Jean M. Twenge · Preventive Medicine Reports 2018 · cross-sectional population-based survey · n=40,337

Associations between screen time and lower psychological well-being among children and adolescents: Evidence from a population-based study

Cited 1259 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional survey of a population-based sample (by design analogy)

OpenAlex W2896921383 · doi:10.1016/j.pmedr.2018.10.003 · record verified 2026-08-31

What was done

Researchers analyzed data from a 2016 US national random sample of 40,337 children and adolescents aged 2 to 17 years. The study evaluated associations between total daily screen time (including cell phones, computers, electronic devices, games, and TV) and measures of psychological well-being, mental health diagnoses, and treatment.

What was found

Screen use exceeding 1 h/day was associated with lower psychological well-being, including less curiosity, lower self-control, more distractibility, difficulty making friends, less emotional stability, being harder to care for, and inability to finish tasks. Non-users and low users (1 h/day) generally did not differ. Among 14- to 17-year-olds, high users (7+ h/day vs. 1 h/day) had higher risks of ever being diagnosed with depression (RR 2.39, 95% CI 1.54, 3.70), ever diagnosed with anxiety (RR 2.26, 95% CI 1.59, 3.22), treated by a mental health professional (RR 2.22, 95% CI 1.62, 3.03), or taking psychiatric medication in the past 12 months (RR 2.99, 95% CI 1.94, 4.62). Moderate use (4 h/day) was also associated with lower well-being. Associations were larger among adolescents than younger children.

Why it matters

This large population-based study provides detailed correlational evidence linking high screen use to lower well-being and clinical mental health diagnoses in youth, informing screen time guideline debates.

Limits

The cross-sectional design cannot establish causality or determine if screen time leads to poorer well-being or if distressed youth spend more time on screens. Measures relied on survey responses rather than objective usage tracking or direct clinical assessments.

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