Association Between Screen Overuse and Behavioral and Emotional Problems in Elementary School Children

Excessive screen time and problem behaviours among school-age children in Fujian, China: a cross-sectional study

BACKGROUND

Screen time encompasses activities conducted on digital devices, including traditional devices such as televisions and computers, as well as modern devices like smartphones, tablets, and other digital screens. Excessive screen time among children has been linked to a heightened likelihood of engaging in high-risk problem behaviours. This study aimed to quantify the prevalence of excessive screen time and delve into its correlation with problem behaviours among school-aged children in Fujian, thereby gaining insight into the prevalence and trends within this region.

METHODS

From October to November 2022, we used cluster sampling and invited 891 school-age children from Fujian as participants. Parents recorded children's screen time for a week, taking the average value of seven days, and the unit is minutes. The Child Behaviour Checklist was used to assess their problem behaviours. Correlation analysis, Propensity Score Matching, Single-factor analysis, and Multi-factor analysis were used to explore the influencing factors and correlation.

RESULTS

Screen exposure time of school-age children was 34.29 (17.14, 55.71) min/day. Then, 17.06% were exposed to excessive video. The total CBCL score of school-age children was 10.00 (3.00, 22.00), and 10.00% had problem behaviours. After matching the propensity score, the total score of problem behaviours in the daily over-exposure group was higher than that in the non-over-exposure group (Z = 5.466, p < 0.001). Generalized linear model analysis showed that after controlling confounding variables, daily video exposure time or daily excessive screening could affect problem behaviours (p < 0.05).

CONCLUSIONS

The incidence of problem behaviours among school-age children is low in Fujina. The daily screen time, weekday screen time, and weekend screen time were positively associated with problem behaviours. We suggested family members shift to more serious and cautious attitudes toward children's screen exposure and adopt appropriate digital-related parenting practices, such as accompanying children when they inevitably need to watch electronic devices, to better understand and manage their screen time.

Lower-Income Predicts Increased Smartphone Use and Problematic Behaviors Among Schoolchildren During COVID-19 Related School Modification: A Longitudinal Study

BACKGROUND

As the coronavirus disease 2019 (COVID-19) has continued for a couple of years, the long-term effects of the pandemic and the subsequent school curriculum modification on the mental health of children and parents need to be investigated. To clarify the changes that can occur during one school year and to predict the risk factors for vulnerable groups, this study identified parameters relative to children's screen time, their problematic behavior, and parental depression.

METHODS

A total of 186 participants were analyzed who were parents of elementary schoolchildren in South Korea. These parents were required to complete a web-based questionnaire twice. The questionnaires were conducted in June 2020 and September 2021. Participants' general demographics including family income, children's screen time, sleep patterns, problematic behavior, and parental depression were assessed via the parental questionnaire that included various measurement tools.

RESULTS

Children's body mass index (BMI) increased significantly in 2021 (18.94 ± 3.75 vs. 18.14 ± 3.30, P < 0.001). Smartphone frequency of use per week (5.35 vs. 4.54, P < 0.001) and screen time per day (3.52 vs. 3.16, P < 0.001) significantly increased during the period of the COVID-19 pandemic. The television screen time (2.88 vs. 3.26, P < 0.001), frequency of viewing (3.77 vs. 4.77, P < 0.001), and children's problematic behaviors significantly decreased (9.15 vs. 11.85, P < 0.001). A lower income household was a key predictor of increased smartphone frequency (B = 1.840, 95% confidence interval [CI], 0.923-2.757, P < 0.001) and smartphone screen time (B = 1.992, 95% CI, 1.458-2.525, P < 0.001). The results showed that the lower income household (B = 5.624, 95% CI, 2.927-8.320, P < 0.001) and a child's psychiatric treatment history (B = 7.579, 95% CI, 5.666-9.492, P < 0.001) was the most significant predictor of problematic behaviors of children and parental depression (B = 3.476, 95% CI, 1.628-5.325, P < 0.001; B = 3.138, 95% CI, 1.827-4.450, P < 0.001).

CONCLUSION

This study suggested that children's smartphone screen time and BMI increased during COVID-19 because of the school curriculum modification following school closures in South Korea. The increased children's problematic behaviors and parental depression were predicted by lower-income households and the previous psychiatric history of children. These results indicate that multiple social support systems to the vulnerable group are needed during the ongoing pandemic and that a modified school setting is required.

Associations between problematic smartphone use and behavioural difficulties, quality of life, and school performance among children and adolescents

BACKGROUND

European studies on determinants and factors associated with problematic smartphone use (PSU) in children and adolescents are still sparse. This study reports the current amount of PSU symptoms and the presence of (clinically relevant) PSU in German children and adolescents. We also investigated associations between socio-demographic factors, different smartphone usage patterns, and daily smartphone usage time and the amount of PSU symptoms in this group. In addition, associations of PSU symptoms and high smartphone usage times (> 2 h/day) with behavioural problems, quality of life (QoL), and school performance were investigated.

METHODS

Within the framework of the LIFE Child study, 564 children and adolescents aged 10-18 years provided information on PSU symptoms (using the Smartphone Addiction Proneness Scale), daily smartphone usage time, smartphone activities, behavioural strengths and difficulties (using the Strengths and Difficulties Questionnaire), QoL (using the KIDSCREEN-27), and school performance. Multiple regression analyses were applied to assess associations.

RESULTS

In the present sample, PSU was present in 13 children (2.3%). Older age, female gender, high daily smartphone usage time of > 2 h, and intensive smartphone use for social networking, gaming, or watching video clips were significantly associated with more PSU symptoms. Children and adolescents reporting more PSU symptoms also showed lower QoL, more behavioural difficulties, and poorer school performance, independently of age, gender, socio-economic status, and daily smartphone usage time. In contrast, daily smartphone usage time per se showed only weak or non-significant associations with these aspects of health and behaviour.

CONCLUSION

Intensive smartphone use for entertainment may increase the risk of developing PSU symptoms. Furthermore, the results indicate that PSU symptoms (more than long smartphone usage times per se) are associated with more behavioural difficulties and poorer QoL.