The Change of Screen Time and Screen Addiction, and their Association with Psychological Well-being During the COVID-19 Pandemic: An Analysis of US Country-Wide School-Age Children and Adolescents Between 2018 and 2020

Previous studies on screen use and childrens mental health during the Coronavirus Disease 2019 (COVID-19) pandemic either focused only on the timeframe during the pandemic, or only on children previously reporting COVID-related severe family economic hardship or worries. Instead, we used a large sample (n=63,211) of the National Survey of Childrens Health (NSCH) years 2018-20 to analyze changes in the trends of recreational screen device use before, versus during the COVID-19 pandemic, and associations with psychological well-being, widely among school-age children (6-17 year-olds) across the US. We assessed recreational screen use, instead of overall use including both instructional and recreational use, and developed psychological well-being issue scores to evaluate the associations among the pandemic, recreational screen use, and psychological well-being states. We found an increase in the prevalence of screen overuse/addiction and psychological well-being issues during the pandemic compared to the years prior, detected an association between the pandemic and psychological well-being issue scores (p <0.01 across all models), and observed increased magnitude of association between recreational screen overuse/addiction and mental health during the pandemic year (p <0.01 across all models). Further studies on elucidating and addressing the specific aspects of the pandemic that contribute to these associations are critical.