A TELEVISION IN THE BEDROOM IS ASSOCIATED WITH LOWER STANDARDIZED TEST SCORES AMONG THIRD GRADE STUDENTS

CHICAGO—In a study of third graders, children with a television in their bedrooms had lower scores on standardized tests while children with access to a home computer had higher scores, researchers report in the July issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

U.S. households with children have an average of 2.8 television sets and 97 percent of those households have at least one video cassette recorder (VCR) or DVD player, according to background information in the article. More than two thirds of households with children have at least one computer and more than half (53 percent) have home Internet access. While substantial evidence exists to show that people who use media more heavily are at greater risk for obesity and aggressive behavior, the relationship between media and academic achievement is less clear, the researchers suggest.

Dina L. G. Borzekowski, Ed.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and Thomas N. Robinson, M.D., M.P.H., of Stanford University, Stanford, Calif., compared students' third grade tests scores on the Stanford Achievement Test (mathematics, reading and language arts sections) in the spring of 2000 with data on television and computer use collected through student surveys and telephone interviews with parents for children in six elementary schools in the fall of 1999 and the spring of 2000. Three hundred forty-eight students completed the survey. The children had an average age of 8.5 years, were ethnically diverse and evenly divided between the sexes (53 percent girls).

The children reported an average of 3.3 television sets per households and almost all had a VCR. Seventy-one percent of the children had a TV set in their own bedroom and 71 percent had access to a home computer. Media environment variables were not significantly associated with the parents' education, students' ethnicity or the primary language spoken in the home. "On average, children with a bedroom television set reported that they watch 12.8 hours per week compared with those without a bedroom television set, who reported 10.7 hours per week," the authors report. "From parents' report, we found that students with home computer access spent, on average, 4.5 hours per week using the computer, compared with those without access who spent 1.0 hours per week."

"Looking at the media environment in spring 2000, students with a bedroom television scored significantly lower on all the tests compared with their peers without bedroom television sets...," the authors write. "Those with home computer access scored higher on all the tests than those without access. ...When we simultaneously considered bedroom television and/or home computer access, we observed significant differences for each standardized test. Consistently, those with a bedroom television but no home computer access had, on average, the lowest scores and those with home computer access but no bedroom television had the highest scores."

"Using these models [a statistical model that controlled for parents' educational level, student's sex, students' media use, reading and doing homework], the differences in predicted test scores are quite large," the researchers report. "For example, we observe that the predicted mathematics scores (using students' estimates [of media use]) range from 41 to 58, showing a 17-point difference if a child's household media environment is taken into consideration."

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Media Advisory: To contact Robert J. Hancox, M.D., e-mail: bob.hancox{at}otago.ac.nz.

YOUNG CHILDREN WHO WATCH LESS TV MORE LIKELY TO FINISH COLLEGE

CHICAGO—Children who watch the most television during childhood and adolescence may be less likely to finish school or go on to earn a university degree, according to a study in the July issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Despite several decades of research, there is little consensus on whether childhood television viewing has beneficial, harmful or negligible effects on educational achievement, according to background information in the article. There have been no previous long-term follow-up studies measuring childhood viewing and later educational achievement.

Robert J. Hancox, M.D., of the University of Otago, Dunedin, New Zealand, and colleagues conducted a long-term study of approximately 1,000 children born in Dunedin, New Zealand between April 1, 1972 and March 31, 1973. Information about their television viewing habits was collected at ages five, seven, nine, 11, 13 and 15. Information on the highest level of educational attainment was collected for 980 of the study members (96 percent) at 26 years of age. Measures of other variables that might influence educational attainment, including socioeconomic status, IQ and childhood behavioral problems were assessed at several ages. Childhood television viewing was calculated based on viewing hours per weekday reported at ages five to 11. Adolescent viewing was calculated based on weekday reported viewing at 13 and 15 years of age.

"Analysis of educational achievement using both childhood and adolescent viewing as independent variables found that mean weekday viewing hours at 13 and 15 years of age were a stronger predictor of leaving school without qualifications [lowest level of educational achievement]," the authors report. "By contrast, lower mean viewing hours between five and 11 years of age were a stronger predictor of achieving a university degree."

"The results of this study indicate that increased time spent watching television during childhood and adolescence was associated with a lower level of educational attainment by early adulthood," the authors write. "These effects were independent of intelligence, family socioeconomic status, and childhood behavioral problems."

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Media Advisory: To contact Frederick J. Zimmerman, Ph.D., call Pam Sowers at 206-543-3620. To contact editorial author Deborah L. Linebarger, Ph.D., call Jacquie Posey at 215-898-6460.

TV HAS NEGATIVE IMPACT ON VERY YOUNG CHILDREN'S LEARNING ABILITIES

CHICAGO—Television viewing before the age of three may have adverse effects on subsequent cognitive development, according to a study in the July issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Three- to five-year-old children watch an average of two or more hours of television or videos per day and much of this is not children's educational programming, according to background information in the article. Fifty-nine percent of children younger than two years regularly watch an average of 1.3 hours of television per day, despite the fact that there is no programming of proven educational value for children this young. A substantial portion of television actually watched by children does not meet the American Academy of Pediatrics recommendation of no screen time for children younger than two and only high quality, age-appropriate viewing thereafter, the authors suggest.

Frederick J. Zimmerman, Ph.D., and Dimitri A Christakis, M.D., M.P.H., of the University of Washington, Seattle, analyzed data from The National Longitudinal Survey of Youth 1979 Children and Young Adults (NLSY-Child), begun in 1986 and conducted every other year. The NLSY-Child collects information on more than 11,000 children regarding developmental assessment, family background, home environment and health history. The researchers assessed data on 1,797 children who were approximately six years of age at the time of one of the four most recent survey interviews in 1994, 1996, 1998 and 2000. Scores in mathematics, reading recognition and reading comprehension from a commonly used and well-standardized test were compared with the level of television watching before age three and from ages three to five.

"This analysis has shown a consistent pattern of negative associations between television viewing before age three years and adverse cognitive outcomes at ages six and seven years," the authors report. "The inclusion of extensive controls for parental preferences, ability, and investment in their children's cognitive development suggests that these associations may in some direct or indirect way be causal."

"By contrast, this analysis suggests that television viewing at ages three to five years has a more beneficial effect, at least for the outcomes of reading recognition and short-term memory," the authors write. The researchers found no beneficial effect on mathematics outcomes or reading comprehension, and they state, "Because reading recognition and short-term memory are arguably the most basic of the cognitive outcomes studied, the implication would seem to be that the net effect of television viewing from a population perspective is limited in its beneficial impact."

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ANTI-TOBACCO ADVERTISING ASSOCIATED WITH REDUCED SMOKING AND INCREASED ANTI-SMOKING ATTITUDES AMONG YOUTH

CHICAGO—Reduced cigarette smoking and more favorable anti-smoking attitudes were found among youth exposed to state-sponsored anti-tobacco advertising, according to a study in the July issue of the Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

The U.S. population has been exposed to an increasing number and variety of televised anti-tobacco advertisements since the early 1990s, according to background information in the article. However, given recent state budget crises and other political influences, many states have severely cut their anti-tobacco campaigns. Despite early evidence suggesting that state-sponsored anti-tobacco media campaigns may reduce adult smoking, few studies have explored their effect on youth.

Sherry Emery, Ph.D., from the University of Illinois at Chicago, and colleagues examined the association between exposure to state anti-tobacco advertising and youth smoking-related beliefs and behaviors. The researchers used targeted ratings point (TRPs) to assess the ratings of an advertisement among U.S. teen audiences. An ad with 80 TRPs per month is estimated to have been seen an average of one time by 80 percent of this age group. This information was combined with survey data from school-based samples of 51,085 students in the contiguous 48 states.

The researchers found that among survey respondents, 14 percent had an average of zero exposures to state-sponsored advertisements in the last four months, 65 percent of the students had an average exposure greater than zero, but less than one, and 21 percent had an average exposure of one or more state-sponsored anti-tobacco advertisements. Students in states with a TRP measure of one or higher were significantly less likely to report having smoked in the past 30 days (18.6 percent) compared with those in markets with no exposure to anti-tobacco advertisements (26.7 percent). Those with one or more state TRPs were more likely to perceive great harm from smoking one or more packs of cigarettes per day (72.1 percent vs. 65.1 percent). Also, students living in areas with an average exposure of at least one state-sponsored anti-tobacco advertisement were more likely to say that they believed they would definitely not be smoking in five years (64 percent vs. 55.3 percent).

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ANTIDEPRESSANTS MAY LOWER RISK OF RECURRENT HEART ATTACK AND DEATH IN DEPRESSED HEART ATTACK PATIENTS

CHICAGO—In depressed patients who have experienced a heart attack, use of antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), was associated with a reduced risk of death and recurrent heart attack, according to an article in the July issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

Cardiovascular disease (CVD) is the leading cause of death, major disease and disability among U.S. men and women, according to background information in the article. Major depression was found in approximately 20 percent of patients with a recent myocardial infarction (MI; heart attack); a similar prevalence was found for minor depression. Depression is a risk factor for recurrent non-fatal heart attack and cardiac death in patients who experience an acute MI (AMI), independent of cardiac disease severity. Despite their effectiveness in treating depression, the use of antidepressants in patients with CVD remains controversial.

C. Barr Taylor, M.D., from Stanford Medical Center, Stanford, Calif., and colleagues conducted a secondary analysis of data from the Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial to determine the effects of antidepressants on post-MI patients. The ENRICHD trial randomized 2,481 depressed and/or socially isolated patients from October 1, 1996 to October 31, 1999. The analysis in this report is based on 1834 patients (985 men and 849 women) who had depression, with or without low social support. Of these, 446 patients took antidepressants during the study, including 301 who were prescribed SSRIs (a class of drugs that increases the levels of serotonin in the body); and 145 patients who were prescribed other types of antidepressants.

During an average follow-up of 29 months, 457 fatal and non-fatal cardiovascular events occurred. Twenty-six percent (361 of 1,388) of the patients who did not receive antidepressants died or had a recurrent MI, compared to 21.5 percent (96 of 446) of the patients who did take antidepressants. After adjusting for baseline depression and cardiac risk, SSRI use was associated with 43 percent lower risk of death or recurrent non-fatal MI, and 43 percent lower risk of death from all causes, compared with patients not receiving SSRIs. Risk of death or recurrent MI, all-cause death, or recurrent MI was 28 percent, 36 percent, and 27 percent lower, respectively, in patients taking non-SSRI antidepressants, compared with nonusers.

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PROBLEM GAMBLERS SHARE PERSONALITY PROFILES OF SUBSTANCE ABUSERS

CHICAGO—Individuals with problem gambling behavior have personality profiles similar to the profiles of those with alcohol, marijuana and nicotine-associated addictive disorders, according to an article in the July issue of the Archives of General Psychiatry, one of the JAMA/Archives journals.

It has been difficult to identify personality traits associated with problem gambling because most previous studies have drawn subjects from those seeking treatment for a gambling disorder, who are unlikely to be representative of the majority of individuals in the community with gambling problems, according to background information in the article. Previous studies have also shown problem gambling associated with alcohol dependence and suggested an association with drug and nicotine dependence as well.

Wendy S. Slutske, Ph.D., of the University of Missouri-Columbia, and colleagues compared personality assessments obtained in 1991-1992 for 939 young adults (475 men and 464 women) from Dunedin, New Zealand, who were 18 years old, with diagnoses of problem gambling and alcohol, cannabis [marijuana] and nicotine dependence in the previous year based on structured interviews conducted when the individuals were 21 years old in 1993-1994. The researchers conducted two analyses of the data. In the first, the researchers examined the associations between problem gambling and each of three substance abuse disorders (alcohol, cannabis and nicotine). In the second, the researchers examined the independent association of 10 basic aspects of personality variation with problem gambling and each of the three substance addictive disorders.

"Past-year problem gambling was significantly associated with past-year alcohol dependence, cannabis dependence, and nicotine dependence," the authors report. "The associations between problem gambling and the three substance use disorders were similar in magnitude and were nearly as large as the well-established association between alcohol and nicotine dependence." Young adults with a problem gambling diagnosis in the year before they turned 21 were, on average, more likely to have high scores for negative emotionality and for impulsive and risk-taking behavior on personality tests taken at age 18 years, the researchers found. "In particular, young adults with a diagnosis of problem gambling were characterized by negative emotions such as nervousness or worry, anger or aggressiveness, feeling mistreated or victimized, and unconstrained behaviors of risk-taking, impulsivity, and rebelliousness," they write.