Television- and Screen-Based Activity and Mental Well-Being in Adults


      Sedentary behavior is emerging as an independent risk factor for physical health, although there is no existing evidence regarding mental well-being.


      This study aimed to examine the association between recreational sedentary behavior (based on TV- and screen-based entertainment [TVSE] time) and mental health in a representative sample of adults.


      Participants were 3920 men and women (mean age 51.0±15.8 years) from the 2003 Scottish Health Survey. The General Health Questionnaire (GHQ-12) and the mental health component of the 12-Item Short-Form Survey Instrument (MCS-12) were administered to obtain information on current mental health. Self-reported TVSE time, physical activity, and physical function was also measured. Analyses were conducted in 2009.


      Approximately 25% of participants engaged in at least 4 hours/day of TVSE. In general linear models, TVSE time per week was independently associated with GHQ-12 score (higher scores represent worse mental health status) after adjustment for age, gender, physical activity, physical function, area deprivation level, smoking, alcohol, fruit and vegetable intake, and BMI. After full adjustment, participants in the group with the highest TVSE level (>4 hours/day) had an increase in GHQ-12 score of 0.28 (95% CI=0.05, 0.51) compared with participants in the group with the lowest TVSE level (≤2 hours/day). In stratified analyses, the association between TVSE time and GHQ-12 score persisted across all physical activity levels. Similar associations were observed using the MCS-12.


      Sedentary behavior in leisure time is independently associated with poorer mental health scores in a representative population sample.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Brown W.J.
        • Ford J.H.
        • Burton N.W.
        • Marshall A.L.
        • Dobson A.J.
        Prospective study of physical activity and depressive symptoms in middle-aged women.
        Am J Prev Med. 2005; 29: 265-272
        • Strawbridge W.J.
        • Deleger S.
        • Roberts R.E.
        • Kaplan G.A.
        Physical activity reduces the risk of subsequent depression for older adults.
        Am J Epidemiol. 2002; 156: 328-334
        • Farmer M.E.
        • Locke B.Z.
        • Moscicki E.K.
        • Dannenberg A.L.
        • Larson D.B.
        • Radloff L.S.
        Physical activity and depressive symptoms: the NHANES I Epidemiologic Follow-up Study.
        Am J Epidemiol. 1988; 128: 1340-1351
        • Camacho T.C.
        • Roberts R.E.
        • Lazarus N.B.
        • Kaplan G.A.
        • Cohen R.D.
        Physical activity and depression: evidence from the Alameda County Study.
        Am J Epidemiol. 1991; 134: 220-231
        • Paffenbarger Jr, R.S.
        • Lee I.M.
        • Leung R.
        Physical activity and personal characteristics associated with depression and suicide in American college men.
        Acta Psychiatr Scand Suppl. 1994; 377: 16-22
        • Hamer M.
        • Molloy G.J.
        • de Oliveira C.
        • Demakakos P.
        Leisure time physical activity, risk of depressive symptoms, and inflammatory mediators: the English Longitudinal Study of Ageing.
        Psychoneuroendocrinology. 2009; 34: 1050-1055
        • Hamer M.
        • Stamatakis E.
        • Steptoe A.
        Psychiatric hospital admissions, behavioral risk factors, and all-cause mortality: the Scottish health survey.
        Arch Intern Med. 2008; 168: 2474-2479
        • Haskell W.L.
        • Lee I.M.
        • Pate R.R.
        • et al.
        • American College of Sports Medicine; American Heart Association
        Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association.
        Circulation. 2007; 116: 1081-1093
        • Katzmarzyk P.T.
        • Church T.S.
        • Craig C.L.
        • Bouchard C.
        Sitting time and mortality from all causes, cardiovascular disease, and cancer.
        Med Sci Sports Exerc. 2009; 41: 998-1005
        • Hamilton M.T.
        • Hamilton D.G.
        • Zderic T.W.
        Role of low energy expenditure and sitting in obesity, metabolic syndrome, type 2 diabetes, and cardiovascular disease.
        Diabetes. 2007; 56: 2655-2667
        • Hu F.B.
        • Li T.Y.
        • Colditz G.A.
        • Willett W.C.
        • Manson J.E.
        Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women.
        JAMA. 2003; 289: 1785-1791
        • Healy G.N.
        • Wijndaele K.
        • Dunstan D.W.
        • et al.
        Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab).
        Diabetes Care. 2008; 31: 369-371
        • Healy G.N.
        • Dunstan D.W.
        • Salmon J.
        • et al.
        Breaks in sedentary time: beneficial associations with metabolic risk.
        Diabetes Care. 2008; 31: 661-666
        • Räikkönen K.
        • Matthews K.A.
        • Kuller L.H.
        The relationship between psychological risk attributes and the metabolic syndrome in healthy women: antecedent or consequence?.
        Metabolism. 2002; 51: 1573-1577
        • Vogelzangs N.
        • Beekman A.T.
        • Kritchevsky S.B.
        • et al.
        Psychosocial risk factors and the metabolic syndrome in elderly persons: findings from the Health, Aging and Body Composition study.
        J Gerontol A Biol Sci Med Sci. 2007; 62: 563-569
        • Hamer M.
        • Stamatakis E.
        • Mishra G.
        Psychological distress, television viewing, and physical activity in children aged 4 to 12 years.
        Pediatrics. 2009; 123: 1263-1268
        • Ormel J.
        • Rijsdijk F.V.
        • Sullivan M.
        • van Sonderen E.
        • Kempen G.I.
        Temporal and reciprocal relationship between IADL/ADL disability and depressive symptoms in late life.
        J Gerontol B Psychol Sci Soc Sci. 2002; 57: P338-P347
        • The Scottish Government Statistics
        Scottish health survey publications.
        • Goldberg D.
        • Gater R.
        • Sartorius N.
        • et al.
        The validity of two versions of the GHQ in the WHO study of mental illness in general health care.
        Psychol Med. 1997; 27: 191-197
        • Gandek B.
        • Ware J.E.
        • Aaronson N.K.
        • et al.
        Cross-validation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project.
        J Clin Epidemiol. 1998; 51: 1171-1178
        • Joint Health Surveys Unit
        Health Survey for England Physical Activity Validation Study: substantive report.
        Information Centre for Health and Social Care, Leeds2007
        • The Scottish Government Statistics
        Scottish indices of deprivation 2003.
        • Primack B.A.
        • Swanier B.
        • Georgiopoulos A.M.
        • Land S.R.
        • Fine M.J.
        Association between media use in adolescence and depression in young adulthood: a longitudinal study.
        Arch Gen Psychiatry. 2009; 66: 181-188
        • Pressman S.D.
        • Matthews K.A.
        • Cohen S.
        • et al.
        Association of enjoyable leisure activities with psychological and physical well-being.
        Psychosom Med. 2009; 71: 725-732
        • Kop W.J.
        • Weinstein A.A.
        • Deuster P.A.
        • Whittaker K.S.
        • Tracy R.P.
        Inflammatory markers and negative mood symptoms following exercise withdrawal.
        Brain Behav Immun. 2008; 22: 1190-1196
        • Hamburg N.M.
        • McMackin C.J.
        • Huang A.L.
        • et al.
        Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers.
        Arterioscler Thromb Vasc Biol. 2007; 27: 2650-2656
        • Dworak M.
        • Schierl T.
        • Bruns T.
        • Struder H.K.
        Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children.
        Pediatrics. 2007; 120: 978-985
        • Lemal M.
        • Van den Bulck J.
        Television news exposure is related to fear of breast cancer.
        Prev Med. 2009; 48: 189-192
        • Clark B.K.
        • Sugiyama T.
        • Healy G.N.
        • Salmon J.
        • Dunstan D.W.
        • Owen N.
        Validity and reliability of measures of television viewing time and other non-occupational sedentary behavior of adults: a review.
        Obes Rev. 2009; 10: 7-16
        • Epstein L.H.
        • Roemmich J.N.
        • Robinson J.L.
        • et al.
        A randomized trial of the effects of reducing television viewing and computer use on body mass index in young children.
        Arch Pediatr Adolesc Med. 2008; 163: 239-245