Patterns of screen use and off-screen activities among children and adolescents and their associations with mental health

Despite the great number of studies about the association between adolescents’ screen use and mental health, the underlying mechanisms of the link are not well understood. According to the displacement hypothesis, excessive screen use may negatively affect children's development and health when it replaces developmentally beneficial off-screen activities. This study aimed to identify subtypes of children and adolescents based on their screen time and off-screen activities, and to compare these subgroups in terms of mental health and wellbeing outcomes. The study sample consisted of 681 school children who completed the Psychological Wellbeing subscale of the Kidscreen-52 and reported their daily screen time and problematic screen use. Adolescents (≥ 11 years) additionally completed the Pediatric Symptoms Checklist (PSC-17) youth version and the Revised Child Anxiety and Depression Scale. Parents of participating children and adolescents completed the PSC-17 parent version, and a questionnaire including items on the frequency of children’s and adolescents’ involvement in joint family activities and family conversations. The study employed Latent Class Analysis (LCA) to identify distinct groups of children and adolescents based on their self-reported screen time and training attendance, as well as parent-reported frequency of participation in joint family activities and family conversations. Age and self-perceived problematic screen use were included as covariates predicting class membership. The resulting classes were compared on psychological wellbeing and mental health indicators. Three distinct time-use patterns emerged from the LCA: Screen-Dominant (20.1%), Balanced (48.5%), and Off-Screen Active (31.4%). Members of the Screen-Dominant class exhibited poorer mental health and lower wellbeing than those in the other two classes, while self-reported attentional problems were lowest in the Balanced class. Unexpectedly, the Off-Screen Active class did not differ from the Balanced class on any mental health indicators. These findings show that c hildren and adolescents who use screens excessively, spend less time with family, and participate less frequently in training activities are at increased risk of poorer mental health outcomes, providing empirical support for the displacement hypothesis. Displacement emerges primarily among subgroups whose daily routines are characterized by intensive screen use. This underscores the importance of addressing both screen use and off-screen activities in preventive efforts to support youth mental health and well-being.