Canadian study finds causal link between time playing videogames at age 12 and ADHD symptoms at age 13

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Recent stud­ies have linked screen time — includ­ing video game play — to con­cern­ing out­comes in chil­dren, includ­ing low self-esteem, low life sat­is­fac­tion, and depres­sive symp­toms. Screen time has also been found to be cor­re­lat­ed with symp­toms of ADHD in chil­dren and ado­les­cents, even when ear­li­er atten­tion dif­fi­cul­ties are tak­en into account.

These find­ings sug­gest that exces­sive video game play may be a risk fac­tor for the devel­op­ment of ADHD symp­toms. Oth­er research sug­gests the pos­si­bil­i­ty of reverse cau­sa­tion, i.e., that ADHD symp­toms pre­dicts the devel­op­ment of exces­sive video game play.

Deter­min­ing whether causal links exist between ADHD symp­toms and video game play requires a lon­gi­tu­di­nal study in which ADHD symp­toms and video game play are mea­sured at 2 points in time.

With this design, researchers can test whether video game use at Time 1 pre­dicts an increase in ADHD symp­toms at Time 2, after con­trol­ling for ADHD symp­toms at Time 1., i.e., more video game play leads to more ADHD symptoms.

Sim­i­lar­ly, one can test whether ADHD symp­toms at Time 1 pre­dicts high­er video game use at Time 2, con­trol­ling for video game use at Time 1., i.e., more ADHD symp­toms leads to more video game play.

The New Study:

This design was employed in a study pub­lished recent­ly in the Jour­nal of Atten­tion Dis­or­ders: Asso­ci­a­tions between video game engage­ment and ADHD symp­toms in ear­ly ado­les­cence.

Par­tic­i­pants were over 1400 youth (rough­ly 50% female) from a rep­re­sen­ta­tive sam­ple drawn from the province of Que­bec. As part of a larg­er lon­gi­tu­di­nal study, these youth self-report­ed their week­ly hours of video game as well as their ADHD symp­toms at age 12, and again one year lat­er. Video game engage­ment was rat­ed on a scale from zero hours per week to more than 20 hours per week. ADHD symp­toms were rat­ed on a 3‑point scale from ‘Nev­er true’ to ‘Often or very true’.

Results:

After con­trol­ling for sex, socioe­co­nom­ic sta­tus, and ADHD symp­toms at age 12, the week­ly amount video game play report­ed at age 12 pre­dict­ed high­er lev­els of self-report­ed ADHD symp­toms at age 13; this was true for both inat­ten­tive and hyper­ac­tive impul­sive symp­toms. The mag­ni­tude of the effect was not large, but it was sta­tis­ti­cal­ly significant.

In con­trast, high­er lev­els of ADHD symp­toms at age 12 did not pre­dict an increase in video game play one year lat­er. Although being male and of low­er socioe­co­nom­ic sta­tus was linked to high­er ADHD symp­toms and more video game play at age 12, these fac­tors did not pre­dict an increase in either ADHD symp­toms or video game play over time.

Summary and Implications:

Results from this study pro­vide evi­dence that youth who engage in more video game play are at risk for an increase in ADHD symp­toms over time. Because this result was obtained with a rep­re­sen­ta­tive com­mu­ni­ty sam­ple of youth, and was not restrict­ed to youth diag­nosed with ADHD, it sug­gests that video game play may be a gen­er­al risk fac­tor for ADHD symptoms.

The authors note sev­er­al impor­tant study lim­i­ta­tions, includ­ing the fact that both ADHD symp­toms and video game play were self-report­ed. There was also not infor­ma­tion col­lect­ed on the type of video game play; this is espe­cial­ly impor­tant in that the FDA recent­ly approved a video game (Endeav­or RX) as a treat­ment for ADHD based on favor­able results in a clin­i­cal trial.

Because atten­tion prob­lems need not be ele­vat­ed to a lev­el typ­i­cal­ly seen in youth with ADHD can still adverse­ly affect aca­d­e­m­ic achieve­ment, these find­ings are poten­tial­ly con­cern­ing. How­ev­er, it should be empha­sized that the impact of video game play on increas­ing ADHD symp­toms, although sta­tis­ti­cal­ly sig­nif­i­cant, was mod­est. The clin­i­cal impli­ca­tions of these find­ings thus remains unclear.

It is also not clear whether video game play may need to be above a cer­tain thresh­old lev­el before it may con­tribute to an increase in ADHD symp­toms while low­er lev­els of engage­ment are not asso­ci­at­ed with any risk.

The above con­sid­er­a­tions high­light that while exces­sive use of some types of video games may lead to an increase in ADHD symp­toms over time, it is pre­ma­ture to con­clude that any type of video game play has this effect. Devel­op­ing a bet­ter under­stand­ing of this issue will hope­ful­ly emerge over time.

– Dr. David Rabin­er is a child clin­i­cal psy­chol­o­gist and Direc­tor of Under­grad­u­ate Stud­ies in the Depart­ment of Psy­chol­o­gy and Neu­ro­science at Duke Uni­ver­si­ty. He pub­lish­es the Atten­tion Research Update, an online newslet­ter that helps par­ents, pro­fes­sion­als, and edu­ca­tors keep up with the lat­est research on ADHD.

The Study in Context: