Interaction effects of screen time and content on emotional and behavioral problems in preschool children

XING Yanfei; JIANG Lin; HU Yan; MA Bingjie; LU Shaomin; LIANG Jingjing

doi:10.11852/zgetbjzz2025-0973

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Chinese Journal of Child Health Care ›› 2026, Vol. 34 ›› Issue (6) : 656-662. DOI: 10.11852/zgetbjzz2025-0973

Child Emotional and Behavioral Health

Interaction effects of screen time and content on emotional and behavioral problems in preschool children

XING Yanfei, JIANG Lin, HU Yan, MA Bingjie, LU Shaomin, LIANG Jingjing

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Abstract

Objective To investigate the current status of screen exposure among preschool children in Guangzhou and to examine the interaction between screen exposure duration and content type in relation to children′s emotional and behavioral problems, so as to provide evidence for targeted interventions. Methods Using a random cluster sampling method, a self-designed health survey questionnaire for preschool children was used to collect data on screen exposure among preschool children in Guangzhou from July to September 2024.Emotional and behavioral problems were assessed using the parent-reported Strengths and Difficulties Questionnaire (SDQ).A total of 878 valid questionnaires were included in the analysis.Multivariable logistic regression models were used to examine the associations of screen exposure with emotional and behavioral problems, as well as the interaction between screen exposure duration and content type on SDQ subscales. Results After adjustment for potential confounders, compared with children whose daily screen exposure was＜1h, those with daily screen exposure≥2h had an increased risk of abnormalities in the total difficulties(OR=2.443), emotional symptoms(OR=2.090), conduct problems(OR=2.172), and hyperactivity/inattention subscales(OR=2.011) (P＜0.05).Compared with children who used electronic devices mainly for learning purposes, those who primarily watched videos (e.g., cartoons or short videos) had an increased risk of abnormalities in the emotional symptoms(OR=2.433), peer problems(OR=1.534), and prosocial behavior subscales (OR=2.341) (P＜0.05).There was a positive interactive effect between watching videos (e.g., cartoons or short videos) and exposure time≥1h/d on the emotional symptoms and peer problems subscales. Conclusions Excessive screen exposure is prevalent among preschool children in Guangzhou.Daily screen exposure of more than 2 hours is associated with increased risks of abnormalities in multiple emotional and behavioral domains, whereas the use of electronic devices for learning is associated with lower risks.In particular, prolonged exposure (≥1 h/d) to entertainment-oriented video content, such as cartoons and short videos, may have a synergistically amplified adverse impact on children′s emotional stability and peer interaction.

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preschool children / screen exposure / screen time / screen content / emotional and behavioral problems / interaction effects

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XING Yanfei, JIANG Lin, HU Yan, MA Bingjie, LU Shaomin, LIANG Jingjing. Interaction effects of screen time and content on emotional and behavioral problems in preschool children[J]. Chinese Journal of Child Health Care. 2026, 34(6): 656-662 https://doi.org/10.11852/zgetbjzz2025-0973

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