Association between screen time and hyperactive behaviors in children under 3 years in China

Emotion Regulation, Coping, and Alexithymia in Adolescents With Obsessive-Compulsive Disorder: A Mediational Analysis

BACKGROUND

Obsessive-compulsive disorder (OCD) is a debilitating mental health condition that impacts daily functioning. In addition to classical symptoms, emotion regulation (ER), alexithymia and maladaptive coping are thought to be involved in the symptomology and maintenance of the disorder. This study aims to investigate the relationship between ER, alexithymia and coping in adolescents with a sole diagnosis of OCD.

METHODS

The study comprised of 93 participants with OCD and 92 healthy controls. Patients with any psychiatric disorder other than OCD were set as exclusion criteria. A sociodemographic form, Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children, Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS), Difficulties in Emotion Regulation Scale (DERS), Toronto Alexithymia Scale (TAS) and KidCOPE were applied.

RESULTS

The TAS and DERS scores of participants with every subscale, except awareness in DERS, and the KIDCOPE-Avoidant Coping scores were significantly higher in the OCD group (p < 0.05). A positive and moderately significant relationship was identified between the CY-BOCS-Obsession, CY-BOCS-Compulsion and CY-BOCS-Total scores and the DERS-Total (p < 0.05). Linear regression analysis revealed that CY-BOCS-Total scores significantly predicted DERS-Total scores in a positive direction even when TAS-Total and KidCOPE scores were controlled (p = 0.001). Difficulties in ER mediated the relationship between OCD and the severity of negative coping (b = 0.064, 95% CI (0.036-0.097)).

CONCLUSIONS

There is limited evidence regarding the specific contribution of OCD with emotion dysregulation, alexithymia and avoidant coping. Our study suggests a possible relationship with OCD and these parameters, highlighting the need to develop effective intervention techniques tailored to this population.

The relationship between screen time, screen content for children aged 1-3, and the risk of ADHD in preschools

OBJECTIVE

This study investigates the relationship between screen time, screen content, and the risk of Attention Deficit Hyperactivity Disorder (ADHD) using data from a large sample. Specifically, it examines how different types of screen content (such as educational videos, cartoon videos, and interactive videos) are associated with the risk of ADHD. The aim is to offer a scientific foundation for the rational management of children's screen time and screen content.

METHODS

We collected data through a questionnaire survey involving a study population of 41,494 children from Longhua District, Shenzhen City, China. The questionnaire recorded the daily screen time and the type of content viewed by the children at ages 1-3 years and assessed their risk of ADHD using the Strengths and Difficulties Questionnaire (SDQ) at ages 4-6 years. Hierarchical logistic regression analysis, controlling for confounding factors, was employed to explore the associations between screen time, screen content, and ADHD risk.

RESULTS

In the total sample, 6.7% of the participants had screen time exceeding 60 minutes per day, with educational videos predominant type (63.4%). 16.5% of the participants were identified as being at risk for ADHD. Statistically significant positive associations with ADHD were observed across all categories of screen time (P<0.001). Moreover, as screen time increased, the risk of ADHD also rose (OR1~60 mins/d=1.627, 95%CI=1.460~1.813; OR61~120 mins/d=2.838, 95%CI=2.469~3.261; OR>120 mins/d=3.687, 95%CI=2.835~4.796). Significant positive associations with ADHD were observed across all categories of screen time in the educational videos and cartoon videos. For the educational videos group, the odds ratios were as follows: OR1-60 mins/day=1.683 (95% CI=1.481-1.913), OR61-120 mins/day=3.193 (95% CI=2.658-3.835), and OR>120 mins/day=3.070 (95% CI=2.017-4.673). For the cartoon videos group, the odds ratios were: OR1-60 mins/day=1.603 (95% CI=1.290-1.991), OR61-120 mins/day=2.758 (95% CI=2.156-3.529), and OR>120 mins/day=4.097 (95% CI=2.760-6.081). However, no significant associations with ADHD risk were found for any category of screen time in the interactive videos group (OR1~60 mins/d=0.744, 95%CI=0.361~1.534; OR61~120 mins/d=0.680, 95%CI=0.296~1.560; OR>120 mins/d=1.678, 95%CI=0.593~4.748).

CONCLUSION

Increased screen time is associated with a higher risk of ADHD, particularly for educational and cartoon videos, while interactive videos show no significant link. To mitigate this risk, parents and educators should implement strategies such as setting time limits, encouraging breaks, and promoting alternative activities. Future research should focus on longitudinal studies and intervention trials to further explore and address this relationship.

Association between early childhood outdoor activity and anxiety symptoms in preschoolers

BACKGROUND

Recently, a decreasing trend has been observed in the frequency and duration of outdoor activity among children, which has garnered concern regarding the potential impacts of this decline during mental health in early childhood. Currently, the association between outdoor activity in early childhood and the symptoms of anxiety disorders in preschoolers remains unclear. The purpose of this study was to investigate the association between the frequency and duration of outdoor activity in children aged 0-1 and 1-3 years and anxiety symptoms in preschoolers.

METHODS

A cross-sectional study was conducted in 2021 using questionnaires, included 69,571 preschoolers residing in Longhua District, Shenzhen. Data on family social demographics, outdoor activity frequency and duration in children aged 0-3 years, and the anxiety symptoms of preschoolers were collected through parent-completed questionnaires. Anxiety symptoms were measured using the Chinese version of the Spence Preschool Anxiety Scale (SPAS), which assesses symptoms across various dimensions. The association between early childhood outdoor activity and anxiety symptoms in preschoolers was analyzed using a binary logistic regression model.

RESULTS

Children 0-1 years of age who were outdoors < 1 times/week had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥ 7 times/week (OR = 2.55, 95% confidence interval(CI): 2.22-2.94). Children in this age group who were outdoors < 30 min/session had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥ 120 min/ session (OR = 1.62, 95%CI: 1.38-1.90). Children 1-3 years of age, who were outdoors < 1 time/week had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors ≥ 7 times/week, (OR = 3.10, 95%CI: 2.72-3.54). Children in this age group who were outdoors for < 30 min/session had a higher risk of screening positive for anxiety symptoms in preschool age compared with children who were outdoors time ≥ 120 min/ session (OR = 2.07, 95%CI: 1.73-2.48).

CONCLUSION

Lower frequency and shorter duration of outdoor activity during infancy (0-1 and 1-3 years) had higher odds of screening positive for anxiety symptoms in preschoolers. A frequency of ≥ 7 outdoor activity per week and a duration of ≥ 120 min/session during infancy were associated with lower levels of anxiety symptoms in preschoolers.These findings provide actionable insights for parents and caregivers, highlighting the importance of promoting outdoor activity in early childhood care and parenting practices. Future studies should further explore the causal relationship between outdoor activity and the prevention of anxiety.

Problematic Digital Technology Use Measures in Children Aged 0 to 6 Years: Scoping Review

BACKGROUND

In the interest of accurately assessing the effects of digital technology use in early childhood, researchers and experts have emphasized the need to conceptualize and measure children's digital technology use beyond screen time. Researchers have argued that many patterns of early digital technology use could be problematic, resulting in the emerging need to list and examine their measures.

OBJECTIVE

We aimed to review existing empirical literature that is using measures for problematic digital technology use in preschool children with the end goal of identifying a set of reliable and valid measures, predicting negative outcomes for children's health, development, or well-being.

METHODS

We conducted a scoping review across the Web of Science, PubMed, and Google Scholar databases to identify peer-reviewed publications that were published from January 2012 to December 2023, were written in the English language, described an empirical study, and included a measure of problematic digital technology use beyond exposure (ie, screen time) in children aged 0 to 6 years.

RESULTS

The search yielded 95 empirical studies, in which 18 composite measures of problematic use and 23 measures of specific problematic use aspects were found. Existing composite measures conceptualize problematic use as either a group of risky behaviors or as a group of symptoms of a presumed underlying disorder, with the latter being more common. Looking at their conceptual background and psychometric properties, existing composite measures fall short of reliably assessing all the crucial aspects of problematic digital technology use in early childhood. Therefore, the benefits and shortcomings of single-aspect problematic digital technology use measures are evaluated and discussed.

CONCLUSIONS

On the basis of current research, early exposure to digital technologies, device use before sleep, and solitary device use represent measures that have been consistently associated with negative outcomes for children. In addition, potential measures of problematic use include device use during meals, device use for emotional regulation, device multitasking, and technoference, warranting further research. Public health benefits of defining problematic digital technology use as a group of risky behaviors rather than a group of addiction symptoms are discussed.

Relationship between bedtime, nighttime sleep duration, and anxiety symptoms in preschoolers in China

Background

Sleep problems in preschoolers are becoming increasingly prominent, and the association between sleep status and anxiety symptoms has attracted growing attention. However, studies investigating the relationship between bedtime and nighttime sleep duration in preschoolers and their anxiety symptoms remain scant. We used the large sample data from the Longhua Cohort Study of Children in Shenzhen, China (LCCS) to analyze the association between bedtime and sleep in preschoolers and their anxiety symptoms.

Methods

A cross-sectional study of 69,138 preschoolers in Longhua District, Shenzhen, China was conducted in 2022. Data on sociodemographic characteristics of families, bedtime, nighttime sleep duration of preschoolers, and their anxiety symptoms (measured by the Spence Preschool Children Anxiety Scale) were collected through a structured questionnaire completed by the parents. Using binary logistic regression models, the relationship between bedtime, nighttime sleep duration, and childhood anxiety symptoms was examined.

Results

The bedtimes of preschoolers were concentrated between 21:01-22:00 (52.41%). Among the preschoolers, 38.70% had bedtimes later than 22:00, and 75.49% had insufficient nighttime sleep duration. The positive screening rate for anxiety symptoms among preschoolers was 3.50%. After adjusting for confounding factors using binary logistic regression models, compared with preschoolers with bedtime ≤21:00, The OR (95%CI) values of anxiety in preschoolers with bedtime ≥23:01, 22:01-23:00 and 21:01-22:00 were 2.86 (2.21-3.69), 1.51 (1.27-1.79) and 1.48 (1.26-1.76), respectively. Compared with those with sufficient nighttime sleep duration, the OR (95%CI) of children with nighttime sleep duration less than 9 h was 1.36 (1.23-1.51).

Conclusion

An association exists between bedtime and nighttime sleep duration in preschoolers and their anxiety symptoms. Preschoolers with 21:00 for bedtime and a nighttime sleep duration of 10 h may have lower anxiety symptoms. These findings support the importance of adequate sleep for preventing anxiety symptoms in children.