Reducing Screen Time Improves Child, Adolescent Mental Health

Reducing screen time during leisure is associated with improved prosocial behavior and decreased internalizing issues among children and adolescents, according to study findings published in JAMA Network Open.

Although some research indicates that self-reported screen media use is linked to adverse psychological effects among children and adolescents, evidence is relatively sparse and primarily relies on observational studies. Therefore, researchers evaluated the utility of a 2-week screen media reduction intervention for improving mental health among children and adolescents.

The researchers conducted a prespecified secondary analysis of the Short-term Efficacy of Reducing Screen-Based Media Use (SCREENS) study, a randomized clinical trial (NCT04098913) that included 181 children and adolescents from 89 families in Southern Denmark. Enrollment began in June 2019 with final follow-up through March 2021. Eligible participants were families with at least 1 parent with leisure-time screen media use above the 40^th percentile and at least 1 child aged 6 to 10 years.

The included families were randomly assigned 1:1 to the screen media reduction intervention group or the control group.  For the intervention group, leisure-time screen media use was reduced to 3 hours or less per person per week and tablets and smartphones were voluntarily surrendered to researchers. The primary outcome of interest was the between-group mean difference in total behavioral difficulties measured at the 2-week follow-up, evaluated using the Strengths and Difficulties Questionnaire (SDQ).

The control group consisted of 44 families for a total of 95 children (mean [SD] age, 9.5 [2.5] years; 60% girls) and the intervention group consisted of 45 children for a total of 86 children (mean [SD] age, 8.6 [2.7] years; 49% girls).

The researchers observed that reducing screen time was associated with a significant between-group mean difference in SDQ total difficulties score from baseline to follow-up (-1.67; 95% CI, -2.68 to -0.67; Cohen d, 0.53). When stratified by the SDQ subscales, the researchers found that children and adolescents in the intervention group demonstrated the greatest improvements in internalizing symptoms (between-group mean difference, -1.03; 95% CI, -1.76 to -0.29) and prosocial behavior (between-group mean difference, 0.84; 95% CI, 0.39-1.30).

These findings remained robust in sensitivity analyses.

“Taken together, the results of this secondary analysis of a randomized clinical trial show that when entire families – both parents, children, and adolescents – reduce their leisure-time screen media use for 2 weeks, it can positively affect children’s and adolescents’ behavioral strengths and difficulties,” the researchers concluded. “Future research should explore the potential differential effects of various types of screen media use and look deeper into whether collective family participation in such interventions is a pivotal component for observed benefits.”

Study limitations include assessment bias of behavioral strengths and difficulties introduced by the open-label study design, potential underestimation of the intervention effect given that some families in the control group reduced their leisure-time screen media use, and family participation on a volunteer basis may influence the generalizability of results.

This article originally appeared on Psychiatry Advisor