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More research needed on relationship between digital media use, ADHD in teens
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Data published in JAMA revealed that more frequent use of digital media was linked to increased odds of ADHD symptom occurrence over a 2-year period in midadolescence.
“A meta-analysis of studies conducted from 1987 to 2011 found that use of traditional forms of digital media ... was modestly associated with ADHD and related outcomes. Digital media has since evolved,” Adam M. Leventhal, PhD, from the department of preventive medicine, University of Southern California Keck School of Medicine, and colleagues wrote. “Whether the variety of modern digital media platforms currently available and the high frequency at which some teens use them increases risk of ADHD symptom occurrence is unknown.”
Researchers examined whether the frequency of using digital media among teens aged 15 and 16 years without significant ADHD symptoms was tied to later occurrence of ADHD symptoms in a 2-year follow-up period.
In this longitudinal cohort study, students from 10 California high schools were given surveys at baseline, 6-, 12-, 18-, and 24-month follow-up from September 2014 (10th grade) to December 2016 (12th grade). Students were asked how frequently they engaged in each of 14 digital media activities in the previous week — never, one to two times per week; one to two times per day; or many times per day.
The investigators dichotomized each response into high-frequency compared with other frequency levels, then summed in a cumulative media-use index ranging from 0 to 14. They measured students’ self-rated frequency of ADHD symptoms — nine inattentive and nine hyperactive-impulsive symptoms — 6 months before the survey, classifying those who reported often or very often experiencing six or more symptoms in either category as being ADHD symptom-positive.
The results showed that distribution of high-frequency digital media activities had an average rate of 3.62. Of 2,587 teenagers (54.4% girls) without significant symptoms of ADHD at baseline, 1,398 students (54.1%) indicated high frequency of social media use (95% CI, 52.1-56), which was the most common media activity.
High-frequency engagement in each additional digital media activity at baseline was linked with a significantly higher likelihood of having symptoms of ADHD during the 6-month intervals between the follow-up surveys (OR = 1.11; 95% CI, 1.06-1.16). This relationship remained significant after covariate adjustment (OR = 1.1; 95% CI, 1.05-1.15). In addition, high-frequency use of 10 digital media activities was linked to increased odds of ADHD symptoms across follow-ups after covariate adjustment.
Analysis also revealed boys and teens with more depressive symptoms and delinquent behaviors were more likely to experience ADHD symptoms during follow-up; however, there was no association between other covariates and ADHD symptoms. Using repeated measures linear regression models adjusted for baseline ADHD symptom level, researchers found that each additional baseline high-frequency digital media activity used (range, 0-14) was tied to a 0.11-point higher ADHD symptom severity score across follow-ups (95% CI, 0.02-0.2).
“Although alternative explanations remain possible, modern digital media use could play a role in the development of ADHD symptoms,” Leventhal and colleagues wrote. “Further research is needed to determine whether this association is causal.”
Future studies should use methods that go beyond self-report, Jenny Radesky, MD, from the University of Michigan School of Medicine, Ann Arbor, wrote in a related editorial.
“Studies of adolescent media use have started using unobtrusive browser loggers to capture social media behavior or rapid attentional shifts, passive sensing apps to examine diurnal patterns of mobile media use, or ecological momentary assessment to capture context and user emotional reactions to media,” Radesky wrote. “Because these methods have privacy implications and generate vast amounts of data, more research is needed to establish data analysis algorithms and standardized implementation approaches.” – by Savannah Demko
Disclosures: The authors report no relevant financial disclosures. Radesky reports she will receive payment for articles to be published bimonthly on the PBS Parents website and reports grant support from the National Institute of Child Health and Human Development.