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Cited by 62Physical Activity and HealthImpact of Technology on AdolescentsChild and Adolescent Psychosocial and Emotional Development

Reciprocal associations between screen time and emotional disorder symptoms during adolescence

Open access
Zink, Jennifer, Belcher, Britni R., Kechter, Afton, Stone, Matthew D., Leventhal, Adam M.·2019·Preventive Medicine Reports
DOI 10.1016/j.pmedr.2019.01.014PMC PMC6354617
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Abstract

Screen-based sedentary behaviors and emotional disorders are associated with one another in youth. Yet, the direction of the association is unclear, as is whether specific types of screen-based sedentary behaviors and emotional disorder symptoms are more closely linked. This study estimated the bi-directional associations between two types of screen-based sedentary behaviors and four types of self-reported emotional disorder symptoms, and tested whether physical activity buffered these associations in a Los Angeles high school student cohort (N = 2525, baseline Mage = 14.6 years). Participants completed baseline (9th Grade, 2013) and 12-month follow-up (10th grade, 2014) surveys reporting on: television viewing and computer/videogame use (≥4 h/day; yes/no), physical activity (≥60 min/day for ≥5 days/week), and Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), Panic Disorder (PD), and Social Phobia (SP) symptoms (meet/exceed [sub]clinical symptom threshold; yes/no). After adjusting for baseline screen-based sedentary behavior and covariates, students with (sub)clinical baseline MDD and GAD were at increased odds of high computer/videogame use one year later (OR = 1.36[95%CI, 1.07–1.73]; OR = 1.36[95%CI,1.09–1.71], respectively). Baseline SP was marginally related to increased computer/videogame use at follow-up (OR = 1.33[95%CI,1.04–1.69]). Greater baseline computer/videogame use was associated with increased odds of (sub)clinical GAD (OR = 1.54[95%CI,1.23–1.94]) and (sub)clinical SP (OR = 1.64[95%CI 1.27–2.12]) at follow-up; these associations were suppressed among baseline physically active students. Television viewing was unrelated to emotional disorder symptoms and PD was not associated with screen-based sedentary behaviors. Thus, only reciprocal associations between computer/videogame use, SP, and GAD during a one-year period of adolescence were observed. Interventions reducing computer/videogame use and increasing physical activity may improve adolescent emotional health.

AI snapshot

Written from the paper’s full text.

TL;DR

In a Los Angeles high school cohort (N = 2525), computer/videogame use showed reciprocal associations with generalized anxiety disorder and suggestive reciprocal associations with social phobia over one year, while television viewing was largely unrelated to emotional disorder symptoms. Physical activity moderated the associations between high computer/videogame use and later GAD/SP symptoms.

Key findings

  • Baseline (sub)clinical MDD and GAD predicted high computer/videogame use at 12-month follow-up (AOR = 1.36, 95% CI 1.07–1.73; AOR = 1.36, 95% CI 1.09–1.71), with baseline SP marginally related (AOR = 1.33, 95% CI 1.04–1.69; p = 0.022 vs corrected threshold P < 0.016).
  • Baseline high computer/videogame use predicted follow-up (sub)clinical GAD (AOR = 1.54, 95% CI 1.23–1.94) and SP (AOR = 1.64, 95% CI 1.27–2.12), but not MDD (AOR = 1.23, 95% CI 0.96–1.57) or PD (AOR = 1.12, 95% CI 0.89–1.42).
  • Television viewing was associated only with subsequent PD in adjusted models (AOR = 1.38, 95% CI 1.03–1.85), and this did not persist after multiple-testing correction; PD was not associated with screen-based sedentary behaviors.
  • Physical activity moderated the computer/videogame–GAD and –SP associations: among students not meeting physical activity recommendations (n = 887), high computer/videogame use predicted GAD (OR = 1.98, 95% CI 1.39–2.82) and SP (OR = 2.40, 95% CI 1.61–3.57), while associations were not significant among those meeting guidelines (n = 1638).

Methods

  • Observational longitudinal cohort from the Happiness and Health study; 10 Los Angeles-area high schools; baseline 9th grade in fall 2013 and 12-month follow-up in 10th grade in 2014; analytic sample N = 2525, baseline mean age 14.6 years, 56% female, 47% Hispanic.
  • Screen-based sedentary behaviors were measured with YRBSS items for television viewing and computer/videogame use, dichotomized at ≥4 h/day; physical activity was measured with a YRBSS item and dichotomized as ≥60 min/day for ≥5 days/week; emotional disorder symptoms used RCADS subscales for MDD, GAD, PD, and SP with (sub)clinical thresholds.
  • Logistic regression models tested reciprocal associations, adjusted for baseline outcome and covariates including sex, age, race/ethnicity, parental education/SES, BMI percentile, and physical activity; moderation by physical activity and sex was tested, with multiple imputation for missing covariates and Benjamini-Hochberg correction yielding P < 0.016.

Limitations

  • The paper states: single-item YRBSS screen measures did not capture content or context, did not differentiate weekday from weekend screen time, combined computer and videogame use, and did not assess active versus passive screen use; clinician diagnoses, medication use, parental diagnoses, and parental screen time/physical activity were not assessed; observational design leaves possible unmeasured confounding.
  • Evident from the text: the sample came from 10 Los Angeles high schools, so generalizability is limited; screen time and emotional symptoms were self-reported; and 615 of 3140 students (19.6%) with full surveys at both waves were excluded for incomplete data, which may introduce bias.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.pmedr.2019.01.014

Cites

71 of 71 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 47 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Baseline (sub)clinical MDD was associated with increased odds of high computer/videogame use at 12-month follow-up after adjustment (OR=1.36, 95%CI 1.07-1.73).

    “students with (sub)clinical baseline MDD and GAD were at increased odds of high computer/videogame use one year later (OR = 1.36[95%CI, 1.07–1.73]; OR = 1.36[95%CI,1.09–1.71], respectively).”
    Quote in the paperSubstantial claim
  • Findingown data

    The association between baseline (sub)clinical SP and high television viewing at follow-up did not persist after correction for multiple testing.

    “This association did not persist after correction for multiple testing.”
    Quote in the paperNot a substantial claim
  • Findingown data

    The association between (sub)clinical SP symptom status and high daily computer/videogame use at follow-up was not significant beyond the corrected threshold of 0.016 (test p-value = 0.022).

    “The association between (sub)clinical SP (OR 1.33, 95% CI 1.04–1.69) symptom status and high daily computer/videogame use at follow-up was not significant beyond the corrected threshold of 0.016, (test p-value = 0.022).”
    Quote in the paperNot a substantial claim
  • Findingown data

    No other significant associations between baseline (sub)clinical emotional disorder symptoms and high television viewing at follow-up were observed.

    “No other significant associations between baseline (sub)clinical emotional disorder symptoms and high television viewing at follow-up were observed (Table 3).”
    Quote in the paperNot a substantial claim
  • Findingown data

    Baseline high computer/videogame use was not significantly associated with subsequent (sub)clinical PD after adjustment (OR 1.12, 95%CI 0.89-1.42, p=0.32).

    “the associations with subsequent (sub)clinical MDD (OR 1.23, 95% CI 0.96–1.57, p = 0.10) and PD (OR 1.12, 95% CI 0.89–1.42, p = 0.32) were no longer significant”
    Quote in the paperNot a substantial claim
  • The quote only partly states this claim. 2
  • May combine two claims. 16
  • Classified as probably not a substantial claim. 24

  • The quote only partly states this claim.

    Findingown data

    Baseline high computer/videogame use was associated with increased odds of (sub)clinical GAD at follow-up after adjustment (OR 1.54, 95%CI 1.23-1.94, p<0.001).

    “Greater baseline computer/videogame use was associated with increased odds of (sub)clinical GAD (OR = 1.54[95%CI,1.23–1.94])”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    This study provides novel findings that associations were more consistent for anxiety disorder symptoms and computer/videogame use, regardless of concurrently-reported television viewing.

    “This study extends previous evidence of longitudinal associations between depression and screen-based sedentary behavior (Sund et al., 2011; Primack et al., 2009; Selfhout et al., 2009) and provides novel findings that associations were more consistent for anxiety disorder symptoms and computer/videogame use, regardless of concurrently-reported television viewing.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    Interclass correlations for school effects on baseline MDD, GAD, PD, SP, television viewing, and computer/videogame use ranged from 0.0005 to 0.015, indicating minimal impact of nesting of data by school and permitting the modeling of school as a fixed effect.

    “Interclass correlations for school effects on baseline MDD, GAD, PD, SP, television viewing, and computer/videogame use ranged from 0.0005 to 0.015, indicating minimal impact of nesting of data by school and permitting the modeling of school as a fixed effect in all logistic regression models.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Previous cross-sectional studies have demonstrated weaker associations between screen-based sedentary behaviors and emotional disorder symptoms in youth who also engage in higher (vs. lower) levels of physical activity and in boys (vs. girls).

    “Previous cross-sectional studies have demonstrated weaker associations between screen-based sedentary behaviors and emotional disorder symptoms in youth who also engage in higher (vs. lower) levels of physical activity (Cao et al., 2011; Griffiths et al., 2010) and in boys (vs. girls) (Suchert et al., 2015; Brodersen et al., 2005; Desai et al., 2010; Godinho et al., 2014).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Cao et al., 2011 source

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    • cites Griffiths et al., 2010 source

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    • cites Suchert et al., 2015 source

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    Premisecitation

    Positive associations between screen-based sedentary behaviors and emotional disorder symptoms have been previously identified, but much of the work to date is cross-sectional.

    “While positive associations between screen-based sedentary behaviors and emotional disorder symptoms have been previously identified, much of the work to date is cross-sectional (Hoare et al., 2016; Teychenne et al., 2015)”
    Quote in the paperSubstantial claim0 of 2 sources checked
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    • cites Teychenne et al., 2015 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Leisure-time screen-based sedentary behaviors can increase risk for adverse cardiometabolic, social, and health outcomes throughout youth and adulthood.

    “Leisure-time screen-based sedentary behaviors (e.g., television, computer, videogames) can increase risk for a host of adverse cardiometabolic, social, and health outcomes throughout youth and adulthood (Pate et al., 2011; Sisson et al., 2009; Utter et al., 2003; Sardinha et al., 2008; Lou, 2014; Biswas et al., 2015; Chassiakos et al., 2016).”
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  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    The RCADS has shown adequate factorial reliability and convergent validity in prior work among youth.

    “The RCADS has shown adequate factorial reliability and convergent validity in prior work among youth (Chorpita et al., 2005; Kosters et al., 2015).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Chorpita et al., 2005 source

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    Study design and conductcitation

    YRBSS items assessing physical activity have previously demonstrated adequate psychometric properties.

    “YRBSS items assessing physical activity have previously demonstrated adequate psychometric properties (Brener et al., 2013; Brener et al., 2002).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Brener et al., 2013

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    • cites Brener et al., 2002 source

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    Study design and conductown data

    Cronbach's alpha for each RCADS subscale ranged from 0.89 to 0.92 in our sample.

    “Cronbach's alpha for each subscale ranged from 0.89 to 0.92 in our sample.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    The analytic sample comprised 2525 participants after exclusions.

    “Of the remaining 3140 who completed the full survey at both waves, 615 (19.6%) students did not provide complete data for all emotional health, screen-based sedentary behavior, physical activity, or sex variables, leaving an analytic sample of (N = 2525) for this report.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Consistent with the YRBSS, single-item questions were used to assess the quantity of time spent in television viewing or computer/videogame use, which does not allow us to examine how the content or the context of screen-based sedentary behaviors may impact emotional health.

    “Consistent with the YRBSS, single-item questions were used to assess the quantity of time spent in television viewing or computer/videogame use, which does not allow us to examine how the content or the context of screen-based sedentary behaviors may impact emotional health.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Physical activity has been a longstanding behavior recommended to minimize anxiety because of its anxiolytic properties.

    “Physical activity has been a longstanding behavior recommended to minimize anxiety because of its anxiolytic properties (Ströhle, 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ströhle, 2009 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    It is plausible that television viewing may only lead to emotional health consequences when one typically engages in this behavior alone.

    “Thus, it is plausible that television viewing may only lead to emotional health consequences when one typically engages in this behavior alone.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisenone given

    Most of these previous longitudinal studies failed to distinguish between subtypes of screen-based sedentary behavior and did not assess specific types of anxiety disorder symptoms that are common among youth, such as SP, PD, and GAD.

    “However, most of these studies failed to distinguish between subtypes of screen-based sedentary behavior and did not assess specific types of anxiety disorder symptoms that are common among youth, such as SP, PD, and GAD.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationcitation

    Extreme levels of computer/videogame use may indicate pathological, addictive behavior.

    “Extreme levels of computer/videogame use may indicate pathological, addictive behavior.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Adolescents often accumulate a majority of their physical activity in the form of organized sports.

    “Adolescents often accumulate a majority of their physical activity in the form of organized sports (Payne et al., 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Payne et al., 2013 source

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The YRBSS items also did not differentiate weekday from weekend day screen-based sedentary behaviors, which may overlook variations in youth's screen time accumulation across the week.

    “The YRBSS items also did not differentiate weekday from weekend day screen-based sedentary behaviors, which may overlook variations in youth's screen time accumulation across the week (Ortega et al., 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ortega et al., 2013 source

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    Interpretationreasoning

    Those who fear in-person social interactions may gravitate toward computer use as means of communicating with peers.

    “Those who fear in-person social interactions may gravitate toward computer use as means of communicating with peers”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Social withdrawal theory postulates that screen-based sedentary behavior may relate to poorer emotional health by promoting social isolation.

    “Given that television viewing was not consistently associated with emotional disorder symptoms in the current study, we draw from the social withdrawal theory, which postulates that screen-based sedentary behavior may relate to poorer emotional health by promoting social isolation (Rubin and Burgess, 2001).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rubin and Burgess, 2001

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    Premisecitation

    Evidence in a similar sample of youth indicates that both forms of screen-based sedentary behaviors influence mental health outcomes similarly.

    “Additionally, we did not assess active versus passive screen-based sedentary behaviors, however evidence in a similar sample of youth indicates that both forms of screen-based sedentary behaviors influence mental health outcomes similarly (Ra et al., 2018).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Ra et al., 2018

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  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    Outcome expectancies and the content of computer/videogames may influence screen-time emotional disorder symptom associations.

    “Thus, outcome expectancies and the content of computer/videogames may influence screen-time emotional disorder symptom associations.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Our study highlights that computer/videogame use, but not television viewing, relates to symptoms of anxiety disorders in youth.

    “Altogether, our study highlights that computer/videogame use, but not television viewing, relates to symptoms of anxiety disorders in youth.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Peer socialization and support experienced during participation in organized sports promotes psychosocial well-being and healthy youth development.

    “Peer socialization and support experienced during participation in organized sports promotes psychosocial well-being and healthy youth development (Kiluk et al., 2009; Solomon, 1980), and could prevent any social anxiety resulting from isolation on computers/videogames.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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    Interpretationown data

    The present study found that the associations between different types of screen-based sedentary behaviors (computer/videogame use and television viewing) and emotional disorder symptoms (MDD, GAD, SP, and PD) were non-monotonic and in some cases reciprocal.

    “The present study found that the associations between different types of screen-based sedentary behaviors (computer/videogame use and television viewing) and emotional disorder symptoms (MDD, GAD, SP, and PD) were non-monotonic and in some cases reciprocal.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Interpretationcitation

    Peer socialization and support could prevent any social anxiety resulting from isolation on computers/videogames.

    “Peer socialization and support experienced during participation in organized sports promotes psychosocial well-being and healthy youth development (Kiluk et al., 2009; Solomon, 1980), and could prevent any social anxiety resulting from isolation on computers/videogames.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Computer and videogame use were combined in our survey, despite literature suggesting these two types of screen-based sedentary behaviors might influence emotional health in different ways.

    “Computer and videogame use were combined in our survey, despite literature suggesting these two types of screen-based sedentary behaviors might influence emotional health in different ways (Maras et al., 2015; Casiano et al., 2012).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
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    • cites Casiano et al., 2012

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    Premisecitation

    Physical activity also alters activity in neuropharmacological pathways (i.e., serotonin, brain derived neurotropic factor, and endorphins) implicated in anxiety, which may underlie subjective feelings of post-exercise relaxation.

    “Physical activity also alters activity in neuropharmacological pathways (i.e., serotonin, brain derived neurotropic factor, and endorphins) implicated in anxiety, which may underlie subjective feelings of post-exercise relaxation (De Moor et al., 2006; Carek et al., 2011).”
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    Premisecitation

    One study among a similar sample of adolescents found that sleep problems predicted lower distress tolerance skills and were more likely to be absorbed by, or ruminate on, negative emotions one year later.

    “One study among a similar sample of adolescents found that sleep problems predicted lower distress tolerance skills and were more likely to be absorbed by, or ruminate on, negative emotions one year later (Kechter and Leventhal, 2018), which is a prominent symptom of GAD.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kechter and Leventhal, 2018

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    Premisecitation

    SP can be both a risk factor for and consequence of excessive computer use.

    “Additionally, SP can be both a risk factor for and consequence of excessive computer use (Selfhout et al., 2009; Caplan, 2006).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Selfhout et al., 2009 source

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  • May combine two claims.

    Interpretationown data

    In this study of Los Angeles high school students, an association between screen-based sedentary behavior and emotional disorder symptoms over a one-year period of follow-up was observed, with some evidence of bi-directionality, specificity between computer/videogame use and certain emotional conditions, and generalizability across boys and girls.

    “In this study of Los Angeles high school students, an association between screen-based sedentary behavior and emotional disorder symptoms over a one-year period of follow-up was observed, with some evidence of bi-directionality, specificity between computer/videogame use and certain emotional conditions, and generalizability across boys and girls.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Due to the observational study design, it is unclear whether there are unknown and unmeasured confounding variables that may explain the associations found.

    “Lastly, due to the observational study design, it is unclear whether there are unknown and unmeasured confounding variables that may explain the associations found.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Sleep problems are an established risk factor for poorer emotional health.

    “Computer and videogames can also be linked to sleep problems in adolescents (Hale and Guan, 2015), which is an established risk factor for poorer emotional health (Medic et al., 2017).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Medic et al., 2017 source

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    Study design and conductown data

    We did not assess active versus passive screen-based sedentary behaviors.

    “Additionally, we did not assess active versus passive screen-based sedentary behaviors, however evidence in a similar sample of youth indicates that both forms of screen-based sedentary behaviors influence mental health outcomes similarly (Ra et al., 2018).”
    Quote in the paperNot a substantial claim
33 of 33

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Numerous cross-sectional studies and a limited number of longitudinal studies suggest that high levels of social media use are associated with internalizing problems, including depressive and anxiety symptoms, although results are not entirely consistent.

    “Numerous cross-sectional studies and a limited number of longitudinal studies suggest that high levels of social media use are associated with internalizing problems, including depressive and anxiety symptoms, [3][4][5][6] although results are not entirely consistent.7”

    From Associations Between Time Spent Using Social Media and Internalizing and Externalizing Problems Among US Youth. (2019) · cites this paper as [3]

    Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • Longitudinal studies observe either no or very small effects for the impact of screen time on depressive symptoms, video games, social media, and passive screen use.

    “A handful of studies that have approached questions around screen time using longitudinal methods observe either no or very small effects for the impact of screen time on experiences such as depressive symptoms [21,45]. This holds when exploring specific forms of screen activities such as video games [46], social media [5,6,47,48], and passive screen use [21].”

    From The Conceptual and Methodological Mayhem of “Screen Time” (2020) · cites this paper as [46]

  • The association between total screen time and anxiety disorder symptoms remained significant and non-negligible in size for symptoms specific to Generalised Anxiety Disorder and Social Phobia after adjusting for covariates.

    “This association remained significant and non-negligible in size for symptoms specific to Generalised Anxiety Disorder and Social Phobia after adjusting for covariates.”

    From The relationship between screen time and mental health in young people: A systematic review of longitudinal studies (2021) · cites this paper as Zink et al., 2019

  • There were no significant associations between television viewing and subsequent Generalised Anxiety Disorder or Social Phobia symptoms in unadjusted models, and a small, negative association between television viewing and subsequent Social Phobia symptoms in adjusted models.

    “There were no significant associations between television viewing, and subsequent Generalised Anxiety Disorder or Social Phobia symptoms in unadjusted models, and a small, negative association between television viewing and subsequent Social Phobia symptoms in adjusted models.”

    From The relationship between screen time and mental health in young people: A systematic review of longitudinal studies (2021) · cites this paper as Zink et al., 2019

  • There was a small, positive association between television viewing and subsequent Panic Disorder symptoms in both adjusted and unadjusted models.

    “One study reported a small, positive association between television viewing, and subsequent Panic Disorder symptoms in both adjusted and unadjusted models (Zink et al., 2019).”

    From The relationship between screen time and mental health in young people: A systematic review of longitudinal studies (2021) · cites this paper as Zink et al., 2019

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Computer/videogame cutoff is defined inconsistently

    Minor

    The Methods define the computer/videogame categories as >4 hours versus ≥4 hours, which overlap and omit students reporting less than 4 hours. The abstract instead defines high use as ≥4 hours versus not.

  • Abstract calls the social phobia association reciprocal despite its corrected result

    Minor

    The abstract says a reciprocal association with social phobia was observed, but the Results state that the social-phobia-to-computer/videogame association did not meet the paper's corrected significance threshold.

2 of 2

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Related

Authors
Zink, J., Belcher, B. R., Kechter, A., Stone, M. D., & Leventhal, A. M.
Affiliations
  • University of Southern California (US)
  • University of California San Diego (US)
Corresponding author
Leventhal, Adam M.
ORCID
Venue
Preventive Medicine Reports
Publisher
Elsevier BV
Published
2019-03
Volume
13
Pages
281-288
ISSN
2211-3355 (ISSN-L)
DOI
10.1016/j.pmedr.2019.01.014
PMC
PMC6354617
OpenAlex
W2911516854
Cited by
62
References
78
Citations by year
2026: 4 · 2025: 8 · 2024: 10 · 2023: 8 · 2022: 9 · 2021: 8 · 2020: 13 · 2019: 2
FWCI
5.48
Type
journal article
Language
en
Open access
Licence
Locations
  • Preventive Medicine Reports (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • National Institutes of Health (T32 CA009492)
  • National Institute on Drug Abuse (R01-DA033296)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
screen time, television viewing, sedentary behavior, depression, generalized anxiety disorder, panic disorder, social anxiety disorder, physical activity, bidirectional relationship, adolescent mental health, high school students

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-08.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-08.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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