Chain mediating role of self-esteem and resilience in the association between screen time and depression symptoms among Chinese children and adolescents

To explore the effects of screen time on depression symptoms in Chinese children and adolescents, and to examine the mediating effect role of self-esteem and resilience between the association from a longitudinal perspective. A total of 653 students graded 4th to 8th were selected through a stratified cluster sampling method from Shanghai, China. The Screen Time Scale, the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), the Rosenberg Self-esteem Scale (RSES), and the Chinese version of the Connor–Davidson Resilience Scale (CD-RISC) were applied in this study. Structural equation modeling was performed to investigate the mediating role of self-esteem and resilience. The direct effect of baseline screen time (T1) on subsequent depression symptoms (T2) was not statistically significant after controlling for depression symptoms at T1 (β = -0.029, p >.05). There were three significantly intricate multiple-chain-mediated associations between baseline screen time and subsequent depression symptoms. In each pathway, screen time was associated with self-esteem, which, in turn, was linked to depression symptoms three months later through resilience. While screen time may not directly impact depression symptoms 3-month later, it can indirectly influence these symptoms through self-esteem and resilience at different time points.