Screen Time on School Days and Risks for Psychiatric Symptoms and Self-Harm in Mainland Chinese Adolescents

Abstract

Objective: To investigate associations of television and of video game or non-educational computer use (VG/CU) exposure volumes in a typical school day with psychiatric symptoms and suicidal ideation/self-injurious behavior (self-harm), in mainland Chinese adolescents.Methods: Secondary school pupils (N = 13,659; mean age: 15.18 ± 1.89) from 10 urban areas sampled from different regions of mainland China were recruited. The subjects were divided into the following four screen exposure volume groups for television and VG/CU respectively based on a self-administered questionnaire: 0 h/day, >0 to ≤1 h/day, >1 to ≤2 h/day, and >2 h/day. Demographic and psychiatric symptoms were recorded for each respondent. Odds ratios (ORs) and 95% confidence intervals (CIs) for several types of psychological problems and self-harm were calculated.Results: More than 2 h per school day television watching was associated with higher risk of depression in both boys (OR = 1.33, 95%CI: 1.02–1.73) and girls (OR = 1.62, 95%CI: 1.19–2.21), of anxiety in boys (OR = 1.43, 95%CI: 1.05–1.95), of general emotional, behavioral, and social problems (GEBSPs; OR = 1.55, 95%CI: 1.01–2.39), and of oppositional defiant problems (OR = 1.65, 95% CI: 1.09–2.50) in girls, compared with no television exposure. Conversely, television exposure of no more than 1 h per school day was associated with lower self-harm risk in boys (OR = 0.81, 95%CI: 0.67–0.99) compared with no television exposure. High school day VG/CU time (>2 h) compared with no VG/CU were associated with higher risks of anxiety (OR = 1.40, 95%CI: 1.06–1.86) and of attention deficit/hyperactivity problems (ADHPs; OR = 1.56, 95%CI: 1.02–2.38) in boys. And any school day VG/CU exposure was associated with higher risks of self-harm and all other psychiatric problems in boys and all psychiatric problems (including anxiety and ADHPs) in girls (ORs, 1.44–3.69), compared to no VG/CU exposure.Conclusion: For secondary school students, associations of psychiatric problems and self-harm were more strongly associated with exposure to VG/CU than with exposure to television. The findings suggest that VG/CU and television exposure on weekdays should be considered in psychiatric interventions for adolescents.

Longitudinal associations between changes in screen-time and mental health outcomes in adolescents

“…Associations between changes in screen-time and psychological difficulties were inconclusive and television/DVD use was the only significant association found. Previous research examining the relationship between screen-time and psychological difficulties has also produced inconsistent findings in cross-sectional (Booker et al, 2015;Busch et al, 2013;Liu, Ming, Yi, Wang, & Yao, 2016) and longitudinal studies (Booker et al, 2015;Chen & Lu, 2009;Parkes et al, 2013)(O'Connor et al, 2016Parkes et al, 2013) in young people. It is possible the varying outcomes may be due to differences in the measurement of screentime (in addition to the combining of time engaged in television and DVD viewing) and or the duration of follow-up periods.…”

“…Although such examinations were beyond the scope of this study, previous findings suggest that elevated levels of psychological distress can lead to changes in behavior in adolescence. Studies have shown that television use (especially if the content is violent) may increase conduct problems (Parkes et al, 2013) (Liu et al, 2016), and may predict aggression and attention problems (Strasburger, Jordan, & Donnerstein, 2010;Zimmerman & Christakis, 2007). The nature of screen viewing (how adolescents watch, what they watch, and with whom) may have also been important implications for their mental health.…”

Suicidal ideation and attempted suicide amongst Chinese transgender persons: National population study

“…Furthermore, self-harm behaviours that are common in Chinese young people (Liu et al, 2016;Xin et al, 2016;Xin et al, 2017) significantly increased suicidal ideation and attempt for both TW and TM. While a previous study reported that TM appear more vulnerable to self-harm behaviors than TW (Peterson et al, 2017), the present study found that TW have significantly higher self-harm behavior than TM.…”

Prospective associations between internet use and poor mental health: A population-based study

“…[4][5][6][7] A growing number of studies have found an association between high levels of internet use in young people and poor mental health, including depression, anxiety, attention deficit hyperactivity disorder, hostility/aggression, suicidal ideation, and self-harm. [3,[8][9][10][11][12][13][14][15][16] However, most existing research is based on cross-sectional data and so the temporal relationship between mental health problems and internet use is currently unclear. The lack of longitudinal studies assessing the consequences of screen-based activities was recently highlighted as a key limitation in the field.…”