Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Association Between Screen Overuse and Behavioral and Emotional Problems in Elementary School Children

  • Choi, Yeonkyu (Department of Psychiatry, Ajou University School of Medicine) ;
  • Lee, Dong Yun (Department of Biomedical Informatics, Ajou University School of Medicine) ;
  • Lee, Sangha (Department of Psychiatry, Ajou University School of Medicine) ;
  • Park, Eun-Jin (Department of Psychiatry, Inje University Ilsan Paik Hospital) ;
  • Yoo, Hee Jeong (Department of Psychiatry, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Shin, Yunmi (Department of Psychiatry, Ajou University School of Medicine)
  • Received : 2021.05.13
  • Accepted : 2021.08.18
  • Published : 2021.10.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: This study identified the association between excessive exposure to screen media and behavioral and emotional problems in elementary school students. Methods: A total of 331 parents of children aged 7-10 years were recruited from "The Kids Cohort for Understanding of Internet Addiction Risk Factors in Early Childhood (K-CURE)" study. Children's demographics, household media ownership, screen time, and behavioral/emotional problems were assessed using a parental questionnaire. Children's behavior/emotional problems were measured using the Korean version the of Child Behavior Checklist (K-CBCL) score. Results: The total K-CBCL score in the screen overuse group was 51.18±9.55, significantly higher than 47.28±10.09 in the control group (t=2.14, p=0.05). For each subscale, the externalization score (51.65±10.14, 48.33±8.97, respectively; t=2.02, p<0.05), social problem score (55.41±6.11, 53.24±5.19, respectively; t=2.27, p<0.05), and rule breaking behavior score (55.71±6.11, 53.24±5.19, respectively; t=2.27, p<0.05) were significantly higher in the screen overuse group than in the control group. In addition, the screen overuse group also had a significantly higher usage rate than the control group, even if limited to smartphones, not only on weekdays (3.56±2.08, 1.87±2.02, respectively; t=-4.597, p<0.001) but also weekends (1.62±0.74, 1.19±0.83, respectively; t=-3.14, p=0.003). Conclusion: The study suggested that screen media overuse patterns in children in Korea are particularly relevant to the excessive use of smartphones and are related to higher risks of emotional and behavioral problems.

Keywords

Acknowledgement

This research was supported by the grant from the Korean Mental Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HL19C0012).

References

  1. Stiglic N, Viner RM. Effects of screentime on the health and wellbeing of children and adolescents: a systematic review of reviews. BMJ Open 2019;9:e023191. https://doi.org/10.1136/bmjopen-2018-023191
  2. Gottschalk F. Impacts of technology use on children: exploring literature on the brain, cognition and well-being. OECD Education Working Papers No. 195 [Internet]. Paris: OECD Publishing;2019 [cited 2021 March 15]. Available from: https://doi. org/10.1787/8296464e-en.
  3. Twenge JM, Martin GN, Spitzberg BH. Trends in US adolescents' media use, 1976-2016: the rise of digital media, the decline of TV, and the (near) demise of print. Psychol Pop Media Cult 2019;8:329-345. https://doi.org/10.1037/ppm0000203
  4. Genuneit J, Brockmann PE, Schlarb AA, Rothenbacher D. Media consumption and sleep quality in early childhood: results from the Ulm SPATZ health study. Sleep Med 2018;45:7-10. https://doi.org/10.1016/j.sleep.2017.10.013
  5. Vijakkhana N, Wilaisakditipakorn T, Ruedeekhajorn K, Pruksananonda C, Chonchaiya W. Evening media exposure reduces night-time sleep. Acta Paediatr 2015;104:306-312. https://doi.org/10.1111/apa.12904
  6. Miguel-Berges ML, Santaliestra-Pasias AM, Mouratidou T, Androutsos O, de Craemer M, Pinket AS, et al. Associations between food and beverage consumption and different types of sedentary behaviours in European preschoolers: the ToyBox-study. Eur J Nutr 2017;56:1939-1951. https://doi.org/10.1007/s00394-016-1236-7
  7. Wu X, Tao S, Rutayisire E, Chen Y, Huang K, Tao F. The relationship between screen time, nighttime sleep duration, and behavioural problems in preschool children in China. Eur Child Adolesc Psychiatry 2017;26:541-548. https://doi.org/10.1007/s00787-016-0912-8
  8. Ribner A, Fitzpatrick C, Blair C. Family socioeconomic status moderates associations between television viewing and school readi-ness skills. J Dev Behav Pediatr 2017;38:233-239. https://doi.org/10.1097/DBP.0000000000000425
  9. Carson V, Rahman AA, Wiebe SA. Associations of subjectively and objectively measured sedentary behavior and physical activity with cognitive development in the early years. Ment Health Phys Act 2017;13:1-8. https://doi.org/10.1016/j.mhpa.2017.05.003
  10. Council on Communications and Media. Media use by children younger than 2 years. Pediatrics 2011;128:1040-1045. https://doi.org/10.1542/peds.2011-1753
  11. World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age [Internet]. Geneva: World Health Organization;2019 [cited 2021 March 15]. Available from: https://www.who.int/publications/i/item/9789241550536/.
  12. Taylor K, Silver L. Smartphone ownership is growing rapidly around the world, but not always equally [Internet]. Washington: Pew Research Center;2019 [cited 2021 March 15]. Available from: https:// www.pewresearch.org/global/2019/02/05/smartphone-ownershipis-growing-rapidly-around-the-world-but-not-always-equally/.
  13. Ministry of Science and ICT. The survey on smartphone overdependence 2018 [Internet]. Gwacheon: Ministry of Science and ICT;2018 [cited 2021 March 15]. Available from: https://www.nia.or.kr/site/nia_kor/ex/bbs/View.do?cbIdx=65914&bcIdx=20876&parentSeq=20876.
  14. Auxier B, Anderson M, Perrin A, Turner E. Parenting children in the age of screens [Internet]. Washington: Pew Research Center;2020 [cited 2021 March 15]. Available from: https://www.pewresearch. org/internet/2020/07/28/parenting-children-in-the-age-of-screens/.
  15. Oh K, Lee H, Hong K, Ha E. Korean version of Child Behavior Checklist (K-CBCL). Seoul: Chung Ang Aptitude Publishing Co;1997.
  16. Achenbach TM, Ruffle TM. The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies. Pediatr Rev 2000;21:265-271. https://doi.org/10.1542/pir.21-8-265
  17. Kim M, Lee J, Kim Y, Ha E, Oh K. Secular changes in behavior problems of Korean youths based on the Korean-CBCL and-YSR. Kor J Psychol 2015;34:769-793.
  18. Tremblay MS, Carson V, Chaput JP, Connor Gorber S, Dinh T, Duggan M, et al. Canadian 24-hour Movement Guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Appl Physiol Nutr Metab 2016;41:S311-S327.
  19. Korea Communications Commission. A survey on broadcast media usage behavior in 2019 [Internet]. Gwacheon: Korea Communications Commission;2020 [cited 2021 March 15]. Available from: https://kcc.go.kr/user.do?mode=view&page=A02060100&dc=60100&boardId=1027&cp=1&boardSeq=48358.
  20. Australian Government Department of Health. Guidelines for healthy growth & development for children & young people (5 to 17 years): a guide for parents & educators [Internet]. Canberra: Australian Government Department of Health;2014 [cited 2021 March 15]. Available from: https://www.health.gov.au/sites/default/files/documents/2021/05/24-hour-movement-guidelines-children-and-young-people-5-to-17-years-brochure.pdf.
  21. Tandon PS, Zhou C, Sallis JF, Cain KL, Frank LD, Saelens BE. Home environment relationships with children's physical activity, sedentary time, and screen time by socioeconomic status. Int J Behav Nutr Phys Act 2012;9:88. https://doi.org/10.1186/1479-5868-9-88
  22. Chen W, Adler JL. Assessment of screen exposure in young children, 1997 to 2014. JAMA Pediatr 2019;173:391-393. https://doi.org/10.1001/jamapediatrics.2018.5546
  23. Bucksch J, Sigmundova D, Hamrik Z, Troped PJ, Melkevik O, Ahluwalia N, et al. International trends in adolescent screen-time behaviors From 2002 to 2010. J Adolesc Health 2016;58:417-425. https://doi.org/10.1016/j.jadohealth.2015.11.014
  24. Nigg CR, Wunsch K, Nigg C, Niessner C, Jekauc D, Schmidt SCE, et al. Are physical activity, screen time, and mental health related during childhood, preadolescence, and adolescence? 11-year results from the German Motorik-Modul longitudinal study. Am J Epidemiol 2021;190:220-229. https://doi.org/10.1093/aje/kwaa192
  25. Kim Y. Analysis of mobile phone possession and use behavior of children and adolescents. KISDI STAT Report 2019;19:1-7 [Epub]. Available from: https://www.kisdi.re.kr/report/view.do?key=m2101113025790&arrMasterId=4333447&masterId=4333447&artId=554166.
  26. Martin CA, Kelly TH, Rayens MK, Brogli B, Himelreich K, Brenzel A, et al. Sensation seeking and symptoms of disruptive disorder: association with nicotine, alcohol, and marijuana use in early and mid-adolescence. Psychol Rep 2004;94:1075-1082. https://doi.org/10.2466/pr0.94.3.1075-1082
  27. Wang P, Lei L, Wang X, Nie J, Chu X, Jin S. The exacerbating role of perceived social support and the "buffering" role of depression in the relation between sensation seeking and adolescent smartphone addiction. Pers Individ Differ 2018;130:129-134. https://doi.org/10.1016/j.paid.2018.04.009
  28. Jensen JD, Weaver AJ, Ivic R, Imboden K. Developing a brief sensation seeking scale for children: establishing concurrent validity with video game use and rule-breaking behavior. Media Psychol 2011;14:71-95. https://doi.org/10.1080/15213269.2010.547831
  29. Harden KP, Patterson MW, Briley DA, Engelhardt LE, Kretsch N, Mann FD, et al. Developmental changes in genetic and environmental influences on rule-breaking and aggression: age and pubertal development. J Child Psychol Psychiatry 2015;56:1370-1379. https://doi.org/10.1111/jcpp.12419
  30. Tansriratanawong S, Louthrenoo O, Chonchaiya W, Charnsil C. Screen viewing time and externalising problems in pre-school children in Northern Thailand. J Child Adolesc Ment Health 2017;29:245-252. https://doi.org/10.2989/17280583.2017.1409226
  31. Yilmaz G, Demirli Caylan N, Karacan CD. An intervention to preschool children for reducing screen time: a randomized controlled trial. Child Care Health Dev 2015;41:443-449. https://doi.org/10.1111/cch.12133
  32. Sourander A, Helstela L. Childhood predictors of externalizing and internalizing problems in adolescence. A prospective follow-up study from age 8 to 16. Eur Child Adolesc Psychiatry 2005;14:415-423. https://doi.org/10.1007/s00787-005-0475-6