Meuhedet Health Services, Jerusalem, Israel.
Environ Res. 2018 Jul;164:149-157. doi: 10.1016/j.envres.2018.01.015. Epub 2018 Feb 27.
A growing body of literature is associating excessive and addictive use of digital media with physical, psychological, social and neurological adverse consequences. Research is focusing more on mobile devices use, and studies suggest that duration, content, after-dark-use, media type and the number of devices are key components determining screen time effects. Physical health effects: excessive screen time is associated with poor sleep and risk factors for cardiovascular diseases such as high blood pressure, obesity, low HDL cholesterol, poor stress regulation (high sympathetic arousal and cortisol dysregulation), and Insulin Resistance. Other physical health consequences include impaired vision and reduced bone density. Psychological effects: internalizing and externalizing behavior is related to poor sleep. Depressive symptoms and suicidal are associated to screen time induced poor sleep, digital device night use, and mobile phone dependency. ADHD-related behavior was linked to sleep problems, overall screen time, and violent and fast-paced content which activates dopamine and the reward pathways. Early and prolonged exposure to violent content is also linked to risk for antisocial behavior and decreased prosocial behavior. Psychoneurological effects: addictive screen time use decreases social coping and involves craving behavior which resembles substance dependence behavior. Brain structural changes related to cognitive control and emotional regulation are associated with digital media addictive behavior. A case study of a treatment of an ADHD diagnosed 9-year-old boy suggests screen time induced ADHD-related behavior could be inaccurately diagnosed as ADHD. Screen time reduction is effective in decreasing ADHD-related behavior.
Components crucial for psychophysiological resilience are none-wandering mind (typical of ADHD-related behavior), good social coping and attachment, and good physical health. Excessive digital media use by children and adolescents appears as a major factor which may hamper the formation of sound psychophysiological resilience.
越来越多的文献将过度和成瘾性使用数字媒体与身体、心理、社会和神经方面的不良后果联系起来。研究越来越关注移动设备的使用，研究表明，使用时长、内容、夜间使用、媒体类型和设备数量是决定屏幕时间效应的关键因素。身体健康影响：过度的屏幕时间与睡眠质量差以及心血管疾病的风险因素有关，如高血压、肥胖、低 HDL 胆固醇、压力调节不良（交感神经兴奋和皮质醇失调）和胰岛素抵抗。其他身体健康影响包括视力受损和骨密度降低。心理影响：内化和外化行为与睡眠质量差有关。抑郁症状和自杀与屏幕时间引起的睡眠不佳、数字设备夜间使用和手机依赖有关。与注意力缺陷多动障碍相关的行为与睡眠问题、总屏幕时间以及激活多巴胺和奖励途径的暴力和快节奏内容有关。早期和长期接触暴力内容也与反社会行为风险和亲社会行为减少有关。精神神经影响：上瘾的屏幕时间使用会降低社会应对能力，并涉及类似于物质依赖行为的渴望行为。与数字媒体成瘾行为相关的大脑结构变化涉及认知控制和情绪调节。一项针对一名被诊断患有注意力缺陷多动障碍的 9 岁男孩的治疗案例研究表明，由屏幕时间引起的注意力缺陷多动障碍相关行为可能被误诊为注意力缺陷多动障碍。减少屏幕时间可有效减少与注意力缺陷多动障碍相关的行为。
对于心理生理弹性至关重要的因素是不 wandered 的心（与注意力缺陷多动障碍相关行为典型）、良好的社会应对能力和依恋以及良好的身体健康。儿童和青少年过度使用数字媒体似乎是一个主要因素，可能会阻碍健全的心理生理弹性的形成。
