Examining the bidirectional relationship between physical activity, screen time, and symptoms of anxiety and depression over time during adolescence
Abstract
More physical activity (PA) and less screen time (ST) are positively associated with mental health in adolescents; however, research is limited by short-term designs and the exclusion of ST when examining PA. We examined: (a) changes in PA, ST, symptoms of depression, and symptoms of anxiety over four assessments spanning 11years, and (b) bidirectional relationships between initial PA, ST, and symptoms of depression and anxiety as predictors of change in each other during adolescence. Between 2006 and 2010, participants from Ottawa Canada (Time1; N=1160, Mean age=13.54years) completed questionnaires at four points covering the ages from 10 to 21years. Latent growth modeling was used. PA decreased over time whereas ST and symptoms of depression and anxiety increased over time. Controlling for sex, ethnicity, school location, zBMI, birth year, and parents' education, initially higher anxiety was associated with initially higher ST (covariance=.88, p<.05) and initially lower PA (covariance=-6.84, p=.07) independent of initial symptoms of depression. Higher initial depression was associated with higher initial ST (covariance=2.55, p<.05). Increases in anxiety were associated with increases in ST (covariance=.07, p=.06) and increases in depression (covariance=.41, p<.05). Examining bidirectional relationships, higher initial symptoms of depression predicted greater decreases in PA (b=-.28, p<.05). No other significant findings between initial PA, ST, anxiety, or depression were found as predictors of change in each other. Interventions targeting depression around age 13 may be useful to prevent further declines in PA. Similarly, interventions to reduce ST may be beneficial for concurrent reductions in symptoms of depression and anxiety, irrespective of PA.
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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 [45]
There was no significant association between total screen time at baseline and changes in anxiety symptoms over time.
“A second study reported no significant association between total screen time at baseline and changes in anxiety symptoms over time (Gunnell et al., 2016).”
From The relationship between screen time and mental health in young people: A systematic review of longitudinal studies (2021) · cites this paper as Gunnell et al., 2016
There was no significant association between anxiety symptoms at baseline and subsequent changes in total screen time over time.
“A second study reported no significant association between anxiety symptoms at baseline and subsequent changes in total screen time over time (Gunnell et al., 2016).”
From The relationship between screen time and mental health in young people: A systematic review of longitudinal studies (2021) · cites this paper as Gunnell et al., 2016
Previous longitudinal studies have found bi-directional associations between screen-based sedentary behaviors, anxiety, and depression in adolescents.
“Previous longitudinal studies have found bi-directional associations between screen-based sedentary behaviors, anxiety, and depression in adolescents (Gunnell et al., 2016; Houghton et al., 2018; Raudsepp, 2016).”
From Reciprocal associations between screen time and emotional disorder symptoms during adolescence (2019) · cites this paper as Gunnell et al., 2016
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References 50 · Cited by 196
- Authors
- Gunnell, K. E., Flament, M. F., Buchholz, A., Henderson, K. A., Obeid, N., Schubert, N., & Goldfield, G. S.
- Affiliations
- Children's Hospital of Eastern Ontario (CA)
- Royal Ottawa Mental Health Centre (CA)
- Carleton University (CA)
- Corresponding author
- Gunnell, Katie E.
- ORCID
- Venue
- Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 88
- Pages
- 147-152
- ISSN
- 0091-7435 (ISSN-L)
- OpenAlex
- W2339526270
- Cited by
- 196
- References
- 50
- Citations by year
- 2026: 13 · 2025: 20 · 2024: 19 · 2023: 23 · 2022: 31 · 2021: 26 · 2020: 21 · 2019: 25 · 2018: 11 · 2017: 6 · 2016: 1
- FWCI
- 11.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ontario Centre of Excellence for Child and Youth Mental Health (RG627)
- University of Ottawa Medical Research (03-2009)
- Children's Hospital of Eastern Ontario Research Institute (RI 11-19)
- Topics
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
- Keywords
- physical activity, screen time, adolescent depression, adolescent anxiety, bidirectional relationship, longitudinal change, mental health, prevention interventions
- MeSH terms
- Adolescent, Anxiety, Depression, Female, Humans, Longitudinal Studies, Male, Ontario, Surveys and Questionnaires, Schools, Television, Exercise, Sedentary Behavior
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