently, numerous studies have examined the potential of mindfulness programs (MPs) for reducing PUI. We conducted a comprehensive systematic review and meta-analysis in this emerging field. We searched eight databases from inception to October 18, 2022, with no language restrictions. We included randomized controlled trials (RCTs) and nonrandomized trials (NRTs). The primary outcome was change in self-reported PUI, the secondary outcome was change in screen time. Of 3,473 identified records, 19 RCTs and 20 NRTs with a total of 1,549 participants were included. Participation in an MP was associated with large reductions in PUI in between-group analysis in RCTs (k = 19; g = -1.67; 95% CI -2.15, -1.19) and in within-group pre-post analysis in all studies (k = 35; g = -1.67; 95% CI -1.99, -1.36). Screen time showed a medium reduction in within-group pre-post analysis (k = 10; g = -0.65; 95% CI -0.90, -0.41). The effects for PUI remained significant in a series of sensitivity analyses, such as excluding low quality studies, excluding outliers, adjusting for publication bias, or using follow-up data. Heterogeneity between studies was high and the overall quality of evidence was rated low. MPs are probably effective in reducing PUI and might be effective in reducing screen time. Shortcomings in the quality of evidence highlight the need for high-quality controlled trials with long-term follow-ups to confirm results.

Change in screen time and overuse, and their association with psychological well-being among US-wide school-age children during the COVID-19 pandemic: analysis of the National Survey of Children’s Health (NSCH) years 2018–21

BackgroundPrevious studies on screen use and children’s mental health during the Coronavirus Disease 2019 (COVID-19) pandemic focused only on the timeframe during the pandemic, on children between narrow age ranges, only among a subset of children who have previously reported COVID-related severe family economic hardship or worries, or did not distinguish between instructive versus recreational device usage. Thus, in this study, we analyzed trends, specifically related to recreational screen use, and associations with psychological well-being (PWB) in the years before versus during the COVID-19 pandemic, among a wide range of school-aged children, widely across the nation.MethodsUsing the National Survey of Children’s Health (NSCH) years 2018–21, we analyzed a large random sample of school-aged children (6–17 years old) across the US (n = 88,823). We developed PWB issue scores (PWBIS) using self-reported measures relevant to this age group, and constructed regression models to assess the magnitude of the contribution of the pandemic on recreational screen use and PWB.ResultsThe prevalence of recreational screen overuse and PWBIS increased significantly during the pandemic, compared to prior years. We also detected a notable effect of the pandemic on increased PWBIS, as well as its interaction term finding that it strengthened the association between screen time and PWBIS (p < 0.01 across all regression models).ConclusionsAccordingly, our results demonstrate the importance of the pandemic itself as an independent adverse factor and effect measure modifier for screen overuse and PWB more generally among all school-age children widely across the US. Our study used the most current data available, and future studies to evaluate whether these effects are persistent in the years after the pandemic are important.

A73: Associations of Screen Time Changes with Body Mass Index and Obesity in Chinese Preschoolers

Purpose: To understand the longitudinal association of screen time (ST) and its changes on body mass index (BMI) and obesity in Chinese preschool children. Methods: Parents of 735 preschoolers participated in our studies at baseline and were followed up one year interval, in Jiaxing, China. Linear regression models and generalized linear models were used to analyze the prospective association of ST and its changes with BMI and obesity in preschool-aged children. Relative risks (RR) and 95% confidence intervals (CI) were used to describe the effect level of each factor upon BMI and obesity at follow-up. Results: A total of 624 preschoolers, including 319 boys (51.1%) and 305 girls (48.9%) were followed up. The increase of ST (from ≤1h/d at baseline to &gt;1h/d at follow-up, β (SE)=0.45 (0.15), p=0.003) and preschoolers’ age at baseline (β (SE)=-0.21 (0.10), p=0.039) were prospectively associated with BMI in preschoolers at follow-up, and preschoolers’ ST from ≤1 h/day to &gt;1 h/day (RR: 2.49, 95% CI: 1.20-5.08, p=0.014) were related to obesity in preschoolers at follow-up after adjusting of sex, age, primary caregiver, and one child. Conclusions: The unfavorable changes of ST were associated with BMI and obesity in preschool-aged children. Future intervention studies were needed to confirm our results.

Effect of school lockdown due to the COVID-19 pandemic on screen time among adolescents in Hungary: a longitudinal analysis.

Studies indicate that due to school lockdown during the Coronavirus Disease 2019 (COVID-19) pandemic, screen time increased more steeply than pre-pandemic years. The aim of our study was to examine changes in screen time and its components (screen time spent on videos, games, homework, and other activities) of adolescents affected by COVID-19 school closures compared to controls from pre-pandemic years and to assess the effect of family structure and family communication. Two sets of ninth-grader boys and girls transitioning into 10th grade were included in the analysis. The 'pre-COVID classes' (controls) completed the baseline survey in February 2018 and the follow-up survey in March 2019. 'COVID classes' (cases) completed the baseline survey in February 2020 (1 month before the COVID-19-related school lockdowns) and the follow-up survey in March 2021. Linear mixed models stratified by sex were built to assess the change in screen time over one year adjusted for family structure and communication. Our study population consisted of 227 controls (128 girls, 99 boys) and 240 cases (118 girls, 122 boys). Without COVID-19, overall screen time did not change significantly for boys, but there was a decrease in screen time for gaming by 0.63 h, which was accompanied by an increase of 1.11 h in screen time for other activities (consisting mainly of social media and communication). Because of the pandemic, all components increased by 1.44-2.24 h in boys. Girls' screen time and its components remained stable without school lockdown, while it increased for videos and homework by 1.66-2.10 h because of school lockdown. Living in a single-parent household was associated with higher, while better family communication resulted in lower screen time. Our results indicate that COVID-19-related school lockdowns modified the age-specific increase in screen time for boys and girls as well. This trend, however, may be counterbalanced by improving communication between family members.

Changes in screen time from 4 to 7 years of age, dietary patterns and obesity: Findings from the Generation XXI birth cohort

Background and aimsIncreased screen exposure is associated with unhealthy eating behaviours and obesity. Screen time (ST) changes from pre-school to school age, and associations with dietary patterns (DP) and obesity remain unknown. We, therefore, analysed ST changes from 4 to 7 years of age, associated factors, and the relation with DP and obesity. Methods and resultsWe included 4531 children evaluated at 4 and 7 years, as part of the Generation XXI birth cohort (Porto, Portugal). ST was assessed for weekdays and weekend, and average daily time was estimated. Associations between covariates and ST changes, and between ST changes and 3 DP previously identified (Energy-dense foods, Snacking, and Healthier) were estimated by odds ratios (OR) and 95% confidence interval (95%CI), using adjusted multinomial regression models. From 4 to 7 years, 31.5% of the children decreased their ST, 21.8% increased, 16.5% maintained low (≤60 min), and 30.2% maintained high (61–120 min or >120 min) ST. After adjustment, lower maternal education (OR = 2.33, 95%CI:1.82–2.99) and lower family income (OR = 1.72, 95%CI:1.35–2.21) were associated with higher odds of increasing ST, while being a girl was associated with 35% decreased odds of increasing ST. Children that increased and those that maintained high ST showed greater odds of presenting a Snacking DP at 7 years (OR = 2.34, 95%CI:1.64–3.35) and (OR = 2.65, 95%CI:1.89–3.72), respectively. No statistically significant differences were found regarding changes in ST and the child's BMI. ConclusionChildren increasing screen exposure during this period were more frequently from lower socioeconomic strata and presented unhealthier DP.

Longitudinal associations between different types of screen use and depression and anxiety symptoms in adolescents.

Evidence examining the longitudinal associations between different types of screen behaviours and mental health among adolescents is limited. The present study examined the association between five types of screen behaviours and symptoms of anxiety and depression one year later. This study also assessed how changes in screen time were associated with changes in anxiety and depressive symptoms and whether the observed relationships were moderated by sex. Longitudinal data of 17,174 students in grades 9-12 (53.5% females; mean age: 15.1 ± 0.9 years) attending high schools in Canada from two waves (year 6: 2017/18, year 7: 2018/19) of the COMPASS study were analyzed. Leisure screen time and mental health measures were self-reported. To test if the associations between screen time and anxiety, and depression vary by sex, two-way interactions were examined for sex. Analyses accounted for school clustering, race/ethnicity, sex, age, income, body mass index z-score, and previous year anxiety and depression symptoms. There were significant longitudinal associations between time spent on each type of screen and subsequent anxiety and depression symptoms. The strength of the associations varied by type of screen behaviour. Interaction analysis indicated a sex difference for television viewing and anxiety and depression symptoms, and internet surfing and anxiety symptoms. A dose-response relationship was observed between phone talking and anxiety symptoms. Beta estimates indicated that an increase in screen duration was associated with a further increase in anxiety and depression symptoms. Higher screen time was longitudinally associated with higher anxiety and depression symptoms at one-year follow-up in adolescents. Time-change associations between screen usage and depressive and anxiety symptoms were observed. Also, associations differed based on sex and screen type, whereby greater increases in screen use predicted greater emotional distress. Findings from this prospective analysis suggest that screen time is an important determinant of anxiety and depressive symptoms among adolescents. Future studies are recommended to help inform programs promoting screen time reduction with a goal to enhance adolescents' mental health.

Changes in Children’s Recreational Screen Time During the COVID-19 Pandemic

This cohort study compared children’s recreational screen time with screen time before the COVID-19 pandemic and during 3 pandemic waves to examine whether changes in screen time were greater than those associated with age.

Change in screen time of preschool children according to parental attitudes during the COVID-19 pandemic with an online survey

ABSTRACT The relationship between the change in the screen time of preschool children according to both parent–child characteristics and parental attitudes was investigated in an online study involving 403 mothers. Mothers completed a questionnaire on baseline characteristics and Parent Attitude Scale. Multiple logistic regression and generalized linear models revealed the associations. Change in screen time was grouped as “increase” and “no increase”. 70% stated an increase in the screen time during the pandemic period. The overprotective score was low in the group with increased screen time after adjusting parental age, education, and working status, family type, number of the children, the enrolled child’s age, gender, daily screen time before the pandemic, and caregiver of the child. The child having longer screen time also had higher risk for the history of an increase in screen time in the lockdown period. This situation shows a need for parental guidance for healthy screen use.

Associations of racial and ethnic discrimination with adverse changes in exercise and screen time during the COVID-19 pandemic in the United States.

During the coronavirus disease 2019 (COVID-19) pandemic, a growing prevalence of racial and ethnic discrimination occurred when many Americans struggled to maintain healthy lifestyles. This study investigated the associations of racial and ethnic discrimination with changes in exercise and screen time during the pandemic in the United States. We included 2,613 adults who self-identified as non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, or Hispanic from the Health, Ethnicity, and Pandemic study, a cross-sectional survey conducted among a nationally representative sample of United States adults between October and November 2020. We assessed self-reported racial and ethnic discrimination by measuring COVID-19-related racial and ethnic bias and examined its associations with changes in exercise and screen time using multivariable logistic regression models. We analyzed data between September 2021 and March 2022. COVID-19-related racial and ethnic bias was associated with decreased exercise time among non-Hispanic Asian (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.13 to 1.89) and Hispanic people (OR, 1.91; 95% CI, 1.32 to 2.77), and with increased screen time among non-Hispanic Black people (OR, 1.94; 95% CI, 1.33 to 2.85), adjusting for age, sex, education, marital status, annual household income, insurance, and employment status. Racial and ethnic discrimination may have adversely influenced exercise and screen time changes among racial and ethnic minorities during the COVID-19 pandemic in the United States. Further studies are needed to investigate the mechanisms through which racial and ethnic discrimination can impact lifestyles and to develop potential strategies to address racial and ethnic discrimination as a barrier to healthy lifestyles.

Activities Online and Compulsive Internet Use in Primary School-Aged Children: Whether and How it Has Changed during the COVID-19 Pandemic?

There has been a growing concern among researchers about the use of various information technologies with screens and the Internet by children and adolescents over the past decade. Researchers are concerned that such type of activities can have negative consequences for mental health. Recent studies reveal that Internet use and screen time increased due to the quarantine restrictions, lockdowns and therefore distance education during the COVID-19 pandemic. This study aims: 1) based on parental reports, to find out the changes in screen time, the online activities and the compulsive Internet use (CIU) of 10-11 years old children during the quarantine due to the COVID-19 pandemic; 2) to determine the links between children’s CIU and the screen time, online activities, children’s gender and their parents’ education. The results of this study showed that screen time was longer and children’s CIU scores were significantly higher in Spring 2020 if to compare to Autumn 2019. Boys were reported to have higher CIU scores than girls. Children’s CIU was significantly predicted by overall screen time and online activities for entertainment, especially when during quarantine.

Screen time and myopia: A serial multiple mediator SEM analysis.

BackgroundCOVID-19 has influenced education systems worldwide, and significantly increased screen time for college students, posing a potential risk of myopia. In China, ninety percent of college students suffer from myopia. Excessive screen time changes college students' lifestyles, imposes potential health risks, and affects opportunities for employment. It is important to identify the potential correlation between screen time use and myopia among college students.MethodsThis paper conducted a nationwide experiment using Chinese college students and set a multiple-mediator SEM model to analyze the potential correlation between screen time and myopia. The two mediators were sedentary behavior and physical activity, respectively.ResultsWe obtained three valuable conclusions as follows: First, there was no significant direct relationship between screen time and myopia among Chinese college students during the COVID-19 pandemic. Second, sedentary behavior and physical activity significantly predicted the increase/decrease of myopia among Chinese college students, respectively. Third, a serial multiple mediator that encompassed sedentary behavior and physical activity sequentially fully mediated the relationship between screen time and myopia.ConclusionsAlthough there was no directly significant relationship between screen time and myopia, screen time can indirectly influence the risk of suffering myopia by influencing sedentary behavior and physical activity. Our study demonstrates the need to prevent the potential influence of overuse of electronic devices on myopia in college students, especially during the COVID-19 pandemic.

Changes in Canadian Adolescent Time Use and Movement Guidelines During the Early COVID-19 Outbreak: A Longitudinal Prospective Natural Experiment Design.

Comprehensive, prospective, longitudinal data are lacking on the effects of the COVID-19 outbreak on adolescents' movement behaviors (moderate to vigorous physical activity [MVPA], sleep, recreational screen use, and strengthening exercises). The purpose was to compare movement behavior changes among adolescents affected by the pandemic with controls. Survey data from 10,659 students at 82 Canadian secondary schools (aged 12-19y) during the 2018-2019 and 2019-2020 school years were analyzed. One-year change in time spent in movement behaviors and likelihood of meeting Canadian 24-hour movement guidelines was compared between preoutbreak controls (October 2019-March 2020) and early outbreak respondents (May-July 2020) after controlling for sociodemographic factors. Compared with controls, the early outbreak group reported a greater decrease in time spent in MVPA and greater increases in time spent in sleep and recreational screen use. The early outbreak group was less likely to meet MVPA and recreational screen time guidelines but more likely to meet guidelines for strengthening exercises and sleep duration. Findings for MVPA and screen time changes were in the same direction as retrospective reports from children and youth samples. Sleep adherence may have improved due to no longer having to commute to school. Strengthening exercises may represent physical activity that is easier to do in the home with minimal equipment leading to improved adherence during restrictions.

Associations Between Adverse Childhood Experiences, Adolescent Screen Time and Physical Activity During the COVID-19 Pandemic.

ObjectiveTo determine the associations between Adverse Childhood Experiences (ACEs), adolescent screen time, and physical activity during the early COVID-19 pandemic.MethodsData (2016–2020) from the Adolescent Brain Cognitive Development (ABCD) study were analyzed. Linear regression analyses estimated associations between ACE score and screen time and physical activity in May 2020, adjusting for potential confounders.ResultsOf the 6749 adolescent respondents primarily aged 12–13, 81.6% reported a history of one ACE or more. In adjusted models, a higher ACE score was significantly associated with greater hours per day of screen time, with youth with ≥4 ACEs associated with 2.3 more hours of screen time per day compared to youth with 0 ACEs. In addition, the adjusted models found that a higher ACE score was associated with lower physical activity; youth with ≥4 ACEs averaged 0.8 fewer hours per week of physical activity and 0.5 fewer days per week of 60 minutes of physical activity compared to youth with 0 ACEs. Gender and race were also significantly associated with changes in screen time and physical activity.ConclusionsACEs are associated with higher adolescent sedentary behaviors, particularly greater screen time, during the early COVID-19 pandemic (May 2020). Clinicians caring for youth exposed to trauma in the postpandemic environment should explore screen time and physical activity behaviors.

The impact of screen time changes on anxiety during the COVID-19 pandemic: sleep and physical activity as mediators.

Under the burden caused by COVID-19 and rapid lifestyle changes, many people increased their screen time due to psychological needs and social requirements. The current study investigated the relationship between screen time changes and anxiety symptoms during the pandemic of COVID-19. Furthermore, we examined whether sleep and physical activity would mediate the association between screen time changes and anxiety. The self-developed questionnaire was delivered online to collect people’s changes in anxiety, sleep patterns, and screen time during COVID-19. 970 participants (74.4% female) with an average age of 23 years were involved in this study. After adjusting demographic variables, the ordinal logistic regression analyses revealed that a significant increase in screen time was linked with anxiety. Slightly increased screen time, slightly and significantly decreased screen time did not predict anxiety symptoms during the pandemic. The level of anxiety was significantly higher among respondents who reported decreased sleep quality. Sleep quality directly mediated the association between screen time changes and anxiety, while sleep latency did not. The longer sleep latency caused by increased screen time would amplify anxiety by affecting sleep quality. In addition, the relationship between screen time changes and anxiety was also mediated by physical activity. We concluded that the fluctuation of screen time in a modest range does not affect the anxiety level substantially. The significantly increased screen time would contribute to poor sleep (including longer sleep latency and worse sleep quality) and lack of physical activity, which would lead to higher levels of anxiety.

Changes and correlates of screen time in adults and children during the COVID-19 pandemic: A systematic review and meta-analysis

SummaryBackgroundScreen time has increased as a result of the COVID-19 pandemic, and several correlates have been associated with these increases. These changes, however, have not been aggregated. It was the aim of this review to (a) aggregate changes in screen time in adults and children, and (b) report on variables in relation to screen time during the COVID-19 pandemic.MethodsA systematic review of major databases was undertaken for studies published from inception to 06/12/2021, using a pre-published protocol (PROSPERO ID: CRD42021261422). Studies reporting (a) screen time pre-versus-during the pandemic, (b) screen time percentage change, or (c) correlates of screen time during the pandemic were included. A random effects meta-analysis was undertaken with subgroup analysis by age group and type of screen time.FindingsAfter review, 89 studies (n = 204,734; median age=20·6; median female=53·3%) were included. The majority of studies were cross-sectional. With regards to total screen time, primary aged children (6–10 years) reported largest increases (1·4 hrs/day; 95%CI 1·1–1·7), followed by adults (>18 years; 1·0 hrs/day; 95%CI 0·7–1·2), adolescents (11–17 years; 0·9 hrs/day; 95%CI 0·3–1·5), and young children (0–5 years; 0·6 hrs/day 95%CI 0·3–0·9 hrs/day). For leisure screen time (non-work/non-academic), primary aged children reported largest increases (1·0 hrs/day 95%CI 0·8–1·3), followed by adults (0·7hr/day 95%CI 0·3–1·2), young children (0·6 hrs/day; 95%CI 0·4–0·8), with adolescents reporting the lowest increase (0·5 hrs/day 95%CI 0·3–0·7). Several correlates were associated with reported increases in screen time, including adverse dietary behaviours, sleep, mental health, parental health, and eye health.InterpretationPooled evidence suggest that primary aged children reported the highest increase in both total and leisure screen time during COVID-19. It is recommended that screen time should be reduced in favour of non-sedentary activities. This study has the potential to inform public health policy and future guidance regarding screen time, and to inform future research in this area.FundingNo funding was received for this study.

Distinct patterns of emotional and behavioral change in child psychiatry outpatients during the COVID-19 pandemic

BackgroundStudies are documenting the impact of the COVID-19 pandemic on youth mental health. We extended this literature by characterizing a child psychiatric outpatient sample in the United States during the middle of the 2020–2021 school year. We also used a computational strategy to identify distinct patterns of psychopathology symptom change and examined correlates and predictors of such change. Among potential predictors were cognition and clinical diagnoses, which have not been studied in this context previously.MethodsParticipants were 171 youth (aged 10.6 ± 3.1) referred for neuropsychiatric evaluation who enrolled in research and whose parents filled out a survey on COVID-19. The questionnaire included eight psychiatric and six psychosocial domains rated retrospectively prior to the pandemic and currently at the time of evaluation. We examined change in severity of individual domains with Wilcoxon signed-rank tests. We used a latent profile analysis (LPA) to identify groups with distinct symptom change profiles. Using multinomial logistic regression, we examined potential predictors and correlates of LPA-derived groups. Models controlled for age, sex, and assessment date and corrected for multiple testing.ResultsAlthough the majority of individual psychopathology domains were worse on average during the 2020–2021 school year, youth showed distincive patterns of symptom change. In addition to a large group (72.2%) with relatively stable symptoms and a small group (6.4%) that improved on most symptoms, there were two groups with different constellations of worsening symptoms. These latter groups both showed increased sadness, anxiety and oppositionality; however, one had increased hyperactivity/impulsivity and no change in hopelessness while the other showed greater hopelessness and no change in hyperactivity. Symptoms related to the distinguishable domains of these groups predicted group membership, and changes in screen time, conflict with parents and social isolation were correlates of worsening. Cognition and lifetime clinical diagnoses failed to predict group membership.ConclusionsIn youth outpatients, psychiatric and psychosocial difficulties were worse on average during the school year following the spring 2020 COVID-19 lockdown; yet, some youth experienced greater and distinctive symptom change. A personalized approach to support may be needed as youth emerge from this period.