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Melkam M, Demilew D, Kassew T, Fanta B, Yitayih S, Alemu K, Muhammed Y, Getnet B, Abetu E, Tarekeg GE, Oumer M, Nenko G. Anxiety disorders among youth with substance use and associated factors in Northwest Ethiopia: A community-based study. PLoS One 2024; 19:e0300927. [PMID: 38512930 PMCID: PMC10956842 DOI: 10.1371/journal.pone.0300927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 03/05/2024] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION Anxiety disorder is an unpleasant emotional feeling with symptoms related to psychological and autonomic symptoms such as headache, perspiration, palpitations, dizziness, and stomach discomfort. The use of substances become a worldwide problem among youth which brings situation that leads to serious social and health-related problems. Anxiety disorders with substance use have a huge impact on their high prevalence, therapeutic issues, and poor prognosis on clinical effects. Although the prevalence of anxiety disorders is significant among young people who use substances, limited studies were conducted. Therefore, this study revealed the burden of anxiety disorders among youth with substance use and associated factors in Ethiopia. METHOD A community-based multi-stage with a simple random sampling technique was conducted. A total of 372 substance users study participants were recruited for this study. Alcohol, Smoking, and Substance Involvement Screening Tests, Depression Anxiety Stress Scales, and other tools were used to assess anxiety disorders with substance use and associated factors. Data were entered into Epi-data version 4.6, and exported to SPSS version 20 for further analysis. Bi-variables logistic regression analysis was employed to identify variables with a p-value of < 0.2 and associated factors were determined in multi-variables logistic regression analysis with a p-value < 0.05 with AOR and CI. RESULTS From a total of 372 respondents the overall prevalence of anxiety disorders with substance use was 48.1%. Male sex [AOR = 1.99; 95% CI: (1.01-3.93)], low educational status of the father [AOR = 6.38 95%CI: (1.50-7.08)], and the presence of stress [AOR = 2.48; 95% CI: 2.48(2.43-4.40)] were significantly associated factors with anxiety disorders with substances use. CONCLUSIONS AND RECOMMENDATIONS The prevalence of anxiety disorders with substance use was 48.1% therefore; it is recommended that the zonal administration give collaborative work with the health bureau and facilitate awareness creation about the impact of substance abuse. Clinicians are recommended to mitigate anxiety disorders with substance use to get a good prognosis for clients with controlling their stress.
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Affiliation(s)
- Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Demeke Demilew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Tilahun Kassew
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Biruk Fanta
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Sewbesew Yitayih
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Department of Biostatistics & Epidemiology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Yassin Muhammed
- Department of Psychology, College of Social Science and Humanities, University of Gondar, Gondar, Ethiopia
| | - Berhanie Getnet
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Eden Abetu
- Department of Clinical Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Gebrekidan Ewnetu Tarekeg
- Department of Biostatistics & Epidemiology, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Mohammed Oumer
- Department of Human Anatomy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of Psychiatry, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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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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Forte C, O'Sullivan D, McDowell CP, Hallgren M, Woods CB, Herring MP. Associations between screen-time, physical activity and depressive symptoms differ based on gender and screen-time mode. Eur Child Adolesc Psychiatry 2023; 32:2313-2322. [PMID: 36097092 DOI: 10.1007/s00787-022-02080-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/04/2022] [Indexed: 11/03/2022]
Abstract
Higher levels of physical activity (PA) and screen time (ST) are associated with positive and negative mental health outcomes among adolescents, respectively. Research is needed to determine the interrelationship between ST and PA with depressive symptoms and the influence of ST modes. This study examines the associations between ST and PA level with depressive symptoms among 1756 adolescents (15.2 ± 1.6y; 995 female) in Ireland. Participants completed the Quick Inventory of Depressive Symptomatology and self-reported weekly ST (TV, computer, and phone use) and PA level (low, moderate, and high). Linear regressions examined associations between ST mode, PA level and relevant covariates with depressive symptoms in the full sample by gender, and in a sample stratified by PA level. Chi-square tests and one-way ANOVA examined gender differences in hours of ST, PA levels, and depressive symptoms. Differential associations were observed depending on the gender and ST mode. Higher levels of computer (β = 0.106, p ≤ 0.000) and phone use (β = 0.138, p ≤ 0.000) showed the strongest associations with depressive symptoms. PA level was inversely associated with depressive symptoms (β = - 0.175, p ≤ 0.000). When the sample was stratified by PA level, only associations between phone use and depressive symptoms were moderated by PA level for males and females. These findings highlight the complex interrelationships between ST, PA, and depressive symptoms, and that associations may vary based on gender and ST mode. This may have implications for future interventions. Increasing PA and reducing ST should be targeted concurrently with consideration given to different media and genders. Future research should explore longitudinal and prospective associations.
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Affiliation(s)
- Chloe Forte
- Department of Physical Education and Sport Science, University of Limerick, Limerick, Ireland.
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Darragh O'Sullivan
- Department of Physical Education and Sport Science, University of Limerick, Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Cillian P McDowell
- Health Information and Quality Authority, Trinity College Dublin, The University of Dublin, Smithfield, Dublin, Ireland
| | - Mats Hallgren
- Epidemiology of Psychiatric Conditions, Substance Use, and Social Environment (EPiCSS), Department of Global Public Health Sciences, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Catherine B Woods
- Department of Physical Education and Sport Science, University of Limerick, Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Matthew P Herring
- Department of Physical Education and Sport Science, University of Limerick, Limerick, Ireland
- Physical Activity for Health Cluster, Health Research Institute, University of Limerick, Limerick, Ireland
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He X, Hu J, Yin M, Zhang W, Qiu B. Screen Media Use Affects Subcortical Structures, Resting-State Functional Connectivity, and Mental Health Problems in Early Adolescence. Brain Sci 2023; 13:1452. [PMID: 37891820 PMCID: PMC10604980 DOI: 10.3390/brainsci13101452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
The association between excessive screen media use and mental health problems has attracted widespread attention. The literature to date has neglected the biological mechanisms underlying such a relationship and failed to distinguish between different types of screen media activities. A sample from the Adolescent Brain and Cognitive Development study was used in the present study to elucidate the longitudinal associations between specific types of screen media use, brain development, and diverse mental health problems. The results showed that different types of screen media use have differentiated associations with mental health problems, subcortical volume, and cortical-subcortical connectivity. Specifically, more passive media use was associated with increased rule-breaking behavior, while more video game playing was associated with increased withdrawn/depressed symptoms. In addition, more social media use was associated with a reduced volume of the hippocampus, caudate, and thalamus proper. More research is needed to examine the differential effects of screen media use on neurodevelopmental processes and mental health problems across adolescence.
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Affiliation(s)
- Xu He
- School of Health Management, Guangzhou Medical University, Guangzhou 510180, China;
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Guangzhou 510631, China
- School of Psychology, South China Normal University, Guangzhou 510631, China
| | - Jiaxin Hu
- School of International Culture, South China Normal University, Guangzhou 510631, China
| | - Mengyun Yin
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Guangzhou 510631, China
- School of Psychology, South China Normal University, Guangzhou 510631, China
| | - Wei Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Guangzhou 510631, China
- School of Psychology, South China Normal University, Guangzhou 510631, China
| | - Boyu Qiu
- School of Health Management, Guangzhou Medical University, Guangzhou 510180, China;
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Liu Y, Sun Y, Zheng K, Zheng J, Kong L, Gu J, Huang T. Association of Screen Time with Anxiety and Depressive Symptoms in College Students During COVID-19 Outbreak in Shanghai: Mediation Role of Sleep Quality. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2023; 26:755-763. [PMID: 37729063 DOI: 10.1089/cyber.2022.0373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
The study aimed to investigate the associations between different types of screen time (ST) and anxiety and depressive symptoms in college students during the Coronavirus disease 2019 (COVID-19) outbreak in Shanghai, China; the potential mediation role of sleep quality was also examined. A total of 1,550 college students completed an online survey in May 2022. ST, Self-rating Anxiety Scale (SAS) score, Self-rating Depression Scale (SDS) score, Pittsburgh Sleep Quality Index (PSQI) score, and physical activity were self-reported. Multiple linear regression and mediation analysis were conducted. The results showed that more time spent in TV/movie viewing (>2 h/day) and recreational reading (>1 h/day) was associated with higher levels of anxiety, while more time spent in online social media (>2 h/day) was associated with a higher level of depressive symptoms. In contrast, time spent in online social media (1-2 h/day) was associated with a lower level of anxiety. Meanwhile, recreational reading (2-3 h/day) had a significant indirect effect on anxiety and depressive symptoms through sleep quality. During the COVID-19 outbreak, the associations of ST with anxiety and depressive symptoms varied by the type of screen viewing in college students. The associations of slightly excessive time spent on recreational reading with higher levels of anxiety and depressive symptoms were partially mediated by sleep quality.
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Affiliation(s)
- Yiting Liu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Yishan Sun
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Kefeng Zheng
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Jiaxin Zheng
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Lingxuan Kong
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Jianping Gu
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Huang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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Paulus MP, Zhao Y, Potenza MN, Aupperle RL, Bagot KS, Tapert SF. Screen media activity in youth: A critical review of mental health and neuroscience findings. JOURNAL OF MOOD AND ANXIETY DISORDERS 2023; 3:100018. [PMID: 37927536 PMCID: PMC10624397 DOI: 10.1016/j.xjmad.2023.100018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
This review has two primary objectives: (1) to offer a balanced examination of recent findings on the relationship between screen media activity (SMA) in young individuals and outcomes such as sleep patterns, mood disturbances, anxiety-related concerns, and cognitive processes; and (2) to introduce a novel multi-level system model that integrates these findings, resolves contradictions in the literature, and guides future studies in examining key covariates affecting the SMA-mental health relationship. Key findings include: (1) Several meta-analyses reveal a significant association between SMA and mental health issues, particularly anxiety and depression, including specific negative effects linked to prolonged screen time; (2) substantial evidence indicates that SMA has both immediate and long-term impacts on sleep duration and quality; (3) the relationship between SMA and cognitive functioning is complex, with mixed findings showing both positive and negative associations; and (4) the multifaceted relationship between SMA and various aspects of adolescent life is influenced by a wide range of environmental and contextual factors. SMA in youth is best understood within a complex system encompassing individual, caregiver, school, peer, and environmental factors, as framed by Bronfenbrenner's ecological systems theory, which identifies five interrelated systems (microsystem, mesosystem, exosystem, macrosystem, and chronosystem) that influence development across both proximal and distal levels of the environment. This model provides a framework for future research to examine these interactions, considering moderating factors, and to develop targeted interventions that can mitigate potential adverse effects of SMA on mental well-being.
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Affiliation(s)
- Martin P. Paulus
- Laureate Institute for Brain Research, 6655S. Yale Ave., Tulsa, OK 74136, USA
- School of Community Medicine, The University of Tulsa, 1215 South Boulder Ave. W., Tulsa, OK 74119, USA
| | - Yihong Zhao
- Columbia University School of Nursing, 560W 168th Street, Room 614, New York, NY 10032, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Marc N. Potenza
- Department of Psychiatry, Child Study Center, Department of Neuroscience, Yale University School of Medicine, 1 Church Street, Room 726, New Haven, CT 06510, USA
- Connecticut Mental Health Center, 1 Church Street, Room 726, New Haven, CT 06510, USA
- Connecticut Council on Problem Gambling, Wethersfield, 1 Church Street, Room 726, New Haven, CT 06510, USA
- Wu Tsai Institute, Yale University, 1 Church Street, Room 726, New Haven, CT 06510, USA
| | - Robin L. Aupperle
- Laureate Institute for Brain Research, 6655S. Yale Ave., Tulsa, OK 74136, USA
| | - Kara S. Bagot
- iIcahn School of Medicine at Mount Sinai, Departments of Psychiatry and Pediatrics, USA
| | - Susan F. Tapert
- Department of Psychiatry, UCSD Health Sciences, 9500 Gilman Drive, La Jolla, CA 92093, USA
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Oliveira BN, dos Santos PC, da Costa BGG, Malheiros LEA, Lopes MVV, Silva KS. Screen Time Correlates of Bullying Perpetration and Victimization in Brazilian Adolescents. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:607-613. [PMID: 37593059 PMCID: PMC10427572 DOI: 10.1007/s40653-023-00515-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/04/2023] [Indexed: 08/19/2023]
Abstract
This study is an investigation of the associations of time spent in different screen time activities with bullying among Brazilian adolescents. In this cross-sectional study, adolescents answered questions related to bullying in the past 30 days and reported the weekly volume of screen time spent studying, working, watching videos, playing video games, and using social media applications. Multilevel logistic regression models were used. Our results indicate that higher social media use was associated with higher odds of bullying victimization among males but not females. Excessive use of screen time for work and social media purposes was associated with a higher likelihood of bullying victimization.
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Affiliation(s)
- Bruno Nunes Oliveira
- Research Center for Physical Activity and Health, School of Sports, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina Brazil
| | - Priscila Cristina dos Santos
- Research Center for Physical Activity and Health, School of Sports, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina Brazil
| | - Bruno Gonçalves Galdino da Costa
- Research Center for Physical Activity and Health, School of Sports, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina Brazil
- School of Physical and Health Education, Nipissing University, North Bay, ON Canada
| | - Luís Eduardo Argenta Malheiros
- Research Center for Physical Activity and Health, School of Sports, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina Brazil
| | - Marcus Vinicius Veber Lopes
- Research Center for Physical Activity and Health, School of Sports, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina Brazil
| | - Kelly Samara Silva
- Research Center for Physical Activity and Health, School of Sports, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina Brazil
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Santos RMS, Mendes CG, Sen Bressani GY, de Alcantara Ventura S, de Almeida Nogueira YJ, de Miranda DM, Romano-Silva MA. The associations between screen time and mental health in adolescents: a systematic review. BMC Psychol 2023; 11:127. [PMID: 37081557 PMCID: PMC10117262 DOI: 10.1186/s40359-023-01166-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/14/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Adolescents have extensive use of screens and, they have common complains related to mental health. Here a systematic review was done to understand the association between screen time and adolescent's mental health. METHOD This review was conducted in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA. An update search was performed in January 2023 with the following keywords: "screen time," "adolescent," and "mental health" on PubMed, PsycINFO and Scopus databases. RESULTS 50 articles were included, most have found associations between screen exposure and mental health in adolescents. The most used device by adolescents was the smartphone and the use on weekdays was associated with diminished mental well-being. Social media use was negatively associated with mental well-being and, in girls, associated at higher risk for depression. CONCLUSION Excessive screen time in adolescents seems associated with mental health problems. Given the profusion and disparity of the results, additional studies are needed to clarify elements such as the screen content or the interaction of adolescents with different screen devices. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022302817.
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Affiliation(s)
- Renata Maria Silva Santos
- Graduate Program Molecular Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.
| | - Camila Guimarães Mendes
- Graduate Program Children and Adolescent Health, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Guilherme Yanq Sen Bressani
- Graduate Program Children and Adolescent Health, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Samara de Alcantara Ventura
- Scientific Research Program Molecular Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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Hökby S, Westerlund J, Alvarsson J, Carli V, Hadlaczky G. Longitudinal Effects of Screen Time on Depressive Symptoms among Swedish Adolescents: The Moderating and Mediating Role of Coping Engagement Behavior. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3771. [PMID: 36834466 PMCID: PMC9963273 DOI: 10.3390/ijerph20043771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Studies suggest that hourly digital screen time increases adolescents' depressive symptoms and emotional regulation difficulties. However, causal mechanisms behind such associations remain unclear. We hypothesized that problem-focused and/or emotion-focused engagement coping moderates and possibly mediates this association over time. Questionnaire data were collected in three waves from a representative sample of Swedish adolescents (0, 3 and 12 months; n = 4793; 51% boys; 99% aged 13-15). Generalized Estimating Equations estimated the main effects and moderation effects, and structural regression estimated the mediation pathways. The results showed that problem-focused coping had a main effect on future depression (b = 0.030; p < 0.001) and moderated the effect of screen time (b = 0.009; p < 0.01). The effect size of this moderation was maximum 3.4 BDI-II scores. The mediation results corroborated the finding that future depression was only indirectly correlated with baseline screen time, conditional upon intermittent problem-coping interference (C'-path: Std. beta = 0.001; p = 0.018). The data did not support direct effects, emotion-focused coping effects, or reversed causality. We conclude that hourly screen time can increase depressive symptoms in adolescent populations through interferences with problem-focused coping and other emotional regulation behaviors. Preventive programs could target coping interferences to improve public health. We discuss psychological models of why screen time may interfere with coping, including displacement effects and echo chamber phenomena.
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Affiliation(s)
- Sebastian Hökby
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77 Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
| | - Joakim Westerlund
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
- Department of Psychology, Stockholm University, 106 91 Stockholm, Sweden
| | - Jesper Alvarsson
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
- Stockholm Centre for Health and Social Change (SCOHOST), Department of Psychology, School of Social Sciences, Södertörn University, 141 89 Huddinge, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77 Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, 171 77 Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, 171 77 Stockholm, Sweden
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Smout S, Gardner LA, Newton N, Champion KE. Dose-response associations between modifiable lifestyle behaviours and anxiety, depression and psychological distress symptoms in early adolescence. Aust N Z J Public Health 2023; 47:100010. [PMID: 36645951 DOI: 10.1016/j.anzjph.2022.100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE To investigate associations between key modifiable lifestyle behaviours (sleep; physical activity; fruit, vegetable and sugar-sweetened beverage consumption; screen time; alcohol use and tobacco use) and mental health among early adolescents in Australia. METHODS Cross-sectional self-report data from 6,640 Year 7 students (Mage:12.7[0.5]; 50.6% male, 48.9% female, 0.5% non-binary) from 71 schools in New South Wales, Queensland and Western Australia were analysed using multivariate linear regression adjusting for sociodemographic factors and school-level clustering. RESULTS All examined behaviours were associated with anxiety, depression and psychological distress (p≤0.001), with the lowest mental health symptom scores observed in participants who slept 9.5-10.5 hours per night; consumed three serves of fruit daily; consumed two serves of vegetables daily; never or rarely drank sugar-sweetened beverages; engaged in six days of moderate-to-vigorous physical activity per week; kept daily recreational screen time to 31-60 minutes; had not consumed a full standard alcoholic drink (past six months); or smoked a cigarette (past six months). CONCLUSIONS Targeting modifiable risk behaviours offers promising prevention potential to improve adolescent mental health; however, further longitudinal research to determine directionality and behavioural interactions is needed. IMPLICATIONS FOR PUBLIC HEALTH While Australian Dietary, Movement and Alcohol Guidelines target physical health, findings indicate similar behaviour thresholds may offer mental health benefits.
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Affiliation(s)
- Scarlett Smout
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Nicola Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
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Hu X, Drenowatz C, Duncan M, Bao R, Chen S, He J, Tang Y. Physical education, muscle strengthening exercise, sport participation and their associations with screen time in adolescents. Front Public Health 2023; 11:1100958. [PMID: 36891338 PMCID: PMC9986278 DOI: 10.3389/fpubh.2023.1100958] [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: 11/17/2022] [Accepted: 01/19/2023] [Indexed: 02/22/2023] Open
Abstract
Background/Objective Physical activity (PA) has been suggested to reduce screen time. This study aimed to explore the associations of physical education (PE), muscle-strengthening exercise (MSE), and sport participation with screen time. Methods A multi-cluster sampling design was used to select 13,677 school-attending adolescents that participated in the Youth Risk Behavior Surveillance 2019 survey. Adolescents self-reported their frequency of PE attendance, participations in MSE, sport participation and hours for screen time. Additionally, participants provided demographic information including sex, age, race, grade, and weight status. Results Collectively, there were beneficial associations between participating in MSE for 4 (OR = 1.31, CI: 1.02-1.68), 5 (OR = 1.65, CI: 1.31-2.08), 6 (OR = 2.23, CI: 1.47-3.36), 7 (OR = 1.62, CI: 1.30-2.01) days and video or computer game hours. Similarly, beneficial associations between participating in 1 team sport (OR = 1.23, CI: 1.06-1.42), 2 team sports (OR = 1.61, CI: 1.33-1.95), 3 or more team sports (OR = 1.45, CI: 1.16-1.83) and video or computer game hours were observed. Participating in 1 team sport (OR = 1.27, CI: 1.08-1.48), 2 teams sport (OR = 1.41, CI: 1.09-1.82), 3 or more team sport (OR = 1.40, CI: 1.03-1.90) also increased the odds for meeting guidelines for television viewing hours. Only 2 days of PE attendance (OR = 1.44, CI: 1.14-1.81) was significantly associated with video or computer game hours. Conclusion The promotion of sports participation appears to be an important component for reducing excess screen time in adolescents. Further, MSE may have beneficial effects on reducing time spent on the computer and playing video games.
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Affiliation(s)
- Xiaoqing Hu
- Center for Post-doctoral Studies of Sport Science, School of Physical Education and Sport Science, Fujian Normal University, Fuzhou, China
| | - Clemens Drenowatz
- Division of Sport, Physical Activity and Health, University of Education Upper Austria, Linz, Austria
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Ran Bao
- Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
| | - Sitong Chen
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Jinsheng He
- School of Physical Education, Shanghai Normal University, Shanghai, China
| | - Yan Tang
- School of Physical Education, Shanghai University of Sport, Shanghai, China
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12
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Mougharbel F, Chaput JP, Sampasa-Kanyinga H, Colman I, Leatherdale ST, Patte KA, Goldfield GS. Longitudinal associations between different types of screen use and depression and anxiety symptoms in adolescents. Front Public Health 2023; 11:1101594. [PMID: 37213617 PMCID: PMC10193840 DOI: 10.3389/fpubh.2023.1101594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
Background Evidence examining the longitudinal associations between different types of screen behaviours and mental health among adolescents is limited. The present study examined the association between five types of screen behaviours and symptoms of anxiety and depression one year later. This study also assessed how changes in screen time were associated with changes in anxiety and depressive symptoms and whether the observed relationships were moderated by sex. Methods Longitudinal data of 17,174 students in grades 9-12 (53.5% females; mean age: 15.1 ± 0.9 years) attending high schools in Canada from two waves (year 6: 2017/18, year 7: 2018/19) of the COMPASS study were analyzed. Leisure screen time and mental health measures were self-reported. To test if the associations between screen time and anxiety, and depression vary by sex, two-way interactions were examined for sex. Analyses accounted for school clustering, race/ethnicity, sex, age, income, body mass index z-score, and previous year anxiety and depression symptoms. Results There were significant longitudinal associations between time spent on each type of screen and subsequent anxiety and depression symptoms. The strength of the associations varied by type of screen behaviour. Interaction analysis indicated a sex difference for television viewing and anxiety and depression symptoms, and internet surfing and anxiety symptoms. A dose-response relationship was observed between phone talking and anxiety symptoms. Beta estimates indicated that an increase in screen duration was associated with a further increase in anxiety and depression symptoms. Conclusion Higher screen time was longitudinally associated with higher anxiety and depression symptoms at one-year follow-up in adolescents. Time-change associations between screen usage and depressive and anxiety symptoms were observed. Also, associations differed based on sex and screen type, whereby greater increases in screen use predicted greater emotional distress. Findings from this prospective analysis suggest that screen time is an important determinant of anxiety and depressive symptoms among adolescents. Future studies are recommended to help inform programs promoting screen time reduction with a goal to enhance adolescents' mental health.
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Affiliation(s)
- Fatima Mougharbel
- School of Population Health, University of Ottawa, Ottawa, ON, Canada
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Hugues Sampasa-Kanyinga
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | | | - Karen A. Patte
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Gary S. Goldfield
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- *Correspondence: Gary S. Goldfield,
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13
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Huang T, Zheng K, Li S, Yang Y, Kong L, Zhao Y. Screen-based sedentary behaviors but not total sedentary time are associated with anxiety among college students. Front Public Health 2022; 10:994612. [PMID: 36339232 PMCID: PMC9632443 DOI: 10.3389/fpubh.2022.994612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/26/2022] [Indexed: 01/26/2023] Open
Abstract
Objective The purpose of the study was to investigate the associations of device-measured total sedentary time and screen-based sedentary time with anxiety in college students. Methods Three hundred and twenty-one college students (mean age = 19.72 ± 1.18, 55.8% females) were recruited from Shanghai, China. Total sedentary time was objectively measured using accelerometry, while screen-based sedentary time was self-reported. Anxiety symptom was evaluated using the Self-Rating Anxiety Scale. Linear regression modeling was used to assess the associations of total sedentary time and screen-based sedentary time with anxiety symptom. Results Accelerometer-assessed total sedentary time was not associated with anxiety symptom. Prolonged sedentary time on TV and movie viewing (>2 h on weekdays) and social media using (>2 h on weekdays and weekend) were associated with a higher level of anxiety. However, time on video gaming and recreational reading was not associated with anxiety symptom. Conclusion The findings indicated that screen-based sedentary behaviors but not total sedentary time were associated with anxiety symptom among college students. The associations of screen-based sedentary behaviors with anxiety symptom varied by the types of screen time.
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Affiliation(s)
- Tao Huang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Tao Huang
| | - Kefeng Zheng
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Shiyuan Li
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Yanxiang Yang
- Chair of Sport and Health Management, Technical University of Munich, Munich, Germany
| | - Lingxuan Kong
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Zhao
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai, China
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14
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A Systematic Review of the Associations of Adiposity and Cardiorespiratory Fitness With Arterial Structure and Function in Nonclinical Children and Adolescents. Pediatr Exerc Sci 2022:1-12. [PMID: 36150705 DOI: 10.1123/pes.2022-0029] [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: 02/16/2022] [Revised: 08/02/2022] [Accepted: 08/07/2022] [Indexed: 11/07/2022]
Abstract
PURPOSE To summarize the evidence on associations of adiposity and cardiorespiratory fitness (CRF) with arterial structure and function in nonclinical children and adolescents. METHODS Two researchers conducted a search in 5 electronic databases in April 2022 to find studies in nonclinical youth (age 5-17.9 y) reporting multivariable associations. Studies were eligible if adiposity and/or CRF were used as the predictor and arterial structure and/or function was the outcome. The Quality Assessment Tool for Quantitative Studies was used to assess methodological quality for experimental studies, and a modified version was used for observational studies. RESULTS Ninety-nine studies (72.7% cross-sectional) were included. Ninety-four assessed associations between adiposity and arterial outcomes, most using overall body proportion (n = 71), abdominal (n = 52), or whole-body adiposity (n = 40). Most evidence was inconsistent or nonsignificant, but 59 studies suggested higher abdominal adiposity and worse body proportion were associated with adverse arterial outcomes. Twenty-one assessed associations between CRF and arterial outcomes, with findings inconsistent. Most evidence was rated weak in quality. CONCLUSION While high adiposity may contribute to poor arterial outcomes, evidence is limited regarding CRF. Future studies should disentangle these associations by studying youth with healthy adiposity but poor CRF, or vice versa, using longitudinal or experimental study designs.
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15
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Chen S, Clark CCT, Ren Z. Different types of screen-based sedentary time and anxiety in adolescents: Video games may be more important. Front Public Health 2022; 10:918234. [PMID: 36148333 PMCID: PMC9486474 DOI: 10.3389/fpubh.2022.918234] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/11/2022] [Indexed: 01/22/2023] Open
Abstract
Aim Evidence demonstrates the negative impact of excessive screen-based sedentary time (screen-based sedentary behavior; SSB) on mental health in adolescents. However, little is known regarding the associations between different types of SSBs and anxiety symptoms in adolescents. Thus, this study sought to explore the associations between different types of SSBs and anxiety symptoms in a sample of Chinese adolescents. Methods A web-based questionnaire survey was used to collect data. In total, 1,998 study participants conveniently recruited in Guangdong Province completed the questionnaire. Of them, 1,331 study participants provided valid data for variables of interest. SSB was categorized into television/movie time, video game time, and internet-surfing time. Anxiety symptoms were assessed using Zung Self-Rating Anxiety Scale, a validated assessment in Chinese youth populations. Generalized linear models were used to explore the associations between different types of SSBs and anxiety symptoms. Results In adolescents, video game time of 6 or more h was positively and significantly associated with anxiety symptoms (odds ratio = 5.25, 95% CI: 1.86-14.84, p < 0.01). This association was also observed specifically in boys (odds ratio = 5.12, 95% CI: 1.56-17.44, p < 0.05); however, in girls, there were no associations between different types of SSBs and anxiety symptoms. Conclusion Interventions aiming at reducing video games in adolescents, especially in boys, should be designed to prevent anxiety symptoms. This kind of intervention should also take sex differences into consideration. Future studies are encouraged to confirm the veracity of the findings in this study.
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Affiliation(s)
- Sitong Chen
- School of Physical Education and Sport, Shenzhen University, Shenzhen, China
| | - Cain C. T. Clark
- Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
| | - Zhanbing Ren
- School of Physical Education and Sport, Shenzhen University, Shenzhen, China,*Correspondence: Zhanbing Ren
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16
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Yu W, Abbey C, Qian Y, Wang H, Rozelle S, Singh MK. Behavioral Strengths and Difficulties and Their Associations with Academic Performance in Math among Rural Youth in China. Healthcare (Basel) 2022; 10:healthcare10091642. [PMID: 36141254 PMCID: PMC9498325 DOI: 10.3390/healthcare10091642] [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: 07/22/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
Behavioral strengths and difficulties among children and adolescents may be significantly associated with their academic performance; however, the evidence on this issue for rural youth in developing contexts is limited. This study explored the prevalence and correlates of mental health from three specific dimensions—internalizing problems, externalizing problems, and prosocial behavior—measured by the Strengths and Difficulties Questionnaire (SDQ), and the association of these dimensions with academic performance in math among a sample of 1500 students in rural China. Our findings indicated that students in rural China had worse behavioral difficulties and poorer prosocial skills when compared to most past studies conducted inside and outside of China. In addition, total difficulties and prosocial scores on the SDQ were significantly associated with student math test scores, as students whose externalizing, internalizing, and prosocial scores were in the abnormal range scored lower in math by 0.35 SD, 0.23 SD, and 0.33 SD, respectively. The results add to the growing body of empirical evidence related to the links between social environment, mental health, and academic performance in developing countries, highlighting the importance of students’ mental health for their academic performance, and of understanding risk factors in the social environment among rural youth in developing countries.
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Affiliation(s)
- Wenjing Yu
- China Academy for Rural Development, Zhejiang University, Hangzhou 310058, China
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Cody Abbey
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Yiwei Qian
- Research Institute of Economics and Management, Southwestern University of Finance and Economics, Chengdu 610074, China
- Correspondence:
| | - Huan Wang
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Scott Rozelle
- Stanford Center on China’s Economy and Institutions, Stanford University, Stanford, CA 94305-6055, USA
| | - Manpreet K. Singh
- Stanford School of Medicine, Stanford University, Stanford, CA 94305-5101, USA
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17
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Zink J, Yang CH, McAlister KL, Huh J, Pentz MA, Page KA, Belcher BR, Dunton GF. Patterns of Objectively Measured Sedentary Time and Emotional Disorder Symptoms Among Youth. J Pediatr Psychol 2022; 47:757-768. [PMID: 35260899 PMCID: PMC9297093 DOI: 10.1093/jpepsy/jsac014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE We examined the within-person longitudinal and bidirectional associations between patterns of sedentary time accumulation [alpha (sedentary bout duration/length), sedentary breaks (number of breaks in sedentary bouts)], and symptoms of major depressive disorder and generalized anxiety disorder. METHODS Children [N = 167, 10.1(0.9) years old, 54.5% female, 59.3% Hispanic, 35.9% overweight/obese at baseline] participated in a 3-year longitudinal study that consisted of assessments of sedentary time, and depressive and anxiety symptoms. At each assessment, participants wore accelerometers and completed the Revised Child Anxiety and Depression Scale. Separate random intercept cross-lagged panel models estimated the within-person longitudinal and bidirectional associations between alpha, sedentary breaks, and symptoms of major depressive disorder and generalized anxiety disorder across chronological age intervals. RESULTS Having greater than one's own usual depressive symptoms at age 11 was associated with fewer sedentary breaks 1 year later. Having greater than one's own usual generalized anxiety symptoms at age 11 was associated with longer sedentary bouts and fewer sedentary breaks 1 year later. In contrast, having greater than one's own usual sedentary breaks at age 10 was associated with fewer generalized anxiety symptoms 1 year later. All other associations, including at younger ages, were null. CONCLUSION Deviations from one's usual levels of depressive or anxiety symptoms may be important for how sedentary time is subsequently accumulated. Intraindividual processes appear to be at play, therefore more within-person research is needed. Intervention strategies for promoting a healthier accumulation of sedentary time may consider targeting occasions when depressive and anxiety symptoms are greater than usual.
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Affiliation(s)
- Jennifer Zink
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, USA
| | - Kelsey L McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Mary Ann Pentz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Kathleen A Page
- Department of Medicine, Keck School of Medicine, University of Southern California, USA
| | - Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, USA
- Department of Psychology, University of Southern California, USA
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18
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Associations of Passive and Active Screen Time With Psychosomatic Complaints of Adolescents. Am J Prev Med 2022; 63:24-32. [PMID: 35725131 DOI: 10.1016/j.amepre.2022.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/29/2021] [Accepted: 01/02/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Increased screen time is a ubiquitous part of adolescent life and is adversely associated with their well-being. However, it remains unclear whether different types of screen time have equivalent associations, or if relationships are dose-dependent. METHODS The data were from 2 nationally representative Health Behaviour in School-aged Children (2010, 2014) surveys across 44 European and North American countries. Psychosomatic health was assessed using 8 complaints and dichotomized as high or low. Discretionary time spent on passive (e.g., TV) and mentally active (e.g., electronic games, computer use) screen-based activities was categorized into 3 groups. Data were analyzed in 2021. RESULTS The study included 414,489 adolescents (average age, 13.6 [SD=1.63] years; 51.1% girls). Multilevel modeling showed that psychosomatic complaints increased monotonically once all forms of screen time exceeded 2 hours/day. Adolescents reporting high (>4 hours/day) TV time, compared with those reporting low (≤2 hours/day), had higher odds of reporting psychosomatic complaints with 67% higher odds (OR=1.67, 95% CI=1.62, 1.72) in boys and 71% (OR=1.71, 95% CI=1.66, 1.75) in girls. High electronic game use was associated with psychosomatic complaints, with odds being 78% higher in boys (OR=1.78, 95% CI=1.73, 1.84) and 88% higher in girls (OR=1.88, 95% CI=1.82, 1.94). Similar associations were found between computer use and psychosomatic complaints. CONCLUSIONS Passive and mentally active screen time are adversely associated with psychosomatic complaints in a dose-dependent manner, with associations slightly stronger for active than passive screen time. This study supports limiting any type of screen time, either passive or active, to 2 hours/day to foster well-being.
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19
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Chen X, Gao H, Shu B, Zou Y. Effects of changes in physical and sedentary behaviors on mental health and life satisfaction during the COVID-19 pandemic: Evidence from China. PLoS One 2022; 17:e0269237. [PMID: 35727743 PMCID: PMC9212146 DOI: 10.1371/journal.pone.0269237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 05/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background
While restriction measures are critical in containing the COVID-19 outbreak, limited studies have investigated the behavioral and psychological impact of these measures. This study aimed to investigate the effects of physical and sedentary behavioral changes and online behavior during the COVID-19 pandemic on mental health and life satisfaction among the Chinese population.
Methods
The data were obtained from a cross-sectional survey of 2145 residents aged between 18 and 80 in Hubei province, China between March 23, 2020, and April 9, 2020.
Results
Participants who had high frequencies of physical activities before or during the COVID-19 outbreak exhibited higher levels of life satisfaction. Participants who increased their sitting time during the pandemic or kept sitting for more than eight hours before and during the pandemic reported worse mental health than those who maintained less sedentary behavior. Besides, participants who used the Internet for information seeking, communication, and entertainment more frequently reported better mental health and life satisfaction. In contrast, there was a positive association between commercial use of the Internet and symptoms of mental disorders.
Conclusion
Given the link between physical and sedentary behavioral changes with worse mental wellbeing, strategies to reduce sedentariness and increase physical activity during the COVID-19 pandemic are needed.
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Affiliation(s)
- Xi Chen
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- * E-mail:
| | - Haiyan Gao
- Faculty of Humanities and Social Sciences, Beijing University of Technology, Chaoyang, China
| | - Binbin Shu
- Department of Sociology, Shenzhen University, Shenzhen, China
| | - Yuchun Zou
- Institute of Sociology, Chinese Academy of Social Sciences, Beijing, China
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20
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Zink J, Yang CH, Alves JM, McAlister KL, Huh J, Pentz MA, Page KA, Dunton GF, Belcher BR. Time-Varying Associations Between Device-Based and Ecological Momentary Assessment-Reported Sedentary Behaviors and the Concurrent Affective States Among Adolescents: Proof-of-Concept Study. JMIR Form Res 2022; 6:e37743. [PMID: 35687383 PMCID: PMC9233247 DOI: 10.2196/37743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Previous studies on affective state-sedentary behavior (SB) associations have not accounted for their potentially time-varying nature and have used inconsistent SB measurement modalities. We investigated whether the strength of the associations between affective states and SB varied as a function of the time of day and by SB measurement modality (device-measured SB vs ecological momentary assessment-reported screen-based SB) in youth. OBJECTIVE This study aimed to establish a proof of concept that SB-affective state associations may not be static during the day. In addition, we aimed to inform the methodology of future work, which may need to model associations as functions of the time of day and carefully consider how SB is operationalized or measured. METHODS A total of 15 adolescents (age: mean 13.07, SD 1.03 years; 10/15, 67% female; 6/15, 40% Hispanic; 10/15, 67% healthy weight) wore thigh-mounted activPAL accelerometers and simultaneously reported their screen-based SBs and concurrent positive and negative affective states via ecological momentary assessment for 7 to 14 days (N=636 occasions). Time-varying effect models (varying slopes) examined how each measure of SB was associated with concurrent affective states from 7 AM to 8 PM. RESULTS Time-varying effect model plots revealed that these associations varied in strength throughout the day. Specifically, device-based SB was related to greater concurrent negative affect only after approximately 5 PM and was unrelated to concurrent positive affect. Screen-based SB was related to greater concurrent negative affect only from 7 AM to approximately 9 AM. This was also related to greater concurrent positive affect from 7 AM to approximately 9:30 AM and from approximately 3 PM to approximately 7 PM. CONCLUSIONS We provide preliminary evidence to suggest that future confirmatory studies investigating the SB-affective state relationship should consider the time-varying nature of these associations and SB measurement modality. There may be critical time windows when specific types of SBs co-occur with affect, suggesting that interventions may need tailoring to the time of day and type of SB if future studies using similar methodologies can replicate our findings.
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Affiliation(s)
- Jennifer Zink
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Jasmin M Alves
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Kelsey L McAlister
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jimi Huh
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Mary Ann Pentz
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Kathleen A Page
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Britni R Belcher
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
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21
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Zhang J, Yang SX, Wang L, Han LH, Wu XY. The influence of sedentary behaviour on mental health among children and adolescents: A systematic review and meta-analysis of longitudinal studies. J Affect Disord 2022; 306:90-114. [PMID: 35304232 DOI: 10.1016/j.jad.2022.03.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 12/12/2021] [Accepted: 03/10/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Systematic reviews that have examined associations between sedentary behaviour (SB) and mental health among children and adolescents are mainly based on cross-sectional investigations. There is a lack of evidence for a prospective relationship between SB and mental health in children and adolescents. This systematic review synthesized longitudinal studies that examined prospective associations between SB and mental health among children and adolescents. METHODS We conducted computer searches for English language literature from electronic databases of PubMed, Embase, PsycInfo and Google scholar, and manually screened the references of existing relevant studies to select studies for the synthesis. We included observational longitudinal studies that assessed the association between SB and mental health among children and adolescents. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS In total, 58 longitudinal studies met the inclusion criteria and were synthesized in the review. We found that higher SB among children and adolescents was associated with increased depression, anxiety and other mental health problems later in life. A dose-response association between SB and mental health was observed, suggesting that children and adolescents who spend more time on SB may have a higher risk of developing poorer mental health later. CONCLUSIONS The findings in the present study suggest that intervention programs targeting reducing SB may benefit to the prevention of poor mental health among children and adolescents. Future intervention studies especially randomized controlled trials are needed to elucidate a causal relationship between SB and mental health among children and adolescents.
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Affiliation(s)
- Jing Zhang
- Weifang Medical University, Weifang, Shandong, China; Weifang Municipal Center for Disease Control and Prevention, Weifang, Shandong, China
| | | | - Liang Wang
- Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, China
| | - Li Hui Han
- The Affiliated Weihai Second Municipal Hospital of Qingdao University, Shandong, China
| | - Xiu Yun Wu
- Weifang Medical University, Weifang, Shandong, China.
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22
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Balanzá-Martínez V, Cervera-Martínez J. Lifestyle Prescription for Depression with a Focus on Nature Exposure and Screen Time: A Narrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095094. [PMID: 35564489 PMCID: PMC9104582 DOI: 10.3390/ijerph19095094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/15/2022] [Accepted: 04/19/2022] [Indexed: 12/10/2022]
Abstract
Recent lifestyles changes have favored increased time in contact with screens and a parallel reduction in contact with natural environments. There is growing awareness that nature exposure and screen time are related to depression. So far, the roles of how these environmental lifestyles affect depressive symptoms and disorders have not been reviewed simultaneously. The aim of this review was to gather the literature regarding the role of nature exposure and screen time in depression. An emphasis was made on clinical samples of patients with well-defined depression and the different methodological approaches used in the field. A second goal was to suggest an agenda for clinical practice and research. Studies were included if they assessed depressive symptoms in patients with a clinical diagnosis of depression. An overview of the published literature was conducted using three scientific databases up to December 2021. Several interventions involving nature exposure have shown positive effects on depressive symptoms and mood-related measures. The most consistent finding suggests that walks in natural environments may decrease depressive symptoms in patients with clinical depression. Less researched interventions, such as psychotherapy delivered in a forest or access to natural environments via virtual reality, may also be effective. In contrast, fewer observational studies and no experimental research on screen time have been conducted in patients with clinical depression. Thus, recommendations for practice and research are also discussed. Scarce research, diverse interventions, and several methodological shortcomings prevent us from drawing conclusions in this area. More high-quality experimental research is needed to establish interventions with proven efficacy in clinical depression. At this stage, it is too early to formulate practice guidelines and advise the prescription of these lifestyles to individuals with depression. The present findings may serve as a basis to develop strategies based on nature exposure and screen time targeting clinical depression.
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Affiliation(s)
- Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
- Teaching Unit of Psychiatry and Psychological Medicine, Department of Medicine, University of Valencia, 46010 Valencia, Spain
- Correspondence: ; Tel.: +34-963-983-349
| | - Jose Cervera-Martínez
- Department of Medicine, University of Valencia, 46010 Valencia, Spain;
- Hospital de Denia-Marina Salud, 03700 Denia, Spain
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Tsou MT. Influence of Prolonged Visual Display Terminal Use on Physical and Mental Conditions among Health Care Workers at Tertiary Hospitals, Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073770. [PMID: 35409467 PMCID: PMC8998003 DOI: 10.3390/ijerph19073770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/12/2022] [Accepted: 03/18/2022] [Indexed: 02/04/2023]
Abstract
This study aimed to examine the effects of prolonged VDT working time on physical and mental health disadvantages among health care workers (HCWs) in tertiary hospitals based on their work characteristics, age, and sex. Included in the study were 945 and 1868 participants in the non-doctor/nurse and doctor/nurse groups, respectively. The questionnaire included VDT usage-related information, the Nordic Musculoskeletal Questionnaire (NMQ), computer vision syndrome (CVS), perceived occupational stress, burnout, the Brief Symptom Rating Scale-5 (BSRS-5), and self-rated health (SRH). After adjustment, multiple logistical regression analysis revealed that the two groups showed that the longer the VDT working time, the higher the risk of muscle pain, severe headaches, severe job stress, and self-assessed bad sleep quality. This showed that the condition of the doctor/nurse group was more severe than that of the non-doctor/nurse group. According to the stratified analysis by sex and age, in the group of women under the age of 30, the adjusted odds ratio value of physical and mental conditions increased with longer VDT working time and was statistically significant. The result show that it is important to reduce daily VDT exposure for doctor, nurses, and women under 30.
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Affiliation(s)
- Meng-Ting Tsou
- Department of Family Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan; or ; Tel.: +886-2-2543-3535 (ext. 2131/2132)
- Department of Occupation Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, New Taipei City 25245, Taiwan
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Damodar S, Lokemoen C, Gurusamy V, Takhi M, Bishev D, Parrill A, Deviney M, Person U, Korie I, Branch R. #Trending: A Systematic Review of Social Media Use’s Influence on Adolescent Anxiety and Depression. ADOLESCENT PSYCHIATRY 2022. [DOI: 10.2174/2210676612666220225122720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
With new technological advancements, adolescents can obtain
devices that give them virtually unlimited access to social media (SM) which may impact
adolescent mental health.
Objectives:
This literature review aims to evaluate the influence of social media use on
adolescent anxiety and depression.
Methods:
A literature search of PubMed from June 2010 through June 2020 was completed
for the following MeSH terms: social media, adolescent, anxiety, depression, and mental
health. English language articles that discussed adolescents aged 13 to 18 years, anxiety
and/or depression and SM were included. Extracted data included the SM platform, impact
on anxiety and depression, interventions, temporal and dose-response relationships, and
observed versus self-reported usage.
Results:
The majority of articles positively associated depression (82.6%) and anxiety
(78.3%) with SM use. depression corresponded with cyber-bullying (42.1%), negative
social perspective (21.0%), diminished self-esteem (15.8%), and sleep disturbance (10.5%).
Anxiety corresponded with a negative social perspective (44.4%), diminished self-esteem
(33.3%), sleep disturbance (16.7%), and cyber-bullying (16.7%). Many studies suggested
the use of interventions to reduce depression (72.7%) and anxiety (72.7%), such as screen
time restrictions (n=6) and social support (n=4), but lacked evaluation of their
implementation.
Conclusion:
Current literature suggests a positive association between adolescent SM use
with anxiety and depression. Our study highlights the need for further investigation of
temporal and dose-response associations between SM use and adolescent mental health, and
the potential benefits of SM-driven interventions.
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Affiliation(s)
- Sreedevi Damodar
- American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten
| | - Cidney Lokemoen
- American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten
| | - Vikram Gurusamy
- American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten
| | - Manpreet Takhi
- American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten
| | - Daniel Bishev
- American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten
| | - Allison Parrill
- American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten
| | - Melissa Deviney
- American University of the Caribbean School and Medicine, 1 University Drive, Cupecoy, Sint
Maarten
| | - Ulziibat Person
- Department of Behavioral Sciences and Psychiatry, Nassau University Medical Center, 2201
Hempstead Turnpike, East Meadow, New York, 11554, United States
| | - Ijendu Korie
- Henry Mayo Newhall
Hospital, 23845 McBean Pkwy, Valencia, California, 91355, United States
| | - Romain Branch
- Department of Behavioral Sciences and Psychiatry, Nassau University Medical Center, 2201
Hempstead Turnpike, East Meadow, New York, 11554, United States
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25
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The relationships between screen time and mental health problems among Chinese adults. J Psychiatr Res 2022; 146:279-285. [PMID: 34785040 DOI: 10.1016/j.jpsychires.2021.11.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/03/2021] [Accepted: 11/05/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND This study aimed to examine the specific relationships between screen time and various mental health problems among community-dwelling adults in China. METHODS Self-reports of weekday and weekend screen time (TV, computer use and cell phone/tablet use), symptoms of PTSD, depression, and ADHD, and psychotic-like experiences (PLEs) were completed by 7121 Chinese adults. Logistic regression was used to examine specific relationships between screen time and mental health problems with demographics, physical activity, drinking, smoking, and sleep duration as covariates. RESULTS On weekdays, the participants spending at least 3 h on watching TV, computer use and cell phone/tablet use respectively accounted for 6.8%, 15.9% and 45.9%. On weekends, the proportions were 15.5%, 12.1% and 50.0%. Computer use on weekends was associated with higher risk of PTSD (OR = 1.81); cell phone/tablet use on weekdays and weekends was related to increased depression (OR = 1.38, OR = 1.28, respectively), while only computer use on weekends was related to depression (OR = 1.33); cell phone/tablet use both on weekdays and weekends was also connected to ADHD (OR = 1.56, OR = 1.48, respectively); on weekdays and weekends, more time TV viewing (OR = 1.76-1.79, OR = 1.46-1.71, respectively) and less cell phone/tablet use (OR = 0.66, OR = 0.65, respectively) were associated with higher numbers of PLEs. CONCLUSIONS The relationships between different types of screen time and mental health problems are variant. Future longitudinal studies should subdivide screen time on the basis of content and explore the specific causal relationship between screen time and mental health problems.
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Kidokoro T, Shikano A, Tanaka R, Tanabe K, Imai N, Noi S. Different Types of Screen Behavior and Depression in Children and Adolescents. Front Pediatr 2022; 9:822603. [PMID: 35141183 PMCID: PMC8819072 DOI: 10.3389/fped.2021.822603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 12/27/2021] [Indexed: 01/02/2023] Open
Abstract
The purpose of this study was to examine the associations between different types of screen behavior and depression, taking into account exercise and sleep among children and adolescents. A total of 23,573 Japanese children and adolescents (aged 8-15 years) participated in this cross-sectional study. Different types of screen behavior, weekly exercise time, sleep duration, and prevalence of depression were assessed using a questionnaire. Independent associations between various types of screen behavior and prevalence of depression were examined using logistic regression analyses after adjusting for age, school, sleep duration, exercise time, and other screen behavior types. A two-way analysis of covariance was conducted to examine whether exercise and sleep can attenuate the negative effects of screen behavior. The associations between screen behavior and depression varied by screen behavior types and participant characteristics. More time spent engaging in newer types of screen behavior, including social media, online games, and online videos, was associated with a higher prevalence of depression. In contrast, more time spent on TV was associated with a lower prevalence of depression. Sufficient exercise can lower the prevalence of depression, regardless of the length of time and content of the screen, and its associations were particularly significant for junior high school girls. Sleep was not associated with the prevalence of depression among any participant group except elementary school boys. Our findings suggest that age- and sex-specific intervention strategies that also consider screen-based behavior can effectively lower the risk of depression in children and adolescents.
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Affiliation(s)
- Tetsuhiro Kidokoro
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Akiko Shikano
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Ryo Tanaka
- School of Health and Sport Science, Osaka University of Health and Sport Science, Osaka, Japan
| | - Kosuke Tanabe
- Faculty of Modern Life, Teikyo Heisei University, Tokyo, Japan
| | - Natsuko Imai
- Faculty of Sport Science, Nippon Sport Science University, Tokyo, Japan
| | - Shingo Noi
- Research Institute for Health and Sport Science, Nippon Sport Science University, Tokyo, Japan
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27
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Li TMH, Chan NY, Li CT, Chen J, Chan JWY, Liu Y, Li SX, Li AM, Zhang J, Wing YK. The Associations of Electronic Media Use With Sleep and Circadian Problems, Social, Emotional and Behavioral Difficulties in Adolescents. Front Psychiatry 2022; 13:892583. [PMID: 35757219 PMCID: PMC9218337 DOI: 10.3389/fpsyt.2022.892583] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Electronic media use (EMU) becomes one of the most common activities in adolescents. The present study investigated the deleterious influence of excessive EMU and EMU before bedtime on social, emotional, and behavioral difficulties (SEBD) in adolescents. The role of sleep and circadian problems in mediating the association of EMU with SEBD was examined. METHODS A cross-sectional survey study was conducted with 3,455 adolescents (55.7% female, mean age = 14.8 ± 1.57 years, 36.6% monthly family income < HK$15,000) between December 2011 and March 2012 in Hong Kong. The associations of EMU with sleep and circadian problems and SEBD were analyzed using multiple binary logistic regression and path analysis. Sleep problems were measured by the Insomnia Severity Index and the reduced Horne and Östberg Morningness and Eveningness Questionnaire. Circadian problems were calculated based on established formulas. SEBD was measured using the Strengths and Difficulties Questionnaire. Participants' mental health status was assessed by the General Health Questionnaire. RESULTS A longer duration of EMU, excessive EMU (daily duration ≥ 2 h), and bedtime EMU (an hour before bedtime) were associated with the risk of sleep and circadian problems, poor mental health, and SEBD (p < 0.05). Insomnia, eveningness, social jetlag, and sleep deprivation were found to mediate the associations of EMU (including bedtime EMU of computers, electronic game consoles, phones, and televisions, together with excessive EMU of computers for leisure purposes and phones) with mental health and SEBD. CONCLUSIONS The findings suggest the need for setting up guidelines and advocacy for education for appropriate EMU and intervention for the associated sleep and circadian problems to ameliorate EMU-related mental and behavioral health problems in adolescents.
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Affiliation(s)
- Tim M H Li
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Chun-Tung Li
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jie Chen
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Joey W Y Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Yaping Liu
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.,The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Albert Martin Li
- Department of Pediatrics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Jihui Zhang
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Guangdong Mental Health Center, Guangdong General Hospital and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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Abstract
This article discusses child onset anxiety disorders in conjunction with the risks and benefits of the rapidly changing digital world including screen time, social media, and potential treatment platforms. A section includes the impact of pandemic stressors including social distancing, quarantining, the association of the pandemic and youth mental health, and prolonged screen time.
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Affiliation(s)
- Jenna Glover
- Pediatric Mental Health Institute, Children's Hospital Colorado, 13123 East 16th Avenue, B130, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, F546, Aurora, CO 80045, USA
| | - Merlin Ariefdjohan
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, F546, Aurora, CO 80045, USA
| | - Sandra L Fritsch
- Pediatric Mental Health Institute, Children's Hospital Colorado, 13123 East 16th Avenue, B130, Aurora, CO 80045, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, 13001 East 17th Place, F546, Aurora, CO 80045, USA.
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29
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Gupta PC, Rana M, Ratti M, Duggal M, Agarwal A, Khurana S, Jugran D, Bhargava N, Ram J. Association of screen time, quality of sleep and dry eye in college-going women of Northern India. Indian J Ophthalmol 2021; 70:51-58. [PMID: 34937207 PMCID: PMC8917561 DOI: 10.4103/ijo.ijo_1691_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Purpose: To evaluate the association of daily screen time and quality of sleep with the prevalence of dry eye among college-going women. Methods: This study was a cross-sectional, comparative questionnaire-based study of 547 college-going women in northern India. A 10-item Mini Sleep Questionnaire was used to check the quality of sleep, and the Standard Patient Evaluation of Eye Dryness (SPEED) scale was used to examine the prevalence of dry eye among college-going women. Results: Multinomial logistic regression showed a significant association between dry eye with daily screen time spent (P < 0.05) and the quality of sleep (P < 0.05) among college-going girls. Using Latent Class Analysis, two latent classes were selected based on the Bayesian Information Criteria. It was found that the majority population falls in class two and was having Severe Sleep-Wake difficulty. It was seen that the participants in class two belonged to the age bracket of 18–21 years, were from stream Humanities, education of father and mother equal to graduation, father working only, belonging to the nuclear family, having one sibling, hailing from the urban locality, spending more than 6 h daily on-screen, a majority of them using mobile phones, not using eye lubricants, and reported an increase in screen time during COVID-19. Conclusion: Dry eye and sleep quality are essential global health issues, and coupled with increased screen time, may pose a challenge in the present era. Preventive strategies need to be incorporated in school and college curriculums to promote physical, social, and psychological well-being and quality of life.
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Affiliation(s)
- Parul Chawla Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Minakshi Rana
- Department of Sociology, Mehr Chand Mahajan DAV College for Women, Chandigarh, India
| | - Mamta Ratti
- Department of Commerce, Mehr Chand Mahajan DAV College for Women, Chandigarh, India
| | - Mona Duggal
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aniruddha Agarwal
- Department of Ophthalmology, Eye Institute, Cleveland Clinic, Abu Dhabi, UAE
| | - Surbhi Khurana
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Jugran
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nisha Bhargava
- Principal, Mehr Chand Mahajan DAV College for Women, Chandigarh, India
| | - Jagat Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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30
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Li X, Vanderloo LM, Keown-Stoneman CDG, Cost KT, Charach A, Maguire JL, Monga S, Crosbie J, Burton C, Anagnostou E, Georgiades S, Nicolson R, Kelley E, Ayub M, Korczak DJ, Birken CS. Screen Use and Mental Health Symptoms in Canadian Children and Youth During the COVID-19 Pandemic. JAMA Netw Open 2021; 4:e2140875. [PMID: 34962557 PMCID: PMC8715351 DOI: 10.1001/jamanetworkopen.2021.40875] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPORTANCE Longitudinal research on specific forms of electronic screen use and mental health symptoms in children and youth during COVID-19 is minimal. Understanding the association may help develop policies and interventions targeting specific screen activities to promote healthful screen use and mental health in children and youth. OBJECTIVE To determine whether specific forms of screen use (television [TV] or digital media, video games, electronic learning, and video-chatting time) were associated with symptoms of depression, anxiety, conduct problems, irritability, hyperactivity, and inattention in children and youth during COVID-19. DESIGN, SETTING, AND PARTICIPANTS A longitudinal cohort study with repeated measures of exposures and outcomes was conducted in children and youth aged 2 to 18 years in Ontario, Canada, between May 2020 and April 2021 across 4 cohorts of children or youth: 2 community cohorts and 2 clinically referred cohorts. Parents were asked to complete repeated questionnaires about their children's health behaviors and mental health symptoms during COVID-19. MAIN OUTCOMES AND MEASURES The exposure variables were children's daily TV or digital media time, video game time, electronic-learning time, and video-chatting time. The mental health outcomes were parent-reported symptoms of child depression, anxiety, conduct problems and irritability, and hyperactivity/inattention using validated standardized tools. RESULTS This study included 2026 children with 6648 observations. In younger children (mean [SD] age, 5.9 [2.5] years; 275 male participants [51.7%]), higher TV or digital media time was associated with higher levels of conduct problems (age 2-4 years: β, 0.22 [95% CI, 0.10-0.35]; P < .001; age ≥4 years: β, 0.07 [95% CI, 0.02-0.11]; P = .007) and hyperactivity/inattention (β, 0.07 [95% CI, 0.006-0.14]; P = .04). In older children and youth (mean [SD] age, 11.3 [3.3] years; 844 male participants [56.5%]), higher levels of TV or digital media time were associated with higher levels of depression, anxiety, and inattention; higher levels of video game time were associated with higher levels of depression, irritability, inattention, and hyperactivity. Higher levels of electronic learning time were associated with higher levels of depression and anxiety. CONCLUSIONS AND RELEVANCE In this cohort study, higher levels of screen use were associated poor mental health of children and youth during the COVID-19 pandemic. These findings suggest that policy intervention as well as evidence-informed social supports are needed to promote healthful screen use and mental health in children and youth during the pandemic and beyond.
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Affiliation(s)
- Xuedi Li
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Leigh M. Vanderloo
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
- School of Occupational Therapy, Western University, London, Ontario, Canada
- ParticipACTION, Toronto, Ontario, Canada
| | - Charles D. G. Keown-Stoneman
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Alice Charach
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathon L. Maguire
- Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, St Michael’s Hospital, Toronto, Ontario, Canada
| | - Suneeta Monga
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Crosbie
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christie Burton
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Evdokia Anagnostou
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Holland Bloorview Research Institute, Toronto, Ontario, Canada
| | - Stelios Georgiades
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Rob Nicolson
- Department of Psychiatry, Western University, London, Ontario, Canada
| | - Elizabeth Kelley
- Department of Psychology, Queens University, Kingston, Ontario, Canada
| | - Muhammad Ayub
- Department of Psychiatry, Queens University, Kingston, Ontario, Canada
| | - Daphne J. Korczak
- Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Catherine S. Birken
- Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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31
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Associations of 24-Hour Movement Behavior with Depressive Symptoms and Anxiety in Children: Cross-Sectional Findings from a Chinese Sample. Healthcare (Basel) 2021; 9:healthcare9111532. [PMID: 34828578 PMCID: PMC8620023 DOI: 10.3390/healthcare9111532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/16/2021] [Accepted: 11/04/2021] [Indexed: 12/27/2022] Open
Abstract
This study examined the associations between adherence to 24-hour movement behavior guidelines (24-HMB) and the mental-health-related outcomes of depressive symptoms and anxiety in Chinese children. Data on movement behavior from 5357 children (4th and 5th grades), including physical activity, recreational screen time and sleep, were self-reported using the Health Behavior School-Aged Children Survey. Depressive symptoms and anxiety were self-reported using the Chinese version of the nine-item Patient Health Questionnaire and the Generalized Anxiety Disorder Scale, respectively. Depressive symptoms and anxiety were treated as categorical variables. Only 3.2% of the participants met physical activity, screen time, and sleep 24-HMB guidelines. Ordinal logistic regressions showed that, compared with participants who met the 24-HMB guidelines, participants who met none (odds ratio (OR) = 2.62, 95% CI: 1.76-3.90) or any one of the guidelines (OR = 1.88, 95% CI: 1.27-2.77) had higher odds of depressive symptoms. Similarly, there were higher odds of anxiety in participants who met none (OR = 2.32, 95% CI: 1.45-3.70) or any one of the recommendations (OR = 1.62, 95% CI: 1.03-2.57) compared with participants who met all the 24-HMB guidelines. Meeting the 24-HMB guidelines is associated with better mental-health-related outcomes in Chinese children. Because of the low prevalence of Chinese children meeting the 24-HMB recommendations, the present findings highlight the need to encourage children to regularly engage in physical activity, decrease their time spent sitting, and improve their sleep patterns.
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32
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Souza MA, Ostolin TLVDP. The effect of replacing sedentary behavior by different intensities of physical activity in body composition: a systematic review. ABCS HEALTH SCIENCES 2021. [DOI: 10.7322/abcshs.2020089.1486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Introduction: The isotemporal substitution model (ISM) is a statistical approach that estimates the effects of replacing, in minutes, a block of physical activity or sedentary behavior by another block with different intensity. Previous studies have used the ISM to evaluate the effect of different isotemporal substitutions on body composition. Thus, the ISM can contribute to the understanding of changes in body composition related to distinct lifestyles and, hence, guiding future recommendations for maintaining and/or improving body composition. Objective: To review the effect of replacing sedentary behavior by physical activity on body composition change analyzed through ISM. Methods: Original articles in English were identified from searches in PubMed and Periódicos Capes databases. The search was carried out by two researchers. Last search was performed in October 2020. Results: A total of 17 included articles, which evaluated different applications of ISM in relation to body composition change, mostly obtained by BMI and body fat. The physical activity was mainly assessed by using an accelerometer. Several methodological differences among the included studies limited comparisons between findings, including the sample profile and cut off points for physical activity. Conclusion: Among the studies that evaluate the effect of replacing sedentary behavior for different intensities of physical activity through ISM, replacing sedentary behavior by moderate-to-vigorous physical activity presented a more consistent effect in body composition change in comparison to replacement by other physical activity intensities, even for small blocks of time (five minutes).
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Electronic media use and symptoms of depression among adolescents in Norway. PLoS One 2021; 16:e0254197. [PMID: 34234359 PMCID: PMC8263301 DOI: 10.1371/journal.pone.0254197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 06/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The purpose of this study was to examine the association between electronic media use, including use of social media and gaming, and symptoms of depression, and whether gender or having friends moderated these associations. METHODS This study was based on self-reported cross-sectional data from the Ungdata survey, conducted in 2018 by the Norwegian Social Research (NOVA) Institute in cooperation with seven regional drug and alcohol competence centres. The target group comprised 12,353 15-16 years old adolescents. Binominal logistic regression was used to analyse the association between electronic media use and symptoms of depression. RESULTS The odds of having symptoms of depression were higher for those who used social media more than 3 hours per day (OR: 1.60, 95% CI: 1.43-1.80), compared to those who used social media 3 hours or less per day. Additionally, the odds of having symptoms of depression was higher for those who used more than 3 hours on gaming per day (OR: 1.57, 95% CI: 1.36-1.80), compared to those who used 3 hours and less on gaming per day after adjustment for potential confounders. There were no interaction effects between social media and gaming use with symptoms of depression. Neither were the associations between social media use and gaming with symptoms of depression moderated by gender or having friends. CONCLUSIONS The odds of having symptoms of depression were significantly higher for adolescents with a more frequent use of electronic media.
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Predictors of Adolescent Depressive Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094508. [PMID: 33922778 PMCID: PMC8122983 DOI: 10.3390/ijerph18094508] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 12/14/2022]
Abstract
The present study expands the existing literature and supplements today’s knowledge on the relationship between personal, psychosocial and lifestyle factors and depressive symptoms among adolescents. The study aimed to investigate the variety of depressive symptoms predictors—personal resources, adverse school and family, health, lifestyle-related (sense of coherence, self-esteem, school involvement, negative acts at school, family stress and violence, psychosomatic health complaints, physical activity, smoking, alcohol) as well as gender, employing hierarchical linear regression analysis in a large representative sample of adolescents (N = 2212) in Kaunas, Lithuania. Four blocks of predictors were employed in hierarchical linear regression analysis. In the final model 64.9% of depressive symptoms were explained by all the predictors. Sense of coherence was the strongest predictor of depressive symptoms (standardized regression coefficient β = −605, p < 0.001 in the first model and β = −263, p < 0.001 in the final model after adjustment for all other independent variables) and accounted for 36.6% of variance. In conclusion, this study supports the notion that depressive symptoms among adolescents have multifactorial origins with many predictors showing significant effect seizes. Therefore, high sense of coherence and self-esteem, school involvement, higher levels of physical activity would be protective and influence lower levels of depressive symptoms among adolescents. Exposure to negative acts at school and negative experiences in the family, psychosomatic health complaints, smoking would increase the probability of depressive symptoms. Girls are more prone to depression as compared to boys.
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Wang W, Du X, Guo Y, Li W, Zhang S, Zhang W, McIntyre RS, Tamura JK, Guo L, Lu C. Associations Among Screen Time, Sleep Duration and Depressive Symptoms Among Chinese Adolescents. J Affect Disord 2021; 284:69-74. [PMID: 33582434 DOI: 10.1016/j.jad.2021.01.082] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 01/06/2021] [Accepted: 01/30/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Relatively few studies have explored the inter-relationship between screen time (ST), sleep duration and depressive symptoms. The study herein sought to determine (1) the relationships between ST, sleep duration and depressive symptoms among Chinese adolescents; (2) whether sleep duration mediates the relationships between ST and depressive symptoms. METHODS 1st grade students (n=1,976) from ten high schools in Guangzhou, China were invited through cluster sampling between January and April 2019. Self-reported ST with electronic devices and Internet, sleep duration, and The Center for Epidemiology Scale for Depression (CES-D) score were collected. Generalized mixed linear models and mediation analyses were conducted. RESULTS There were 1,956 self-reported questionnaires received (response rate: 98.99%). Approximately 25% (471/1,929 for Internet use, 399/1,928 for electronic device) of the total sample reported ST >2 hours/day. Approximately 8.9% (169/1,894) reported a CES-D score >28. Longer ST with electronic devices (estimate=0.52, 95%CI: 0.24~0.80), Internet usage (estimate=0.82, 95%CI: 0.53~1.11) were positively associated with depressive symptoms, while less sleep (estimate=-1.85, 95%CI: -2.27~-1.43) was negatively associated with depressive symptoms. There is significant indirect effect of electronic device usage on depressive symptoms through sleep duration (indirect effect=0.08, 95%CI: 0.01~0.15). LIMITATIONS This study only included school students from Guangzhou. Causal relationship cannot be inferred by this cross-sectional design. CONCLUSIONS ST and sleep duration were significantly associated with depressive symptoms severity. The indirect effect of sleep duration suggests a possible mechanism of the association between ST and depressive symptoms. Future interventions to manage depressive symptoms should target sleep time and decrease ST among adolescents.
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Affiliation(s)
- Wanxin Wang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Xueying Du
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510080, China
| | - Yangfeng Guo
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, 510080, China
| | - Wenyan Li
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Sheng Zhang
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Weihong Zhang
- International Centre for Reproductive Health (ICRH), Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Jocelyn K Tamura
- Mood Disorders Psychopharmacology Unit, University Health Network, Toronto, Ontario, Canada
| | - Lan Guo
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
| | - Ciyong Lu
- Department of Medical statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China.
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Tang S, Werner-Seidler A, Torok M, Mackinnon AJ, Christensen H. The relationship between screen time and mental health in young people: A systematic review of longitudinal studies. Clin Psychol Rev 2021; 86:102021. [PMID: 33798997 DOI: 10.1016/j.cpr.2021.102021] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/03/2021] [Accepted: 03/17/2021] [Indexed: 12/20/2022]
Abstract
An increase in time spent on screen-based technologies has been suggested to underlie recent increases in mental health problems among young people. However, this hypothesis has primarily been based on the findings of cross-sectional studies. The aim of the current review was to provide a comprehensive overview of longitudinal studies examining the relationship between screen time and internalising mental health symptoms. PsycINFO, PubMed/Medline and EMBASE were systematically searched for articles published up to August 2020. Thirty-five studies, with sample sizes ranging from 126 to 12,866 participants, met inclusion criteria. The association between screen time and subsequent depressive symptoms was found to be small to very small in size. There was limited evidence of any reverse association between depressive symptoms and subsequent screen time. The association between screen time and depressive symptoms varied between different devices and uses. In contrast to depressive symptoms, evidence to support longitudinal associations between screen time and other internalising mental health symptoms, including anxiety, self-esteem, and general internalising problems, was lacking. Together, these results suggest that the impact of increased screen time on the prevalence of mental health problems among young people is likely to be negligible or small. Further longitudinal studies that examine screen content and motivations underlying screen use are required to better discern any relationship between screen time and internalising mental health symptoms.
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Affiliation(s)
- Samantha Tang
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
| | | | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Andrew J Mackinnon
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Helen Christensen
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
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Wu X, Veugelers PJ, Ohinmaa A. Health Behavior, Health-Related Quality of Life, and Mental Health Among Canadian Children: A Population-Based Cohort Study. Front Nutr 2021; 8:638259. [PMID: 33777992 PMCID: PMC7991792 DOI: 10.3389/fnut.2021.638259] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/03/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Studies that have reported the associations of diet quality, physical activity (PA), sedentary behavior (SB), and health-related quality of life (HRQoL) with mental health among children and adolescents are predominantly cross-sectional in design. Very few studies have examined the longitudinal relationship of mental health with health behavior and HRQoL among children. This study aimed to investigate the associations of diet quality, PA, SB, and HRQoL among children with mental health disorders throughout childhood. Methods: We linked data from grade five students aged primarily 10 and 11 years who participated in the Raising Healthy Eating and Active Living (REAL) Kids Alberta survey in 2012 in the Canadian province of Alberta with their administrative health care data from birth to 2012. Mental health outcomes included internalizing disorder and attention deficit and hyperactivity disorder (ADHD) defined by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) or Tenth Revision, Canadian version (ICD-10-CA). The HRQoL was measured by the EQ-5D-Y, a five-dimensional descriptive system for children and youth. We applied negative binomial regressions to examine the associations between health behaviors, HRQoL, and mental health. Results: Of the 1,352 participating students, 12.31 and 8.32% had a diagnosis of internalizing disorders and ADHDs, respectively, during childhood from birth to the ages of 10–11 years. Students in the highest tertile for diet quality, relative to the lowest tertile, were 56% less likely to have diagnoses of internalizing disorders (incidence rate ratio, IRR = 0.44, 95% CI = 0.23–0.85). Students engaged in less PA (vs. more PA) were more likely to be diagnosed for internalizing disorders (IRR = 1.98, 95% CI = 1.19–3.30). Poorer diet quality, low PA, excessive use of computers/video games, and watching TV were significantly associated with more diagnoses of ADHDs. Children who experienced some or a lot of problems in “feeling worried, sad, or unhappy” and “having pain or discomfort” were more likely to receive diagnoses of internalizing disorders and ADHDs, respectively. Conclusions: These observed associations suggest that health promotion programs targeting promoting diet quality, PA, and HRQoL and reducing SB among children may contribute to improving mental health.
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Affiliation(s)
- Xiuyun Wu
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Paul J Veugelers
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Arto Ohinmaa
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Wang MH, Xiao DM, Liu MW, Lu YA, He QQ. Relationship between sedentary behaviour and anxiety symptoms among youth in 24 low- and middle-income countries. PLoS One 2020; 15:e0241303. [PMID: 33104737 PMCID: PMC7588091 DOI: 10.1371/journal.pone.0241303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/12/2020] [Indexed: 11/19/2022] Open
Abstract
Background Anxiety is burdensome and common in youth. Sedentary behaviour has been identified as potentially modifiable dangerous factors for many diseases. Nevertheless, little is known about the relationship between sedentary behaviour and the risk of anxiety symptoms in youth. Therefore, we aimed to examine the association among youth in 24 low- and middle-income countries (LMICs). Methods Data from the Global School-based Student Health Survey (GSHS) were analyzed in 59587 youth aged 12–15 years. Most of the country-wide data were nationally representative. Anxiety symptoms were self-reported. Multivariable logistic regression and meta-analyses of country-wise estimates were conducted. Results The prevalence of anxiety symptoms was 10.3%. Countrywide meta-analysis demonstrated that sedentary behaviour of >2 h/day (vs.≤2 h/day) was associated with an increased risk of anxiety symptoms (OR = 1.22; 95% CI = 1.10–1.37). Conclusions This study provides multi-national evidence of the dangerous effect of sedentary behaviour against anxiety symptoms among youth in LMICs. Decreasing the level of sedentary behaviour during adolescence could be an important target for reducing the prevalence of anxiety.
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Affiliation(s)
- Ming-Hui Wang
- School of Health Sciences, Wuhan University, Wuhan, China
| | | | - Ming-Wei Liu
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Yuan-An Lu
- Environmental Health Laboratory, Department of Public Health Sciences, University Hawaii at Manoa, Honolulu, HI, United States of America
| | - Qi-Qiang He
- School of Health Sciences, Wuhan University, Wuhan, China
- * E-mail:
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Pippi R, Buratta L, Germani A, Fanelli CG, Mazzeschi C. Physical Activity Habits and Well-Being among 6-Year-Old Children: The "Improving Umbrian Kids' Healthy Lifestyle", an Uncontrolled Pilot Study Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6067. [PMID: 32825418 PMCID: PMC7503798 DOI: 10.3390/ijerph17176067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/25/2022]
Abstract
There is evidence that promoting physical activity programs and decreasing sedentary behavior is a potential strategy for improving health-outcomes, peer relationships and social/emotional well-being in at-risk youth. The World Health Organization recommends enhancing physical education and school-based programs with multi-component and evidence-based assessment methodology. In Umbria (Italy) an uncontrolled pilot study project referred to as "Improving Umbrian kids' healthy lifestyle" was implemented as a systemic school-based intervention directed at 6-year-old primary school children. The intervention applied a consolidated assessment methodology developed by the C.U.R.I.A.Mo. and Eurobis projects that inserted two hours per week of physical education activity into the school curriculum, structured and supervised by specialists with Exercise and Sport Science degrees, for eight months (from October to June) of the school year. We measured anthropometric values (BMI, waist circumference, waist-to-height ratio index) with objective tools. Moreover, we evaluated physical performance variables (speed, strength, and flexibility) using standard tests. Additionally, self-report measures (measured physical activity during the week, sedentary habits, and psychological well-being) were assessed using validated questionnaires. We observed a significant decrease in waist to height ratio, and improvements in physical performance values and self-report questionnaire measures. Our study suggests that the promotion of physical activity in the school setting is likely to result in physically, mentally, and psycho-socially healthier primary-school-age children.
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Affiliation(s)
- Roberto Pippi
- Centro Universitario Ricerca Interdipartimentale Attività Motoria (C.U.R.I.A.MO.), Healthy Lifestyle Institute, University of Perugia, Via Giuseppe Bambagioni 19, 06126 Perugia, Italy;
| | - Livia Buratta
- Department of Philosophy, Social, Human and Educational Sciences, University of Perugia, Piazza G. Ermini 1, 06123 Perugia, Italy; (L.B.); (A.G.); (C.M.)
| | - Alessandro Germani
- Department of Philosophy, Social, Human and Educational Sciences, University of Perugia, Piazza G. Ermini 1, 06123 Perugia, Italy; (L.B.); (A.G.); (C.M.)
| | - Carmine Giuseppe Fanelli
- Centro Universitario Ricerca Interdipartimentale Attività Motoria (C.U.R.I.A.MO.), Healthy Lifestyle Institute, University of Perugia, Via Giuseppe Bambagioni 19, 06126 Perugia, Italy;
| | - Claudia Mazzeschi
- Department of Philosophy, Social, Human and Educational Sciences, University of Perugia, Piazza G. Ermini 1, 06123 Perugia, Italy; (L.B.); (A.G.); (C.M.)
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