青少年不同类型的屏幕使用与抑郁和焦虑症状之间的纵向关联。
Longitudinal associations between different types of screen use and depression and anxiety symptoms in adolescents.
机构信息
School of Population Health, University of Ottawa, Ottawa, ON, Canada.
Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.
出版信息
Front Public Health. 2023 Apr 27;11:1101594. doi: 10.3389/fpubh.2023.1101594. eCollection 2023.
BACKGROUND
Evidence examining the longitudinal associations between different types of screen behaviours and mental health among adolescents is limited. The present study examined the association between five types of screen behaviours and symptoms of anxiety and depression one year later. This study also assessed how changes in screen time were associated with changes in anxiety and depressive symptoms and whether the observed relationships were moderated by sex.
METHODS
Longitudinal data of 17,174 students in grades 9-12 (53.5% females; mean age: 15.1 ± 0.9 years) attending high schools in Canada from two waves (year 6: 2017/18, year 7: 2018/19) of the COMPASS study were analyzed. Leisure screen time and mental health measures were self-reported. To test if the associations between screen time and anxiety, and depression vary by sex, two-way interactions were examined for sex. Analyses accounted for school clustering, race/ethnicity, sex, age, income, body mass index -score, and previous year anxiety and depression symptoms.
RESULTS
There were significant longitudinal associations between time spent on each type of screen and subsequent anxiety and depression symptoms. The strength of the associations varied by type of screen behaviour. Interaction analysis indicated a sex difference for television viewing and anxiety and depression symptoms, and internet surfing and anxiety symptoms. A dose-response relationship was observed between phone talking and anxiety symptoms. Beta estimates indicated that an increase in screen duration was associated with a further increase in anxiety and depression symptoms.
CONCLUSION
Higher screen time was longitudinally associated with higher anxiety and depression symptoms at one-year follow-up in adolescents. Time-change associations between screen usage and depressive and anxiety symptoms were observed. Also, associations differed based on sex and screen type, whereby greater increases in screen use predicted greater emotional distress. Findings from this prospective analysis suggest that screen time is an important determinant of anxiety and depressive symptoms among adolescents. Future studies are recommended to help inform programs promoting screen time reduction with a goal to enhance adolescents' mental health.
背景
目前关于不同类型屏幕行为与青少年心理健康之间纵向关联的证据有限。本研究旨在探讨一年后五种类型的屏幕行为与焦虑和抑郁症状之间的关联。本研究还评估了屏幕时间的变化与焦虑和抑郁症状变化之间的关系，以及观察到的关系是否受性别调节。
方法
对参加加拿大 COMPASS 研究的 17174 名 9-12 年级学生（53.5%为女性；平均年龄：15.1±0.9 岁）的纵向数据进行了分析，该研究有两个波次（第 6 年：2017/18 年，第 7 年：2018/19 年）。休闲屏幕时间和心理健康测量均为自我报告。为了检验屏幕时间与焦虑和抑郁的关联是否因性别而异，我们对性别进行了双向交互作用检验。分析考虑了学校聚类、种族/民族、性别、年龄、收入、体重指数得分以及前一年的焦虑和抑郁症状。
结果
各种类型的屏幕时间与随后的焦虑和抑郁症状之间存在显著的纵向关联。关联的强度因屏幕行为类型而异。交互分析表明，看电视与焦虑和抑郁症状以及上网与焦虑症状存在性别差异。手机通话与焦虑症状之间存在剂量反应关系。β估计表明，屏幕时间的增加与焦虑和抑郁症状的进一步增加有关。
结论
在青少年中，较高的屏幕时间与一年后较高的焦虑和抑郁症状呈纵向相关。观察到屏幕使用与抑郁和焦虑症状之间的时间变化关联。此外，关联因性别和屏幕类型而异，其中屏幕使用的增加预示着更大的情绪困扰。这项前瞻性分析的结果表明，屏幕时间是青少年焦虑和抑郁症状的一个重要决定因素。建议进行未来的研究，以帮助制定减少屏幕时间的计划，以促进青少年的心理健康。
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