Prospective Predictors of Adolescent Screen Time and Problematic Screen Use.

Objective: Adolescent digital media use is highly prevalent. However, potential harms are unclear, as prospective studies of outcomes of screen-naïve youth are sparse. This study assessed whether individual differences in 4 domains relevant to addiction, measured in late childhood, prospectively predicted average daily hours of screen time (ST) and problematic screen use (PSU), defined as screen use that is compulsive and distressing, of 3 screen activities in mid-adolescence. Method: Youth (N = 4,754) with available data at the baseline and year 4 waves of the Adolescent Brain Cognitive Development℠ (ABCD) Study (data release 5.1) were included. Independent linear mixed-effects regression models tested whether facets of impulsivity, motivation, psychopathology, and cognitive ability at ages 9 to 10, when screen use was minimal, predicted ST and PSU of video games, social media, and smartphones at ages 12 to 15, controlling for demographics and nesting participants within families and study sites. Results: ST in mid-adolescence was positively predicted by baseline urgency, a facet of impulsivity, as well as reward sensitivity and externalizing. ST was negatively predicted by cognitive ability. Across all measured screen activities, PSU at ages 12 to 15 was positively predicted by urgency and punishment sensitivity, but not by cognitive abilities. PSU of video games and smartphones was predicted by externalizing. In mid-adolescence, ST and PSU of video games was predicted by internalizing. Conclusion: Engaging with digital media for many hours each day does not necessarily imply problematic use. Problematic screen use in mid-adolescence appears uniquely predicted by traits related to anxious distress. Comparisons with other addictive behaviors are discussed. Clinical guidance: • Routinely assess the healthiness of young patients' screen use behaviors in mental health contexts.• Initiate open-ended conversations with child and adolescent patients about their feelings about screen media.• Encourage parents of adolescents to consider monitoring the screen use of their children, especially children with pre-existing mental health challenges.