Contemporary screen time modalities and disruptive behavior disorders in children: a prospective cohort study

Abstract

Background: Cross-sectional studies have demonstrated associations between screen time and disruptive behavior disorders (conduct disorder and oppositional defiant disorder); however, prospective associations remain unknown. This study's objective was to determine the prospective associations of contemporary screen time modalities with conduct and oppositional defiant disorder in a national cohort of 9-11-year-old children. Methods: We analyzed data from the Adolescent Brain Cognitive Development (ABCD) Study (N = 11,875). Modified Poisson regression analyses were conducted to estimate the associations between baseline child-reported screen time (total and by modality) and parent-reported conduct or oppositional defiant disorder based on the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) at 1-year follow-up, adjusting for potential confounders. Results: Participants reported an average of 4 hr of total screen time per day at baseline. Each hour of total screen time per day was prospectively associated with a 7% higher prevalence of conduct disorder (95% CI 1.03-1.11) and a 5% higher prevalence of oppositional defiant disorder (95% CI 1.03-1.08) at 1-year follow-up. Each hour of social media per day was associated with a 62% higher prevalence of conduct disorder (95% CI 1.39-1.87). Each hour of video chat (prevalence ratio [PR] 1.21, 95% CI 1.06-1.37), texting (PR 1.19, 95% CI 1.07-1.33), television/movies (PR 1.17, 95% CI 1.10-1.25), and video games (PR 1.14, 95% CI 1.07-1.21) per day was associated with a higher prevalence of the oppositional defiant disorder. When examining thresholds, exposure to >4 hr of total screen time per day was associated with a higher prevalence of conduct disorder (69%) and oppositional defiant disorder (46%). Conclusions: Higher screen time was prospectively associated with a higher prevalence of new-onset disruptive behavior disorders. The strongest association was between social media and conduct disorder, indicating that future research and interventions may focus on social media platforms to prevent conduct disorder.

Association of physical activity and screen time with cardiovascular disease risk in the Adolescent Brain Cognitive Development Study

“…We have previously shown that greater screen time is associated with higher BMI percentile in the ABCD Study [ 19 , 50 ]. In addition, contemporary screen modalities (e.g., social media, video games) may lead to exposure to cyberbullying, violence, or other stressful content that could raise blood pressure [ 32 , 51 ]. These mechanisms may explain why high screen time may be associated with poorer cardiovascular health.…”

“…Screen time was calculated as a continuous variable and categorized into four-hour increments. This categorization was based on prior studies identifying four hours per day to be a threshold linked to poor mental health outcomes and overweight in adolescents [ 30 – 32 ], and other national surveys of adolescent screen time have used similar categories (e.g., 4 and 8 h per day) with similar distributions [ 19 , 33 ]. Screen time (hours per day) was ordered into three categories: 0 to 4 h (low; reference category), 4 to 8 h (medium), and more than 8 h (high).…”

Association of Physical Activity and Screen Time With Body Mass Index Among US Adolescents

“…Similar self-reported television-watching measures have had acceptable test-retest reliability (7-day test-retest intraclass correlations of 0.76-0.81). 17,18 We categorized total recreational screen time in 4-hour increments given that previous studies have identified 4 hours per day to be a threshold associated with overweight and poor mental health outcomes in adolescent populations, [19][20][21][22] and other nationally representative surveys of adolescent screen time have used similar categories (ie, 4 hours per day and 8 hours per day). 23 Screen time was grouped into 3 categories: 0 hours to 4 hours per day (low; reference category), more than 4 hours to 8 hours per day (medium), and more than 8 hours per day (high).…”

The causal effect of screen uses versus reading on the brain development in early adolescents

“…In contrast, the relationship between screen use and child development is not yet well understood. The majority of studies indicate that prolonged screen use is associated with adverse effects on brain structure and function [19][20][21] , as well as cognitive and behavioral problems 9,10,22 . One possible explanation for the negative effects of screen use is the displacement hypothesis 5 , which suggests that screen time and other activities compete for leisure time and that longer screen time may reduce other leisure activities, such as exercise and reading 5,23 .…”