Zhang Chengcheng, Peng Weijing, Chen Zhiyan, Lai Cong, Xiao Shuiyuan, Hu Mi
Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China.
Hunan Academy of Education Sciences, Changsha, China.
Eur Child Adolesc Psychiatry. 2024 Dec 20. doi: 10.1007/s00787-024-02632-2.
Excessive screen time was associated with mental health problems, yet whether the associations differ by screen content types remain unknown. Here, we conducted a cross-sectional study of adolescents from 156 junior and high school to investigate the association of types of on-screen content with mental health problems in China. The exposure variable was screen exposure, measured by the self-reported questionnaire. Symptoms of depression and anxiety were assessed by Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7), respectively. Suicide-related behavior was adapted from the Centers for Disease Control's Youth Risk Behavior Surveillance. Generalized linear models and network analysis were performed. Of the 15,194 adolescents included in the final analysis, 8,019 were males and mean (SD) age was 14.50 (1.68) years. 34.6% of adolescents had an average screen time of ≥ 4 h/day on weekends. The most frequently used screen contents (≥ 4 h/d) were electronic games (9.1%), followed by short video (6.6%). Learning online had strong associations with depression (OR = 2.03, 95%CI: 1.29-3.11, P = 0.002) and anxiety (OR = 2.05, 95%CI: 1.24-3.27, P = 0.004) symptoms. The associations between on-screen content and mental health varied. The strongest edges linked to screen content types were edge between "Electronic games" and "Anhedonia" in the network model. "Control worry" was the most central nodes, followed by "Irritable" and "Worry A Lot". Findings suggested that both screen time and different types of screen content were associated with mental health problems among adolescents. Limiting screen exposure and developing effective interventions to improve mental health should be a priority.
过多的屏幕使用时间与心理健康问题相关，但这种关联是否因屏幕内容类型而异仍不清楚。在此，我们对156所初中和高中的青少年进行了一项横断面研究，以调查中国屏幕上的内容类型与心理健康问题之间的关联。暴露变量为屏幕暴露，通过自我报告问卷进行测量。抑郁和焦虑症状分别通过患者健康问卷-9（PHQ-9）和广泛性焦虑障碍量表-7（GAD-7）进行评估。自杀相关行为改编自疾病控制中心的青少年风险行为监测。进行了广义线性模型和网络分析。在最终分析纳入的15194名青少年中，8019名是男性，平均（标准差）年龄为14.50（1.68）岁。34.6%的青少年在周末平均屏幕使用时间≥4小时/天。最常使用的屏幕内容（≥4小时/天）是电子游戏（9.1%），其次是短视频（6.6%）。在线学习与抑郁（OR = 2.03，95%CI：1.29 - 3.11，P = 0.002）和焦虑（OR = 2.05，95%CI：1.24 - 3.27，P = 0.004）症状有很强的关联。屏幕上的内容与心理健康之间的关联各不相同。网络模型中与屏幕内容类型相关的最强边是“电子游戏”和“快感缺乏”之间的边。“控制担忧”是最核心的节点，其次是“易怒”和“经常担忧”。研究结果表明，屏幕使用时间和不同类型的屏幕内容都与青少年的心理健康问题有关。限制屏幕暴露并制定有效的干预措施以改善心理健康应成为优先事项。
