Total Screen Time Research Articles

Family conflict and less parental monitoring were associated with greater screen time in early adolescence.

The current study investigated the prospective relationships between parental monitoring, family conflict, and screen time across six screen time modalities in early adolescents in the USA. We utilised prospective cohort data of children (ages 10-14 years) from the Adolescent Brain Cognitive Development (ABCD) Study (years baseline to Year 2 of follow-up; 2016-2020; N = 10 757). Adjusted coefficients (B) and 95% confidence intervals (CIs) were estimated using mixed-effect models with robust standard errors. A higher parental monitoring score was associated with less total screen time (B = -0.37, 95% CI -0.58, -0.16), with the strongest associations being with video games and YouTube videos. Conversely, a higher family conflict score was associated with more total screen time (B = 0.08, 95% CI 0.03, 0.12), with the strongest associations being with YouTube videos, video games, and watching television shows/movies in Years 1 and 2. The current study found that greater parental monitoring was associated with less screen time, while greater family conflict was linked to more screen time. These results may inform strategies to reduce screen time in adolescence, such as improving communication between parents and their children to strengthen family relationships.

Associations between bedtime media use and sleep outcomes in an adult population-based cohort

Abstract Background We aimed to extend existing research on associations between bedtime media use and sleep in adults by taking relevant covariates into account and testing hypothesised mediating and moderating pathways. Methods Frequency of bedtime media use and sleep outcomes were examined by questionnaire in 4188 adults (59% women, aged 19-94 years) from the Specchio cohort in Geneva, Switzerland. We tested: 1) associations between bedtime media use and sleep (bedtimes, sleep latency, sleep duration, sleep quality, insomnia symptoms, and daytime sleepiness), adjusting for prior sleep, mental health, and health behaviours (physical activity, binge drinking, smoking, total leisure screen time), 2) whether bedtime media use mediates associations between individual susceptibility factors (age, chronotype, and mental health) and sleep, and 3) whether individual susceptibility factors moderate associations between bedtime media use and sleep. Results Often using a screen in the 30 minutes before going to sleep at night was associated with a late bedtime (≥midnight; OR [95% CI]=1.90 [1.44, 2.51], p < 0.001), short sleep duration (<7 hours; 1.21 [1.01, 1.46], p < 0.05), and excessive daytime sleepiness (Epworth score >9; 1.47 [1.25, 1.74], p < 0.001) after adjustment for all covariates. Bedtime media use partly mediated the association between younger age and an evening chronotype and these sleep outcomes. Mental health moderated the association between bedtime media use and sleep quality/insomnia, such that the former was associated with poorer sleep quality/insomnia among individuals with better mental health, but not among those with poorer mental health. Conclusions Frequent bedtime media use was associated with various sleep outcomes, independently of relevant covariates. Limiting the use of screens at bedtime is important to promote sleep among adults. Individuals with poorer mental health likely require additional support to improve their sleep quality. Key messages • Frequent bedtime media use is associated with a late bedtime, short sleep duration, and more daytime sleepiness in adults, and these associations hold after adjustment for relevant covariates. • Frequent bedtime media use mediates the association between individual susceptibility factors and sleep outcomes. Mental health moderates the association between bedtime media use and sleep quality.

Exploring Screen Time and Its Effects on Children's Mental Health: A Cross-Sectional Study.

Background The increasing prevalence of screen-based activities among children has raised concerns about potential mental health effects. This study investigates the relationship between screen time and mental health outcomes in children aged 6 to 14 years in Saudi Arabia and Bahrain, focusing on emotional symptoms, conduct problems, hyperactivity, peer problems, and depressive symptoms. Methods A cross-sectional study was conducted with 670 children recruited through stratified random sampling. Data were collected using self-reported questionnaires and parental surveys from January to June 2024. Screen time was assessed across four activities: TV viewing, smartphone usage, computer/tablet use, and video game playing, recorded separately for weekdays and weekends. Mental health was evaluated using the Strengths and Difficulties Questionnaire (SDQ) and the Children's Depression Inventory (CDI). Descriptive statistics and Pearson correlation coefficients were used to analyze the data. Results Participants reported a mean total screen time of 7.25 ± 2.4 hours on weekdays and 8.4 ± 2.65 hours on weekends. Smartphone usage (2.75 ± 1.3 hours/day) was the most common activity. Emotional symptoms, conduct problems and depressive symptoms were significantly correlated with both weekday and weekend total screen time (weekday r = 0.43, r = 0.31, and r = 0.49, respectively, p < 0.001; weekend r = 0.47, r = 0.33, and r = 0.54, respectively, p < 0.001). Smartphone usage had the strongest association with depressive symptoms (r = 0.46, p < 0.001). Conclusion This study identifies a significant positive correlation between increased screen time and adverse mental health outcomes in children, particularly emotional symptoms and depressive symptoms. The findings emphasize the need for public health strategies to manage screen time and promote healthier digital habits to mitigate the potential negative effects on children's mental health.

Screen time and mental health: a prospective analysis of the Adolescent Brain Cognitive Development (ABCD) Study

BackgroundDespite the ubiquity of adolescent screen use, there are limited longitudinal studies that examine the prospective relationships between screen time and child behavioral problems in a large, diverse nationwide sample of adolescents in the United States, which was the objective of the current study.MethodsWe analyzed cohort data of 9,538 adolescents (9–10 years at baseline in 2016–2018) with two years of follow-up from the Adolescent Brain Cognitive Development (ABCD) Study. We used mixed-effects models to analyze associations between baseline self-reported screen time and parent-reported mental health symptoms using the Child Behavior Checklist, with random effects adjusted for age, sex, race/ethnicity, household income, parent education, and study site. We tested for effect modification by sex and race/ethnicity.ResultsThe sample was 48.8% female and racially/ethnically diverse (47.6% racial/ethnic minority). Higher total screen time was associated with all mental health symptoms in adjusted models, and the association was strongest for depressive (B = 0.10, 95% CI 0.06, 0.13, p < 0.001), conduct (B = 0.07, 95% CI 0.03, 0.10, p < 0.001), somatic (B = 0.06, 95% CI 0.01, 0.11, p = 0.026), and attention-deficit/hyperactivity symptoms (B = 0.06, 95% CI 0.01, 0.10, p = 0.013). The specific screen types with the greatest associations with depressive symptoms included video chat, texting, videos, and video games. The association between screen time and depressive, attention-deficit/hyperactivity, and oppositional defiant symptoms was stronger among White compared to Black adolescents. The association between screen time and depressive symptoms was stronger among White compared to Asian adolescents.ConclusionsScreen time is prospectively associated with a range of mental health symptoms, especially depressive symptoms, though effect sizes are small. Video chat, texting, videos, and video games were the screen types with the greatest associations with depressive symptoms. Future research should examine potential mechanisms linking screen use with child behavior problems.

Screen Time and its Determinants in Infants and Toddlers: Results from a Metropolitan Area of Istanbul

Objective: This cross sectional study aimed to assess screen time and associated factors in infants and toddlers under the age of 3 years in a metropolitan area. Method: Data were collected from 269 mothers registered in a family health center using a questionnaire. The questionnaire examines the demographic characteristics of families, the time spent by infants and toddlers with screen devices, and factors that may affect screen time, such as income status, education level and resources. Results: Three-quarters of infants and toddlers in this sample used screen devices (n=202, 75.1%). Total screen time ranged from 20 to 270 min/day, with a mean of 101.8±56.2 min/day. Infants and toddlers spent an average of 71.9 min/day watching television, 63.1 min/day using tablets, and 36.85 min/day using mobile phones. Total daily screen time exceeded World Health Organization (WHO) recommendations in 36.3% of infants aged 0-12 months, 84.3% of toddlers aged 13-24 months, and 49.4% of toddlers aged 25-36 months. Age of infant and toddler, maternal education level, and family income were identified as factors associated with risky screen exposure. Conclusion: Families can be educated about the potential consequences of screen time and strategies to reduce screen use. In trainings, families in the risk group should be given priority in terms of factors affecting screen time such as income status, education level and age.

Screen time, problematic screen use, and eating disorder symptoms among early adolescents: findings from the Adolescent Brain Cognitive Development (ABCD) Study

PurposeEmerging research evidence suggests positive relationships between higher screen time and eating disorders. However, few studies have examined the prospective associations between screen use and eating disorder symptoms in early adolescents and how problematic screen use may contribute to symptom development.MethodsWe analyzed prospective cohort data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 10,246, 2016–2020, ages 9–14). Logistic regression analyses were used to estimate the longitudinal associations between baseline self-reported screen time and eating disorder symptoms in year two. Logistic regression analyses were also used to estimate cross-sectional associations between problematic screen use in year two (either problematic social media or mobile phone use) and eating disorder symptoms in year two. Eating disorder symptoms based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) included fear of weight gain, self-worth tied to weight, engaging in compensatory behaviors, binge eating, and distress with binge eating.ResultsEach additional hour of total screen time and social media use was associated with higher odds of fear of weight gain, self-worth tied to weight, compensatory behaviors to prevent weight gain, binge eating, and distress with binge eating two years later (odds ratio [OR] 1.05–1.55). Both problematic social media and mobile phone use were associated with higher odds of all eating disorder symptoms (OR 1.26–1.82).ConclusionsFindings suggest greater total screen time, social media use, and problematic screen use are associated with more eating disorder symptoms in early adolescence. Clinicians should consider assessing for problem screen use and, when high, screen for disordered eating.Level of evidenceLevel III: Evidence obtained from well-designed cohort or case–control analytic studies.

Screen Use at Bedtime and Sleep Duration and Quality Among Youths

Although questionnaire-based cross-sectional research suggests that screen time before bed correlates with poor sleep, self-reported data seem unlikely to capture the complexity of modern screen use, requiring objective night-by-night measures to advance this field. To examine whether evening screen time is associated with sleep duration and quality that night in youths. This repeated-measures cohort study was performed from March to December 2021 in participant homes in Dunedin, New Zealand. Participants included healthy youths aged 11 to 14.9 years. Data were analyzed from October to November 2023. Objectively measured screen time, captured using wearable or stationary video cameras from 2 hours before bedtime until the first time the youth attempted sleep (shut-eye time) over 4 nonconsecutive nights. Video data were coded using a reliable protocol (κ = 0.92) to quantify device (8 options [eg, smartphone]) and activity (10 options [eg, social media]) type. Sleep duration and quality were measured objectively via wrist-worn accelerometers. The association of screen use with sleep measures was analyzed on a night-by-night basis using mixed-effects regression models including participant as a random effect and adjusted for weekends. Of the 79 participants (47 [59.5%] male; mean [SD] age, 12.9 [1.1] years), all but 1 had screen time before bed. Screen use in the 2 hours before bed had no association with most measures of sleep health that night (eg, mean difference in total sleep time, 0 minutes [95% CI, -3 to 20 minutes] for every 10 minutes more total screen time). All types of screen time were associated with delayed sleep onset but particularly interactive screen use (mean difference, 10 minutes; 95% CI, 4 to 16 minutes for every additional 10 minutes of interactive screen time). Every 10 minutes of additional screen time in bed was associated with shorter total sleep time (mean difference, -3 minutes; 95% CI, -6 to -1 minute). The mean difference in total sleep time was -9 minutes (95% CI, -16 to -2 minutes) for every 10 minutes of interactive screen use and -4 minutes (95% CI, -7 to 0 minutes) for passive screen use. In particular, gaming (mean difference, -17 minutes; 95% CI, -28 to -7 minutes for every 10 minutes of gaming) and multitasking (mean difference, -35 minutes; 95% CI, -67 to -4 minutes on nights with vs without multitasking) were associated with less total sleep time. In this repeated-measures cohort study, use of an objective method showed that screen time once in bed was associated with impairment of sleep, especially when screen time was interactive or involved multitasking. These findings suggest that current sleep hygiene recommendations to restrict all screen time before bed seem neither achievable nor appropriate.

Relationship of work-related and leisure-based screen time with obesity: a cross-sectional study on adults including older adults.

The relationship between screen time (ST) and obesity has been demonstrated; however, few studies have differentiated between work-related and leisure-based use in Japanese adults, including older adults. This study aimed to examine the relationship between both work-related and leisure-based ST and obesity in adults. This cross-sectional study was based on a questionnaire survey conducted in 2018. Overall, 9947 adults were invited; 3161 participants (31.8%) returned the questionnaire. Finally, 2488 participants (597 younger men (YM), 792 younger women (YW), 542 older men (OM), 557 older women (OW)) were included. The main exposures were work-related, leisure-based, and total ST. The outcome was obesity (body mass index ≥ 25 kg/m2). Log-binomial regression analysis was used to calculate prevalence ratios (PRs) and confidence intervals (CIs) for obesity with 1-h increments of each ST. Analyses were conducted in all participants and subgroups comprising YM, YW, OM, and OW. Total ST was significantly associated with obesity in all participants (PR (95% CI) 1.07 (1.04-1.10), YM (1.05 (1.01-1.10)), OM (1.13 (1.05-1.22)), and OW (1.13 (1.02-1.26)). Work-related ST was significantly associated with obesity in all participants (1.08 (1.04-1.12)), YM (1.06 (1.00-1.12)), and OM (1.24 (1.08-1.42)). Leisure-based ST was significantly associated with obesity in all participants (1.09 (1.04-1.14)), YM (1.09 (1.00-1.18)), and YW (1.10 (1.01-1.20)). ST is associated with obesity in Japanese adults including older adults; particularly, work-related ST is associated with obesity in men, and leisure-based ST, in younger individuals.

Leisure Screen Time and Food Consumption among Brazilian Adults.

Screen time, involving activities like watching television (TV), and using tablets, mobile phones, and computers (electronic devices), is associated with the consumption of unhealthy foods. This study aimed to analyze the association between prolonged leisure screen time and healthy and unhealthy food consumption indicators among Brazilian adults (≥18 years). Data from the National Health Survey (NHS), conducted in 2019 (n = 88,531), were used. Prolonged leisure screen time (screen time ≥ 3 h/day) was analyzed in three dimensions: watching TV; use of electronic devices; and total screen time (TV and electronic devices). Food consumption was analyzed in two dimensions: healthy (in natura and minimally processed foods) and unhealthy (ultra-processed foods). Poisson regression models were used to calculate prevalence ratios (crude and adjusted (PRa)) by sociodemographic factors (sex, age, schooling, income, area of residence, and race/color) and health factors (weight status, self-rated health, and presence of noncommunicable disease), to assess the association between prolonged screen time and food consumption indicators. Among Brazilian adults, the prevalence of prolonged screen time was 21.8% for TV and 22.2% for other electronic devices for leisure. The highest frequency of watching TV for a prolonged time was observed among women, older adults, and those with a lower income and schooling. Prolonged use of electronic devices was more common among young adults and those with intermediate schooling and income. Prolonged screen time was associated with an unhealthy diet, due both to the higher consumption of unhealthy foods (PRa = 1.35 for TV, PRa = 1.21 for electronic devices, and PRa = 1.32 for both types) and the lower consumption of healthy foods (PRa = 0.88 for TV, PRa = 0.86 for electronic devices, and PRa = 0.86 for both). Prolonged screen time was negatively associated with the consumption of healthy foods and favored the consumption of unhealthy foods among Brazilian adults.

Investigation of bi-directional relations between pre-sleep electronic media use and sleep: A seven-day dairy study

The current study aimed to examine the bi-directional relationships between pre-sleep electronic media use and sleep, and to assess the relative predictive strength of different types of electronic media use in the evening on subsequent sleep. Eighty-eight young adults (20.57 ± 0.99, 27 males) completed an online intake survey and received notifications to complete daily diaries for seven consecutive days. Results of dynamic structural equation models (DSEM) revealed that the total screen time, sleep onset time, sleep latency, sleep duration, and sleep quality showed significant positive autoregressive parameters. In contrast, the results revealed no statistically significant cross-lagged associations between the total screen time in the evening and sleep outcomes. Inspection of the predictive strength of various types of screen activities at the within-person level revealed that increased active social media use is linked to delayed sleep onset, while internet browsing is associated with shorter sleep latency. At the between-person level, screen time of T.V. watching, video streaming, social media use, and shopping correlated with delayed sleep onset. Shopping was also connected to longer sleep latency. Additionally, more time spent on T.V., video streaming, non-work internet browsing, and shopping was linked to reduced total sleep duration. These findings indicated a screen activity-dependent association between pre-sleep screen time and subsequent sleep. More objective assessments of electronic media use (e.g., app recording screen time) and sleep (e.g., actigraphy) and longitudinal monitoring over a relatively long period (i.e., several weeks or months) are warred to further elucidate (cross-lagged) relationships between electronic media use and sleep.

Sports and exercise-related smartphone use is antagonistic to hedonic use in regular exercisers: A cross-sectional study examining the roles of exercise frequency and duration.

Hedonic smartphone use has been associated with dependence and addiction studied under the umbrella term Problematic Smartphone Use (PSU). Research usually explores total screen time as an index of PSU. A few studies suggest that exercise is inversely related to smartphone use time. However, it is unknown which primary characteristics of exercise behavior are related to more moderate smarthone use. Furthermore, the purpose of smartphone use, such as hedonic use associated with PSU versus utilitarian use, was not tested in the sports and exercise contexts. Hedonic use generally means playing with the smartphone for joy, distraction, and satisfaction. Utilitarian use implies practical and valuable use. There is a conjecture that sports involvement may foster utilitarian use through increased involvement in sports-related information-seeking, goal-setting, and self-monitoring. Therefore, we examined whether weekly exercise frequency, workout duration, and perceived exercise intensity relate to total daily smarthone and hedonic use and whether this relationship is mediated by sports-related utilitarian device use. We tested regularly exercising adults (n = 360, 132 males, M age = 39.0 ± 9.8, M weekly exercise = 5.8 ± 1.9) who volunteered for this study and provided demographic information about their exercise habits and smartphone use. The results revealed that all exercise parameters mediated the total daily smartphone use, with perceived exercise intensity being a negative predictor. Further, exercise frequency and duration (but not intensity) positively predicted sports-related smartphone use, which inversely predicted hedonic use. These results suggest that exercise parameters directly relate to daily smartphone use, which completely mediates hedonic use. These findings may partially account for the frequently reported inverse relationship between regular exercise and PSU by suggesting that the connection is mediated via sports-related smartphone use.

The role of gadgets in the everyday life of a young child: exploring the impact of digital dementia and the importance of digital hygiene

Introduction. With the rapid integration of digital technology into every aspect of society, it is inevitable that preschool children are also exposed to gadgets. This has raised concerns among parents, educators, and researchers alike. While there are undeniable benefits such as access to educational resources and innovative learning techniques, the excessive use of gadgets can have detrimental effects on children's attention span, speech development, and social skills. Therefore, it is crucial to establish a balanced and appropriate interaction between preschoolers and digital devices, drawing from the experiences of key influencers in children's development, namely parents and preschool teachers. The purpose of the research is to analyze the perspective and approach of parents, kindergarten teachers, and additional preschool education teachers regarding the utilization of electronic devices by young children. Materials and methods. The online survey involved 412 kindergarten teachers in the Sverdlovsk region (Russian Federation), as well as 15 teachers of additional preschool education institutions and 15 mothers of preschool children took part in a semi-structured interview. Results. Preschoolers have been found to have the highest level of exposure to gadgets both at home and in kindergartens. However, in additional education institutions, the integration of gadgets into their activities is not as prevalent, as they tend to rely more on traditional teaching methods. The majority of kindergarten teachers utilize gadgets when working with preschoolers. They often employ videos, cartoons, and interactive whiteboard lessons as teaching tools. It is worth noting that the percentage of teachers who oppose the use of gadgets has significantly decreased to 5%. On the other hand, 90% of teachers have a positive attitude towards digitalization and believe that the effective use of modern technologies can simplify their work and engage children, ultimately benefiting them. Nevertheless, it has been discovered that the prescribed norms for the use of digital technologies by preschool children are often not adhered to. This is due to the fact that children use gadgets at home for entertainment purposes, such as watching cartoons and playing games for 30-60 minutes or more per day. Additionally, in kindergartens, children spend around 20-30 minutes watching videos and educational content, resulting in a total screen time that often exceeds one hour per day. This highlights the necessity to enhance the digital competence of parents and teachers, implement a monitoring system for children's gadget usage, and develop comprehensive guidelines for children's interaction with digital technologies. Conclusion. The results of the study highlight the necessity of formulating comprehensive guidelines for children's engagement with digital technologies, alongside enhancing the digital proficiency of parents and educators. This approach will facilitate the proper utilization of gadgets and maximize the advantages they offer for a child's growth and development.

Impact of smart technology use on sleep quality in individuals with autism spectrum disorder: a mixed-methods investigation

BackgroundSleep disturbances are common among individuals with autism spectrum disorder (ASD) and can have a negative impact on their daily functioning and core symptoms. As the use of smart technologies continues to rise, it is crucial to understand how these devices affect the sleep quality of individuals with ASD.AimThe objective of this study was to examine the relationship between the use of smart technology and sleep quality in individuals with ASD.MethodsA mixed-methods approach was employed, combining both quantitative and qualitative data collection techniques. A sample of 83 individuals with ASD, aged between 8 and 25 years, assessed their sleep quality using the Pittsburgh Sleep Quality Index. Additionally, information regarding patterns of smart technology use and relevant covariates was collected. Correlation and regression analyses were conducted to analyze the data. Furthermore, semi-structured interviews were conducted with a subset of participants and their caregivers.ResultsSignificant positive correlations were found between poorer sleep quality scores and total screen time (r = 0.42, p &amp;lt; 0.001), pre-bedtime technology use (r = 0.51, p &amp;lt; 0.001), gaming (r = 0.32, p = 0.003), and social media use (r = 0.29, p = 0.008). Pre-bedtime technology use was a significant predictor of poorer sleep quality (β = 0.32, p = 0.006), even after controlling for age, gender, and ASD severity.ConclusionThe findings of this study emphasize the significant associations between the use of smart technology, particularly before bedtime, and poorer sleep quality in individuals with ASD. These results underscore the importance of developing evidence-based interventions and guidelines to promote healthy sleep habits and mitigate the negative effects of technology exposure in this population.

Effects of electronic screen exposure time on hypertensive disorders in pregnancy: a retrospective cohort study

BackgroundWe previously conducted a case-control study and found that exposure to electronic screen before nocturnal sleep was associated with hypertensive disorders in pregnancy (HDP). Hence, we carried out this cohort study aiming to identify the effects of screen exposure time on the incidence rate and severity of HDP.MethodsA retrospective cohort study was conducted from January 2022 and July 2022 from three hospitals in Wuxi and Changzhou cities. A total of 732 women were recruited and the information included socio-demographic characteristics, screen exposure and outcomes. Generalized estimating equations and binary non-conditional logistic models were applied to multivariate analysis, calculating the odds ratios (ORs) and 95% confidence intervals (CIs) of screen exposure time.ResultsThe duration order of total screen time was smartphone > computer > television, while the duration order of screen time before nocturnal sleep was smartphone > television > computer. Multivariate analyses showed that the susceptibility of HDP among women who exposed to television before nocturnal sleep was 81.5% percent higher than those not exposed (P = 0.018, OR[95%CI] = 1.815[1.106–2.981]). In addition, total daily exposure time of television in the third trimester of pregnancy significantly increased the severity of HDP (P = 0.021, OR[95%CI] = 3.641[1.213–10.927]).ConclusionsBased on this preliminary study, we would suggest that pregnant women do not watch television before nocturnal sleep. While in the third trimester of pregnancy, total exposure time of television should be limited. Investigations from other areas and experimental studies should be conducted to verify the conclusion.

An Observational Study to Assess Smartphone Usage in Patients of Anxiety and Depression

Abstract Background: Anxiety and depression disorders are among the most common psychiatric illness in the community and primary care. There is paucity in data regarding the assessment of smartphone use in mental disorders. Therefore, the study was undertaken to assess the use of smartphones at the time of presentation at a tertiary care centre and after an episode of anxiety and/or depression. Methodology: 145 subjects were screened for depression and anxiety subjectively. Smartphone use was assessed at the time of diagnosis, and for 1 week, 5 weeks and 3 months by using Stay Free© App. Results: There was significant correlation between total screen time with HAM D and HAM A scores. Conclusion: Smartphone usage is significantly associated with severity of depression and anxiety. Counselling of the subjects with anxiety and depression regarding the effect of smartphones on health is required and instructions should be given regarding the proper use of gadgets.

Screen use in transgender and gender-questioning adolescents: Findings from the Adolescent Brain Cognitive Development (ABCD) Study

ObjectiveTo assess the association between transgender or gender-questioning identity and screen use (recreational screen time and problematic screen use) in a demographically diverse national sample of early adolescents in the U.S. MethodsWe analyzed cross-sectional data from Year 3 of the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®, N = 9859, 2019–2021, mostly 12–13-years-old). Multiple linear regression analyses estimated the associations between transgender or questioning gender identity and screen time, as well as problematic use of video games, social media, and mobile phones, adjusting for confounders. ResultsIn a sample of 9859 adolescents (48.8% female, 47.6% racial/ethnic minority, 1.0% transgender, 1.1% gender-questioning), transgender adolescents reported 4.51 (95% CI 1.17–7.85) more hours of total daily recreational screen time including more time on television/movies, video games, texting, social media, and the internet, compared to cisgender adolescents. Gender-questioning adolescents reported 3.41 (95% CI 1.16–5.67) more hours of total daily recreational screen time compared to cisgender adolescents. Transgender identification and questioning one’s gender identity was associated with higher problematic social media, video game, and mobile phone use, compared to cisgender identification. ConclusionsTransgender and gender-questioning adolescents spend a disproportionate amount of time engaging in screen-based activities and have more problematic use across social media, video game, and mobile phone platforms.

Executive dysfunction as a possible mediator for the association between excessive screen time and problematic behaviors in preschoolers.

Excessive screen time in children is a growing concern for parents and healthcare providers worldwide because it frequently leads to behavioral problems. Although executive dysfunction is proposed to be one of the contributing factors to maladaptive behaviors, little is known about the link between screen time and behaviors. This study aimed to identify whether executive dysfunction contributes to the negative behaviors of children exposed to excessive screen time. A cross-sectional study was conducted on preschool-aged children from public and private schools in Chiang Mai, Thailand. The parents/guardians of each child completed the questionnaires regarding clinical characteristics and screen time use, the Behavior Rating Inventory for Executive Function-Preschool (BRIEF-P), and the Strengths and Difficulties Questionnaire (SDQ). Children with more than one hour of media exposure per day were considered to have excessive screen time. Multivariable Gaussian regression was analyzed to compare the BRIEF-P and SDQ scores between the excessive and appropriate screen time groups. Causal mediation analysis was performed to examine the effects of total screen time on increasing behavioral problems with executive functioning as a mediator. A total of 1,126 preschoolers were included in the analyses. After controlling for age, sex, socioeconomic status, and maternal education, the excessive screen time group had significantly higher BRIEF-P global executive composite score than the appropriate screen time group (mean difference of global executive composite score = 1.49, 95% CI [0.12, 2.86], and p = 0.033). Concurrently, there were significant differences in externalizing behavior subscales and SDQ total difficulties scores between the excessive and appropriate screen time groups (mean difference of total difficulties score = 0.90, 95% CI [0.29, 1.50], and p = 0.004). A significant average causal mediation effect (ACME) of screen time on behavioral problems mediated through executive functioning was β = 0.28, 95% CI [0.13-0.44], which was more than half of the total effect (54.9%, 95% CI [37.4-100%]). The current study suggests that the increase in behavioral issues in preschoolers might be partly explained by the direct effect of excessive screen time and the mediating effect of impaired executive functioning. Our results may raise concerns about the necessity to limit screen time and monitor for executive function deficits and behavioral problems in young children with high screen time.

Associations between screen use while eating and eating disorder symptomatology: Exploring the roles of mindfulness and intuitive eating

Screen use while eating has been recently identified as a highly common and potentially important specific setting of screen use in relation to eating disorder symptomatology. However, given this area of research is still in its infancy, how screen use while eating may be related to eating disorder symptomatology remains largely unexplored. To fill this gap, the present study probed the potential roles of mindfulness and intuitive eating in the association between screen use while eating and eating disorder symptomatology. A large sample of Chinese adults (N = 800, aged 18–67 years old) recruited through a Chinese survey platform, Credamo, completed questionnaires assessing screen use while eating, eating disorder symptomatology, mindfulness, and intuitive eating. Structural equation modeling was used to test the proposed model. Results confirmed our hypotheses that the association between screen use while eating and eating disorder symptomatology was partially explained by mindfulness and intuitive eating, after adjusting for covariates (e.g., gender, age, body mass index, total screen time, and social media use). That said, higher screen use while eating was associated first with lower mindfulness and then with lower intuitive eating, which in turn were related to higher eating disorder symptomatology. The findings underline the importance of including eating-specific screen use for future research on eating disorder symptomatology and also have implications for an integrative intervention of mindfulness-based approaches and intuitive eating for mitigating the adverse effects of excessive screen use on eating behaviors.

Preschooler Screen Time During the Pandemic Is Prospectively Associated With Lower Achievement of Developmental Milestones.

The aim of this study was to assess the developmental risks associated with total screen time, and specifically newer mobile devices, in the context of the pandemic. This study uses parent-reported data from a prospective cohort of Canadian preschool-age children. The exposure variable is child daily screen time measured at the age of 3.5 years categorized as light (<1 hr/d), moderate (1-4 hr/d), or intensive (>4 hr/d) use (N = 315). Time spent on mobile devices was considered separately as a continuous variable. Our outcome is child global development scores, which combine assessments of communication, cognitive, personal-social, and motor skills measured at the age of 4.5 years using the Ages and Stages Questionnaire (ASQ) (N = 249, 79% retained). ASQ scores were dichotomized to distinguish children at risk of developmental delays (below the 15th percentile) from those not at risk. We estimate associations between child screen time and later global development using multiple regressions adjusted for child sex and temperament, and parent education. We also examine whether associations are moderated by child and parent characteristics. Logistic regressions revealed that intensive users were more at risk of global developmental delays compared with light users (OR = 4.29, p = 0.020). Mobile device use was also associated with lower global scores (β = -3.064; p = 0.028), but not with risk of delays. We found no evidence that associations were moderated by child sex and temperament, or parent education. The findings suggest that intensive screen time may be associated with delays in child global development. Early childhood professionals should encourage families with preschoolers to prioritize screen-free activities to promote optimal cognitive, language, social, and motor development.

Examining Profiles of U.S. Children's Screen Time and Associations with Academic Skills.

Children's screen time (ST) increased in recent years, but investigations of the content and context (e.g., parental presence, and device type) of ST in predicting early academic skills remains understudied. In this study of 127 four- and five-year-olds, we examined whether the educational content and contextual information about children's ST from time diary interviews at age 4 predicted direct assessments of academic skills at age five. Cluster analyses detected three unique groups: Cluster One was "lowest ST and highest non-educational TV, with little parental presence," Cluster Two was "moderate ST and highest educational mobile devices, with moderate parental presence," and Cluster Three was "highest total ST and moderate educational ST and high parental presence." Children in Cluster Two scored significantly higher in literacy skills at age five than peers in Cluster One and Cluster Three. Children in Cluster One scored significantly higher in spatial skills compared to those in Cluster Three. No significant associations were detected between children's ST and number skills. Findings suggest that educational content and contextual features of ST combine in meaningful ways and appear to better predict children's literacy and spatial skills compared to variable-centered approaches. Methodological implications of this research and future directions are discussed.