Screen time, problematic media use, and clinical concerns in the ABCD Study: Differences by sex and race/ethnicity

This study assesses the relation between screen time, problematic media use behaviors, and clinical concerns (internalizing and externalizing problems) and suicidal ideation and non-suicidal self-injury within race/ethnicity and sex in the Adolescent Brain Cognitive Development (ABCD) Study (youth aged 11 to 12; <i>N</i> = 10,052). Understanding behaviors around screens (problematic media use), rather than focusing on screen time alone is useful in guiding clinical recommendations. In this analysis, regression models indicated that problematic media use consistently predicted clinical concerns with a larger effect size than screen media use. When examining how problematic media use and screen media use related to clinical concerns along domains of race/ethnicity and sex, problematic media use was a more consistent predictor of clinical concerns than screen media use for almost every race/ethnicity (except American Indian/Alaska Native participants). Problematic media use was also a consistent predictor of clinical concerns for both males and females, with some difference in screen media use predictors. This study has implications for the utility of assessing screen media use in research on clinical concerns in youth, and further suggests that researchers and clinicians should consider behaviors around screens in addition to screen time itself when assessing for impact on mental health.