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Feng S, Liu R, Tomar A, Ma P. Sex Differences in the Associations of mental Health, Suicidality, Screentime, and Sleep: A Mediation Effect Analysis of Sleep Using Youth Risk Behavioral Surveillance Survey 2021. Psychol Rep 2024:332941241277096. [PMID: 39180376 DOI: 10.1177/00332941241277096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
Objective: This study was conducted to explore the sex differences in the direct and indirect associations among mental health/suicidality, sleep, and screen time. Methods: Using the 2021 Youth Risk Behavior Survey (YRBS) data, 9408 participants were included in the analyses. The associations of endogenous variables (mental health and suicidality), exogenous variable (screen time), mediator (sleep), and covariates (demographic features and risky behaviors) were analyzed using the Structural Equation Model and "medsem" package, as well as logistic regression and bootstrapping methods. To explore the sex differences in the mediation effect, the Likelihood Ratio Test was used for the multiple-group analysis to compare the unconstrained model with the mediation path-constrained model. Results: Screen time had a significant negative association with sleep duration (female: β = -.09, p < .001; male: β = -.04, p < .001), positive relations to mental health problems (female: β = .10, p < .001; male: β = .12; p < .001), and suicidality (female: OR: 1.07, 95% CI: 1.02-1.13; male: OR: 1.06, 95% CI: 1.01-1.23). Sleep duration is negatively associated with mental health problems (female: β = -.16, p < .001; male: β = -.14; p < .001) and negatively associated with the likelihood of suicidality (female: .89, 95% CI: .85-.94; male: OR: .84, 95% CI: .79-.90). Furthermore, female adolescents had higher frequencies in mental health problems, higher odds ratio in suicidality, shorter sleep duration, and bigger mediation effects of sleep, compared to their male counterparts. Conclusion: Mental health and suicidality were affected differently by screen time and sleep between female and male adolescents. Future research may continue to explore sex differences and their underlying reasons.
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Affiliation(s)
- Shuo Feng
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Renming Liu
- Department of Educational Psychology, Baylor University, Waco, TX, USA
| | - Aditi Tomar
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Ping Ma
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
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Sancho-Domingo C, Garmy P, Norell A. Nighttime Texting on Social Media, Sleep Parameters, and Adolescent Sadness: A Mediation Analysis. Behav Sleep Med 2024; 22:488-498. [PMID: 38781096 DOI: 10.1080/15402002.2024.2314281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVES The use of social media during bedtime has increased in the past years among adolescents, contributing to disturbed sleep quality, which could potentially be related to emotional problems. This study aimed to analyze the mediation effects of sleep parameters on the relationship between NightTime Texting (NTT) on social media and adolescent sadness. METHODS We used a cross-sectional study and evaluated a total of 1464 Swedish students aged 15-17 (55.7% girls) to examine their frequency of NTT on social media, sleep parameters, and adolescent sadness. Bivariate and mediation analyses were performed. RESULTS Approximately 60% (n = 882) of adolescents engaged in nighttime instant messaging, with 37% (n = 330) reporting texting every night. Higher frequency of NTT was significantly associated with later bedtimes (η2 > 0.12), extended weekend wake-up times (η2 = 0.07), increased social jetlag (η2 = 0.07), and reduced sleep duration on schooldays (η2 = 0.10). Multicategorical parallel mediation analyses revealed that sleep duration on schooldays had an indirect effect on the relationship between both Occasional NTT (a11b1 = 0.05, p < .05) and Daily NTT (a21b1 = 0.12, p < .05) with sadness. Mediation effects were not moderated by gender (p > .05), however, the association between Occasional NTT and higher sadness was significantly linked to boys (t = 2.72; p = .007). CONCLUSIONS Findings showed a large percentage of adolescents engaging in nighttime social media use with worse quality of sleep, and underlined sleep duration on schooldays as a mediator associated with emotional problems in adolescents. These insights can aid in developing strategies for healthier habits to address the misuse of social media and prevent related health problems.
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Affiliation(s)
- Clara Sancho-Domingo
- Center of Applied Psychology, Miguel Hernández University, Elche, Spain
- School of Behavioral, Social and Legal Sciences, Örebro University, Örebro, Sweden
| | - Pernilla Garmy
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- Clinical Health Promotion Centre, WHO-CC, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Annika Norell
- School of Behavioral, Social and Legal Sciences, Örebro University, Örebro, Sweden
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Joseph PL, Gonçalves C, Applewhite J, Fleary SA. Examining provider anticipatory guidance for adolescents' preventive health: A latent class approach. J Pediatr Nurs 2024; 76:e117-e125. [PMID: 38429211 DOI: 10.1016/j.pedn.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND Low rates of anticipatory guidance (AG) are reported across studies with adolescents, and little is known about how these conversations differ across early versus middle adolescence. This study explored adolescent-provider AG conversations for preventive health skills; the study objectives were to (1) identify patterns of provider-adolescent AG conversations across early and middle adolescence and (2) determine socio-demographic characteristics associated with these AG conversations. DESIGN AND METHOD Data from the 2019 National Survey of Children's Health were used to identify patterns of provider-adolescent AG conversations. The sample included 5500 early and 6730 middle adolescents (Mage = 14.67 years old, SD = 1.71, 51.7% boys, 79% White). Multiple group latent class analysis and multinomial regressions were estimated using four indicators of AG conversations (i.e., skills to manage health and healthcare, changes in healthcare that happen at 18, making positive choices about health, and receiving a medical history summary). RESULTS Three types of AG conversations were identified: high AG, low AG, and parent unaware. Among early and middle adolescents, adolescents that were older, girls, had private health insurance, and a personal provider were less likely to receive high AG compared to other types of AG. CONCLUSIONS Policies and strategies to engage adolescents in AG conversations during and outside of the medical appointment are needed. PRACTICE IMPLICATIONS Tools, such as brief screeners, can be used to ensure all adolescents are receiving high AG. School-based health centers, community centers and organizations, and telehealth appointments with medical professionals may be additional opportunities for adolescents to receive AG.
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Affiliation(s)
- Patrece L Joseph
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Dr, Chapel Hill, NC 27599, USA.
| | | | - Janelle Applewhite
- Department of Educational Foundations and Exceptionalities, James Madison University, USA
| | - Sasha A Fleary
- Graduate School of Public Health and Health Policy, City University of New York, USA
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Zink J, O'Connor SG, Blachman-Demner DR, Wolff-Hughes DL, Berrigan D. Examining the Bidirectional Associations Between Sleep Duration, Screen Time, and Internalizing Symptoms in the ABCD Study. J Adolesc Health 2024; 74:496-503. [PMID: 37855753 PMCID: PMC10872986 DOI: 10.1016/j.jadohealth.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/10/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE The likelihood of meeting sleep duration and screen time guidelines decreases as children develop toward adolescence. Simultaneously, the prevalence of internalizing symptoms increases. The purpose of this paper was to examine the bidirectional associations between sleep duration and screen time with internalizing symptoms in a one-year longitudinal study starting in late childhood. METHODS Participants were 10,828 youth (47.8% female) enrolled in the Adolescent Brain Cognitive Development Study. At baseline (mean age 9.9 years) and one-year follow-up (mean age 10.9 years), youth self-reported screen time for weekdays and weekend days. Responses were separately dichotomized as >2 versus ≤2 hours/day (meeting behavioral guidelines). Caregiver-reported youth sleep duration was dichotomized as <9 versus 9-11 hours/night (meeting behavioral guidelines). Caregivers reported internalizing symptoms via the child behavior checklist. The withdrawn/depressed, anxious/depressed, and somatic symptom child behavior checklist subscale t-scores were separately dichotomized as ≥65 (borderline clinical levels of symptoms and above) versus <65. Analyses were gender-stratified. RESULTS In females, longer baseline sleep duration was protective against withdrawn/depressed symptoms (odds ratio [OR] 0.6, 95% confidence interval [CI] 0.4-0.8) and somatic complaints (OR 0.8, 95% CI 0.6-0.97) one year later. In females, greater baseline weekend screen time was associated with increased risk of withdrawn/depressed symptoms (OR 1.6, 95% CI 1.1-2.2) one year later. No other significant associations were observed. DISCUSSION Longitudinal associations between sleep duration, weekend screen time, and internalizing symptoms were unidirectional (behavior preceding internalizing symptoms), among females only, and specific to withdrawn/depressed and somatic symptoms. These prospective study findings warrant attention and inform future research in this cohort.
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Affiliation(s)
- Jennifer Zink
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
| | - Sydney G O'Connor
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Dara R Blachman-Demner
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland
| | - Dana L Wolff-Hughes
- Division of Cancer Control and Population Sciences, Risk Factor Assessment Branch, Epidemiology and Genomics Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - David Berrigan
- Division of Cancer Control and Population Sciences, Health Behaviors Research Branch, Behavioral Research Program, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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Rojo-Wissar DM, Acosta J, DiMarzio K, Hare M, Dale CF, Sanders W, Parent JM. The role of sleep in prospective associations between parent reported youth screen media activity and behavioral health. Child Adolesc Ment Health 2024; 29:33-42. [PMID: 37431157 PMCID: PMC11184563 DOI: 10.1111/camh.12665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Screen media activity (SMA) can negatively affect youth behavioral health. Sleep may mediate this association but has not been previously explored. We examined whether sleep mediated the association between SMA and youth behavioral health among a community sample. METHOD Parents completed questions about their child (N = 564) ages 3-17 at Wave 1, Wave 2 (4-8 months later), and Wave 3 (12 months later). Path analyses were conducted to examine links between Wave 1 SMA and Wave 3 behavioral health problems (i.e., internalizing, externalizing, attention, peer problems) through Wave 2 sleep disturbance and duration. RESULTS SMA was significantly associated with greater sleep disturbance, β = .11, 95% CI [.01, .21] and shorter sleep duration, β = -.16 [-.25, -.06], and greater sleep disturbance was associated with worse youth behavioral health across internalizing, β = .14 [.04, .24], externalizing, B = .23 [.12, .33], attention, β = .24 [.15, .34], and peer problems, β = .25 [.15, .35]. Longer sleep duration was associated with more externalizing, β = .13 [.04, .21], and attention problems, β = .12 [.02, .22], and fewer peer problems, β = -.09 [-.17, -.01], but not with internalizing problems. Lastly, there was a direct effect of SMA on peer problems, β = -.15 [-.23, -.06] such that higher SMA that does not impact sleep may have a positive impact on reducing peer problems. CONCLUSIONS Sleep (i.e., disturbances and shorter duration) may partially account for the small associations observed between SMA and worse behavioral health in youth. To continue expanding our understanding, future research should utilize more diverse representative samples, use objective measures of SMA and sleep, and examine other relevant aspects of SMA, including content, device type, and timing of use.
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Affiliation(s)
- Darlynn M Rojo-Wissar
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, Providence, RI, USA
- E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI, USA
| | - Juliana Acosta
- Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Megan Hare
- Florida International University, Miami, FL, USA
| | | | - Wesley Sanders
- Home Base, a Red Sox Foundation and Massachusetts General Hospital Program, Charlestown, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Justin M Parent
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Bradley/Hasbro Children's Research Center, E.P. Bradley Hospital, Providence, RI, USA
- E.P. Bradley Hospital Sleep Research Laboratory, Providence, RI, USA
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Wen X, Cai Y, Li K, Wang Z, Zhang W, Qin M. A Cross-Sectional Association Between Screen-Based Sedentary Behavior and Anxiety in Academic College Students: Mediating Role of Negative Emotions and Moderating Role of Emotion Regulation. Psychol Res Behav Manag 2023; 16:4221-4235. [PMID: 37877135 PMCID: PMC10591192 DOI: 10.2147/prbm.s430928] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose The study aims to explore the relationship and potential mechanisms between screen time and anxiety and have a clear understanding of the role of negative emotions and emotion regulation, thus providing guidance for Chinese college students to improve mental health. Methods We conducted a questionnaire survey by selecting 1721 academic college students from 6 colleges and universities in 5 provinces in China, and the data were analyzed through the Process program of SPSS for mediating effect and moderating effect. Results There is a significant positive relationship between screen time and anxiety, negative emotions play a mediating role between the two (indirect effect = 0.32, p < 0.001), mediating effect accounts for 59.88% of the total effect, and emotion regulation regulates the direct relationship between screen time and anxiety (interaction effect = 0.027, p < 0.001). Conclusion This study sheds light on the potential mechanisms by which screen time affects anxiety in academic college students, providing a fresh perspective on anxiety reduction. Screen time positively affects anxiety levels, where negative emotions have a mediating role and emotion regulation has a moderating role. In the future, we can control screen ++time, increase physical activities, reduce negative emotions, and improve the emotional regulation ability to relieve anxiety, so as to improve the mental health of academic college students, and expect to have a positive impact on future learning, life, and planning.
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Affiliation(s)
- Xili Wen
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Yujun Cai
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Kai Li
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Zisu Wang
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Weiyi Zhang
- School of Physical Education, Shanghai University of Sport, Shanghai, People’s Republic of China
| | - Man Qin
- Shanghai Lixin University of Accounting and Finance, Shanghai, People’s Republic of China
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Duh-Leong C, Fuller AE, Johnson SB, Coble CA, Nagpal N, Gross RS. Social Capital and Sleep Outcomes Across Childhood in United States Families. Acad Pediatr 2023; 23:1226-1233. [PMID: 36641090 PMCID: PMC10333451 DOI: 10.1016/j.acap.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 12/02/2022] [Accepted: 01/02/2023] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To examine whether aspects of social capital, or benefits received from social relationships, are associated with regular bedtime and sleep duration across childhood in US families with lower income. METHODS Cross-sectional study using the 2018-19 National Survey of Children's Health in participants with incomes <400% federal poverty level. Separately for early childhood (0-5 years), school-age (6-12 years), and adolescence (13-17 years), we used weighted logistic regression to examine associations between social capital (measured by family social cohesion, parent social support, child social support) and sleep (measured by regular bedtime, sleep duration, adequate sleep per American of Academy of Sleep guidelines). Path analysis tested whether regular bedtime mediated associations between social capital and sleep duration. RESULTS In our sample (N = 35,438), 84.9% had a regular bedtime, 60.2% had adequate sleep. Family social cohesion was associated with sleep duration and adequate sleep (infancy: adjusted odds ratio [aOR] 2.18 [95% confidence interval [CI], 1.32, 3.60]; school age: aOR 2.03 [95% CI, 1.57, 2.63]; adolescence: aOR 2.44 [95% CI, 1.94, 3.09]). In toddlerhood, parent social support was associated with adequate sleep (aOR 1.44 [95% CI, 1.06, 1.96]). In adolescence, child social support was associated with regular bedtime (aOR 1.70 [95% CI, 1.25, 2.32]. Across childhood, associations between family social cohesion and sleep duration were partially mediated by regular bedtime. CONCLUSIONS Family social cohesion was associated with adequate sleep across childhood, this was partially mediated by regular bedtime. Associations between social support and sleep outcomes varied by development stage. Future work should consider how supportive relationships may influence child sleep outcomes.
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Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine (C Duh-Leong, N Nagpal, and RS Gross), New York, NY.
| | - Anne E Fuller
- Division of Paediatric Medicine, Department of Paediatrics, Hospital for Sick Children, University of Toronto (AE Fuller), Toronto, Ontario, Canada
| | - Sara B Johnson
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine (SB Johnson), Baltimore, Md
| | - Chanelle A Coble
- Division of Adolescent Medicine, Department of Pediatrics, NYU Grossman School of Medicine (CA Coble), New York, NY
| | - Nikita Nagpal
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine (C Duh-Leong, N Nagpal, and RS Gross), New York, NY
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine (C Duh-Leong, N Nagpal, and RS Gross), New York, NY
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Wang H, Bragg F, Guan Y, Zhong J, Li N, Pan J, Yu M. Association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students: a cross-sectional study in Zhejiang Province, China. Front Public Health 2023; 11:1138152. [PMID: 37261230 PMCID: PMC10229063 DOI: 10.3389/fpubh.2023.1138152] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/10/2023] [Indexed: 06/02/2023] Open
Abstract
Background Existing literature on the association of electronic screen use duration with depression among adolescents is contradictory. The current study aimed to elucidate the association between duration of electronic screen use for non-educational purposes and depression symptoms among middle and high school students in Zhejiang Province, China. Methods A cross-sectional study of 27,070 students in grades 7-12 from 376 middle and high schools was conducted through an anonymous self-administered questionnaire between April and June 2022. Poisson regression was utilized to examine the association between electronic screen use duration for non-educational purposes and depression symptoms. Results Of the 27,006 eligible students, 51.6% (13932) were boys and the mean (SD) age was 15.6(1.7) years. The overall prevalence of symptoms of depression was 22.4% (95%CI 21.4-23.4); girls (27.6%, 26.2-29.0) had a higher prevalence than boys (17.7%, 16.7-18.8). After adjustment for socio-demographic status, lifestyle factors, self-perceived health, academic performance, loneliness and sadness, compared to those who did not use electronic screens for non-educational purposes, the prevalence ratios (PRs) for depression symptoms were 1.03 (95% CI 1.02-1.04) for those exposed to electronic screens for <1 h/day, 1.07 (1.05-1.09) for 1.0-1.9 h/day, 1.10 (1.07-1.13) for 2.0-2.9 h/day, 1.14 (1.10-1.18) for 3.0-3.9 h/day, 1.18 (1.12-1.23) for 4.0-4.9 h/day, and 1.21 (1.15-1.29) for ≥5 h/day. Conclusion Duration of electronic screen use for non-educational purposes was positively associated with symptoms of depression among middle and high school students, even with a relatively short daily duration of use.
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Affiliation(s)
- Hao Wang
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Fiona Bragg
- Medical Research Council Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Yunqi Guan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jieming Zhong
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Na Li
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jin Pan
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Min Yu
- Department of NCDs Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Uddin H, Hasan MK. Family resilience and neighborhood factors affect the association between digital media use and mental health among children: does sleep mediate the association? Eur J Pediatr 2023:10.1007/s00431-023-04898-1. [PMID: 36922452 PMCID: PMC10257603 DOI: 10.1007/s00431-023-04898-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023]
Abstract
The associations between digital media use and mental well-being among children and adolescents have been inconclusive. We examined (i) the associations between digital media use and mental health outcomes, anxiety, depression, and ADHD, (ii) whether family resilience and neighborhood factors attenuate the associations, and (iii) whether sleep mediates these associations. We used the National Survey of Children's Health data from 2019 to 2020. A total of 45,989 children's (6-17 years) data were analyzed in this study. Multivariate logistic regression was used to assess the associations between digital media use and anxiety, depression, and ADHD. Path models and Paramed command in STATA were used to test the role of sleep as a mediator of these associations. The prevalence of heavy digital media users (who spent 4 or more hours per day) among the analytic sample was 30.52%, whereas anxiety was 13.81%, depression was 5.93%, and ADHD was 12.41%. Children in the heavy media user group had 63% increased odds of anxiety (95% CI: 1.32-2.01) and 99% increased odds of depression (95% CI: 1.35-2.94) after adjusting for sociodemographic factors, compared to the children in light media user group (who spent < 2 h per day), and these relations were significant at 0.01 level. However, family resilience and community factors significantly attenuated the effect of digital media use on anxiety and depression. Sleep did not mediate the associations between digital media use and anxiety or depression. Conclusions: Family resilience and neighborhood factors protect against the harmful effects of digital media use. Further research is needed to examine the relationships of media contents, the presence of electronic devices in bedrooms, and sleep quality with mental health. What is Known: • Spending long hours on digital media may adversely affect children and adolescents' health and development. However, the mediating role of sleep in the association between digital media use and mental health outcomes is inconclusive. What is New: • Digital media use has detrimental effects on anxiety and depression. However, family resilience and neighborhood factors attenuated the association. The study highlights the importance of positive family functioning and neighborhood conditions reducing the harmful effects of digital media use.
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Affiliation(s)
- Helal Uddin
- Department of Global Public Health, Karolinska Institutet, Solna, 17177, Sweden. .,Department of Sociology, East West University, Dhaka, 1212, Bangladesh. .,Unit for Research in Emergency and Disaster, Faculty of Medicine and Health Sciences, University of Oviedo, Oviedo, 33006, Spain.
| | - Md Khalid Hasan
- Institute of Disaster Management and Vulnerability Studies, University of Dhaka, Dhaka 1000, Dhaka, Bangladesh.
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E Y, Yang J, Shen Y, Quan X. Physical Activity, Screen Time, and Academic Burden: A Cross-Sectional Analysis of Health among Chinese Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4917. [PMID: 36981825 PMCID: PMC10049325 DOI: 10.3390/ijerph20064917] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/01/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
This paper aims to analyze the effects of physical activity, screen time, and academic burden on adolescent health in China and compare their effects by using the nationally representative sample data from the CEPS (China Educational Panel Survey) cross-section data. This paper first uses regression analysis to examine the relationship between physical activity, screen time, academic burden and health among Chinese adolescents. Then, this paper uses the clustering analysis the influence of physical activity, screen time, and academic burden on the health of Chinese adolescents. The empirical results show that: (1) along with exercise, helping with the housework also has a clear health-promoting effect on adolescents; (2) the time spent surfing the Internet or playing video games, and heavy studying or homework off campus have a negative effect on adolescents' self-rated health and mental health; (3) physical activity has the greatest impact on self-rated health, while screen time has the greatest impact on mental health, and academic burden is not the most important factor affecting adolescent health in China.
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Affiliation(s)
- Yiting E
- Department of Sociology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Jianke Yang
- Department of Sociology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Yifei Shen
- Department of Sociology, Xi’an Jiaotong University, Xi’an 710049, China
| | - Xiaojuan Quan
- Department of Marxism, Xi’an Jiaotong University, Xi’an 710049, China
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Gao M, Li X, Lee CY, Ma H, Chen T, Zhang S, Chiang YC. Sleep duration and depression among adolescents: Mediation effect of collective integration. Front Psychol 2022; 13:1015089. [PMID: 36518962 PMCID: PMC9744325 DOI: 10.3389/fpsyg.2022.1015089] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/02/2022] [Indexed: 11/10/2023] Open
Abstract
Adolescence is a time of dramatic physical and mental change when adolescents are extremely vulnerable to various mental health problems. Depression and poor sleep duration are increasingly common among adolescents. This study is mainly aimed to verify the important mediating role of collective integration on sleep duration and depression and examine the interrelationship between sleep duration and depression in adolescents longitudinally. The data were obtained from the Wave 1 (in 2013-2014) and Wave 2 (in 2014-2015) longitudinal surveys of China Education Panel Survey (CEPS). The analytic sample in the present study included 8,829 seventh-grade students aged about 14 years (51.50% boys and 48.50% girls). A structural equation modeling (SEM) was used to investigate parent-child/teacher factors affecting adolescent sleep duration and depression, and Monte Carlo resampling with R was employed to confirm the significance of the mediation effects of collective integration. An autoregressive cross-lagged model was employed to analyze the interrelationship between adolescent sleep duration and depression. The findings were as follows. Firstly, collective integration strongly mediated the relationships among academic self-efficacy, parental involvement, teacher praise/criticism, sleep duration, and depression. Secondly, sleep duration and depression were found to have enduring effects and have effects on each other. Thirdly, parental involvement and teacher praise were positively associated with sleep quality and negatively associated with depression. Teacher criticism was negatively associated with sleep quality and positively associated with depression. Compared with teacher praise, teacher criticism has stronger effects on youth sleep duration and depression. In conclusion, improving sleep problems and depression in adolescents as early as possible can stop the persistent and long-term consequences of these problems. Increasing teacher praise, decreasing teacher criticism, and increasing adolescents' collective integration were effective ways to improve adolescents' sleep duration and mediate depression.
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Affiliation(s)
- Min Gao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Xian Li
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Chun-Yang Lee
- School of International Business, Xiamen University Tan Kah Kee College, Zhangzhou, China
| | - Honghao Ma
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | | | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
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Barnhart S, Bode M, Gearhart MC, Maguire-Jack K. Supportive Neighborhoods, Family Resilience and Flourishing in Childhood and Adolescence. CHILDREN 2022; 9:children9040495. [PMID: 35455539 PMCID: PMC9030551 DOI: 10.3390/children9040495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/21/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022]
Abstract
Flourishing is linked with health and well-being in childhood and adulthood. This study applied a promotive factors model to examine how neighborhood assets might benefit child and adolescent flourishing by promoting family resilience. Using data from the combined 2018 and 2019 National Survey of Children’s Health, structural equation models tested direct and indirect relationships between neighborhood physical environment, neighborhood social cohesion, family resilience, and flourishing among 18,396 children and 24,817 adolescents. After controlling for multiple covariates that may influence flourishing, the models supported that higher levels of neighborhood social cohesion were directly associated with higher levels of flourishing adolescents, and indirectly by positive associations with family resilience for both children and adolescents. No indirect effects between neighborhood physical environments and flourishing were supported by the data for either children or adolescents. However, neighborhood physical environments were positively associated with adolescent flourishing. Understanding social environmental factors that strengthen and enhance child and adolescent flourishing are critical toward designing prevention, intervention, and policy efforts that can build on the existing strengths of families and their communities.
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Affiliation(s)
- Sheila Barnhart
- College of Social Work, University of Kentucky, Lexington, KY 40506, USA;
- Correspondence:
| | - Molly Bode
- College of Social Work, University of Kentucky, Lexington, KY 40506, USA;
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An analysis of the factors affecting children and adolescent lifestyle in South Korea: A cross-sectional study with KCYPS 2018. PLoS One 2022; 17:e0263923. [PMID: 35176077 PMCID: PMC8853469 DOI: 10.1371/journal.pone.0263923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The purpose of this study is to identify lifestyle factors that affect the subjective health conditions of adolescents in South Korea by utilizing data from the Korean Children’s and Youth Panel Survey 2018 conducted in Korea. Methods This cross-sectional study used data from 4,490 students (2,399 students in the fourth grade of elementary school and 2,541 students in the first grade of middle school). The data obtained were evaluated using living time (sleep time, study time, leisure time), emotions (happiness, self-esteem, emotional problems), capabilities (cooperative attitude, grit), health (life satisfaction, exercise time, number of breakfasts, quality of sleep), media (smartphone use and dependence), school (school life satisfaction, relationship with friends and teachers), and home (time spent with parents, parenting attitude). Results We confirmed that regardless of grade, living time (leisure time), emotion (happiness, self-esteem, emotional problems), capabilities (grit), health (life satisfaction, exercise time, quality of sleep), media (smartphone dependence), and school (school life satisfaction, friendly, and teacher relations) are related to subjective health conditions. These results confirmed that evaluation parameters are related to subjective health conditions regardless of grade. Conclusion This investigation revealed that the higher the quality of sleep enhanced positive emotions while increased exercise
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Yu J, Yang Z, Wu Y, Ge M, Tang X, Jiang H. Prevalence of and Factors Associated With Depressive Symptoms Among College Students in Wuhan, China During the Normalization Stage of COVID-19 Prevention and Control. Front Psychiatry 2021; 12:742950. [PMID: 34721111 PMCID: PMC8555744 DOI: 10.3389/fpsyt.2021.742950] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 08/30/2021] [Indexed: 12/22/2022] Open
Abstract
Objectives: The 2019 coronavirus disease (COVID-19) epidemic has led to persistent negative psychological effects on the general public, especially on college students, who are highly susceptible to psychological difficulties, such as fear, anxiety, and depression. Little information is known about depressive symptoms among college students during the normalization stage of COVID-19 prevention and control in China. This study aimed to understand the prevalence of and factors associated with depressive symptoms after a long quarantine time and online learning at home among college students in Wuhan, China. Materials and Methods: A web-based survey was conducted from July to August 2020 during the Chinese summer holiday to collect data on sociodemographic variables, depressive symptoms, and their potential associated factors using an electronic questionnaire among college students in Wuhan, China. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Binary logistic regression was used to explore the factors associated with depressive symptoms. Results: A total of 9,383 college students were included in the analysis. The prevalence of depressive symptoms was 15.8% (1,486/9,383) among college students. The binary logistic regression showed that the experience of being quarantined for observation or treatment, family members or friends dying of COVID-19, rarely or never seeking help from others, fewer supportive relatives or friends, less support from family in the past month, a worse relationship with parents at home, a longer time spent daily on electronic devices except for online learning, and feeling anxious in the face of returning to school were independently associated with a higher risk of depressive symptoms. Academic stress and concern about the epidemic were the main reasons for their anxiety. Conclusions: Targeted psychological intervention measures are recommended for college students to improve their mental health during the normalization stage of COVID-19 prevention and control.
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Affiliation(s)
- Jincong Yu
- Education and Counseling Center for Psychological Health, Zhongnan University of Economics and Law, Wuhan, China
| | - Ziyun Yang
- Education and Counseling Center for Psychological Health, Zhongnan University of Economics and Law, Wuhan, China
| | - Yuqin Wu
- School of Foreign Languages, Zhongnan University of Economics and Law, Wuhan, China
| | - Ming Ge
- Education and Counseling Center for Psychological Health, Zhongnan University of Economics and Law, Wuhan, China
| | - Xuemei Tang
- School of Marxism, Wuhan Railway Vocational College of Technology, Wuhan, China
| | - Hongbo Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
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