Lin Huize, Yuan Sitong, Yu Jinna
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ;China.
Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, ;Australia.
Front Psychiatry. 2024 Dec 4;15:1424082. doi: 10.3389/fpsyt.2024.1424082. eCollection 2024.
This study investigates the potential mediating role of mobile phone screen time in the causal relationships between Attention-deficit/hyperactivity disorder (ADHD) and educational attainment. Our analysis explores both the effect of ADHD on educational outcomes and the reverse, i.e., the influence of educational attainment on ADHD risk.
A two-sample Mendelian randomisation (MR) analysis was conducted using genetic instruments from genome-wide association studies (GWAS) of European populations. We employed a two-step MR approach to assess the causal effects between ADHD, mobile phone screen time (both frequency and duration), and educational outcomes, including years of full-time education and college completion. Data from public genome-wide association studies encompassing European populations with sample sizes ranging from 55,374 to 470,941 were utilised.
We found significant causal associations between childhood ADHD and educational attainment, partially mediated by mobile phone screen time. Childhood ADHD was negatively linked to years of full-time education (IVW: OR = 0.93, 95% CI = 0.90-0.97, p = 0.000) and college completion (IVW: OR = 0.97, 95% CI = 0.95-0.98, p = 0.000). Mobile phone use frequency mediated 19.3% of the effect on full-time education (β = -0.158) and 11.9% on college completion (β = -0.084). The duration of phone use mediated 64.8% of the effect on college completion (β = -0.054). When ADHD was the outcome, phone use duration mediated -22.45% of full-time education effects (β = 0.426) and -19.62% of college completion (β = 0.433).
Different MR models reveal the complex mediation role of mobile phone use frequency and duration between ADHD and educational attainment, varying by educational outcome type. Frequency mediates the link between childhood ADHD and full-time education/college completion, while duration significantly impacts ADHD when higher education is the outcome. The notable mediation effect of duration on ADHD underscores the need for further study into screen time's influence on ADHD and academic achievement across stages.
本研究调查手机屏幕使用时间在注意力缺陷多动障碍（ADHD）与教育程度之间的因果关系中可能起到的中介作用。我们的分析探讨了ADHD对教育结果的影响以及相反的情况，即教育程度对ADHD风险的影响。
使用来自欧洲人群全基因组关联研究（GWAS）的基因工具进行两样本孟德尔随机化（MR）分析。我们采用两步MR方法来评估ADHD、手机屏幕使用时间（包括频率和时长）与教育结果之间的因果效应，教育结果包括全日制教育年限和大学毕业情况。利用了来自涵盖欧洲人群的公共全基因组关联研究的数据，样本量从55374到470941不等。
我们发现儿童期ADHD与教育程度之间存在显著的因果关联，手机屏幕使用时间起到了部分中介作用。儿童期ADHD与全日制教育年限呈负相关（逆方差加权法：比值比 = 0.93，95%置信区间 = 0.90 - 0.97，p = 0.000）以及与大学毕业情况呈负相关（逆方差加权法：比值比 = 0.97，95%置信区间 = 0.95 - 0.98，p = 0.000）。手机使用频率介导了对全日制教育影响的19.3%（β = -0.158）以及对大学毕业影响的11.9%（β = -0.084）。手机使用时长介导了对大学毕业影响的64.8%（β = -0.054）。当以ADHD为结果变量时，手机使用时长介导了全日制教育影响的 -22.45%（β = 0.426）以及大学毕业影响的 -19.62%（β = 0.433）。
不同的MR模型揭示了手机使用频率和时长在ADHD与教育程度之间复杂的中介作用，且因教育结果类型而异。频率介导了儿童期ADHD与全日制教育/大学毕业之间的联系，而当以高等教育为结果时，时长对ADHD有显著影响。时长对ADHD显著的中介效应凸显了进一步研究屏幕使用时间在不同阶段对ADHD和学业成绩影响的必要性。
