Association of Screen Time and Depression in Adolescence
Association of Screen Time and Depression in Adolescence
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DOI：
10.1001/jamapediatrics.2019.1759
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发表时间：
2019-09-01
期刊：
影响因子：
26.1
通讯作者：
Conrod, Patricia
中科院分区：
文献类型：
--
作者：
Boers, Elroy;Afzali, Mohammad H.;Conrod, Patricia
重要性屏幕时间的增加已被发现与抑郁症状的增加有关。然而，纵向studies are lacking.OBJECTIVE要反复测量屏幕时间和抑郁症之间的关联，以测试3个解释性假说：位移，向上的社会比较，并加强spirals.DESIGN，设置，和参与者这二次分析使用的数据从一个随机临床试验评估4年的疗效的个性有针对性的药物和酒精预防干预。这项研究评估了屏幕时间和抑郁症在整个4年，使用在大蒙特利尔地区的31所学校进入七年级的青少年样本的年度调查。数据收集时间为2012年9月至2018年9月。分析于2018年12月开始和结束。主要结果和指标自变量是社交媒体、电视、视频游戏和计算机使用。抑郁症状是结果，使用简明症状量表测量。运动和自尊进行了评估，以测试位移和向上的社会比较hypothesis.RESULTS，共有3826名青少年（1798名女孩[47%]，平均[SD]年龄，12.7 [0.5]年）。一般而言，抑郁症状每年增加（第1年平均值[SD]，4.29 [5.10]分;第4年平均值[SD]，5.45 [5.93]分）。多层次模型，包括在学校和个人层面的随机拦截，估计了屏幕时间和抑郁之间的人与人之间和人与人之间的关联。显著的人与人之间的关联表明，使用社交媒体的时间每增加一小时，青少年的抑郁症状就会增加0.64个单位（95%CI，0.32-0.51）。报告了计算机使用的相似水平间关联（0.69; 95%CI，0.47-0.91）。显着的人内关联显示，在给定的一年中，社交媒体使用的进一步增加1小时与同年抑郁症状的进一步增加0.41单位相关。在电视上也发现了类似的人内关联（0.18; 95%CI，0.09-0.27）。屏幕时间与锻炼和自尊之间的显着的人与人之间和人与人之间的关联支持向上的社会比较，而不是位移假说。此外，一个显着的人与人之间的相互作用，关于社会媒体和自尊支持加强螺旋hypothesis.CONCLUSIONS AND RELEVANCE社交媒体，电视和抑郁症之间的时变关联被发现，这似乎是更多的解释向上的社会比较和加强螺旋假说比位移假说。在制定预防措施和向父母提供建议时，应考虑到这两种屏幕时间模式。
IMPORTANCE Increases in screen time have been found to be associated with increases in depressive symptoms. However, longitudinal studies are lacking.OBJECTIVE To repeatedly measure the association between screen time and depression to test 3 explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals.DESIGN, SETTING, AND PARTICIPANTS This secondary analysis used data from a randomized clinical trial assessing the 4-year efficacy of a personality-targeted drug and alcohol prevention intervention. This study assessed screen time and depression throughout 4 years, using an annual survey in a sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. Data were collected from September 2012 to September 2018. Analysis began and ended in December 2018.MAIN OUTCOMES AND MEASURES Independent variables were social media, television, video gaming, and computer use. Symptoms of depression was the outcome, measured using the Brief Symptoms Inventory. Exercise and self-esteem were assessed to test displacement and upward social comparison hypothesis.RESULTS A total of 3826 adolescents (1798 girls [47%]; mean [SD] age, 12.7 [0.5] years) were included. In general, depression symptoms increased yearly (year 1 mean [SD], 4.29 [5.10] points; year 4 mean [SD], 5.45 [5.93] points). Multilevel models, which included random intercepts at the school and individual level estimated between-person and within-person associations between screen time and depression. Significant between-person associations showed that for every increased hour spent using social media, adolescents showed a 0.64-unit increase in depressive symptoms (95% CI, 0.32-0.51). Similar between-level associations were reported for computer use (0.69; 95% CI, 0.47-0.91). Significant within-person associations revealed that a further 1-hour increase in social media use in a given year was associated with a further 0.41-unit increase in depressive symptoms in that same year. A similar within-person association was found for television (0.18; 95% CI, 0.09-0.27). Significant between-person and within-person associations between screen time and exercise and self-esteem supported upward social comparison and not displacement hypothesis. Furthermore, a significant interaction between the between-person and within-person associations concerning social media and self-esteem supported reinforcing spirals hypothesis.CONCLUSIONS AND RELEVANCE Time-varying associations between social media, television, and depression were found, which appeared to be more explained by upward social comparison and reinforcing spirals hypotheses than by the displacement hypothesis. Both screen time modes should be taken into account when developing preventive measures and when advising parents.