Daily screen exposure and health-related quality of life in children and adolescents: Gender-differentiated effects across developmental stages
Background: Prolonged recreational screen exposure adversely affects health-related quality of life (HRQoL), yet developmental shifts in gender-differentiated susceptibility across youth remain understudied.
Objective: This study aimed to investigate both physical and psychosocial HRQoL in relation to daily recreational screen exposure among children and adolescents, asking in particular whether gender differences depend on developmental stage.
Methods: In this cross-sectional study, data were obtained for 1,505 students using the Pediatric Quality of Life Inventory 4.0: 678 children aged 7–12 years were assessed by parent-proxy report, and 827 adolescents aged 13–18 years completed the self-report version. Within each cohort, two-way multivariate analyses of covariance and follow-up univariate analyses of covariance, adjusting for age and parental education, compared HRQoL across screen-exposure levels and gender.
Results: Among children, physical (p = 0.013) and psychosocial (p = 0.004) HRQoL scores were lower at higher screen-exposure levels, and boys and girls did not differ in either domain (p > 0.05). Among adolescents, both physical and psychosocial HRQoL scores were also lower at higher exposure levels for both genders, but a small gender × screen time difference emerged for physical health, F(3,816) = 3.65, p = 0.012, η2p = 0.013, with girls scoring lower than boys at the higher exposure levels. Psychosocial health showed no such difference, F(3,816) = 0.71, p = 0.544, η2p = 0.003.
Conclusion: In childhood, HRQoL did not differ by gender across screen-exposure levels. In adolescence, a small gender difference emerged, limited to physical health. Given the modest effect size and cross-sectional design, these group differences should not be interpreted causally, and reverse causation cannot be ruled out. Age- and gender-sensitive guidance on screen use may still be worth considering for adolescents, pending confirmation in longitudinal research.
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