Association between psychological distress and elevated use of electronic devices among U.S. adolescents: Results from the youth risk behavior surveillance 2009-2017

Mediation of the association between screen time and suicidality by overweight/obesity and perceived overweight: results from the youth risk behavior surveillance system of the United States

Aim

Adolescent suicide is a major public health concern, and modifiable risk factors associated with adolescent suicide remain poorly understood. This study aimed to assess the association between screen time and overweight/obesity and self-perceived overweigh and suicidality in adolescents.

Methods

Adolescents from the United States Youth Risk Behavior Surveillance System (YRBSS) between 2013 and 2019 were included in this cross-sectional study. The outcome was suicidality, including considered suicide, made a suicide plan, attempted suicide, and injurious suicide attempt. Multivariable logistic regression model was used to investigate the associations between screen time, overweight/obesity, self-perceived overweight, and suicidality, and expressed as odds ratio (OR) and 95% confidence interval (CI). Mediation analysis was used to explore the role of overweight/obesity and self-perceived overweight on the association between screen time and suicidality.

Results

A total of 30,731 adolescents were included, of which 6,350 (20.65%) had suicidality, including 5,361 (17.45%) with considered suicide, 4,432 (14.42%) with made a suicide plan, 2,300 (7.45%) with attempted suicide, and 677 (2.21%) with injurious suicide attempt. Adolescents with screen time ≥3h were related to higher odds of suicidality (OR=1.35, 95%CI: 1.23-1.46), overweight/obesity (OR=1.27, 95%CI: 1.19-1.38), and self-perceived overweight (OR=1.38, 95%CI: 1.30-1.48) after adjusting confounders. Adolescents with overweight/obesity (OR=1.30, 95%CI: 1.19-1.43) and self-perceived overweight (OR=1.54, 95%CI: 1.39-1.70) were associated with higher odds of suicidality. The association between screen time and suicidality was 4.67% mediated by overweight/obesity and 9.66% mediated by self-perceived overweight. Moreover, the mediating role of overweight/obesity was observed only in females, whereas there were no sex differences in the mediating effect of self-perceived overweight.

Conclusion

Both overweight/obesity and self-perceived overweight mediated the association between screen time and suicidality.

Association between smartphone usage and health outcomes of adolescents: A propensity analysis using the Korea youth risk behavior survey

OBJECTIVES

We aimed to investigate the association between smartphone use and adverse behavioral health outcomes using nationwide Korea Youth Risk Behavior Web-based Survey data for 2017 and 2020.

METHODS

The 2020 data (N = 54,809) were used to analyze the relationships between daily smartphone usage time (non-user, 0-2 h [hour], 2-4 h, 4-6 h, 6-8 h, and > 8 h), and adverse health outcomes (stress, sleep, depression, suicide, substance use, and smartphone overdependence). A 1:1 propensity score matching (PSM) was used to control for confounding variables.

RESULTS

A total of 40,998 adolescents with < 4 h/day and > 4 h/day of usage were included. Adolescents' mean smartphone usage time in 2020 increased compared to that in 2017 (weighted % of > 2 h/day; 64.3% vs. 85.7%). The curvilinear relationships between smartphone usage time and adverse health outcomes were prominent after > 4 h/day. Adolescents using smartphones 2-4 h/day showed no increased adverse health outcomes compared to non-users, except for smartphone overdependence. Using a smartphone > 4 h/day was significantly associated with stress perception (1.16; 1.11-1.22), suicidal ideation (1.22; 1.13-1.31), and substance use (alcohol, 1.66; 1.57-1.75) after PSM.

CONCLUSIONS

Our study demonstrated the curvilinear relationship between smartphone usage time and adverse health outcomes in adolescents. Our findings can help establish smartphone usage guidelines for adolescents.

Unpacking the relation between children's use of digital technologies and children's well-being: A scoping review

Over the last decade, a substantial number of studies have addressed children's use of technologies and their impact on well-being. Nonetheless, there is still a lack of clarity on the operationalisation of technology use, well-being, and the relation between the two. This scoping review intended to shed lights on Digital Technologies Use, its operationalisation, and the relation between Digital Technologies Negative Use (DTNU) and children's well-being. For the scope of the special issue we focused on negative use. Results showed two conceptualisations of DTNU: compulsive/addictive use of devices and the Internet (e.g., Internet addiction) and negative online experiences/risky behaviours (e.g., cyberbullying). Well-being in relation to DTNU was mainly studied in terms of psycho/social dimensions (e.g., depression), and a gap in cognitive well-being studies was identified. Study designs were largely quantitative, and, in most studies, well-being was considered as a predictor of DTNU. Also, research with children under 12 years was lacking. Future research on DTNU should look at: how dimensions of addiction and negative online experiences relate; provide more evidence on cognitive well-being; explore the interplay of well-being multiple components relying on integrative conceptual frameworks. The recent notion of digital well-being should also be explored considering the results of this review.

Frequent Social Media Use and Its Prospective Association With Mental Health Problems in a Representative Panel Sample of US Adolescents

PURPOSE

This study examined the relationship between frequent social media use and subsequent mental health in a representative sample of US adolescents. Also investigated were sex differences in multiyear growth trajectories of mental health problem internalization relative to social media use.

METHODS

Four waves (2013-2018) of nationally representative, longitudinal Population Assessment of Tobacco and Health data were analyzed. A total of 5,114 US adolescents aged 12-14 years at baseline had repeated data across all waves. Statistical analysis involved testing a series of sequential-weighted single-group and multi-group latent growth curve models using R version 3.6.2.

RESULTS

Of the 5,114 respondents, 2,491 were girls (48.7%). The percentage of frequent social media use was 26.4% at Wave 1 and 69.1% at Wave 4 for boys compared to 38.3% and 80.6% for girls (p < .001). Boys showed an improving (-0.218, p = .005) but girls showed a deteriorating linear trend (0.229, p = .028) for mental health at the full multigroup latent growth curve model. Social media use accounted for mental health conditions across Waves 1-3 for boys (ps<.01) but only at Wave 1 for girls (p = .035). With the addition of the social media use variable alone, model fit dramatically improved, and residual variances in growth patterns (i.e., random effect) became nonsignificant for boys. Substantial sex differences existed in baseline status, directionality, and shape of mental health growth trajectories as well as interplay of social media use with other factors.

DISCUSSION

Findings of the study suggest that frequent social media use is associated with poorer subsequent mental health for adolescents.

Problematic Mobile Phone Use and Life Satisfaction Among University Students During the COVID-19 Pandemic in Shanghai, China

Objective

This study examined problematic mobile phone use (PMPU) and its relationship with life satisfaction in Chinese university students during the pandemic.

Methods

An anonymous online survey was conducted in a university in China. The Mobile Phone Addiction Index (MPAI) and the Satisfaction with Life Scale (SWLS) were used to assess the severity of problematic mobile phone use and life satisfaction, respectively. Data on demographic and health-related factors were also collected.

Results

A total of 1,491 undergraduate students (73.3% were male) completed the survey. On average, students in the survey reported spending 7.4 ± 4.3 h/day on phone use. Their MPAI score was 38.1 ± 13.3 and SWLS score was 24.9 ± 6.8, respectively. After controlling for confounding factors, the MPAI score was significantly associated with lower life satisfaction. Multiple linear regression revealed that higher monthly allowances, frequent insomnia, longer phone use duration were significantly associated with PMPU.

Conclusion

University students in China spend nearly half of their waking hours on mobile phone use, significantly longer than before the COVID-19 pandemic. PMPU is associated with insomnia, lower life satisfaction and higher allowances. If the trend continues after the pandemic, interventions may be needed. Increase in-person interactions, limiting online social and gaming time, awareness campaign may be effective in reducing the impact of PMPU and improve life satisfaction.

Covid-19 pandemic and its impact on increasing the risks of children's addiction to electronic games from a social work perspective

Children are among the social groups most affected by the COVID-19 pandemic because they have found themselves forced to stay at home, far from their schoolmates, their friends, and far from all the activities they used to do before the pandemic. so, it was their only refuge for recreation during their stay in Home is staying in front of the screens of tablets, smartphones, and computers to play electronic games for long hours, and there is no doubt that the sudden shift in the lifestyle of children during the Covid-19 pandemic had serious consequences and risks threatening their stability at all levels. In light of that, the current study aimed to determine the impact of the Covid-19 pandemic on increasing the social, psychological, behavioral, and health risks of children's addiction to electronic games from a social work perspective. This study falls under the type of descriptive-analytical studies that are based on describing the reality of the problem under study. The study sample included 289 children in the age group 6-17 years in the first grade to the twelfth grade at school. The researcher designed a questionnaire that reflects the four risks facing children to assess these risks. The results showed is that the value of all impacts of the Covid-19 pandemic on the increasing risks of children's addiction to electronic games came to a total weight of (27907), weighted relative weight of (80.47%). This indication is High, indicating that the level of impact is High for the Covid-19 pandemic on the increase in all types of risks of children's addiction to electronic games. It ranked first " Behavioral Risks " at 91.15%, It is followed by the ranked second "Social risks " at 85.5%, Then came third place " Psychological Risks" at 80.91%, and in finally in fourth place " Health Risks" at 64.28%, which necessitates the need to take a set of serious measures by educating parents to monitor the content of electronic games that their children play, especially violent games, in addition to, reduce the number of hours the child spends practicing these games, and to encourage parents to form a bridge of communication and constructive dialogue between them and their children, and that parents put controls and restrictions on their children's practice of electronic games to confront abnormal behavioral, psychological and social patterns such as aggression, violence, deception, lying, imitation, vigilance, physical stress, poor eyesight, distance from practicing religious rituals, academic delay, introversion, depression, intolerance, selfishness, sadness, isolation from society, social withdrawal and lack of forming social relationships and lack of communication with others. The researcher took care that the results of the current study are very accurate and representative of the reality of the research problem, in light of the researcher's emphasis on the commitment to observe ethical rules to ensure the confidentiality of data. finally, the current study will greatly benefit researchers interested in the field of childhood and its problems and they will rely on its results and recommendations in how to protect children from the dangers of electronic game addiction in light of the Covid-19 crisis in particular.

Factors contributing to distress among school and college-going adolescents during COVID-19 Lockdown: A cross-sectional study conducted in Sibi Balochistan, Pakistan

BACKGROUND

Due to the COVID-19 pandemic, many countries have implemented nationwide lockdowns. While this leads to a decrease in disease transmission, there is a concurrent increase in the levels of psychological distress. To estimate the levels of psychological distress in school- and college-going adolescents currently under lockdown and to determine the factors associated with this psychological distress.

MATERIALS AND METHODS

A cross-sectional study conducted in Army Public School and College (APSAC) Sibi, Balochistan province of Pakistan between March and May 2020. Students of APSAC Sibi were enrolled in this research. Modified Kuppuswamy Socioeconomic Scale, Godin Leisure-Time Exercise Questionnaire, and Kessler-10 were used for data acquisition. Chi-square and t-tests and univariate analysis (nonparametric test) were performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, US).

RESULTS

Out of 225 participants, 57.4% were studying at school. Sixty-four percent of the participants were likely to be suffering from psychological distress. There is a significant effect of physical activity, sleep duration, bedtime at night, screen-time duration, and COVID-19 positive family member on the levels of distress. A moderate positive correlation was between psychological distress and bed-time at night (rho[223] = 0.328, P < 0.001) and screen time duration (rho[223] = 0.541, P < 0.001). A moderate negative correlation of physical activity (rho[223] = -0.340, P < 0.001) and a weak negative correlation of sleep duration hours (rho[225] = -0.158, P = 0.018) was found with psychological distress levels.

CONCLUSIONS

The COVID-19 lockdown and pandemic have had a considerable psychological impact on both school-going and college-going students, showing increased level of stress. A strong public health campaign along with mental and physical and social support programs are the need of the hour.

Psychological impacts of "screen time" and "green time" for children and adolescents: A systematic scoping review

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.

Associations of Objectively-Assessed Smartphone Use with Physical Activity, Sedentary Behavior, Mood, and Sleep Quality in Young Adults: A Cross-Sectional Study

This study assesses the associations of objectively-measured smartphone time with physical activity, sedentary behavior, mood, and sleep patterns among young adults by collecting real-time data of the smartphone screen-state. The sample consisted of 306 college-aged students (mean age ± SD: 20.7 ± 1.4 years; 60% males). Over seven days of time, the following variables were measured in the participants: objectively-measured smartphone use (Your Hour and Screen Time applications), objective and subjective physical activity (GoogleFit and Apple Health applications, and the International Physical Activity Questionnaire (IPAQ), respectively), the number of hours sitting (IPAQ), mood (The Profile of Mood State (POMS)), and sleep (The Pittsburgh Sleep Quality Index (PSQI)). Multiple regressions analyses showed that the number of hours sitting per day, physical activity, and the POMS Global Score significantly predicted smartphone use (adj.R2 = 0.15). Further, participants with low levels of physical activity were more likely to increase the use of smartphones (OR = 2.981). Moreover, mood state (β = 0.185; 95% CI = 0.05, 0.32) and sleep quality (β = 0.076; 95% CI = -0.06, 0.21) predicted smartphone use, with those reporting poor quality of sleep (PSQI index >5) being more likely to use the smartphone (OR = 2.679). In conclusion, there is an association between objectively-measured smartphone use and physical activity, sedentary behavior, mood, and sleep patterns. Those participants with low levels of physical activity, high levels of sedentary behavior, poor mood state, and poor sleep quality were more likely to spend more time using their smartphones.

A prospective longitudinal relation between elevated use of electronic devices and use of electronic nicotine delivery systems

BACKGROUND

In recent years, there has been a rapid increase in the use of both electronic nicotine delivery systems (ENDS) and electronic devices among U.S. youth. Informed by the Diffusion of Innovations Theory (DIT), it was hypothesized that elevated use of electronic devices (EUED) prospectively would predict ENDS use among youth.

METHODS

Data were drawn from the Population Assessment of Tobacco and Health (PATH) Study, a longitudinal cohort study in a nationally representative sample. Participants who were 12-17 years old, and naïve to both conventional cigarettes and ENDS at baseline (N = 11,325) were sampled. A total of 8723 respondents had matched data from Wave 1 to Wave 2 and 6051 respondents had matched data for all the three waves. Multivariable sequential logistic regressions were conducted to examine determinants of ENDS use in later waves using R version 3.5.2.

RESULTS

Among youth who were naïve to both ENDS and conventional cigarettes at baseline, those with EUED were more likely to initiate ENDS use in later years than those without EUED even after controlling for exposure to ENDS advertisements and other well-established covariates of ENDS use. Daily (adjusted odds ratio [AOR] ranges from 2.76 to 3.56) and weekly (AOR ranges from 2.16 to 2.65) social networking service (SNS) users were more likely to initiate ENDS use than non-users of SNS in the adjusted models.

CONCLUSIONS

The findings support the hypothesis that EUED prospectively predicts ENDS use among youth. The use of DIT framework helps understand the link between EUED and ENDS use.