Digital Media and Inattention Symptoms

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

While there are many positive benefits of media consumption, excessive consumption can have negative consequences.

The average American consumer spends about 4.9 hours per day watching TV, 75 minutes per day on their smartphone and 62 minutes per day listening to radio (1). Many people spend most of their workday working on a computer.

TV and video gaming has been associated with adhd and related symptoms in a review of studies from 1987 to 2011 (2).

A recent study looked at many forms of digital media usage and adhd type symptoms (2).

Who was involved in the study? (3)

  • 4100 students ages 15 and 16 years were followed for 2 years.
  • Starting baseline and every 6 months, they were given surveys on digital media usage, inattention and hyperactivity.

How did the study define digital media (3)?

In this study digital media usage included using a variety of devices for social media, smart phone usage, streaming media, web browsing, messaging/video chatting, etc.

How did they define frequency of digital media usage? (3)

High-frequency (many times per day) vs other frequency levels (0, 1-2 times per week, 1-2 times per day).

What were the results? (3)

  • Among students with no adhd symptoms to begin with, those who used digital media at high frequency were more as likely to report symptoms of inattention and hyperactivity compared to those use rarely used digital media.
  • The most common high frequency media activity reported was checking social media.
  • Over 2 years of  follow up, the students who reported no high-frequency media use at baseline were half as likely to have ADHD symptoms across follow-ups vs students who reported 14 high-frequency activities.

What are some caveats?

  • This is a large study of young adults followed over 2 years.
  • They looked at many participants with little or no adhd symptoms to begin with.
  • While this study shows an association between digital media usage and adhd symptoms, it does not necessarily show that one causes the other.
  • This study was done on adolescents, which limits applicability of results to other age groups.
  • Further study is needed.

What are some negative consequences of excessive screen time?

Excessive screen time can (4):

  • Worse executive functioning
  • Increase aggressive behavior due to violent media content
  • Elevate depression risk
  • Decrease sleep quality.

Some individuals may also spend less time sleeping because of screen usage; which can worsen daytime fatigue and productivity.

Other studies show that screen time can also worsen the physical health of adults in many different ways.

Oftentimes, excessive media consumption can take time away from other self-care activities.

Are there some useful ideas around media usage?

American Academy of Pediatrics guidelines on media use for children and adolescents advise to (6,7):

  • Prioritize activities that promote executive functioning and well-being, including
    • Sleep
    • Physical activity
    • Distraction-free homework
    • And positive interactions with family and friends.
  • Encourages discussions about pro-social uses of media, digital citizenship, misinformation, and persuasion awareness—are relevant to the cognitive and emotional reactions to digital media of adolescents.

Consider periodic breaks, and rules around how often and how much media you consume electively.

  • Consider limiting elective screen-time to less than 2 hours per day (5).  Focus on quality instead of quantity.
  • Some people find it useful to use a timer.
  • There are apps that can help you limit excessive screen time.
  • For other tips, go here
  • In some cases excessive media consumption may be a red flag for mental health concerns.

Any other thoughts on media consumption?

  • While there are no specific guidelines for adults, if most of your day studying or working in front of a screen, choosing to spend leisurely time spent on other electronic devices, phones, tablets etc. may not balance your life or your brain.  It may lead to increased stress and fatigue.
  • How much time are you spending on electronic devices? Is this making you productive or just busy?
  • How do you feeling during and afterwards?
  • How is this impacting your mental health, physical health, productivity, academics ?
  • Have you set limits on elective media consumption and should you cut back?
  • Should you be doing other activities to balance your life; such as sleep, exercise, cooking nutritious food, spending quality time with others, etc. ?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://www.statista.com/topics/1536/media-use/
  2. Nikkelen  SW, Valkenburg  PM, Huizinga  M, Bushman  BJ.  Media use and ADHD-related behaviors in children and adolescents: a meta-analysis.  Dev Psychol. 2014;50(9):2228-2241. doi:10.1037/a0037318
  3. Ra CK, Cho J, Stone MD, et al. Association of Digital Media Use With Subsequent Symptoms of Attention-Deficit/Hyperactivity Disorder Among Adolescents. JAMA. 2018;320(3):255–263. doi:10.1001/jama.2018.8931
  4. Reid Chassiakos Y., Radesky J., Christakis D., et al: Children and Adolescents and Digital Media. Elk Grove Village (IL): The American Academy of Pediatrics, 2016.
  5. https://www.nhlbi.nih.gov/health/educational/wecan/reduce-screen-time/index.htm
  6. Radesky J. Digital Media and Symptoms of Attention-Deficit/Hyperactivity Disorder in Adolescents. JAMA.2018;320(3):1–2. doi:10.1001/jama.2018.8932
  7. Media Use in School-Aged Children and Adolescents. COUNCIL ON COMMUNICATIONS AND MEDIA. 

Alcohol and Grades

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Almost 2 out of 3 college students reported binge drinking of alcohol in the last 30 days (1).
Adults ages 18 to 29 years had the highest proportion of people with alcohol disorders (2).

In the United States, a standard drink is defined as (12):
• 12 ounces of beer with 5 percent alcohol content
• 5 ounces of wine with 12 percent alcohol content
• 1.5 ounces of distilled spirits with 40 percent alcohol content

What is high risk drinking?
High risk, heavy drinking, or binge drinking, defined as 5 or more drinks on one occasion, can impact academics (3, 4, 5).
It is also related to:
• Academic problems (6)
• Fewer study hours (5,7)
• Lower reported grades (8)

How does heavy drinking impact your academic performance?
• Frequent heavy drinking is related to:
• Increased sleepiness (4)
• Disrupted sleep (4)
• Disrupted learning (9)
• Disrupted memory (9)
• Increased social and emotional problems over time (10)
These factors might cause you to miss classes, deadlines, or perform poorly.

What is low risk drinking?

 

 

https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Is-your-drinking-pattern-risky/Whats-Low-Risk-Drinking.aspx

Low risk DOES NOT mean no risk.
For some people a lower cutoff may be more beneficial.

Who should avoid alcohol?
It’s safest to avoid alcohol altogether if you are:
• Taking medications that interact with alcohol (11)
• Managing a medical condition that can be made worse by drinking (11)
• Underage (11)
• Planning to drive a vehicle or operate machinery(11)
• Pregnant or trying to become pregnant (11)
You should also avoid alcohol if you have a family history of addiction because of increased genetic risk of addiction.

Where can you learn more about alcohol?
How much is too much, strategies for cutting down, quitting can be found here:
https://www.rethinkingdrinking.niaaa.nih.gov/Thinking-about-a-change/
http://www.ccs.osu.edu/self-help/alcohol/
• Take the OSU Free Anonymous Mental health Screen

From what I have seen in practice and research, as we learn more about the impact of alcohol, the amount of alcohol that is considered safe continues to be lower than previously thought.

Are you regularly drinking too much alcohol? How is it impacting your academic, emotional and physical health?

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

 References:

1.  SAMHSA. 2014 National Survey on Drug Use and Health (NSDUH). Table 6.89B—Binge Alcohol Use in the Past Month among Persons Aged 18 to 22, \HWVGFGHNSDUH-DetTabs2014/NSDUH-DetTabs2014.htm#tab6-89b 

2. Turrisi R, Larimer ME, Mallett KA, Kilmer JR, Ray AE, Mastroleo NR, et al. A randomized clinical trial evaluating a combined alcohol intervention for high-risk college students. J Stud Alcohol Drugs. 2009;70:555–67.

3. El Ansari W, Stock C, Mills C. Is alcohol consumption associated with poor academic achievement in university students? Int J Prev Med (2013) 4(10):1175–88. 

4. Singleton RA, Jr, Wolfson AR. Alcohol consumption, sleep, and academic performance among college students. J Stud Alcohol Drugs. 2009;70:355–63. 

5. Wolaver AM. Effects of heavy drinking in college on study effort, grade point average, and major choice. Contemp Econ Policy. 2002;20:415–28.

6.  Wechsler H, Dowdall GW, Maenner G, Gledhill-Hoyt J, Lee H. Changes in binge drinking and related problems among American college students between 1993 and 1997. Results of the Harvard School of Public Health College Alcohol Study. J Am Coll Health. 1998;47:57–68. 

7. Webb E, Ashton CH, Kelly P, Kamali F. Alcohol and drug use in UK university students. Lancet. 1996;348:922–5. 

8. Engs RC, Diebold BA, Hanson DJ. The drinking patterns and problems of a national sample of college students. Journal of Alcohol and Drug Education. 1996;41:13–33.

 9. Zeigler DW, Wang CC, Yoast RA, Dickinson BD, McCaffree MA, Robinowitz CB, et al. The neurocognitive effects of alcohol on adolescents and college students. Prev Med. 2005;40:23–32.

10. Crosnoe R, Benner AD, Schneider B. Drinking, socioemotional functioning, and academic progress in secondary school. J Health Soc Behav. 2012;53:150–64.

11. https://www.rethinkingdrinking.niaaa.nih.gov/How-much-is-too-much/Is-your-drinking-pattern-risky/Whats-Low-Risk-Drinking.aspx

12. The National Institute on alcohol abuse and alcoholism. https://pubs.niaaa.nih.gov/publications/collegefactsheet/Collegefactsheet.pdf

 

 

 

Study: Caffeine, Stress, and Brain function

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

According to the Food and Drug Administration, caffeine is widely available and upto 80% of adults have caffeine everyday, upto 200mg, which is about 10 ounces of coffee (1).

Sometimes caffeine is used to help stay awake, alert, keep up with academic demands, etc.

While the many benefits of caffeine have been widely documented, problems and side effects caffeine are not as widely known.

One study looked at the impact of caffeine on stress (2).

Who was involved in the study? (2)

  • 25 participants who used caffeine regularly or were light user of caffeine.
  • Subjects received placebo or caffeine (3.5mg per kilogram of body weight, about 238mg for a person weighing 150 pounds)

What was measured? (2)

  • Blood pressure, cortisol (stress hormone), norepinephrine and epinephrine (also involved in stress response and other functions).
  • Measurements were taken at rest, during a stressful laboratory task, and afterwards at rest.

What were the results? (2)

  • Compared to placebo, caffeine caused more than DOUBLE the levels of epinephrine and cortisol, both involved in stress response.
  • Effects were similar in both habitual and light users.
  • Habitual use of caffeine did not development of tolerance to the bodily response.
  • Even at rest, caffeine increased blood pressure and plasma norepinephrine levels.

What do the results mean?

Caffeine may increase your stress level whether you are using caffeine sporadically or regularly.

What are some other effects of too much caffeine?

  • Caffeine had as early as 7am lead to less efficient sleep and reduced total sleep at 9pm (3).
  • Some people have more daytime sleepiness because of caffeine related sleep disruption (4).
  • Caffeine can reduce bloodflow to the brain by up to 27% (5)
  • Too much caffeine can cause (1):
    • Worsening of anxiety
    • Jitteriness
    • Nervousness
    • Sleep disturbance
    • Headaches
    • Make your heart beat faster,  palpitations, high blood pressure, abnormal heart rhythms

What are some caveats?

  • This is a small study and there are many studies showing positive and negative effects of caffeine.
  • Not everyone has the same benefits or side effects caffeine.
  • The AMOUNT of caffeine that has beneficial and harmful effects can be different for different people.
  • Some people can metabolize caffeine much faster or slower than others (6).
  • For some people, it can take days to weeks to see benefits from reducing or eliminating caffeine.
  • Stopping caffeine abruptly can lead to withdrawal headaches, irritability, and other symptoms.

Are you feeling stressed, irritable or anxious? How is your caffeine intake? Could you benefit from less?

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://www.fda.gov/downloads/ucm200805.pdf
  2. Land JD, Adcock RA, Williams RB, Kuhn CM. Caffeine effects on cardiovascular and neuroendocrine responses to acute psychosocial stress and their relationship to level of habitual caffeine consumption.  Psychosom Med. 1990 May-Jun;52(3):320-36.
  3. H.P. Landolt, E. Werth, A.A. Borbely, D.J. Dijk.  Caffeine intake (200 mg) in the morning affects human sleep and EEG power spectra at night. Brain Research, 675 (1–2) (1995), pp. 67–74.
  4. T. Roehrs, T. Roth. Caffeine: sleep and daytime sleepiness. Sleep Med Rev, 12 (2) (2008), pp. 153–162.
  5. Addicott M.A., Yang L.L., Peiffer A.M., Burnett L.R., Burdette J.H., Chen M.Y.. et al. The effect of daily caffeine use on cerebral blood flow: how much caffeine can we tolerate? Hum. Brain Mapp. 2009;30:3102–3114.
  6. Cornelis, M. C. et al. Genome-wide meta-analysis identifies six novel loci associated with habitual coffee consumption. Mol. Psychiatry 20, 647–656 (2015).