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Pediatrics

Screen Use and Mental Health Symptoms in Canadian Children and Youth During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME
JAMA Network Open
December 28, 2021
Original Investigation
Xuedi Li, MSc1;
Leigh M. Vanderloo, PhD1,2,3;
Charles D. G. Keown-Stoneman, PhD4,5;
Katherine Tombeau Cost, PhD6;
Alice Charach, MD, MSc6,7;
Jonathon L. Maguire, MD, MSc4,8,9;
Suneeta Monga, MD6,7;
Jennifer Crosbie, PhD6,7;
Christie Burton, PhD6;
Evdokia Anagnostou, MD8,10;
Stelios Georgiades, PhD11;
Rob Nicolson, MD12;
Elizabeth Kelley, PhD13;
Muhammad Ayub, MD14;
Daphne J. Korczak, MD, MSc6,7;
Catherine S. Birken, MD, MSc1,8
Author Affiliations
  • 1Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, Toronto, Ontario, Canada
  • 2School of Occupational Therapy, Western University, London, Ontario, Canada
  • 3ParticipACTION, Toronto, Ontario, Canada
  • 4Li Ka Shing Knowledge Institute, St Michael’s Hospital, Toronto, Ontario, Canada
  • 5Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  • 6Department of Psychiatry, The Hospital for Sick Children, Toronto, Ontario, Canada
  • 7Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 8Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 9Department of Pediatrics, St Michael’s Hospital, Toronto, Ontario, Canada
  • 10Holland Bloorview Research Institute, Toronto, Ontario, Canada
  • 11Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
  • 12Department of Psychiatry, Western University, London, Ontario, Canada
  • 13Department of Psychology, Queens University, Kingston, Ontario, Canada
  • 14Department of Psychiatry, Queens University, Kingston, Ontario, Canada
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Key Points

Question  What are the associations between different types of electronic screen use and mental health symptoms in Canadian children and youth during the COVID-19 pandemic?

Findings  In this longitudinal study of 4 cohorts, 2026 children with 6648 observations were included. Compared with children with lower levels of screen use, children with higher levels of screen use had significantly higher levels of mental health symptoms during the COVID-19 pandemic.

Meaning  These findings suggest that policy intervention, as well as evidence-informed social supports, may be required to promote healthful screen use and mental health in children and youth during the pandemic and beyond.

Abstract

Importance  Longitudinal research on specific forms of electronic screen use and mental health symptoms in children and youth during COVID-19 is minimal. Understanding the association may help develop policies and interventions targeting specific screen activities to promote healthful screen use and mental health in children and youth.

Objective  To determine whether specific forms of screen use (television [TV] or digital media, video games, electronic learning, and video-chatting time) were associated with symptoms of depression, anxiety, conduct problems, irritability, hyperactivity, and inattention in children and youth during COVID-19.

Design, Setting, and Participants  A longitudinal cohort study with repeated measures of exposures and outcomes was conducted in children and youth aged 2 to 18 years in Ontario, Canada, between May 2020 and April 2021 across 4 cohorts of children or youth: 2 community cohorts and 2 clinically referred cohorts. Parents were asked to complete repeated questionnaires about their children’s health behaviors and mental health symptoms during COVID-19.

Main Outcomes and Measures  The exposure variables were children’s daily TV or digital media time, video game time, electronic-learning time, and video-chatting time. The mental health outcomes were parent-reported symptoms of child depression, anxiety, conduct problems and irritability, and hyperactivity/inattention using validated standardized tools.

Results  This study included 2026 children with 6648 observations. In younger children (mean [SD] age, 5.9 [2.5] years; 275 male participants [51.7%]), higher TV or digital media time was associated with higher levels of conduct problems (age 2-4 years: β, 0.22 [95% CI, 0.10-0.35]; P < .001; age ≥4 years: β, 0.07 [95% CI, 0.02-0.11]; P = .007) and hyperactivity/inattention (β, 0.07 [95% CI, 0.006-0.14]; P = .04). In older children and youth (mean [SD] age, 11.3 [3.3] years; 844 male participants [56.5%]), higher levels of TV or digital media time were associated with higher levels of depression, anxiety, and inattention; higher levels of video game time were associated with higher levels of depression, irritability, inattention, and hyperactivity. Higher levels of electronic learning time were associated with higher levels of depression and anxiety.

Conclusions and Relevance  In this cohort study, higher levels of screen use were associated poor mental health of children and youth during the COVID-19 pandemic. These findings suggest that policy intervention as well as evidence-informed social supports are needed to promote healthful screen use and mental health in children and youth during the pandemic and beyond.

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Adolescent Medicine Anxiety Disorders Depressive Disorders Neurology Pediatrics Psychiatry and Behavioral Health Child and Adolescent Psychiatry Coronavirus (COVID-19)
Article Information

Accepted for Publication: November 2, 2021.

Published: December 28, 2021. doi:10.1001/jamanetworkopen.2021.40875

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Li X et al. JAMA Network Open.

Corresponding Author: Xuedi Li, MSc, Child Health Evaluative Sciences, Peter Gilgan Centre for Research and Learning, The Hospital for Sick Children, 686 Bay St, Toronto, ON M5G 0A4, Canada (xuedi.li@sickkids.ca).

Author Contributions: Drs Korczak and Birken had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Li, Vanderloo, Keown-Stoneman, Charach, Maguire, Monga, Crosbie, Anagnostou, Georgiades, Korczak, Birken.

Acquisition, analysis, or interpretation of data: Li, Keown-Stoneman, Cost, Monga, Crosbie, Burton, Anagnostou, Georgiades, Nicolson, Kelley, Ayub, Korczak, Birken.

Drafting of the manuscript: Li, Vanderloo, Keown-Stoneman, Crosbie.

Critical revision of the manuscript for important intellectual content: Vanderloo, Keown-Stoneman, Cost, Charach, Maguire, Monga, Crosbie, Burton, Anagnostou, Georgiades, Nicolson, Kelley, Ayub, Korczak, Birken.

Statistical analysis: Li, Keown-Stoneman, Cost, Crosbie, Anagnostou.

Obtained funding: Keown-Stoneman, Maguire, Monga, Crosbie, Burton, Anagnostou, Georgiades, Kelley, Korczak, Birken.

Administrative, technical, or material support: Vanderloo, Keown-Stoneman, Maguire, Burton, Anagnostou, Georgiades, Ayub.

Supervision: Vanderloo, Keown-Stoneman, Maguire, Anagnostou, Georgiades, Korczak, Birken.

Conflict of Interest Disclosures: Dr Charach reported receiving grants from SickKids Hospital and Leong Centre for Healthy Children and in-kind support for all POND data from the Ontario Brain Institute during the conduct of the study. Dr Monga reported receiving grants from Cundill Centre for Youth Depression at the Centre for Addiction and Mental Health, book royalties from Springer Publishers, and grants from Canadian Institutes of Health Research outside the submitted work. Dr Anagnostou reported receiving consultation fees from Roche and Quadrant, research funding from Roche, in-kind support from AMO pharma, editorial honoraria from Wiley, and book royalties from APPI and Springer; she also holds a patent for the device Tully (formerly Anxiety Meter). Dr Nicolson reported receiving grants from Ontario Brain Institute during the conduct of the study. Dr Kelley reported receiving grants from Ontario Brain Institute, Canadian Institutes of Health Research, and the Masonic Foundation of Ontario outside the submitted work. No other disclosures were reported.

Funding/Support: This study was supported by the Canadian Institutes of Health Research (grant 173092), the Centre for Brain & Mental Health at The Hospital for Sick Children, the Ontario Ministry of Health (grant 700), and the Miner’s Lamp Innovation Fund in Prevention and Early Detection of Severe Mental Illness at the University of Toronto.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Additional Contributions: We thank all the participating families for their time and involvement in this research and are grateful to all practitioners who are currently involved in the TARGetKids! practice-based research network.

References
1.
Detsky  AS , Bogoch  II .  COVID-19 in Canada: experience and response.   JAMA. 2020;324(8):743-744. doi:10.1001/jama.2020.14033PubMedGoogle ScholarCrossref
2.
Nielsen  K . A timeline of COVID-19 in Ontario. Global News. April 24, 2020. Accessed April 14, 2021. https://globalnews.ca/news/6859636/ontario-coronavirus-timeline/
3.
Moore  SA , Faulkner  G , Rhodes  RE ,  et al.  Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey.   Int J Behav Nutr Phys Act. 2020;17(1):85. doi:10.1186/s12966-020-00987-8PubMedGoogle ScholarCrossref
4.
Xiang  M , Zhang  Z , Kuwahara  K .  Impact of COVID-19 pandemic on children and adolescents’ lifestyle behavior larger than expected.   Prog Cardiovasc Dis. 2020;63(4):531-532. doi:10.1016/j.pcad.2020.04.013PubMedGoogle ScholarCrossref
5.
López-Bueno  R , López-Sánchez  GF , Casajús  JA ,  et al.  Health-related behaviors among school-aged children and adolescents during the Spanish Covid-19 confinement.   Front Pediatr. 2020;8:573. doi:10.3389/fped.2020.00573PubMedGoogle ScholarCrossref
6.
Medrano  M , Cadenas-Sanchez  C , Oses  M , Arenaza  L , Amasene  M , Labayen  I .  Changes in lifestyle behaviours during the COVID-19 confinement in Spanish children: a longitudinal analysis from the MUGI project.   Pediatr Obes. 2021;16(4):e12731. doi:10.1111/ijpo.12731PubMedGoogle Scholar
7.
Pietrobelli  A , Pecoraro  L , Ferruzzi  A ,  et al.  Effects of COVID-19 lockdown on lifestyle behaviors in children with obesity living in Verona, Italy: a longitudinal study.   Obesity (Silver Spring). 2020;28(8):1382-1385. doi:10.1002/oby.22861PubMedGoogle ScholarCrossref
8.
Okely  AD , Kariippanon  KE , Guan  H ,  et al.  Global effect of COVID-19 pandemic on physical activity, sedentary behaviour and sleep among 3- to 5-year-old children: a longitudinal study of 14 countries.   BMC Public Health. 2021;21(1):940. doi:10.1186/s12889-021-10852-3PubMedGoogle ScholarCrossref
9.
Li  X , Vanderloo  LM , Maguire  JL ,  et al; TARGetKids! Collaboration.  Public health preventive measures and child health behaviours during COVID-19: a cohort study.   Can J Public Health. 2021;112(5):831-842. doi:10.17269/s41997-021-00549-wPubMedGoogle ScholarCrossref
10.
Stiglic  N , Viner  RM .  Effects of screentime on the health and well-being of children and adolescents: a systematic review of reviews.   BMJ Open. 2019;9(1):e023191. doi:10.1136/bmjopen-2018-023191PubMedGoogle Scholar
11.
Hoare  E , Milton  K , Foster  C , Allender  S .  The associations between sedentary behaviour and mental health among adolescents: a systematic review.   Int J Behav Nutr Phys Act. 2016;13(1):108. doi:10.1186/s12966-016-0432-4PubMedGoogle ScholarCrossref
12.
Suchert  V , Hanewinkel  R , Isensee  B .  Sedentary behavior and indicators of mental health in school-aged children and adolescents: a systematic review.   Prev Med. 2015;76:48-57. doi:10.1016/j.ypmed.2015.03.026PubMedGoogle ScholarCrossref
13.
Cost  KT , Crosbie  J , Anagnostou  E ,  et al.  Mostly worse, occasionally better: impact of COVID-19 pandemic on the mental health of Canadian children and adolescents.   Eur Child Adolesc Psychiatry. Published online February 26, 2021. doi:10.1007/s00787-021-01744-3PubMedGoogle Scholar
14.
Tandon  PS , Zhou  C , Johnson  AM , Gonzalez  ES , Kroshus  E .  Association of children’s physical activity and screen time with mental health during the COVID-19 pandemic.   JAMA Netw Open. 2021;4(10):e2127892. doi:10.1001/jamanetworkopen.2021.27892PubMedGoogle Scholar
15.
Kowalski  RM , Giumetti  GW , Schroeder  AN , Lattanner  MR .  Bullying in the digital age: a critical review and meta-analysis of cyberbullying research among youth.   Psychol Bull. 2014;140(4):1073-1137. doi:10.1037/a0035618PubMedGoogle ScholarCrossref
16.
Zink  J , Belcher  BR , Imm  K , Leventhal  AM .  The relationship between screen-based sedentary behaviors and symptoms of depression and anxiety in youth: a systematic review of moderating variables.   BMC Public Health. 2020;20(1):472. doi:10.1186/s12889-020-08572-1PubMedGoogle ScholarCrossref
17.
Centers for Disease Control and Prevention. Mental health and coping during COVID-19. Updated July 22, 2021. Accessed May 26, 2021. https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/managing-stress-anxiety.html
18.
Slobodin  O , Heffler  KF , Davidovitch  M .  Screen media and autism spectrum disorder: a systematic literature review.   J Dev Behav Pediatr. 2019;40(4):303-311. doi:10.1097/DBP.0000000000000654PubMedGoogle ScholarCrossref
19.
Chonchaiya  W , Nuntnarumit  P , Pruksananonda  C .  Comparison of television viewing between children with autism spectrum disorder and controls.   Acta Paediatr. 2011;100(7):1033-1037. doi:10.1111/j.1651-2227.2011.02166.xPubMedGoogle ScholarCrossref
20.
Kennedy  CH , Shukla  S .  Social interaction research for people with autism as a set of past, current, and emerging propositions.   Behav Disord. 1995;21(1):21-35. doi:10.1177/019874299502100104Google ScholarCrossref
21.
Carsley  S , Borkhoff  CM , Maguire  JL ,  et al; TARGetKids! Collaboration.  Cohort profile: the applied research group for kids (TARGetKids!).   Int J Epidemiol. 2015;44(3):776-788. doi:10.1093/ije/dyu123PubMedGoogle ScholarCrossref
22.
SickKids. Spit for science. Accessed May 26, 2021. https://lab.research.sickkids.ca/schachar/spit-for-science/
23.
Crosbie  J , Arnold  P , Paterson  A ,  et al.  Response inhibition and ADHD traits: correlates and heritability in a community sample.   J Abnorm Child Psychol. 2013;41(3):497-507. doi:10.1007/s10802-012-9693-9PubMedGoogle ScholarCrossref
24.
Province of Ontario Neurodevelopmental Network. About POND. Accessed May 26, 2021. https://pond-network.ca/about-pond/
25.
Baribeau  DA , Doyle-Thomas  KAR , Dupuis  A ,  et al.  Examining and comparing social perception abilities across childhood-onset neurodevelopmental disorders.   J Am Acad Child Adolesc Psychiatry. 2015;54(6):479-86.e1. doi:10.1016/j.jaac.2015.03.016PubMedGoogle ScholarCrossref
26.
Goodman  R .  The strengths and difficulties questionnaire: a research note.   J Child Psychol Psychiatry. 1997;38(5):581-586. doi:10.1111/j.1469-7610.1997.tb01545.xPubMedGoogle ScholarCrossref
27.
Goodman  A , Goodman  R .  Strengths and difficulties questionnaire as a dimensional measure of child mental health.   J Am Acad Child Adolesc Psychiatry. 2009;48(4):400-403. doi:10.1097/CHI.0b013e3181985068PubMedGoogle ScholarCrossref
28.
Goodman  R .  Psychometric properties of the strengths and difficulties questionnaire.   J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337-1345. doi:10.1097/00004583-200111000-00015PubMedGoogle ScholarCrossref
29.
Oliver  BR .  Unpacking externalising problems: negative parenting associations for conduct problems and irritability.   BJPsych Open. 2015;1(1):42-47. doi:10.1192/bjpo.bp.115.000125PubMedGoogle ScholarCrossref
30.
Sukhodolsky  DG , Smith  SD , McCauley  SA , Ibrahim  K , Piasecka  JB .  Behavioral interventions for anger, irritability, and aggression in children and adolescents.   J Child Adolesc Psychopharmacol. 2016;26(1):58-64. doi:10.1089/cap.2015.0120PubMedGoogle ScholarCrossref
31.
Chorpita  BF , Yim  L , Moffitt  C , Umemoto  LA , Francis  SE .  Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale.   Behav Res Ther. 2000;38(8):835-855. doi:10.1016/S0005-7967(99)00130-8PubMedGoogle ScholarCrossref
32.
Piqueras  JA , Martín-Vivar  M , Sandin  B , San Luis  C , Pineda  D .  The Revised Child Anxiety and Depression Scale: a systematic review and reliability generalization meta-analysis.   J Affect Disord. 2017;218:153-169. doi:10.1016/j.jad.2017.04.022PubMedGoogle ScholarCrossref
33.
Birmaher  B , Khetarpal  S , Brent  D ,  et al.  The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.   J Am Acad Child Adolesc Psychiatry. 1997;36(4):545-553. doi:10.1097/00004583-199704000-00018PubMedGoogle ScholarCrossref
34.
Swanson  JM , Schuck  S , Porter  MM ,  et al.  Categorical and dimensional definitions and evaluations of symptoms of ADHD: history of the SNAP and the SWAN rating scales.   Int J Educ Psychol Assess. 2012;10(1):51-70.PubMedGoogle Scholar
35.
Lakes  KD , Swanson  JM , Riggs  M .  The reliability and validity of the English and Spanish Strengths and Weaknesses of ADHD and Normal Behavior rating scales in a preschool sample: continuum measures of hyperactivity and inattention.   J Atten Disord. 2012;16(6):510-516. doi:10.1177/1087054711413550PubMedGoogle ScholarCrossref
36.
Spitzer  RL , Kroenke  K , Williams  JBW , Löwe  B .  A brief measure for assessing generalized anxiety disorder: the GAD-7.   Arch Intern Med. 2006;166(10):1092-1097. doi:10.1001/archinte.166.10.1092PubMedGoogle ScholarCrossref
37.
Löwe  B , Kroenke  K , Herzog  W , Gräfe  K .  Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9).   J Affect Disord. 2004;81(1):61-66. doi:10.1016/S0165-0327(03)00198-8PubMedGoogle ScholarCrossref
38.
Van Buuren  S , Groothuis-oudshoorn  K.   mice: Multivariate imputation by chained equations in R.   J Stat Softw. 2011;45(3):1-67. doi:10.18637/jss.v045.i03Google Scholar
39.
R Core Team. R: a language and environment for statistical computing. R Foundation for Statistical Computing; 2018. Accessed November 23, 2021. https://www.r-project.org/
40.
American Academy of Pediatrics; Committee on Public Education.  American Academy of Pediatrics: children, adolescents, and television.   Pediatrics. 2001;107(2):423-426. doi:10.1542/peds.107.2.423PubMedGoogle ScholarCrossref
41.
Canadian Paediatric Society. Digital media: promoting healthy screen use in school-aged children and adolescents. June 6, 2019. Accessed May 13, 2021. https://cps.ca/documents/position/digital-media
42.
Patterson  J , Barlow  J , Mockford  C , Klimes  I , Pyper  C , Stewart-Brown  S .  Improving mental health through parenting programmes: block randomised controlled trial.   Arch Dis Child. 2002;87(6):472-477. doi:10.1136/adc.87.6.472PubMedGoogle ScholarCrossref
43.
Parkes  A , Sweeting  H , Wight  D , Henderson  M .  Do television and electronic games predict children’s psychosocial adjustment? longitudinal research using the UK Millennium Cohort Study.   Arch Dis Child. 2013;98(5):341-348. doi:10.1136/archdischild-2011-301508PubMedGoogle ScholarCrossref
44.
Christakis  DA , Zimmerman  FJ , DiGiuseppe  DL , McCarty  CA .  Early television exposure and subsequent attentional problems in children.   Pediatrics. 2004;113(4):708-713. doi:10.1542/peds.113.4.708PubMedGoogle ScholarCrossref
45.
Swing  EL , Gentile  DA , Anderson  CA , Walsh  DA .  Television and video game exposure and the development of attention problems.   Pediatrics. 2010;126(2):214-221. doi:10.1542/peds.2009-1508PubMedGoogle ScholarCrossref
46.
Mistry  KB , Minkovitz  CS , Strobino  DM , Borzekowski  DLG .  Children’s television exposure and behavioral and social outcomes at 5.5 years: does timing of exposure matter?   Pediatrics. 2007;120(4):762-769. doi:10.1542/peds.2006-3573PubMedGoogle ScholarCrossref
47.
Verlinden  M , Tiemeier  H , Hudziak  JJ ,  et al.  Television viewing and externalizing problems in preschool children: the Generation R Study.   Arch Pediatr Adolesc Med. 2012;166(10):919-925. doi:10.1001/archpediatrics.2012.653PubMedGoogle ScholarCrossref
48.
Landhuis  CE , Poulton  R , Welch  D , Hancox  RJ .  Does childhood television viewing lead to attention problems in adolescence? results from a prospective longitudinal study.   Pediatrics. 2007;120(3):532-537. doi:10.1542/peds.2007-0978PubMedGoogle ScholarCrossref
49.
Primack  BA , Swanier  B , Georgiopoulos  AM , Land  SR , Fine  MJ .  Association between media use in adolescence and depression in young adulthood: a longitudinal study.   Arch Gen Psychiatry. 2009;66(2):181-188. doi:10.1001/archgenpsychiatry.2008.532PubMedGoogle ScholarCrossref
50.
Twenge  JM , Joiner  TE , Rogers  ML , Martin  GN .  Increases in depressive symptoms, suicide-related outcomes, and suicide rates among U.S. adolescents after 2010 and links to increased new media screen time.   Clin Psychol Sci. 2018;6(1):3-17. doi:10.1177/2167702617723376Google ScholarCrossref
51.
Boers  E , Afzali  MH , Newton  N , Conrod  P .  Association of screen time and depression in adolescence.   JAMA Pediatr. 2019;173(9):853-859. doi:10.1001/jamapediatrics.2019.1759PubMedGoogle ScholarCrossref
52.
Sanders  T , Parker  PD , Del Pozo-Cruz  B , Noetel  M , Lonsdale  C .  Type of screen time moderates effects on outcomes in 4013 children: evidence from the Longitudinal Study of Australian Children.   Int J Behav Nutr Phys Act. 2019;16(1):117. doi:10.1186/s12966-019-0881-7PubMedGoogle ScholarCrossref
53.
Johnson  JG , Cohen  P , Kasen  S , Brook  JS .  Extensive television viewing and the development of attention and learning difficulties during adolescence.   Arch Pediatr Adolesc Med. 2007;161(5):480-486. doi:10.1001/archpedi.161.5.480PubMedGoogle ScholarCrossref
54.
Kim  S , Favotto  L , Halladay  J , Wang  L , Boyle  MH , Georgiades  K .  Differential associations between passive and active forms of screen time and adolescent mood and anxiety disorders.   Soc Psychiatry Psychiatr Epidemiol. 2020;55(11):1469-1478. doi:10.1007/s00127-020-01833-9PubMedGoogle ScholarCrossref
55.
Fors  PQ , Barch  DM .  Differential relationships of child anxiety and depression to child report and parent report of electronic media use.   Child Psychiatry Hum Dev. 2019;50(6):907-917. doi:10.1007/s10578-019-00892-7PubMedGoogle ScholarCrossref
56.
Cao  H , Qian  Q , Weng  T ,  et al.  Screen time, physical activity and mental health among urban adolescents in China.   Prev Med. 2011;53(4-5):316-320. doi:10.1016/j.ypmed.2011.09.002PubMedGoogle ScholarCrossref
57.
Mundy  LK , Canterford  L , Olds  T , Allen  NB , Patton  GC .  The association between electronic media and emotional and behavioral problems in late childhood.   Acad Pediatr. 2017;17(6):620-624. doi:10.1016/j.acap.2016.12.014PubMedGoogle ScholarCrossref
58.
Casiano  H , Jolene Kinley  D , Katz  LY , Chartier  MJ , Sareen  J .  Media use and health outcomes in adolescents: findings from a nationally representative survey.   J Can Acad Child Adolesc Psychiatry. 2012;21(4):296-301.PubMedGoogle Scholar
59.
Mathers  M , Canterford  L , Olds  T , Hesketh  K , Ridley  K , Wake  M .  Electronic media use and adolescent health and well-being: cross-sectional community study.   Acad Pediatr. 2009;9(5):307-314. doi:10.1016/j.acap.2009.04.003PubMedGoogle ScholarCrossref
60.
Chan  PA , Rabinowitz  T .  A cross-sectional analysis of video games and attention deficit hyperactivity disorder symptoms in adolescents.   Ann Gen Psychiatry. 2006;5:16. doi:10.1186/1744-859X-5-16PubMedGoogle ScholarCrossref
61.
Ferguson  CJ .  The influence of television and video game use on attention and school problems: a multivariate analysis with other risk factors controlled.   J Psychiatr Res. 2011;45(6):808-813. doi:10.1016/j.jpsychires.2010.11.010PubMedGoogle ScholarCrossref
62.
Goldfield  GS , Murray  M , Maras  D ,  et al.  Screen time is associated with depressive symptomatology among obese adolescents: a HEARTY study.   Eur J Pediatr. 2016;175(7):909-919. doi:10.1007/s00431-016-2720-zPubMedGoogle ScholarCrossref
63.
Brunborg  GS , Mentzoni  RA , Frøyland  LR .  Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems?   J Behav Addict. 2014;3(1):27-32. doi:10.1556/JBA.3.2014.002PubMedGoogle ScholarCrossref
64.
Maras  D , Flament  MF , Murray  M ,  et al.  Screen time is associated with depression and anxiety in Canadian youth.   Prev Med. 2015;73:133-138. doi:10.1016/j.ypmed.2015.01.029PubMedGoogle ScholarCrossref
65.
Wu  X , Bastian  K , Ohinmaa  A , Veugelers  P .  Influence of physical activity, sedentary behavior, and diet quality in childhood on the incidence of internalizing and externalizing disorders during adolescence: a population-based cohort study.   Ann Epidemiol. 2018;28(2):86-94. doi:10.1016/j.annepidem.2017.12.002PubMedGoogle ScholarCrossref
66.
Gentile  DA , Swing  EL , Lim  CG , Khoo  A .  Video game playing, attention problems, and impulsiveness: evidence of bidirectional causality.   Psychol Pop Media Cult. 2012;1(1):62-70. doi:10.1037/a0026969Google ScholarCrossref
67.
Mentzoni  RA , Brunborg  GS , Molde  H ,  et al.  Problematic video game use: estimated prevalence and associations with mental and physical health.   Cyberpsychol Behav Soc Netw. 2011;14(10):591-596. doi:10.1089/cyber.2010.0260PubMedGoogle ScholarCrossref
68.
Rehbein  F , Kleimann  M , Mössle  T .  Prevalence and risk factors of video game dependency in adolescence: results of a German nationwide survey.   Cyberpsychol Behav Soc Netw. 2010;13(3):269-277. doi:10.1089/cyber.2009.0227PubMedGoogle ScholarCrossref
69.
Black  E , Ferdig  R , Thompson  LA .  K-12 virtual schooling, COVID-19, and student success.   JAMA Pediatr. 2021;175(2):119-120. doi:10.1001/jamapediatrics.2020.3800PubMedGoogle ScholarCrossref
70.
Dhawan  S.   Online learning: a panacea in the time of COVID-19 crisis.   J Educ Technol Syst. 2020;49(1):5-22. doi:10.1177/0047239520934018Google ScholarCrossref
71.
Verlenden  JV , Pampati  S , Rasberry  CN ,  et al.  Association of children’s mode of school instruction with child and parent experiences and well-being during the COVID-19 pandemic: COVID experiences survey, United States, October 8-November 13, 2020.   MMWR Morb Mortal Wkly Rep. 2021;70(11):369-376. doi:10.15585/mmwr.mm7011a1PubMedGoogle ScholarCrossref
72.
Orben  A , Tomova  L , Blakemore  SJ .  The effects of social deprivation on adolescent development and mental health.   Lancet Child Adolesc Health. 2020;4(8):634-640. doi:10.1016/S2352-4642(20)30186-3PubMedGoogle ScholarCrossref
73.
Drouin  M , McDaniel  BT , Pater  J , Toscos  T .  How parents and their children used social media and technology at the beginning of the COVID-19 pandemic and associations with anxiety.   Cyberpsychol Behav Soc Netw. 2020;23(11):727-736. doi:10.1089/cyber.2020.0284PubMedGoogle ScholarCrossref
74.
Ellis  WE , Dumas  TM , Forbes  LM .  Physically isolated but socially connected: psychological adjustment and stress among adolescents during the initial COVID-19 crisis.   Can J Behav Sci. 2020;52(3):177-187. doi:10.1037/cbs0000215Google ScholarCrossref
75.
Allen  MS , Vella  SA .  Screen-based sedentary behaviour and psychosocial well-being in childhood: cross-sectional and longitudinal associations.   Ment Health Phys Act. 2015;9:41-47. doi:10.1016/j.mhpa.2015.10.002Google ScholarCrossref
76.
Bélair  MA , Kohen  DE , Kingsbury  M , Colman  I .  Relationship between leisure time physical activity, sedentary behaviour and symptoms of depression and anxiety: evidence from a population-based sample of Canadian adolescents.   BMJ Open. 2018;8(10):e021119. doi:10.1136/bmjopen-2017-021119PubMedGoogle Scholar
77.
Hinkley  T , Verbestel  V , Ahrens  W ,  et al; IDEFICS Consortium.  Early childhood electronic media use as a predictor of poorer well-being: a prospective cohort study.   JAMA Pediatr. 2014;168(5):485-492. doi:10.1001/jamapediatrics.2014.94PubMedGoogle ScholarCrossref
78.
Kleppang  AL , Thurston  M , Hartz  I , Hagquist  C .  Psychological distress among Norwegian adolescents: changes between 2001 and 2009 and associations with leisure time physical activity and screen-based sedentary behaviour.   Scand J Public Health. 2019;47(2):166-173. doi:10.1177/1403494817716374PubMedGoogle ScholarCrossref
79.
Robinson  M , Kendall  GE , Jacoby  P ,  et al.  Lifestyle and demographic correlates of poor mental health in early adolescence.   J Paediatr Child Health. 2011;47(1-2):54-61. doi:10.1111/j.1440-1754.2010.01891.xPubMedGoogle ScholarCrossref
80.
Vanderloo  LM , Carsley  S , Aglipay  M , Cost  KT , Maguire  J , Birken  CS .  Applying harm reduction principles to address screen time in young children amidst the COVID-19 pandemic.   J Dev Behav Pediatr. 2020;41(5):335-336. doi:10.1097/DBP.0000000000000825PubMedGoogle ScholarCrossref
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