Mild videogaming is associated with enhanced cognitive performance and mental health in children

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Abstract Submission 

Bader Chaarani¹

¹University Of Vermont, Burlington, VT

Bader Chaarani  
University Of Vermont
Burlington, VT

It is estimated that by the end of 2023 there will be over three billion active videogamers (VGs) worldwide 1. According to a recent American Psychological Association survey, more than 90% of children in the U.S. play videogames 2, a significant increase from an estimated 70% of children VGs in 2013, when the American Academy of Pediatrics (AAP) recommended limiting entertainment screen-use to <2h/day (AAP, 2013). While prior research links videogaming with adverse cognitive, behavioral and mental health outcomes in children, these studies were conducted in relatively small datasets, limiting their power to investigate videogaming exposure hours including the specific <2h/day AAP recommendation. We have recently shown 3, using the large Adolescent Brain Cognitive Development (ABCD) studyⓇ dataset, that videogaming for ≥3h/day is associated with enhanced cognitive performance in children but also higher attention problems, depression, and attention-deficit/hyperactivity disorder scores, albeit well below clinical thresholds, compared to non-videogamers (NVGs). To investigate these effects in children who spend less time videogaming, we compared mental health and cognitive measures as well as BOLD signal during a working memory N-Back fMRI task in the ABCD Study, defining samples of 9- and 10-year-old children who play <1h/day, 1-2h/day, 2-3h/day and ≥3h/day and NVGs (0h/day).

Participants completed a screen time survey asking how much time they "Play video games on a computer, console, phone or other device (Xbox, PlayStation, iPad)?". Videogaming hours were self-reported for a typical weekday and weekend day, from which videogaming hours/day were derived. Outcomes of interest included mental health scores from the Child Behavior Checklist (CBCL), cognitive scores from the NIH Toolbox® cognition battery, in addition to working memory performance and region-based cortical BOLD signal from the N-back fMRI task (available for approximately half the sample). These outcomes were compared across the groups using linear mixed models with, age, sex, race/ethnicity, combined parental income, TV watching, parental monitoring, and sibling status as nuisance covariates, and scanner site as a random effect. FDR-corrected p values<.05 were considered significant.

VGs who play <1h/day (N=5824) and 2-3h/day (N=1024) did not have higher CBCL measures (uncorrected-p>0.055) compared to NVGs (N=1711), while VGs who play >3h/day (N=1233) had higher scores than all groups on attention, depression and ADHD (Figure 1). Mild and moderate VGs (<3h/day) were the best performers on the NIH toolbox cognitive tasks compared to NVGs, scoring significantly better on pattern recognition and Flanker tasks, and having higher fluid and total IQ scores. Importantly, 1h/day VGs scored higher than all groups on card sorting and picture memory tests, had the highest IQ scores and lower externalizing, depression and conduct disorder scores compared to NVGs. Lastly, all VGs groups (<1h/day: N=4306; 1-2h/day: N=1631; 2-3h/day: N=711; 3h+/day: N=750) performed significantly better on the N-back task and showed higher neural activation on the 2-back vs. fixation contrast compared to NVG (N=1278) in bilateral precuneus and the right precentral gyrus (Figure 2).

The present findings strongly support the AAP recommendations and further show that 1h/day or less of videogaming is associated with better cognitive performance and mental health in children. The enhanced performance on the N-back task, coupled with higher neural activation in cortical brain regions playing a critical role in working memory and visuospatial attention, support the hypothesis that these areas exhibit a practice effect associated with the cognitively demanding videogaming.

Executive Function, Cognitive Control and Decision Making ¹

Working Memory

Activation (eg. BOLD task-fMRI) ²

Attention: Visual

Attention Deficit Disorder

Cognition

Cortex

FUNCTIONAL MRI

Psychiatric Disorders

Other - videogaming, screen time