Screen time and psychopathology: investigating directionality using cross-lagged panel models

Background: Screen time has been previously associated with mental health problems in children and adolescents. However, evidence on the topic has been controversial and is mostly from cross-sectional studies. Our study investigates the bidirectional associations between screen time and psychopathology using a longitudinal design.Methods: The sample consisted of 2,511 children and adolescents (6-17 years of age) from the Brazilian High-Risk Cohort for Psychiatric Disorders, evaluated in two timepoints 3 years apart. Psychopathology was measured by the Child Behavior Checklist, using bifactor models to estimate a measure of overall psychopathology (p factor). Daily screen time was acquired by parent report data. Data was analyzed using cross-lagged panel models.Results: Cross-lagged models revealed that higher overall psychopathology at baseline predicted higher screen time usage (β=0.144, p0.001), but that screen time did not significantly predict psychopathology (β=0.020, p=0.073). Screen time was predicted by internalizing (β=0.316, p0.001) but not by externalizing disorders (β= -0.067, p=0.242). Internalizing disorders predicted screen time significantly in both sexes (β girls=0.374, p0.001; β boys =0.177, p=0.034), although this effect was stronger in girls than in boys (t=1.98, p=0.047).Conclusion: Our study suggests that psychopathology, mostly internalizing, influences screen time, but that screen time does not have a causal effect on psychopathology.