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Screen time - a moral panic for the 21st century?

Caffeine and contemplation

Dominique Thompson

Tuesday, 05 February 2019

AdobeStock_220695173_social.jpgIf, like me, you spent the first few days of January chuckling at various fast food companies (Greggs, Pizza Hut, McDonalds) trolling Piers Morgan on Twitter, and his outrage at their vegan offerings, then you may not have noticed the media also getting excited about the new guidance from the Royal College of Paediatrics and Child Health on screen time in the under 18s.

There were many UK headlines about the guidance, but very few seemed to actually capture the correct key facts. A lot was made of the fact that parents should feel ‘reassured’ about the ‘lack of harm’ spending time on screens might cause to children, whilst other media outlets worried that the guidance didn’t really contain much actual solid guidance.

As GPs and healthcare professionals (and maybe as parents) it may be worth being aware of the facts, as, indirectly (though occasionally parents may mention screens and social media directly as the problem) we will be seeing young people adversely affected by their time spent on screens.

They may be affected by sleep disturbance, bullying, gaming addiction, perfectionism, poor body image and low self-esteem, or by obesity from lack of activity, but in a variety of ways the young people we see in our consulting rooms may be bringing ‘screen related’ issues to us.

Knowing what the ‘review of reviews’ conducted by the RCPCH actually found may prove useful to us, for advising their parents and carers, and the young people themselves.

The first thing to say is that there is relatively good evidence that higher screen time is associated with a higher risk of obesity, increased calorie intake and depressive symptoms. Therefore to state ‘lack of harm’ seems somewhat misleading. However, the overall message seems to be that a small amount of screen time daily is not associated with harm, and therefore the guidance seeks to reassure families.

The RCPCH tries to be pragmatic, asking families to check if screen time is negatively affecting family life, activities, sleep and so on. If so, there may indeed be a problem that needs addressing. It also suggests that families need to work out their own boundaries, and limits, recognising that no evidence clearly identifies ‘healthy limits’.

This has frustrated many parents who want a black and white time limit to set for their children, so perhaps here it may be helpful to look at the evidence from the USA (Twenge et al, 2017) that suggests two hours a day is an optimum amount for wellbeing (as less may be linked to poorer wellbeing through lack of social interaction or contacts, and more may be detrimental in other ways, as rates of depression and suicidal risk are higher, if a teenager uses a screen for more than three hours a day).

But many people agree with the section of the guidance that states that content is a key factor, rather than time spent per se.

What the kids are watching may be far more relevant to wellbeing and sleep quality, than how long they spend on a device.

And there definitely seems to be clear agreement on not using screens for the hour before bedtime (for all of us, actually!), so that is helpful and practical in what is proving to be an emotive and grey area of advice.

There is no doubt that more research is needed in this area, but with technology evolving so rapidly and such a huge variety of content potentially influencing our health and wellbeing, it is going to be challenging to ever have clear guidance for all of us to follow.

In the meantime, the safest approach, which is certainly backed up by the evidence we do have, is that moderation is a reasonable approach, and moral panic and scaremongering are as always, unlikely to be helpful.

I leave the last word to Professor Jean M. Twenge, a world leader in this area, from her excellent book ‘iGen’- ‘(Evidence) suggests that moderation, not necessarily complete elimination of electronic devices from teens’ lives, is key.’


  • Twenge J, Joiner T, Rogers M, Martin G. (2017) Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among U.S. Adolescents After 2010 and Links to Increased New Media Screen Time. Clinical Psychological Science, 6(1), pp.3-17.

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Dominique Thompson

Dominique has been a student health GP since 2000, developing innovative new services to treat eating disorders and personality disorder in primary care. She was the GP member of the NICE Eating Disorders Committee 2017. She was a Pulse ‘GP hero’, in 2014, and a ‘Rising Star’ in 2016. Dominique writes about young adult wellbeing and mental health, in both the medical and non-medical press. Her latest adventure is as an independent consultant in student health and wellbeing www.buzzconsulting.co.uk. She is fuelled by caffeinated drinks.
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