This study is a comprehensive investigation of university students' SV patterns across purposes, devices, and timing, and is the first to investigate the relationships between SV patterns and mental wellbeing and psychological distress in university students. Our study showed that university students exhibited very high levels of SV, with females reporting higher SV than males. While most of the SV was spent studying and using computers, students also engaged in a considerable amount of recreational SV and on mobile devices. Previous studies among university students, predominantly from Western countries reported lower SV levels, varying between 5.5 and 11.5 hours per day [4–11], whereas students in the present study reported an average of more than 14 hours per day. This notable difference could be attributable to the study being conducted during the post-COVID-19 era when online learning was a norm among university students; also, Singapore's ambition to be a Smart Nation ensured widespread internet access and fostered electronic device use [14, 44]. Additionally, unlike earlier research focusing on specific device types, our study considered SV across multiple device types, reflecting the modern reality of college students' electronic device use for communication and socialization, information retrieval, and other purposes [45]. Furthermore, studies have indicated that males tend to use screens more frequently than females across all age groups [46, 47], while female university students demonstrate a greater dependency on smartphones than males [24]. Our observations of higher SV in females may stem from differences in leisure preferences, social media usage habits, or study behaviors between different sexes [24]. Moreover, societal norms and expectations regarding technology use, as well as alternative behaviors, such as sports and exercise, could impact SV habits differently for males and females [47]. Further investigation into these factors is essential for a comprehensive understanding of sex differences in SV.
Another important finding of our study is that approximately one in three university students exhibited poor mental wellbeing, and approximately one in seven reported experiencing psychological distress. The mental health of college students is a significant public health concern. According to the World Health Organization's (WHO) World Mental Health (WMH) Survey, three-quarters of mental illnesses appear before the age of 24, with one-fifth of college students testing positive for mental disorders in a 12-month evaluation [48]. A national mental health survey in Singapore showed that the median age of onset for mental disorders is 22 years, with the highest incidence occurring between the ages of 18 and 24 years [49], and the proportion of young adults with poor mental wellbeing and psychological distress has been gradually increasing in recent years [50]. Previous reviews have examined mental health issues among college students, with most studies being conducted in high-income Western countries [51, 52]. The methodology, assessment instruments, and cultural adaptation of measuring tools differ greatly between studies, which might influence comparability [53]. Furthermore, the prevalence of poor mental wellbeing in Singaporean adults before and during the COVID-19 pandemic was 8.4% and 8.7%, respectively, which is lower than what was reported in our study [54, 55]. It is important to note that our study collected data during the early post-COVID-19 period, and existing literature indicates that the COVID-19 pandemic has had a negative impact on student mental health, particularly in terms of distress [56, 57]. This may explain why poor mental wellbeing was reported to be higher in our study than in Singapore before the pandemic [56, 57].
Total SV in the present study was consistently associated with mental wellbeing and psychological distress, even after adjusting for potential confounders including physical activity and sleep duration. Previous research on the relationship between SV and mental health has yielded inconsistent findings [20, 23, 52]. While some studies have suggested that greater SV is more likely to be associated with higher odds of poor mental wellbeing or psychological distress [46, 58–60], others have found no association or even a potential benefit [20, 61, 62]. Notably, most of these studies focused on adolescents rather than university students and often defined high SV as four or five hours without investigating the role of average daily SV beyond 10 hours. Therefore, the discrepant findings might be attributable to differences in the study population but also the greater amount of SV observed in our study population. Furthermore, previous studies did not adequately consider the influence of other health behaviors, such as physical activity and sleep, on this relationship. The associations between SV and mental health among university students are not as simple as commonly assumed [63]. SV may displace more health-enhancing activities, but individuals engaging in exceptionally high SV might also adopt compensatory mechanisms, such as incorporating positive lifestyle factors like regular physical activity or sufficient sleep, mitigating the detrimental effects on their wellbeing [30, 62]. By considering these factors, our study addresses a research gap that contributes to a better understanding of the complex relationship between SV patterns and mental health among Asian university students.
Our findings suggest that the relationship between SV and mental health in university students may be linked to the purpose of SV rather than just the duration of exposure [20, 62]. High recreational SV was related to poor mental wellbeing. Research among teenagers corroborates our findings reporting that nearly one-fifth of teenagers with greater recreational SV reported signs of depression [64]. The association between recreational SV and mental wellbeing is intertwined with other factors. For instance, the constant availability of smartphones may instill a perceived obligation to remain accessible at all times and increase social comparison, fostering feelings of stress, depression and loneliness [65, 66]. Additionally, intensive screen engagement may disrupt other fundamental behaviors such as eating, exercising, and sleeping, thereby affecting mental wellbeing [67]. High study related SV on the other hand was associated with increased psychological distress. Few previous studies on the associations between study related SV and mental health issues exist and their findings are inconclusive [62, 68]. The observed association could be explained, however, by the increased pressure and demands of university-level studies. The transition from high school to university introduces new challenges and stressors, such as adapting to a more rigorous academic environment, managing greater workloads, and facing heightened expectations for academic performance [16]. As a result, students may resort to prolonged screen use as a means of studying, completing assignments, or seeking information, inadvertently exacerbating psychological distress. Therefore, our findings shed light on the intricate relationship between SV patterns driven by academic obligations and their impact on mental health outcomes among university students during this pivotal transitional phase.
Furthermore, our study indicated that excessive SV on weekends increased the risk of psychological distress, while weekday SV showed no such association. This finding is relatively novel [69] and suggests the importance of comprehensively examining both weekday and weekend SV patterns. It could be hypothesized that individuals who engage in prolonged SV on weekends may have limited participation in interactive activities, such as face-to-face social interactions, outdoor exercises, and group gatherings, which could lead to a lack of social engagement and fewer opportunities to build social connections [19]. Additionally, excessive SV on weekends may lead to increased exposure to potentially distressing or anxiety-inducing content, such as negative news stories or social media posts. Constant exposure to such content can contribute to heightened feelings of stress, anxiety, and overall psychological distress [70]. These conclusions underscore the importance of investigating the effects of the purposes and timing of SV on mental health outcomes, providing strong evidence for further research.
With regard to the type of device, significant differences were observed, with most time spent on computers and smartphones, while TV usage was considerably lower. The associations between SV and mental health varied across these devices. Television SV showed no association with mental wellbeing or psychological distress. Past studies on television SV have produced inconsistent findings [20, 22, 58]. In our study, the limited television viewing among college students may have contributed to the lack of a statistically significant association with mental health. Conversely, high computer SV was found to be more strongly associated with poor mental wellbeing. While utilizing information and communication technology for appropriate reasons may have potential benefits, excessive internet use is more likely to induce stress and negatively impact mental health among young individuals [71]. Contemporary university students are increasingly inclined toward digital learning, with most of their studies being conducted through computers. This mode of learning enhances efficiency and enriches the availability of learning resources. However, it also brings about greater workloads and competition, potentially leading to poorer mental wellbeing [72]. Additionally, it has been reported that using computers might increase exposure to harmful messages and cyberbullying, while excessive social media scrolling has been linked to increased feelings of loneliness and depression, potentially explaining the impact of computer SV on mental health in our study [31]. However, our research revealed no association between mobile phone SV and mental health, nor did it identify any sex differences in the relationship between SV and mental health (results not shown). Previous studies have reported correlations between mobile device SV and mental health symptoms, particularly among girls, attributed to social media usage [20, 62, 73]. In addition, individual variance exists, with youth experiencing different levels of loneliness based on their face-to-face social interaction levels when using social media [58]. Thus, our study showed no association between handheld device SV and mental health, possibly because students used their mobile phones for multiple purposes, including social networking, gaming, news, and productivity [74]. This underscores the importance of future research to delve deeper into the content of media usage and explore potential indirect associations through mediation analysis.
This study comprehensively examines SV patterns among university students, marking the first investigation into their association with mental wellbeing and psychological distress across purposes, timings, and devices. However, several limitations should be noted. First, the data relied on self-reporting, which may have been influenced by social desirability or information bias. Second, we summarized SV across different devices, including TVs, handheld devices, and computers. This may lead to an overestimation of the total SV, as multiscreen use is possible. Third, as a cross-sectional study, causal relationships between SV and mental health could not be established. However, it is important to mention that this study is part of a four-year longitudinal study, and while only baseline data was utilized in this analysis, future results from this longitudinal study may further strengthen the evidence.