Bidirectional Associations of Screen Time with Externalizing and Internalizing Behaviors in Children: A Random Intercept Cross-Lagged Panel Model

We aimed to examine the longitudinal and directional associations of children's screen time (ST) with their extensive behavior scales at ages 2, 3, 4, and 5. This study was a part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Information was gathered prospectively, and 7,747 mother-child pairs were included. Analyses using random-intercept cross-lagged panel models were performed for children aged 2, 3, 4, and 5 years. Information on children’s ST at ages 2, 3, 4, and 5 was collected from questionnaires completed by caregivers. We assessed children's behavior using the Child Behavior Checklist for Ages 1½–5 at aged 2, 3, 4, and 5 years. This study targeted scores on externalizing behavior and its 2 subscales (aggressive behavior and attention problems), and internalizing behavior and its 4 subscales (withdrawal, somatic complaints, anxious/depressed, and emotional responses). As a result, higher than expected screen time at age 2 was consistently associated with all behavioral scales at age 3. At later ages, specific bidirectional associations were identified for each behavioral scale and age group. These findings may offer preliminary guidance for future discussions on age-appropriate screen use recommendations and family media practices.