Association between Leisure Screen Time and Emotional and Behavioral Problems in Spanish Children.

Objective: To assess the relation between leisure screen time and emotional and behavioral problems in Spanish children aged 4-14 years.

Study Design: This cross-sectional study used a representative sample of children aged 4-14 years included in the 2017 Spanish National Health Survey (n = 4073). Emotional and behavioral problems of children were assessed through the parent-report Strengths and Difficulties Questionnaire. Daily leisure screen time in minutes was categorized as 0-59, 60-119, 120-179, and ≥180. We calculated adjusted prevalence ratios (aPR) and their 95% CIs of being at risk of developing emotional and behavioral problems. Associations were adjusted for potential confounding variables.

Results: Children spending 180 minutes or more of daily leisure screen time compared with children spending less than 1 hour were more likely to be at risk of developing emotional and behavioral problems: aPR: 2.19 (95% CI 1.53-3.14), emotional symptomology: aPR: 2.09 (95% CI 1.37-3.18), conduct problems aPR: 1.85 (95% CI 1.34-2.54), peer problems aPR: 1.78 (95% CI 1.15-2.75), and to behave less prosocially: aPR: 2.20 (95% CI 1.43-3.37).

Conclusions: We have found significant associations between daily leisure screen time and emotional and behavioral problems in Spanish children between 6 and 14 years of age. However, these findings should be confirmed in cohort studies, so institutions might consider including screen time as a new risk factor for children.