Browsing by Author "Tomfohr, Lianne"

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    Associations Between Screen Time and Child Internalizing and Externalizing Behaviour Problems: A Meta-Analysis
    (2021-08-19) Eirich, Rachel; Madigan, Sheri; Tomfohr, Lianne; Giesbrecht, Gerald; Climie, Emma
    Background: Research on the effects of screen time on child outcomes has increased exponentially in response to the ubiquity of digital media. However, due to mixed findings, significant debate exists as to whether screen time is associated with problematic child outcomes, including internalizing and externalizing problems. It is important to understand the methodological differences that may be contributing to heterogeneity in findings and the possible risks and benefits of screen time to inform parents, clinicians, policy-makers, and future research. Objectives: To 1) meta-analytically determine the association between screen time (i.e., duration of use) and child externalizing and internalizing problems; 2) identify moderators that may contribute to discrepancies in the literature and point to areas for methodological improvement in future research. Method: Electronic searches were conducted in MEDLINE, Embase, and PsycINFO in June of 2019 and 22,528 non-duplicate articles were identified and screened for inclusion. Quantity of screen time was defined as the duration of time children spend viewing screens (e.g., television, tablets, video games, and/or computers, etc.). Child behaviour problems included externalizing (e.g., aggression, hyperactivity) and/or internalizing (e.g., depression, anxiety) behavioural symptoms or clinical diagnoses. Results: After screening all abstracts for inclusion, 434 full-text articles were assessed for eligibility and a total of 64 studies (with 74 unique samples; 85,225 participants) met all inclusion criteria. Results revealed that screen time was associated with more externalizing problems (k = 72, r = 0.12; 95% CI [0.10, 0.14]). Moderator analyses suggested that effect sizes were larger for males, in older studies, in studies examining aggression (vs. hyperactivity/inattention). Effect sizes were larger when the screen time informant was the child versus the parent. A separate meta-analysis revealed that screen time was also associated with more internalizing problems (k = 26, r = 0.07, 95% CI [0.04, 0.11]) and moderator analyses suggested that effect sizes were larger when the screen time informant was the child (vs. parent). Conclusions: These meta-analyses support small but significant associations between screen time and children’s behaviour problems. Methodological differences across studies were one of the most common contributors to mixed findings in the literature.
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    Trajectories of Sleep Quality and Associations with Mood during the Perinatal Period
    (SLEEP, 2015-08) Tomfohr, Lianne; Buliga, Elena; Letourneau, Nicole; Campbell, Tavis; Giesbrecht, Gerald
    Objective: The aim of this study was to investigate trajectories of sleep quality and associations with mood in the perinatal period. Although it is commonly accepted that subjective sleep quality declines during pregnancy and the transition to parenthood, some women may follow qualitatively distinct trajectories. Design, Setting, and Participants: Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Data were collected from 293 women at four time points: during early pregnancy, at Time 1 (T1;< 22 w gestational age [GA]; late pregnancy, at Time 2 (T2; 32 w GA); during the postnatal period at Time 3 (T3; 3 mo postpartum); and Time 4 (T4; 6 mo postpartum). A group-based semiparametric mixture model was used to estimate patterns of sleep quality throughout the perinatal period. Results: Four trajectory groups were identified, including patterns defined by high sleep quality throughout (21.5%), mild decrease in sleep quality (59.5%), significant decrease in sleep quality (12.3%) and a group with poor sleep quality throughout (6.7%). Women who had the worst sleep quality at Time 1 and those who experienced significant increases in sleep problems throughout pregnancy were also the groups who reported the highest levels of anxiety and depressive symptoms in early pregnancy and the lowest levels of social support. After controlling for covariates, the groups with worst subjective sleep quality during pregnancy were also the most likely to experience high symptoms of depression in the postpartum period. Conclusions: Most of the women in our sample reported mild sleep disturbances through the perinatal period. A subgroup of women reported a significant decline in sleep quality from early to late pregnancy and another reported poor subjective sleep quality throughout pregnancy; these groups had the greatest risk of experiencing high symptoms of depression in the postpartum period. Key Words: depression, postpartum, pregnancy, sleep, trajectories