Association between television viewing and self-esteem in children

Objective: Few studies have examined the effect of excess television (TV) viewing on specific mental health outcomes, such as self-esteem. We explored the cross-sectional association between TV viewing hours and self-esteem in young children. Methods: A total of 70,210 primary 4 (US grade 4) participants of the Department of Health Student Health Service, Hong Kong, in 1998-2000 reported TV viewing hours in a standardized questionnaire. Self-esteem was assessed using the Culture-Free Self-Esteem Inventories for Children (SEI) with 4 subscales. Multivariate linear regression yielded beta coefficients (β) for SEI subscale scores by TV hours, adjusting for age, sex, body mass index, lifestyle characteristics, and highest parental education and occupational status. Results: Only 10.9% of children watched >4 hours per day, while 45.3% watched TV for 1 to ≤2 hours per day. Compared with children who watched <1 hour of TV per day, those who watched a moderate amount (1 to ≤2 hours/day) had higher (more favorable) SEI scores in the General (β = 0.09; 95% confidence interval = 0.02-0.16), Social (0.05; 0.01-0.09), and Parent-Related (0.04; 0.00-0.08) subscales but lower scores in the Academic subscale (-0.06;-0.09 to-0.02). Children who watched >2 hours of TV per day had lower SEI scores than those who watched <1 hour per day in all 4 subscales. Conclusions: An inverted J-shaped relation was observed between TV viewing hours and self-esteem among young children. The development of self-esteem among children who report little or excessive TV viewing should be further studied.