A new study published in JAMA Network Open offers experimental evidence supporting the idea that reducing leisure-time screen media use can improve the mental health of children and adolescents. The research, a secondary analysis of the SCREENS randomized clinical trial, found that reducing leisure-time screen media use led to notable improvements in psychological well-being. Participants showed a reduction in behavioral difficulties, particularly internalizing symptoms like emotional and peer-related issues, along with enhanced prosocial behaviors.
Concerns about the potential negative effects of digital screen use on young people’s mental health have grown in recent years. With children and adolescents increasingly reliant on devices for entertainment and communication, researchers sought to explore whether limiting leisure screen time could have tangible benefits. Previous studies have found small but significant associations between high screen time and poor mental health. However, these studies couldn’t establish causation due to their reliance on self-reported data and the lack of experimental control.
“We were interested in the link between screen media use and mental health because the observational studies conducted remained inconclusive. Some studies found links between screen media use and poorer mental health, while others found no associations,” said study author Jesper Schmidt-Persson, an assistant professor at the University College Copenhagen and guest researcher at the University of Southern Denmark.
The SCREENS trial was designed as a randomized clinical trial to evaluate the effects of reducing leisure-time screen media use on children’s and adolescents’ mental health. The study recruited families from Denmark through a survey of screen media habits, ultimately including 89 families with 181 children aged 6 to 17 years.
Participants were randomly assigned to either an intervention group or a control group. Families in the intervention group were required to hand over their smartphones and tablets for two weeks and limit other leisure screen media use to three hours per week. Necessary screen activities, such as schoolwork, were excluded from this limit. To support communication, participants received basic phones capable only of calls and text messaging. Small financial incentives were provided to families to encourage compliance.
Researchers measured mental health outcomes using the Strengths and Difficulties Questionnaire, which assesses behavioral strengths and challenges across subscales such as emotional symptoms, conduct problems, hyperactivity, peer issues, and prosocial behaviors. Parents completed the questionnaire before and after the two-week intervention.
The results demonstrated improvements in mental health among children in the screen reduction group compared to the control group. On average, children in the intervention group experienced a reduction of 1.67 points on the total difficulties scale, corresponding to a moderate effect size. This effect was most pronounced for internalizing symptoms, including emotional challenges and difficulties with peer relationships.
“I found it particularly interesting that we were able to observe a significant moderate effect size after only two weeks,” Schmidt-Persson told PsyPost. “I am curious to study the effects of a larger break from screen media use on both physical and mental health.”
Additionally, the intervention improved prosocial behaviors, such as helping others and showing consideration for others’ feelings. The findings suggest that reduced screen time allowed for more face-to-face social interactions and meaningful family engagement, which likely contributed to these positive changes.
“Our results showed that reducing screen media together as a family can lead to improved mental health among both children and adolescents,” Schmidt-Persson said. In a previous study, the researchers found that similar improvements could also be observed among adults in the family.
Interestingly, subgroup analyses hinted that boys and children with higher baseline screen time or greater behavioral difficulties might benefit more from reduced screen use. However, these subgroup differences were not statistically significant.
The study provides evidence for the short-term benefits of reduced screen time. But as with all research, there are limitations. First, the open-label design meant that parents knew whether their family was in the intervention group, potentially biasing their responses on the questionnaire. Second, the study’s relatively small sample size and high compliance rates might limit generalizability, as participants may have been unusually motivated to reduce screen use.
“The study was open label because blinding was not possible. Thus, study participants were not blinded to the group allocation of their family. We can only speculate about whether it has had an influence on the results,” Schmidt-Persson noted.
The intervention focused on reducing overall screen media use without differentiating between types of activities, such as educational versus entertainment-based content. Future research could investigate how specific screen media activities impact mental health and whether the benefits of screen reduction persist over longer periods. Additionally, studies targeting high-risk populations with greater baseline behavioral difficulties could help clarify the intervention’s effects.
“Although screen media use was objectively measured, we are unfortunately not able to conclude anything on which types of screen media use are better or worse for children and adolescent mental health. I hope that we can answer these types of questions in future studies,” Schmidt-Persson said.
Kristin Hadfield, an assistant professor of psychology at Trinity College, who was not involved in the study, told the Science Media Centre: “There is a lot of concern about the impacts of ‘screen time’ on children and adolescents, but most of the studies are correlational and so can’t tell us whether more screen time causes worse child mental health. Screen time is a very vague concept, with major differences in effects depending on what someone is actually doing on their phone, computer, tablet, etc. This paper provides experimental evidence about the effects of a screen time intervention on children’s mental health, which is a major advancement.”
“This is a good step in understanding how screen time is related to child and adolescent mental health,” Hadfield added. “However, we should be careful about over-interpreting a relatively small study as considerably more experimental research would be needed to understand how, to what extent, and for whom screen time impacts mental health. People often think of screen time as bad, but it really depends what the child is doing on the screen. Very few people would view it as a negative if a child was video calling their grandparent, watching a documentary, or learning how to code, and we wouldn’t expect any of these things to negatively impact a child’s mental health. A greater focus in research and intervention on what children are doing on computers, phones, and tablets would be more valuable than just counting the time they spend on these.”
The study, “Screen Media Use and Mental Health of Children and Adolescents: A Secondary Analysis of a Randomized Clinical Trial,” was authored by Jesper Schmidt-Persson, Martin Gillies Banke Rasmussen, Sarah Overgaard Sørensen, Sofie Rath Mortensen, Line Grønholt Olesen, Søren Brage, Peter Lund Kristensen, Niels Bilenberg, and Anders Grøntved.
