Does reducing leisure-time screen media use improve mental health among children and adolescents?

By Priyanjana Pramanik, MSc. Reviewed by Danielle Ellis, B.Sc. Jul 17 2024

In a recent study published in JAMA Network Open, researchers investigated whether reducing the use of screen media for leisure improves mental health in adolescents and children. Study: Screen Media Use and Mental Health of Children and Adolescents A Secondary Analysis of a Randomized Clinical Trial. Image Credit: Miljan Zivkovic/Shutterstock.com

Their results indicate that reducing screen time led to fewer behavioral difficulties, with noticeable decreases in peer-related and emotional issues and improvements in positive social interactions. Background

Many children and teenagers worldwide are experiencing worsening mental health. In the US, nearly 30% of adolescents reported poor mental health in a recent survey, and in Europe, 25% of young teens experienced psychological issues like nervousness and trouble sleeping.

Adolescence is a sensitive period, and digital technology use has surged, with screen media becoming central to daily life for entertainment and communication. Concerns have arisen about the negative effects of screen media on mental health, though research findings are mixed.

Some studies show a link between high screen use and poor mental health, but they are mostly observational. Further research is needed to understand whether reducing screen use can benefit adolescents' and children's mental well-being. About the study

Researchers analyzed the Short-term Efficacy of Reducing Screen-Based Media Use (SCREENS) trial, a detailed study involving 89 families in Southern Denmark.

This trial used the cluster randomization method, where families were assigned randomly to either reduce their screen time or continue with their existing habits.

In the intervention group, families were asked to decrease their leisure screen time to less than three hours each week for two weeks, and they handed over their tablets and smartphones. The control group maintained their normal screen usage. Related StoriesHow did hospitalizations for mental health conditions in children change following the COVID-19 pandemic?Technology-assisted therapy for kids and young people is as effective as traditional face-to-face therapyAI analysis of Reddit reveals public interest in GLP-1 drugs for weight loss and mental health benefits

To measure the effects of this intervention, researchers used a tool called the Strengths and Difficulties Questionnaire (SDQ). This questionnaire, completed by parents at the beginning and end of the study, assesses various behavioral and emotional issues in children.

For analyzing the data, researchers employed regression models that allowed them to account for any clustered design of the study (families rather than individuals) and adjust for variables like age. Compliance with the screen time reduction was high, meaning most families followed the instructions closely.

Their goal was to see if reducing screen time positively impacted children's and adolescents' mental health, specifically looking at their behavioral strengths and difficulties. Using this rigorous method, researchers aimed to provide clear and reliable results on the short-term effects of reduced screen media use. Findings

In total, 181 children participated in the study, of whom 86 were in the intervention group and 95 were in the control group. Children in the intervention group were, on average, 8.6 years old; 49% were girls. In the control group, the children were 9.5 years old on average; 60% were girls.

Researchers found a significant improvement in the overall mental health of children who reduced their screen time.

The total difficulties score, which measures behavioral and emotional issues, decreased by an average of 1.67 points more in the intervention group than in the control group. This result corresponds to a moderate effect size.

The study also found that the most significant improvements were in internalizing symptoms, such as emotional problems and peer issues, which decreased by an average of 1.03 points more in the intervention group. Additionally, the prosocial behavior score, indicating positive social interactions, increased by 0.84 points more in the intervention group.

The researchers found similar results when they analyzed the data without adjusting for age. They also noted that the findings were more pronounced for boys than girls, and for those children who had higher total difficulty scores or used screen media more before the intervention took place.

These findings suggest that reducing leisure screen time can positively impact children's mental health, particularly by reducing emotional and peer-related problems and enhancing positive social interactions. Conclusions

The study showed that reducing screen time for two weeks improved children's and adolescents' mental health. Specifically, it reduced emotional and peer-related problems and increased positive social interactions.

This trial is among the first to test screen time reduction in families and confirms findings from previous observational studies that high screen time is linked to poorer mental health. Unlike earlier studies with negligible effect sizes, this trial found a moderate effect size.

The strengths of this study include its randomized design and real-world setting, which support strong causal conclusions. Also, objective measures of screen time and low dropout rates added to the reliability of the results.

However, the study has limitations. The short-term intervention may not reflect long-term habits, and parent-reported measures might be biased. Additionally, the study involved highly motivated families, which could limit generalizability.

Future research should explore the long-term effects of reduced screen time, investigate the impact of different types of screen media, and confirm these findings in high-risk groups. Understanding how family involvement contributes to these outcomes is crucial for designing effective interventions. Journal reference: Screen Media Use and Mental Health of Children and Adolescents: A Secondary Analysis of a Randomized Clinical Trial. Schmidt-Persson, J., Rasmussen, M.G.B., Sørensen, S.O., Mortensen, S.R., Olesen, L.G., Brage, S., Kristensen, P.L., Bilenberg, N., Grøntved, A. JAMA Network Open (2024). doi:10.1001/jamanetworkopen.2024.19881 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821176