Does More Time Spent on Screens Lead to Depression?
For teens, the impact may depend on the use: Work? Play? Entertainment? Social?
Posted July 28, 2019
NOTE: When I originally published this essay on July 28, 2019, I was completely unaware of the dark side of video games. Investigative journalists at the New York Times came up with shocking data about the exploitation of children through their participation in games and other activities that can be found on the internet. In their December 8, 2019 cover story, the reporters shared their findings with their readers. Shocked and horrified, I implore you to read the article, "Video Games and Online Chats are "Hunting Grounds" for Sexual Predators". These findings cast any conclusions from the JAMA Pediatrics article that I describe below into question.
THE ORIGINAL POST:
A July 15 article in JAMA Pediatrics, published by the American Medical Association, looks at the “Association of Screen Time and Depression in Adolescence.” Elroy Boers and his colleagues demonstrated that more time spent on screens is associated with an increase in depressive symptoms in teens. The researchers had access to responses about screen use by 3,659 Montreal children that was within a “gold-standard” prospective study aimed at better understanding the evolution of substance abuse in early adolescence. Because the study was prospective—that is, it followed the same children from seventh grade until they were juniors—its data tracked time spent on screens relative to shifts in symptoms and could see what came first.
The longitudinal design of the study was one of its unique strengths. A second was that researchers identified different types and purposes of screen time. Third, additional study responses let them test three theories that might explain the results.
Category of screen use. Time spent was tabulated in each of four distinct categories:
- Playing video games, regardless of whether on a computer, phone or another digital device.
- Using social media on any device.
- Watching shows or movies on anything from a television to a mobile phone.
- Using a computer for activities different from those listed above.
By breaking down the type of activity, researchers could better describe how the teens were using the screens.
- Video games are active, engaging. They tend to be social because they are often played with “friends” who may be present in person or physically located in other places. The goal of the activity is entertainment, sometimes with a mastery component. Play is usually associated with positive feelings.
- Social media can be interactive but is usually motivated by a desire to either communicate with others or to learn what they are doing or interested in. It subtly invites viewers to compare themselves to others. A large study of adults 19 to 32 found that high social media use was correlated with higher levels of depression, even when other factors associated with greater social media use like less education, younger age, and being female were accounted for.
- Watching shows and movies on screens that are not in theaters, whether on a television, computer, tablet, mobile phone, or another type of screen, is a more passive activity and often a solitary and deliberate one.
- Finally, other computer use is often associated with learning or producing. Much information can be found on the internet; searching for and evaluating it are active skills. And computers can be a huge aid in producing all sorts of materials in visual, verbal or mixed forms. With the help of the internet, this production can (but need not) become a social activity in which people work together, contributing to, improving, and disseminating each other’s work. Learning and producing are different activities than playing, socializing and being entertained.
Boers and his colleagues looked at how much the amount of time spent in each screen activity was associated with changes in depressive symptoms like loneliness, feeling hopeless, and a loss of interest in things.
Results were clear. More time spent on social media or watching shows predicted more negative feelings. They did not increase with a teen’s time spent playing video games or doing other activities on the computer.
Why might screen time affect depressive feelings? Clearly, screen time could have a negative effect. The researchers wanted to understand why. Other information collected from the kids throughout the larger study allowed researchers to test three possible explanations.
- Was screen use taking the place of other, potentially healthier, activities? Children had volunteered the amounts of time spent in physical activities outside of school. When the exercise was accounted for, study results did not change, even though it can be protective of depressive symptoms. What kids were not doing when they were on screens — “displacement” — could not explain the results.
Were the increasingly unhappy feelings because of “social comparisons” with others that left a teen feeling less adequate? Researchers were able to look at measures of self-esteem taken across each teen’s early adolescence to see if it related to increased depression as screen-time increased. Not surprisingly, this relationship was the strongest when the teens were using social media or watching shows. In both cases, others appeared as potential models.
- As people make choices of what they want on a device, that device is programmed to follow the lead and offer more of the same, creating “reinforcing spirals.” Because people tend to choose media that are consistent with what they are thinking or feeling, such a “filter bubble” could amplify a belief or intensify an emotional state.
In summary, distraction could not explain the results, but social comparison and, to a lesser extent, “reinforcing spirals” could. When teens saw others living lives that were “better” than theirs, or perhaps living their lives in a “better” way, they felt worse. The algorithms that promote more of what they are already gravitating towards may amplify the association between time spent on electronic devices and depressive symptoms.
Is a public policy recommendation reasonable and possible?
Might the results of this study argue for limiting screen time for younger adolescents as suggested at the end of the article? Indeed, for emotional well-being and additional reasons (including incivility, noise, theft among classmates, cyberbullying, inappropriate content, and, above all, disruption of attention skills necessary for learning) that is exactly what France did in September of 2018.
The Ministry of Youth and National Education adopted regulations that banned use on school grounds of all portable telephones and other electronic communication devices including tablets, watches, or other ways to access the internet and use it as a phone, at all times when the schools are open — during classes, lunch, recess, activities, sports events, even on school trips. (A few exceptions exist: for health necessities, like measuring glucose for someone who is diabetic, or compensating for a handicap by an electronic aid that facilitates learning.) These rules apply to schools with children roughly fifteen and younger across the country.
The stated purpose of this regulation is to “… sensibiliser les élèves à l'utilisation raisonnée des outils numériques et à leur faire pleinement bénéficier de la richesse de la vie collective.” Roughly translated, this means: “This measure is intended to make students aware (heighten awareness) of the reasonable use of digital tools and help them (the students) benefit fully from the richness of collective life (life within a shared community)."
Stable mental health and social relationships lie at the heart of learning. Lack of both mastery and satisfying social connections are predictive of depression, as amply shown by Blatt and his colleagues. Positive feelings from both sources, when balanced, can protect against depression, and thus its negative consequences for health and well-being.
The study by Elroy Boers and his colleagues adds support for decisions like that of France’s Ministry of Youth and National Education. While public policy restricting time on screens for younger teens — at least during school hours and activities — is indeed reasonable, we do not know if it might be possible in an American locale.
Copyright 2019 Roni Beth Tower
Boers, E, Afzali MH, Newton N, Conrod P. (2019) Association of Screen Time and Depression in Adolescence. JAMA Pediatrics. Published online July 15, 2019. doi:10.1001/jamapediatrics.2019.1759