Association of Screen Time With Internalizing and Externalizing Behavior Problems in Children 12 Years or Younger: A Systematic Review and Meta-analysis
Eirich R, McArthur BA, Anhorn C, McGuinness C, Christakis DA, Madigan S
JAMA psychiatry · 156 citations
Review labels
Neutral facts our review recorded about how this study was done. They describe method, never whether we like the result.
How it was studied
- Design
- Meta-analysis (indexed by PubMed)
- Studied in
- People
- Main outcome
- Health markers and function
Who paid for it
- Funding
- Funding not disclosed
Publication
- Published
- 2022-03-16 · JAMA Psychiatry · vol. 79 · issue 5 · p. 393
- Publisher
- American Medical Association
- Cited
- 296 citations · more than 100% of similar papers · 122.2× the field average
- Impact
- Top 10% most cited in its field
- References
- 151 works
- Access
- Open access (repository copy)
- Research areas
- Child Development and Digital Technology · Impact of Technology on Adolescents · Autism Spectrum Disorder Research
- Keywords
- screen time, children, internalizing problems, externalizing problems, television, video games, ADHD symptoms, depression, anxiety, aggression, child mental health, socioeconomic status, informant differences, effect size heterogeneity, digital media use, child behavior problems, child development
- MeSH
- humans, anxiety, child, female, male, pandemics, problem behavior, screen time, covid-19
6 authors
From CA, US
- Rachel EirichUniversity of Calgary; Alberta Children's Hospital Research Institute
- Brae Anne McArthurUniversity of Calgary; Alberta Children's Hospital Research Institute
- Ciana AnhornUniversity of Calgary
- Claire McGuinnessUniversity of Calgary
- Dimitri ChristakisSeattle Children's Hospital; University of Washington; Seattle Children's Research Institute
- Sheri L. Madigan · correspondingUniversity of Calgary; Alberta Children's Hospital Research Institute
Abstract
Importance
Currently, there is a lack of consensus in the literature on the association between screen time (eg, television, video games) and children's behavior problems.
Objective
To assess the association between the duration of screen time and externalizing and internalizing behavior problems among children 12 years or younger.
Data sources
For this systematic review and meta-analysis, MEDLINE, Embase, and PsycINFO databases were searched for articles published from January 1960 to May 2021. Reference lists were manually searched for additional studies.
Study selection
Included studies measured screen time (ie, duration) and externalizing or internalizing behavior problems in children 12 years or younger, were observational or experimental (with baseline data), were available in English, and had data that could be transformed into an effect size. Studies conducted during the COVID-19 pandemic were excluded. Of 25 196 nonduplicate articles identified and screened for inclusion, 595 met the selection criteria.
Data extraction and synthesis
The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Extracted variables were child age, sex, and socioeconomic status; informants and measurement type for screen time and behavior problems; study publication year; and study design and quality. Data were extracted by 2 independent coders and were pooled using a random-effects model.
Main outcomes and measures
The primary outcome was the association of screen time duration with externalizing (eg, aggression, attention deficit/hyperactivity disorder symptoms) and internalizing (eg, depression, anxiety) behaviors or diagnoses.
Results
Of the 595 full-text articles assessed for eligibility, 87 studies met all inclusion criteria, comprising 98 independent samples and 159 425 participants (mean [SD] age, 6.07 [2.89] years; 83 246 [51.30%] male). Increased duration of screen time had a small but significant correlation with more externalizing problems (90 samples; r, 0.11; 95% CI, 0.10-0.12) and internalizing problems (43 samples; r, 0.07; 95% CI, 0.05-0.08) in children. Several methodological moderators explained between-study heterogeneity. There was evidence of significant between study heterogeneity (I2 = 87.80).
Conclusions and relevance
This systematic review and meta-analysis found small but significant correlations between screen time and children's behavior problems. Methodological differences across studies likely contributed to the mixed findings in the literature.
Abstract via Europe PMC. Copyright remains with the authors or publisher.
Community trust
Loading…
How much do you trust this study's findings?
Comments
Sign in to rate, comment on or flag this study.Sign inSomething wrong here?
Flag this study if its information, labels or funding look wrong. An editor reviews every flag.
Sign in to rate, comment on or flag this study.Sign inEducational information about published research. Not medical advice, and not a recommendation to start or stop anything.