Department of Global Public Health, Karolinska Institutet, Solna, 17177, Sweden.
Department of Sociology, East West University, Dhaka, 1212, Bangladesh.
Eur J Pediatr. 2023 Jun;182(6):2521-2534. doi: 10.1007/s00431-023-04898-1. Epub 2023 Mar 16.
The associations between digital media use and mental well-being among children and adolescents have been inconclusive. We examined (i) the associations between digital media use and mental health outcomes, anxiety, depression, and ADHD, (ii) whether family resilience and neighborhood factors attenuate the associations, and (iii) whether sleep mediates these associations. We used the National Survey of Children's Health data from 2019 to 2020. A total of 45,989 children's (6-17 years) data were analyzed in this study. Multivariate logistic regression was used to assess the associations between digital media use and anxiety, depression, and ADHD. Path models and Paramed command in STATA were used to test the role of sleep as a mediator of these associations. The prevalence of heavy digital media users (who spent 4 or more hours per day) among the analytic sample was 30.52%, whereas anxiety was 13.81%, depression was 5.93%, and ADHD was 12.41%. Children in the heavy media user group had 63% increased odds of anxiety (95% CI: 1.32-2.01) and 99% increased odds of depression (95% CI: 1.35-2.94) after adjusting for sociodemographic factors, compared to the children in light media user group (who spent < 2 h per day), and these relations were significant at 0.01 level. However, family resilience and community factors significantly attenuated the effect of digital media use on anxiety and depression. Sleep did not mediate the associations between digital media use and anxiety or depression. Conclusions: Family resilience and neighborhood factors protect against the harmful effects of digital media use. Further research is needed to examine the relationships of media contents, the presence of electronic devices in bedrooms, and sleep quality with mental health. What is Known: • Spending long hours on digital media may adversely affect children and adolescents' health and development. However, the mediating role of sleep in the association between digital media use and mental health outcomes is inconclusive. What is New: • Digital media use has detrimental effects on anxiety and depression. However, family resilience and neighborhood factors attenuated the association. The study highlights the importance of positive family functioning and neighborhood conditions reducing the harmful effects of digital media use.
数字媒体使用与儿童和青少年心理健康之间的关系尚无定论。我们研究了：(i) 数字媒体使用与心理健康结果、焦虑、抑郁和 ADHD 之间的关系；(ii) 家庭弹性和邻里因素是否会减弱这些关联；以及 (iii) 睡眠是否会调解这些关联。我们使用了 2019 年至 2020 年的全国儿童健康调查数据。本研究共分析了 45989 名儿童（6-17 岁）的数据。多变量逻辑回归用于评估数字媒体使用与焦虑、抑郁和 ADHD 之间的关联。路径模型和 STATA 中的 Paramed 命令用于测试睡眠作为这些关联中介的作用。在分析样本中，重度数字媒体使用者（每天花费 4 小时或以上）的患病率为 30.52%，而焦虑症的患病率为 13.81%，抑郁症的患病率为 5.93%，ADHD 的患病率为 12.41%。与轻度媒体使用者（每天花费 < 2 小时）相比，重度媒体使用者组的儿童焦虑症的几率增加了 63%（95%CI：1.32-2.01），而抑郁症的几率增加了 99%（95%CI：1.35-2.94），这些关联在 0.01 水平上具有统计学意义。然而，家庭弹性和社区因素显著减弱了数字媒体使用对焦虑和抑郁的影响。睡眠并没有调解数字媒体使用与焦虑或抑郁之间的关联。结论：家庭弹性和邻里因素可以预防数字媒体使用带来的不良影响。需要进一步研究以检验媒体内容、卧室中电子设备的存在以及睡眠质量与心理健康之间的关系。已知内容：• 长时间使用数字媒体可能会对儿童和青少年的健康和发育产生不利影响。然而，睡眠在数字媒体使用与心理健康结果之间的关联中的中介作用尚无定论。新内容：• 数字媒体使用对焦虑和抑郁有不良影响。然而，家庭弹性和邻里因素减弱了这种关联。该研究强调了积极的家庭功能和邻里条件对减少数字媒体使用的有害影响的重要性。
