Excessive Television Exposure in Teens Linked to Depression in Adulthood

February 5, 2009 — Excess exposure to television in teens has been linked to an increased risk for depression in early adulthood, particularly among young men.

A large longitudinal study from investigators at the University of Pittsburgh, in Pennsylvania, shows that each extra daily hour of television use was associated with an 8% increase in the odds of developing depressive symptoms by young adulthood.

"We looked at the development of depression over a 7-year period and found that the amount of television exposure was significantly associated with the development of depression," principal investigator Brian A. Primack, MD, told Medscape Psychiatry.

The study is published in the February issue of Archives of General Psychiatry.

Leading Cause of Morbidity Worldwide

Although previous studies have investigated the relationship between electronic media and mental health, this research has largely been cross-sectional and has primarily focused on anxiety.

Findings from these studies have shown a link between excessive use of certain media, social anxiety, and a decline in interpersonal relationships.

Researchers wanted to explore the relationship between media exposure and depression, which has been cited by the World Health Organization as the leading cause of morbidity worldwide and is very common in adolescence.

They hypothesized that an excessive amount of television watching during adolescence would increase depression in young adulthood and would have a greater impact on young females than their male counterparts.

They also theorized that television exposure would turn out to be more potent than other types of electronic media, including videocassettes, computer games, or radio. (The data for the study were collected before Internet use was widespread and prior to the introduction of DVDs).

Males at Greater Risk

Using data from the National Longitudinal Survey of Adolescent Health, investigators looked at the relationship between electronic media exposure in 4142 adolescents who were not depressed at baseline and the subsequent development of depression at 7-year follow-up from 1995 to 2002.

At baseline, teens were asked about the number of hours they had spent during the previous week watching television or videocassettes, playing computer games, or listening to the radio.

Subjects reported an average of 5.68 hours of media exposure per day, including 2.3 hours of television, 0.62 hours of videocassettes, 0.41 hours of computer games, and 2.34 hours of radio.

At follow-up, 308 (7.4%) participants reported symptoms consistent with depression, and researchers found these individuals had watched more television than nondepressed individuals at baseline — 2.64 hours vs 2.28 hours per day — and that this association was statistically significant. However, there was no association between these symptoms and exposure to other media types.

Surprisingly, in contrast to their original hypothesis, the researchers found that, compared with young men, young women were less likely to develop depression given the same total media exposure.

"At study outset, we felt females were more likely to be affected because of all the images that are pervasive in the media of the 'feminine ideal' of thin, beautiful women. However, the study showed the opposite was true," said Dr. Primack.

Greater "Social Reserve" in Girls?

One possible explanation for this finding, he said, is that the impact of media content that presents idealized masculinity and sex roles on the psychological development of young males has been underappreciated.

"The bottom line is that males are also held to a high standard in the media, and it is possible that, for a number of reasons, those portrayals might be more powerful that we had previously thought," he said.

Another possible explanation is that young females have more "social reserve" than young males, which increases their resilience.

"We know that during adolescence and even in early adulthood females have closer relationships than young males. So if a boy watches several hours of television a day, this may substantially displace social interaction. Girls, however, may be able to watch the same amount of television while still maintaining their social relationships," said Dr. Primack.

More research is needed to better understand the mechanisms at play and whether it is the amount of media exposure, the type of media content adolescents are exposed to, or some other mechanism that underlies this association.

Need for Media Literacy

In the meantime, said Dr. Primack, the study has implications for clinicians, including psychiatrists, pediatricians, family physicians, internists, and other health providers who work with adolescents, to ask about television and other media exposure. It also has implications for researchers and research funding agencies.

"At this point, we have enough substantial data from studies like this linking large amounts of media exposure to major health concerns such as substance use, obesity, and aggression. So moderating the amount of media an individual consumes is certainly something physicians can and probably should suggest," he said.

Teaching media literacy, the critical analysis of media content, is also something that should be considered on a widespread basis, he added. "Individuals who are media literate should be better equipped to navigate the modern world. They may be less susceptible to the messages from the barrage of media that are all around us these days. They may even be more psychologically fulfilled because they will set their own goals instead of allowing advertisers and marketers to set their life goals for them," said Dr. Primack.

Arch Gen Psychiatry. 2009;66:181-188. Abstract

Written by Caroline Cassels from Medline