اختلالات درون گرایی در بزرگسالی
Abstract
1- Introduction
2- Methods
3- Results
4- Discussion
5- Conclusion
References
Abstract
Time spent watching television during childhood and adolescence has been linked to socio-emotional and physical health problems in adulthood. It is unclear whether excessive television viewing is a risk factor for internalising mental health disorders such as anxiety and depression. Longitudinal associations between television viewing in childhood and adult diagnoses of anxiety and depression were investigated in a population-based birth cohort from Dunedin, New Zealand. Mean weekday television viewing time was reported by parents and adolescents between ages 5 and 15 years (1977–1987). Diagnoses of any anxiety disorder and major depression were made using standard criteria from symptoms reported for the previous year at ages 18, 21, 26, 32, and 38 years (between 1990 and 2012). Analyses adjusted for sex, parent and teacher reports of worry/fearfulness at age 5, and socioeconomic status during childhood. Diagnoses were counted if present at any of these assessments. Approximately half of all participants met criteria for anxiety disorder or depression during at least one adult assessment. Participants who had watched more television during childhood and adolescence were more likely to have a diagnosis of anxiety in sex-adjusted analyses (OR [95% CI] 1.22 [1.05, 1.41], p = 0.01), although this association weakened after adjustment for early childhood worry/fearfulness and socioeconomic status. There was no association between television viewing and depression in sex- or fully-adjusted analyses. Excessive television viewing during childhood and adolescence may be a risk factor for developing an anxiety disorder in adulthood, but does not appear to influence the long-term risk for major depression.
Introduction
Television and other screen-based media play a major role in modern life, affecting social interactions, family routines, and leisure activities, all of which impact upon child development. Watching television is a particularly common and enduring experience in childhood: American children spend more hours interacting with screen based media than any other waking activity (Rideout, 2015). Excessive childhood television viewing time has been linked to several long-term social, physical and mental health problems in adulthood including unemployment, obesity, poor fitness, raised blood cholesterol, smoking, sleep problems, attention difficulties, and externalising problems such as antisocial behaviour (Owens et al., 1999; Hancox et al., 2005; Landhuis et al., 2007; Johnson et al., 2002; Robertson et al., 2013). However, there has been little research into the long-term effects of television viewing in childhood and internalising mental health disorders, such as depression and anxiety. Several cross-sectional studies of children and adolescents have reported an increased risk of depression (Bickham et al., 2015; Primack et al., 2009) anxiety (Maras et al., 2015) and psychological distress among those with greater total screen time, television viewing, and lower physical activity levels (Hamer et al., 2009; Cao et al., 2011; Liu et al., 2016a), although some studies have found no association (Casiano et al., 2012). In adults, a longitudinal study of university graduates found that time spent watching television or using computers was associated with an increased risk of internalising mental health disorders up to 6 years later (Sanchez-Villegas et al., 2008). Although many children now have access to a wide variety of other media beyond television, television is still the most accessible screenbased medium and television viewing times remain high (Rideout, 2015; AAP Council on Communications and Media, 2016; Reid Chassiakos et al., 2016), with many new media platforms being used to watch television programs. Hence the influence of excessive television viewing on long-term risk for health remains highly relevant and is also a worthwhile target for interventions aimed at decreasing screen time. We investigated the long-term associations between childhood and adolescent television viewing and adult internalising disorders in a population-based birth cohort study followed to age 38.