Table 4. Association of TV or Digital Media Time and Video Game Time With Child Mental Health Domains in Older Children (Spit for Science, SickKids Psychiatry and POND Cohorts) During COVID-19 From May 21, 2020, to April 9, 2021a.
| Child screen use, h/d | TV or digital media | Video game | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Unadjusted | Adjustedb | Post hoc adjustedc | Unadjusted | Adjustedb | Post hoc adjustedc | |||||||
| β (95% CI) | P value | β (95% CI) | P value | β (95% CI) | P value | β (95% CI) | P value | β (95% CI) | P value | β (95% CI) | P value | |
| Depression (RCADS-P T-score)d | ||||||||||||
| 1 h | 0.56 (−0.97 to 2.09) | <.001 | 0.21 (−1.28 to 0.78) | <.001 | 0.14 (−1.34 to 1.63) | <.001 | 0.90 (−0.08 to 1.88) | <.001 | 0.81 (−0.15 to 1.77) | <.001 | 0.74 (−0.21 to 1.69) | <.001 |
| 2-3 h | 2.66 (1.12 to 4.21) | 1.81 (0.29 to 3.33) | 1.69 (0.18 to 3.19) | 3.45 (2.39 to 4.51) | 2.73 (1.69 to 3.78) | 2.54 (1.51 to 3.57) | ||||||
| 4-5 h | 4.28 (2.63 to 5.92) | 2.80 (1.15 to 4.44) | 2.59 (0.96 to 4.21) | 5.71 (4.33 to 7.09) | 4.64 (3.27 to 6.02) | 4.30 (2.94 to 5.66) | ||||||
| 6-8 h | 6.87 (5.05 to 8.69) | 5.16 (3.32 to 7.01) | 4.90 (3.07 to 6.72) | 8.23 (6.37 to 10.09) | 6.73 (4.89 to 8.57) | 6.28 (4.46 to 8.09) | ||||||
| ≥9 h | 7.46 (5.36 to 9.57) | 5.42 (3.30 to 7.54) | 5.08 (2.00 to 7.18) | 8.18 (5.66 to 10.70) | 5.99 (3.48 to 8.50) | 5.17 (2.69 to 7.64) | ||||||
| Anxiety (SCARED score)d | ||||||||||||
| 1 h | 0.09 (−0.33 to 0.51) | <.001 | 0.10 (−0.32 to 0.52) | .003 | 0.07 (−0.35 to 0.49) | .01 | 0.03 (−0.24 to 0.31) | .89 | 0.10 (−0.18 to 0.37) | .90 | 0.08 (−0.19 to 0.35) | .92 |
| 2-3 h | 0.34 (−0.09 to 0.76) | 0.33 (−0.10 to 0.75) | 0.29 (−0.14 to 0.71) | 0.16 (−0.14 to 0.46) | 0.18 (−0.12 to 0.48) | 0.12 (−0.17 to 0.42) | ||||||
| 4-5 h | 0.54 (0.09 to 0.99) | 0.48 (0.01 to 0.95) | 0.41 (−0.06 to 0.87) | 0.15 (−0.23 to 0.54) | 0.17 (−0.23 to 0.56) | 0.04 (−0.35 to 0.43) | ||||||
| 6-8 h | 0.95 (0.45 to 1.45) | 0.90 (0.37 to 1.42) | 0.80 (0.29 to 1.32) | 0.07 (−0.45 to 0.59) | 0.04 (−0.48 to 0.57) | −0.10 (−0.61 to 0.42) | ||||||
| ≥9 h | 0.74 (0.16 to 1.32) | 0.66 (0.06 to 1.26) | 0.53 (−0.06 to 1.13) | 0.26 (−0.44 to 0.97) | 0.20 (−0.52 to 0.92) | −0.03 (−0.74 to 0.67) | ||||||
| Irritability (TIDES score) | ||||||||||||
| 1 h | −0.32 (−1.79 to 1.16) | <.001 | −0.42 (−1.88 to 1.04) | .001 | −0.23 (−1.60 to 1.15) | .007 | 0.92 (0.16 to 1.67) | <.001 | 0.97 (0.21 to 1.73) | .04 | 0.69 (−0.03 to 1.40) | .18 |
| 2-3 h | 0.45 (−0.95 to 1.84) | 0.23 (−1.15 to 1.61) | 0.25 (−1.06 to 1.56) | 0.88 (0.11 to 1.65) | 0.87 (0.09 to 1.65) | 0.40 (−0.33 to 1.13) | ||||||
| 4-5 h | 1.22 (−0.22 to 2.67) | 0.79 (−0.65 to 2.23) | 0.71 (−0.65 to 2.07) | 1.90 (0.90 to 2.91) | 1.72 (0.69 to 2.76) | 1.19 (0.22 to 2.15) | ||||||
| 6-8 h | 1.75 (0.21 to 3.29) | 1.18 (−0.36 to 2.72) | 1.08 (−0.38 to 2.54) | 2.27 (0.91 to 3.64) | 1.93 (0.54 to 3.32) | 0.72 (−0.57 to 2.00) | ||||||
| ≥9 h | 2.67 (1.01 to 4.33) | 2.22 (0.56 to 3.89) | 1.92 (0.35 to 3.50) | 2.39 (0.64 to 4.15) | 2.24 (0.46 to 4.03) | 1.13 (−0.53 to 2.78) | ||||||
| Inattention/hyperactivity (SWAN total score) | ||||||||||||
| 1 h | 2.04 (−1.82 to 5.90) | .007 | 1.31 (−2.42 to 5.05) | .009 | 0.88 (−2.78 to 4.55) | .02 | 2.29 (0.22 to 4.36) | <.001 | 1.62 (−0.39 to 3.62) | .03 | 1.26 (−0.70 to 3.23) | .13 |
| 2-3 h | 1.11 (−2.54 to 4.77) | 0.76 (−2.79 to 4.30) | 0.37 (−3.10 to 3.85) | 3.97 (1.83 to 6.10) | 2.15 (0.07 to 4.24) | 1.54 (−0.49 to 3.58) | ||||||
| 4-5 h | 3.88 (0.08 to 7.68) | 3.78 (0.07 to 7.49) | 3.08 (−0.56 to 6.72) | 5.73 (2.88 to 8.57) | 3.89 (1.09 to 6.70) | 3.15 (0.42 to 5.88) | ||||||
| 6-8 h | 2.77 (−1.32 to 6.87) | 3.22 (−0.81 to 7.25) | 2.58 (−1.37 to 6.54) | 8.61 (4.72 to 12.50) | 5.45 (1.61 to 9.29) | 4.27 (0.50 to 8.04) | ||||||
| ≥9 h | 5.63 (1.21 to 10.06) | 4.61 (0.22 to 9.00) | 4.13 (−0.17 to 8.43) | 9.90 (4.90 to 14.89) | 6.25 (1.34 to 11.16) | 4.95 (0.17 to 9.73) | ||||||
| Inattention (SWAN inattentive subscale) | ||||||||||||
| 1 h | 1.95 (−0.23 to 4.12) | .003 | 1.54 (−0.58 to 3.65) | .02 | 1.27 (−0.30 to 3.34) | .04 | 1.04 (−0.12 to 2.20) | <.001 | 0.74 (−0.40 to 1.87) | .03 | 0.54 (−0.57 to 1.65) | .13 |
| 2-3 h | 1.59 (−0.47 to 3.65) | 1.26 (−0.57 to 3.26) | 1.01 (−0.95 to 2.97) | 2.26 (1.07 to 3.45) | 1.32 (0.14 to 2.49) | 0.98 (−0.17 to 2.12) | ||||||
| 4-5 h | 2.88 (0.74 to 5.02) | 2.58 (0.47 to 4.68) | 2.15 (0.09 to 4.21) | 3.34 (1.76 to 4.93) | 2.26 (0.68 to 3.84) | 1.83 (0.29 to 3.36) | ||||||
| 6-8 h | 2.56 (0.25 to 4.86) | 2.43 (0.15 to 4.71) | 2.01 (−0.22 to 4.25) | 4.70 (2.52 to 6.88) | 2.79 (0.62 to 4.96) | 2.09 (−0.03 to 4.22) | ||||||
| ≥9 h | 4.38 (1.89 to 6.87) | 3.43 (0.95 to 5.91) | 3.11 (0.68 to 5.54) | 6.11 (3.32 to 8.90) | 3.71 (0.94 to 6.48) | 2.95 (0.25 to 5.64) | ||||||
| Hyperactivity/impulsivity (SWAN hyperactive/impulsive subscale) | ||||||||||||
| 1 h | 0.08 (−2.02 to 2.17) | .04 | −0.30 (−2.33 to 1.73) | .01 | −0.49 (−2.48 to 1.51) | .03 | 1.33 (0.21 to 2.45) | <.001 | 0.92 (−0.17 to 2.00) | .04 | 0.74 (−0.33 to 1.80) | .21 |
| 2-3 h | −0.36 (−2.34 to 1.63) | −0.47 (−2.39 to 1.45) | −0.64 (−2.53 to 1.25) | 1.97 (0.82 to 3.11) | 0.94 (−0.18 to 2.06) | 0.62 (−0.48 to 1.72) | ||||||
| 4-5 h | 1.17 (−0.90 to 3.23) | 1.23 (−0.78 to 3.25) | 0.90 (−1.07 to 2.88) | 2.74 (1.21 to 4.26) | 1.77 (0.27 to 3.28) | 1.40 (−0.07 to 2.87) | ||||||
| 6-8 h | 0.57 (−1.65 to 2.79) | 0.97 (−1.21 to 3.16) | 0.67 (−1.48 to 2.81) | 4.50 (2.41 to 6.60) | 2.89 (0.82 to 4.96) | 2.30 (0.26 to 4.34) | ||||||
| ≥9 h | 1.53 (−0.87 to 3.94) | 1.22 (−1.15 to 3.60) | 1.01 (−1.33 to 3.35) | 4.48 (1.79 to 7.16) | 2.86 (0.23 to 5.50) | 2.18 (−0.40 to 4.76) | ||||||
Abbreviations: ASD, autism spectrum disorder; GAD-7, Generalized Anxiety Disorder Scale; PHQ-8, Patient Health Questionnaire; RCADS-P, Revised Children’s Anxiety and Depression Scale–Parent Version; SCARED, Screen for Child Anxiety Related Disorders; SWAN, Strengths and Weaknesses of Attention-Deficit/Hyperactivity Disorder Symptoms and Normal Behavior Scale; TIDES, The Irritability and Dysregulation of Emotions Questionnaire; TV, television.
a
The reference group was 0 to 30 minutes per day.
b
Adjusted for child age (measured at mental health outcomes), child sex, child ancestry, family income, previous ASD diagnosis, calendar date, GAD-7, and PHQ-8.
c
Adjusted for child age (measured at mental health outcomes), child sex, child ancestry, family income, previous ASD diagnosis, calendar date, GAD-7, PHQ-8, and previous mental health (depression, anxiety, obsessive compulsive disorder, and attention-deficit/hyperactivity disorder) diagnosis.
d
The Bonferroni-corrected α is .0125 after adjusting for multiple (4) comparisons.