Insufficient physical activity in combination with high screen time is associated with adolescents' psychosocial difficulties

© The Author(s) 2018. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. Background: Although screen time (ST) and insufficient physical activity (PA) are fairly common among adolescents, it is unclear whether these conditions are jointly associated with adolescents' psychosocial difficulties. This study aimed to examine interactive associations of ST and PA with psychosocial difficulties among adolescents in Bangladesh. Methods: Data were from 671 students (ages 13-16 y) from eight secondary schools of Dhaka City, Bangladesh. Recreational ST was assessed using the Adolescent Sedentary Activity Questionnaire. The 3-day Physical Activity Recall instrument was used to estimate PA. Psychosocial difficulty was measured using the parent version of the Strengths and Difficulties Questionnaire (SDQ). Results: Sixteen percent of the adolescents had high SDQ total difficulties scores (=17) and another 14% had moderate scores (14-16; borderline). Multivariable modelling showed that adolescents with high ST (> 2 h/day) and insufficient PA (< 60 min/day; not meeting the PA recommendation) had more psychosocial difficulties than their counterparts who had low ST and met PA recommendations (p=0.03). The analysis also found marginal evidence (p=0.06) of an association with psychosocial difficulties for adolescents with insufficient PA and low ST. Conclusions: Adolescents in Dhaka City who have high recreational ST and are not meeting PA recommendations are likely to also have psychosocial difficulties. Longitudinal studies are needed to understand the causal relationships between these variables.