Cited by 286Impact of Technology on AdolescentsChild Development and Digital TechnologyChild and Adolescent Psychosocial and Emotional Development

The DOI matches its Crossref record; 72 of the 75 references it cites were found in a registry or an index; 1 of the 77 sources its claims cite were checked for support.

The relationship between screen time and mental health in young people: A systematic review of longitudinal studies

Open access
Tang, Samantha, Werner-Seidler, Aliza, Torok, Michelle, Mackinnon, Andrew J., Christensen, Helen·2021·Clinical Psychology Review

Abstract

An increase in time spent on screen-based technologies has been suggested to underlie recent increases in mental health problems among young people. However, this hypothesis has primarily been based on the findings of cross-sectional studies. The aim of the current review was to provide a comprehensive overview of longitudinal studies examining the relationship between screen time and internalising mental health symptoms. PsycINFO, PubMed/Medline and EMBASE were systematically searched for articles published up to August 2020. Thirty-five studies, with sample sizes ranging from 126 to 12,866 participants, met inclusion criteria. The association between screen time and subsequent depressive symptoms was found to be small to very small in size. There was limited evidence of any reverse association between depressive symptoms and subsequent screen time. The association between screen time and depressive symptoms varied between different devices and uses. In contrast to depressive symptoms, evidence to support longitudinal associations between screen time and other internalising mental health symptoms, including anxiety, self-esteem, and general internalising problems, was lacking. Together, these results suggest that the impact of increased screen time on the prevalence of mental health problems among young people is likely to be negligible or small. Further longitudinal studies that examine screen content and motivations underlying screen use are required to better discern any relationship between screen time and internalising mental health symptoms.

Overview

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TL;DR

This systematic review of 35 longitudinal studies found that screen time is associated with subsequent depressive symptoms only small to very small in size, with limited evidence of a reverse association and little support for anxiety, self-esteem, or general internalising symptoms. The authors conclude that increased screen time is unlikely to account for substantial rises in youth mental health problems and call for research on screen content and motivations.

Key findings

  • Across 35 longitudinal studies with sample sizes from 126 to 12,866 participants, the association between screen time and subsequent depressive symptoms was small to very small; among comparable studies, effect sizes were around r = 0.10, and some studies reported non-significant associations.
  • Evidence for the reverse association—depressive symptoms predicting later screen time—was limited; most studies found no significant association, although some analyses using sophisticated methods reported bidirectional associations.
  • Associations varied by device/use: there was relatively stronger evidence for mobile phone and computer/internet use with subsequent depression, limited evidence for television and videogames, and mixed evidence for social media. Evidence for longitudinal associations with anxiety, self-esteem, and other internalising symptoms was lacking or limited.
  • Sex differences were apparent across the body of work but inconsistent in direction and medium type; few studies analysed sex separately.

Methods

  • Systematic review following PRISMA guidelines, registered with PROSPERO (CRD42020180145). PsycINFO, PubMed/Medline, and EMBASE were searched from 2005 to 4 August 2020, plus hand searches; 5505 records were identified and 35 studies met inclusion criteria.
  • Eligible studies used a longitudinal design with at least six months between time points, included young people aged 10–24 years, measured screen time duration/frequency, and used validated continuous measures of internalising mental health symptoms.
  • Because of wide variation in models and outcomes, the authors conducted a narrative synthesis rather than a meta-analysis; effect sizes were estimated for a subset of studies examining total screen time and depression.

Limitations

  • Stated in the paper: all included studies used self-report or parent-report measures of screen time and mental health; no studies used clinician-rated mental health measures, and only one used ecological momentary assessment for screen time. There was variation in definitions and measures of screen time, few longitudinal studies on smartphone and social media use, and most studies examined depression rather than anxiety, self-esteem, or other internalising symptoms.
  • Stated in the paper: procedural quality varied widely; most studies did not report whether dropouts differed from remaining participants or provide baseline participation rates, and only one study met all nine quality criteria. Quantitative synthesis was judged impractical and potentially misleading due to diverse models and outcomes.
  • Evident from the text: included studies varied substantially in statistical rigour, with some omitting relevant paths or overadjusting for covariates, which may bias estimates; the review is narrative and cannot resolve inconsistent sex or device-specific findings.

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Crossref · 10.1016/j.cpr.2021.102021

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  1. Grøntved, 2015, A prospective study of screen time in adolescence and depression symptoms in young adulthood, Preventive Medicine, 81, 108, 10.1016/j.ypmed.2015.08.009 · DOI

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Metadata

Authors
Tang, S., Werner-Seidler, A., Torok, M., Mackinnon, A. J., & Christensen, H.
Affiliations
Black Dog Institute (AU)
Corresponding author
Tang, Samantha
Venue
Clinical Psychology Review
Publisher
Elsevier BV
Published
2021-06
Volume
86
Pages
102021
ISSN
0272-7358 (ISSN-L)
OpenAlex
W3139313496
Cited by
284
References
75
Citations by year
2026: 74 · 2025: 71 · 2024: 57 · 2023: 42 · 2022: 31 · 2021: 8
FWCI
6.61
Type
journal article
Language
en
Open access
Locations
  • Clinical Psychology Review (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
  • Social Sciences › Education › Child Development and Digital Technology
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
screen time, mental health, youth, depressive symptoms, internalizing problems, anxiety, self-esteem, longitudinal associations, device utilization, screen content
MeSH terms
Screen Time, Adolescent, Anxiety, Cross-Sectional Studies, Humans, Longitudinal Studies, Mental Health

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