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(>= 180): 2.19 (95% CI 1.53-3.14), emotional symptomology: aPR(>= 180): 2.09 (95% CI 1.37-3.18), conduct problems aPR(>= 180): 1.85 (95% CI 1.34-2.54), peer problems aPR(>= 180): 1.78 (95% CI 1.15-2.75), and to behave less prosocially: aPR(>= 180): 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.