Epidemiological screen time associated with anxiety and depression in older children

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Researchers have found that older Canadian schoolchildren who spent the most time looking at screens during the COVID-19 pandemic experienced higher levels of anxiety and depression, while their younger peers had more behavioral problems. However, the study does not conclusively prove that screen time is harmful, and one expert has challenged the conclusions.

However, a study co-author said the findings highlight the potential harms of excessive screen time, particularly in the context of virtual learning in the era of the pandemic. Doctors “really need to advocate for policies that will protect children to reduce screen time and social isolation and increase their participation in school, sports and academic activities,” Katherine S. Birkin, a pediatrician at the University of Toronto, in an interview.

The study appeared December 28 in the journal JAMA Network is open.

Birkin and her colleagues launched the study to examine whether high levels of screen time during the pandemic are disrupting children’s mental health. In particular, they wanted to divide different types of screen time, such as virtual learning, watching TV, and playing video games.

“The bulk of the literature supports a strong association between screen time and mental health symptoms such as anxiety,” Birkin said.

For the study, researchers conducted a parent survey to track screen time for 2,026 children between May 2020 and April 2021.

In a group of 532 younger children (median age, 5.9 years; 52% male; 58% of European ancestry), researchers linked each additional hour of daily television or digital media use to worse behavior, as measured by strengths and difficulties. Questionnaire: 0.22 in modified form for children aged 2-4 years; 95% CI, 0.10 – 0.35; s < .001) and 0.07 in an adjusted model in those age 4 and older (95% CI, 0.02–0.11; s = .007).

However, the researchers noted no statistically significant associations of more anxiety/depression or hyperactivity/inattention in this group of children.

Among 1,494 older children (mean age, 11.3; 57% male; 58% of European ancestry), researchers linked greater daily use of television or digital media to higher levels of depressive symptoms in a dose-dependent relationship, said Birkin (hourly). Single: β, 0.21 [95% CI, -1.28 to 0.78]; 2-3 hours: , 1.81 [95% CI, 0.29 – 3.33]; 4-5 hours: , 2.80 [95% CI, 1.15 – 4.44]; 6-8 hours: 5.16 [95% CI, 3.32 – 7.01]; 9 hours: 5.42 [95% CI, 3.30 – 7.54]; Inclusive s <.001).

“Similarly, higher daily television or digital media time was associated with higher levels of anxiety symptoms,” the researchers stated. “Also, daily television or digital media time was significantly associated with differences in symptoms of irritability, inattention, and hyperactivity/inattention.”

According to the researchers, spending more time learning virtually was associated with higher levels of depression and anxiety in both groups of children. It is not clear whether this finding reflects the effect of screens themselves or because children most exposed to virtual learning may also be most exposed to the stressful disruption of the epidemic.

The researchers also found “insufficient evidence” to link more virtual learning to irritability, inattention, hyperactivity, inattention, and hyperactivity/impulsivity in the modified models.

Birkin said that video chat does not appear to have a protective effect. The researchers also specifically analyzed children with autism and found no link between spending more time in front of screens and various mental health/behavioral problems.

Is it possible for children with more anxiety, depression, and isolation to turn to screens because they are anxious, depressed, and isolated? Birkin said the researchers adjusted the results to take into account previous mental health problems. She noted that the study linked more virtual learning in the era of the pandemic to more depression/anxiety. She said it was “hard to imagine” how mental health issues could lead to more virtual learning.

Bad news or bad stats?

Chris Ferguson, PhD, a professor of psychology at Stetson University in Deland, Florida, who studies screen time, criticized the study in an interview. “The observed effects are so small, it’s impossible to know whether it’s a real or a false positive result common in social science research,” he said. “Ultimately, this study is better evidence of how many scientists are bad at statistics than anything about children and screens.”

Ferguson said the results could be confusing because children are turning to screens to reduce their anxiety. “For the most part, screens have been a godsend during COVID-19,” he said. “They helped the kids stay indoors and gave them something to do during social distancing and allowed them to stay in touch with friends and families. Honestly, what else were we expecting the kids to do, staring at the wallpaper?”

Children with depression and anxiety often turn to screens or books to escape the unpleasantness of real life. “This does not mean that screens or books are the culprits,” he said.

Rather than focusing on screen time, Ferguson suggested parents consider these factors: “Keep in mind that not every child is a genius. Is your child doing as well in school as you would expect, given his natural ability? Are they getting at least some exercise every day? Are they Are they getting enough sleep? Are they able to connect with friends in a context, whether in real life or online? Are they happy?”

The study was funded by the Canadian Institutes of Health Research, the Center for Brain and Mental Health at the Hospital for Sick Children, the Ontario Department of Health, and the University’s Miners’ Lamps Innovation Fund in the Prevention and Early Detection of Severe Mental Illness at the university. Toronto. The study authors mentioned various financial relationships. Ferguson reported no financial related conflicts of interest.

Gamma neto is open. Published online December 28, 2021. Full text

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