Screen Media Overuse and Associated Physical, Cognitive, and Emotional/Behavioral Outcomes in Children and Adolescents: An Integrative Review

Association of children's electronic media use with physical activity, cognitive function, and stress

OBJECTIVE

Electronic media is constantly evolving and has become an integral part of people's lives, especially among youth. This cross-sectional observational study assessed the association between electronic media use, health behaviors and outcomes, specifically, physical activity, stress and cognitive function among youth from an under-resourced community.

METHODS

Participants ages six-sixteen were recruited from a Federally Qualified Health Center to participate in a study to promote park prescriptions with data collection between 2020 and 2024. At baseline, both intervention and control participants were asked to wear an accelerometer for one week and complete surveys about their electronic media time, stress, and cognitive function. We estimated the associations between electronic media use and health outcomes using cross-sectional multiple regressions.

RESULTS

Among the 441 participants, the average amount of electronic media use was 48.6 h per week (95 % CI: 46.0, 51.1), with children ages 6-9 engaging in 37.3 h per week (95 % CI: 34.5, 40.2) and youth ages 10-16 engaging in 56.4 h per week of electronic media time (95 % CI: 52.9, 59.9). Average daily MVPA was 16.6 min (95 % CI: 15.4, 17.8). Electronic media use time was negatively associated with MVPA and with cognitive function for all age groups. Electronic media time was only associated with stress for youth over age 10.

CONCLUSION

The associations among electronic media, MVPA, cognitive function and stress were statistically significant, but relatively modest. Future research should examine whether reducing time on electronic media will have a positive impact on physical activity and mental health outcomes.

CLINICAL TRIALS REGISTRY NUMBER

#NCT04114734.

Sex-dependent effects of early life sensory overstimulation on later life behavioral function in rats

Children today are immersed in electronic technology shortly after birth as they now begin regularly watching television earlier than they did in the past. Many new programs geared towards infants contain lots of lights, color, and sounds, which may constitute a form of sensory overstimulation (SOS) that leads to cognitive and behavioral changes in children and adolescents. Here, we examined the impact of early life SOS exposure on later life behavioral and cognitive function in rodents by exposing developing male and female rats to excessive audiovisual stimulation from postnatal days (PND) 10-40 and assessing anxiety-like behavior, social motivation, compulsive behavior, and spatial learning/cognition from PND 50-60. To evaluate potential SOS effects on hypothalamic-pituitary-adrenal (HPA)-axis function, levels of the stress hormone corticosterone (CORT) were measured at 3 timepoints (e.g., PND 23, 41, 61) post-SOS exposure. Sensory overstimulated males exhibited reduced anxiety-like and compulsive behavior compared to controls, whereas females exhibited reduced social motivation but enhanced spatial learning/cognition compared to controls. No differences in baseline CORT levels were found at any age tested, suggesting no impact of early life SOS on later life basal HPA-axis function. Our results demonstrate sex-specific effects of early life SOS on distinct behavioral domains in early adult rats.

Decreasing Social Media Use Through Motivational Interviewing: A Pediatric Primary Care Quality Improvement Project

BACKGROUND

Social media use has been correlated to worsening anxiety and depression in teenagers.

LOCAL PROBLEM

In the United Staes, social media is frequently used amongst adolescents, and rates of anxiety and depression in this population have increased over time.

METHODS

A convenience sample of adolescents aged 12 to 18 years old were evaluated using a pre-post design.

INTERVENTIONS

This quality improvement project introduced screen time assessment and motivational interviewing to decrease social media use and improve mental health among adolescents.

RESULTS

PHQ-9 scores remained consistent throughout the project. There was an overall decrease in participant SCARED scores and social media use declined over the 12-week period.

CONCLUSIONS

Results from this project suggest an opportunity for pediatric healthcare providers to standardize social media use screening in adolescent care and utilize motivational interviewing to promote adolescent wellbeing.

Mediating pathways between attention deficit hyperactivity disorder and type 2 diabetes mellitus: evidence from a two-step and multivariable Mendelian randomization study

AIMS

Type 2 diabetes (T2D) is a global health burden, more prevalent among individuals with attention deficit hyperactivity disorder (ADHD) compared to the general population. To extend the knowledge base on how ADHD links to T2D, this study aimed to estimate causal effects of ADHD on T2D and to explore mediating pathways.

METHODS

We applied a two-step, two-sample Mendelian randomization (MR) design, using single nucleotide polymorphisms to genetically predict ADHD and a range of potential mediators. First, a wide range of univariable MR methods was used to investigate associations between genetically predicted ADHD and T2D, and between ADHD and the purported mediators: body mass index (BMI), childhood obesity, childhood BMI, sedentary behaviour (daily hours of TV watching), blood pressure (systolic blood pressure, diastolic blood pressure), C-reactive protein and educational attainment (EA). A mixture-of-experts method was then applied to select the MR method most likely to return a reliable estimate. We used estimates derived from multivariable MR to estimate indirect effects of ADHD on T2D through mediators.

RESULTS

Genetically predicted ADHD liability associated with 10% higher odds of T2D (OR: 1.10; 95% CI: 1.02, 1.18). From nine purported mediators studied, three showed significant individual mediation effects: EA (39.44% mediation; 95% CI: 29.00%, 49.73%), BMI (44.23% mediation; 95% CI: 34.34%, 52.03%) and TV watching (44.10% mediation; 95% CI: 30.76%, 57.80%). The combination of BMI and EA explained the largest mediating effect (53.31%, 95% CI: -1.99%, 110.38%) of the ADHD-T2D association.

CONCLUSIONS

These findings suggest a potentially causal, positive relationship between ADHD liability and T2D, with mediation through higher BMI, more TV watching and lower EA. Intervention on these factors may thus have beneficial effects on T2D risk in individuals with ADHD.

Safe Use of Screen Time Among Adolescents: A Randomized Controlled Study of the Efficacy of Yoga

BACKGROUND

For students between the ages of 11 and 18, the estimated daily exposure to electronic media is around 1.5 hours, suggesting a growing trend in the amount of time spent in front of a screen. Increasing screen time use is related to sleep, mental health, cognitive, emotional, and behavioral disorders, unhealthy diets, depressive symptoms, poor quality of life, and substance-behavioral addictions.

METHODS

The current study is a parallel-group, simple randomized controlled trial (RCT). A total of 100 participants were randomized into a yoga group (YG) (n=50) and an attentional control group (CG) (n=50) by using an online randomizer. The YG received yoga practice, whereas the partially active CG received an educational program on digital hygiene. Students were assessed for screen time use, Smartphone Addiction Scale-Short Version (SAS-SV), general well-being, depressive symptoms, and generalized anxiety following 12 weeks of intervention.

RESULTS

 The yoga group showed a significant decrease in the scores of SAS-SV, generalized anxiety, depressive symptoms, and screen time use after the intervention (p<0.001, p<0.05, p<0.01, and p<0.001, respectively). Furthermore, there was a statistically significant decrease in screen time use for all modes of total weekdays, weeknights, and weekends. Additionally, in the yoga group, the majority of the sub-factors of screen time use showed statistically significant changes; time spent on television showed a constant decrease in all modes such as weekdays, weeknights, and weekends.

CONCLUSION

The result of the current study suggests that yoga practice has a positive influence on screen usage behavior and associated health-related complications. More studies are required to understand if yoga practice can help mitigate the pleasure-seeking behavior that drives the excessive usage of screens.

Family factors related to adolescent screen media use and mental health outcomes: A systematic review and recommendation for practices

INTRODUCTION

Screen media serves an essential role in adolescents' lives, posing growth opportunities and mental health challenges. Family plays a crucial role in mitigating these challenges. This systematic review offers a comprehensive analysis of the family factors related to adolescent screen media use and mental health.

METHODS

A systematic search was conducted in PubMed, CINAHL, PsycINFO, Scopus, and Embase, adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines using the following inclusion criteria: English, peer-reviewed, observational design, and published since 2013; adolescent samples aged 10-17 years; and examining screen media use, family factors, and internalizing problems. The role of family factors as predictors, moderators, and mediators was also examined.

RESULTS

Of the 3587 records, 32 met the inclusion criteria. These studies, primarily cross-sectional, presented a global perspective of 14 countries. A heterogeneous range of family factors, screen media use, and mental health outcomes were examined, revealing significant associations between elevated screen media use and internalizing problems. Positive family processes and democratic media-specific parenting mitigate such association. A few studies underscored family socioeconomic status (SES), noting elevated screen media use and mental health risks among adolescents in families of low SES.

CONCLUSIONS

Accumulating evidence supports the important role of positive family contexts in fostering balanced screen media use and mental health in adolescents, accentuating the need for professional screening and education to promote positive screen media use among adolescents and families. Further research requires refinement in measurement and methodology to better capture the intricate relationship between family dynamics, screen media use, and adolescent mental health.

Effects of sensory overstimulation in postpartum rats

Research in rodents has shown that exposure to excessive early life audiovisual stimulation leads to altered anxiety-like behaviors and cognitive deficits. Since this period of stimulation typically begins prior to weaning, newborn rodents receive sensory overstimulation (SOS) as a litter within their home cage while the dam is present. However, the effects of SOS during the postpartum period remain unexplored. To this end, we adapted an SOS paradigm for use in rats and exposed rat dams and their litters from postpartum days (PD) 10-23. Maternal observations were conducted to determine whether SOS produced changes in positive and/or negative maternal behaviors. Next, we assessed changes in anxiety-like behavior and cognition by testing dams in the elevated zero maze, open field, and novel object recognition tests. To assess potential effects on HPA-axis function, levels of the stress hormone corticosterone (CORT) were measured approximately 1-week after the cessation of SOS exposure. Our results indicate increased nursing and licking in SOS dams compared to controls, although SOS dams also exhibited significant increases in pup dragging. Moreover, SOS dams exhibited reduced self-care behaviors and nest-building compared to control dams. No differences were found for anxiety-like behaviors, object recognition memory, or CORT levels. This study is the first to assess the impact of postpartum SOS exposure in rat dams. Our findings suggest an SOS-induced enhancement in positive caregiving, but limited impact in all other measures.

Childhood sleep: physical, cognitive, and behavioral consequences and implications

BACKGROUND

Sleep problems in children have been increasingly recognized as a major public health issue. Previous research has extensively studied and presented many risk factors and potential mechanisms for children's sleep problems. In this paper, we aimed to identify and summarize the consequences and implications of child sleep problems.

DATA SOURCES

A comprehensive search for relevant English language full-text, peer-reviewed publications was performed focusing on pediatric sleep studies from prenatal to childhood and adolescence in a variety of indexes in PubMed, SCOPUS, and Psych Info published in the past two decades. Both relevant data-based articles and systematic reviews are included.

RESULTS

Many adverse consequences are associated with child sleep deficiency and other sleep problems, including physical outcomes (e.g., obesity), neurocognitive outcomes (e.g., memory and attention, intelligence, academic performance), and emotional and behavioral outcomes (e.g., internalizing/externalizing behaviors, behavioral disorders). Current prevention and intervention approaches to address childhood sleep problems include nutrition, exercise, cognitive-behavioral therapy for insomnia, aromatherapy, acupressure, and mindfulness. These interventions may be particularly important in the context of coronavirus disease 2019. Specific research and policy strategies can target the risk factors of child sleep as well as the efficacy and accessibility of treatments.

CONCLUSIONS

Given the increasing prevalence of child sleep problems, which have been shown to affect children's physical and neurobehavioral wellbeing, understanding the multi-aspect consequences and intervention programs for childhood sleep is important to inform future research direction as well as a public health practice for sleep screening and intervention, thus improving sleep-related child development and health.

Private screen access in early adolescence predicts subsequent academic and social impairment at the end of high school for boys and girls

INTRODUCTION

Youth media guidelines in Canada and the United States recommend that bedrooms should remain screen-free zones. This study aims to verify whether bedroom screens at age 12 years prospectively predict academic and social impairment by age 17 years.

METHODS

Participants were from the Quebec Longitudinal Study of Child Development birth cohort (661 girls and 686 boys). Linear regression analyses estimated associations between having a bedroom screen (television or computer) at age 12 years and selfreported overall grades, dropout risk, prosocial behaviour and likelihood of having experienced a dating relationship in the past 12 months at age 17 years, while adjusting for potential individual and family confounding factors.

RESULTS

For both girls and boys, bedroom screens at age 12 years predicted lower overall grades (B = -2.41, p ≤ 0.001 for boys; -1.61, p ≤ 0.05 for girls), higher dropout risk (B = 0.16, p ≤ 0.001 for boys; 0.17, p ≤ 0.001 for girls) and lower likelihood of having experienced a dating relationship (B = -0.13, p ≤ 0.001 for boys; -0.18, p ≤ 0.001 for girls) at age 17. Bedroom screens also predicted lower levels of prosocial behaviour (B = -0.52, p ≤ 0.001) at age 17 years for boys.

CONCLUSION

The bedroom as an early adolescent screen-based zone does not predict long-term positive health and well-being. Pediatric recommendations to parents and youth should be more resolute about bedrooms being screen-free zones and about unlimited access in private exposures in childhood.

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

BACKGROUND

Previous 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.

METHODS

Using 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.

RESULTS

The 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).

CONCLUSIONS

Accordingly, 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.

Effects of Excessive Screen Time on Child Development: An Updated Review and Strategies for Management

Children's heavy reliance on screen media has raised serious public health issues since it might harm their cognitive, linguistic, and social-emotional growth. This study examines the effects of screen time on many developmental domains and covers management and limitation techniques for kids' screen usage. Screen media has a wide range of cognitive consequences, with both beneficial and detrimental effects noted. Screens can improve education and learning; however, too much time spent in front of a screen and multitasking with other media has been related to worse executive functioning and academic performance. As screen time reduces the amount and quality of interactions between children and their caregivers, it can also have an impact on language development. Contextual elements like co-viewing and topic appropriateness are key in determining how language development is impacted. Additionally, excessive screen usage has detrimental effects on social and emotional growth, including a rise in the likelihood of obesity, sleep disorders, and mental health conditions including depression and anxiety. It can obstruct the ability to interpret emotions, fuel aggressive conduct, and harm one's psychological health in general. Setting boundaries, utilizing parental controls, and demonstrating good screen behavior are all techniques that parents may use to manage children's screen usage. We can reduce the possible negative impacts of excessive screen time and promote children's healthy development and well-being by increasing knowledge and encouraging alternative activities that stimulate development.

Screen use before sleep and emotional problems among adolescents: Preliminary evidence of mediating effect of chronotype and social jetlag

BACKGROUND

Screen use before sleep is shown to be positively related to emotional problems. However, whether this relationship was mediated by circadian phenotypes (i.e., chronotype and social jetlag) remains unclear.

METHODS

Data from two independent adolescent surveys among 2685 and 1368 adolescents, respectively, were used. Adolescents reported screen use before sleep (yes/no and screen time), chronotype, social jetlag, and emotional problems using questionnaires. Serial mediation analyses were performed.

RESULTS

Adolescents who reported screen use before sleep showed later chronotype and greater social jetlag, which was further associated with a higher level of emotional problems. Such relationships held for screen use as a yes/no variable and screen time. The serial indirect effect of chronotype and social jetlag accounted for 6.2%-16.7% of the total effect of screen use before sleep on emotional problems.

LIMITATIONS

The use of a cross-sectional design did not allow the establishment of causal links between the variables. All data were self-reported by adolescents, and might be subject to report bias and recall bias.

CONCLUSIONS

These findings contributed to the existing literature by examining the mediating effect of chronotype and social jetlag in the relationship between screen use before sleep and emotional problems from a circadian rhythm perspective. Healthy media use habits and interventions targeting circadian characteristics may work towards promoting emotional health in adolescents.

A network analysis on self-harming and problematic smartphone use - The role of self-control, internalizing and externalizing problems in a sample of self-harming adolescents

BACKGROUND

Research has shown an increased risk for Non-suicidal self-injurious (NSSI) behavior as well as Problematic Smartphone Use (PSU) and particularly in adolescence, a developmental period defined by multi-level changes and still poor self-control capacities associating with risk-taking behaviors.

OBJECTIVE

The current study was aimed to assess the pattern of mutual relations characterizing NSSI considering self-control, internalizing and externalizing problems, and investigating how PSU fits within the network since NSSI and PSU are here conceptualized as attempts at emotion regulation. Age and gender differences were also assessed.

METHOD

Participants were Italian adolescents presenting NSSI behavior (N = 155; Mage = 14.68; SD = 1.647; Range = 11-18; 43.2%-females); the sample is based on community recruitment. A Network Analysis was performed to assess the organizational structure of NSSI; age and gender differences were assessed through multivariate rank tests further applying multiplicity control.

RESULTS

The emerged Network showed the centrality of low self-control and internalizing problems for NSSI. NSSI and PSU were associated through low self-control, and so were PSU and externalizing problems. Significant age differences were observed showing a decrease in NSSI as age increases (stat = -2.86; adj.p = .029). No gender differences have emerged.

CONCLUSIONS

The current findings provide support for the consideration and investigation of PSU as regards NSSI behavior in adolescence. Moreover, these findings point to the relevance of prevention practices during this peculiar developmental period, particularly sustaining self-control capacities and the use of more adaptive emotion regulation strategies, thereby limiting the accrue of at-risk behaviors.