# Trends and Behavioral Correlates of Excessive Screen Time Among Swedish Adolescents: A Repeated Cross-Sectional Study (2017–2023)

## TL;DR

This study tracks how much time Swedish teens spend on screens and finds that less sleep and risky behaviors are linked to more screen time, with social media being the strongest link.

## Contribution

The study reveals distinct behavioral correlates for different screen modalities (gaming, social media, film/TV) and highlights the importance of modality-specific analysis in adolescent screen time research.

## Key findings

- Shorter sleep and alcohol use are consistently linked to higher overall screen time.
- Physical activity and living with both parents are associated with lower screen time across modalities.
- Social media use shows the strongest association with risk behaviors compared to gaming and film/TV.

## Abstract

•High levels of weekday after-school screen time remained common across all survey waves.•Shorter sleep duration and substance use, particularly alcohol use, were associated with higher overall screen time across survey waves.•Higher physical activity and longer sleep duration were consistently associated with lower use across screen modalities.•Risk behaviors were most strongly associated with social media use, with weaker and more heterogeneous associations observed for gaming and film/TV viewing.•Screen-use correlates differed by modality, underscoring the importance of distinguishing between gaming, social media, and film/TV use in adolescent research.

High levels of weekday after-school screen time remained common across all survey waves.

Shorter sleep duration and substance use, particularly alcohol use, were associated with higher overall screen time across survey waves.

Higher physical activity and longer sleep duration were consistently associated with lower use across screen modalities.

Risk behaviors were most strongly associated with social media use, with weaker and more heterogeneous associations observed for gaming and film/TV viewing.

Screen-use correlates differed by modality, underscoring the importance of distinguishing between gaming, social media, and film/TV use in adolescent research.

This repeated cross-sectional study examined trends and behavioral correlates of excessive screen time among Swedish adolescents across 2017, 2020 and 2023. Specifically, this study examined 1) temporal trends of variables used, 2) correlates of pooled screen time, and 3) correlates of specific screen modalities (gaming, social media, and film/TV viewing).

Data were collected from n=8,300 upper secondary school students in Jönköping County (n=2,319 in 2017; n=3,056 in 2020; n=2,925 in 2023). Measures used included risk behaviors (e.g., alcohol, smoking), physical activity, psychosocial trust, exposure to violence and victimization, sleep duration, psychosomatic symptoms, absenteeism and living arrangement. General linear models (GLM; UNIANOVA) were conducted, adjusting for relevant covariates.

Alcohol use, smoking, shorter sleep duration, higher psychosomatic symptoms, and school absenteeism were associated with higher pooled screen time, whereas physical activity, female gender, and living with both parents were associated with lower pooled screen time. Across modality-specific analyses, shorter sleep duration, lower physical activity, living without both parents, and school absenteeism were consistently associated with higher screen use across gaming, social media, and film/TV viewing, while substance-use and gender associations varied by modality.

Sleep, physical activity, family structure, and school absenteeism appear to be robust correlates across screen modalities, supporting the importance of targeting these factors in adolescent health promotion and digital media guidance. These findings highlight the need for parents, researchers, and health professionals to pay closer attention to adolescents’ digital media use.