title: The association of maternal mental distress with television viewing in children under 3 years old.
abstract: OBJECTIVE
  To test the hypothesis that maternal mental distress is associated with excessive television viewing by infants and toddlers.
  
  
  METHODS
  We used data from maternal respondents to the National Survey of Early Childhood Health, a nationally representative cross-sectional study on the health of children aged 4-35 months. Our main outcome measure was television hours viewed per day. Our main predictor was the Mental Health Inventory 5, a short screening tool used in this study to identify mothers with mental distress. We used a previously validated cutoff score of 21. Multivariate negative binomial regression was used to determine the independent association between maternal mental distress and a child's television viewing per day.
  
  
  RESULTS
  Data were available from 1793 mothers. A total of 21% of mothers were found to have mental distress. Children of mothers without mental distress watch significantly less TV (1.6 hours per day; 95% confidence interval, 1.5-1.7) than children of mothers with mental distress (2.1 hours per day; 95% confidence interval, 1.7-2.5) (P = .02). In a multivariate regression model, children of mothers with mental distress watch 25% more television per day than children of mothers without mental distress (rate ratio 1.25 [1.03-1.51]). The numbers in the brackets refer to the 95% Confidence Interval.
  
  
  CONCLUSIONS
  For children younger than 3 years, having a mother with mental distress is associated with increased television viewing. The mental health of mothers should be considered in any intervention aimed at reducing television viewing time in this population.
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University, 200 N. Wolfe Street, Baltimore, MD 21287, USA. dthomp46@jhmi.edu
authors.forename: Darcy A
authors.initials: DA
authors.lastname: Thompson
authors.forename: Dimitri A
authors.initials: DA
authors.lastname: Christakis
mesh_terms: D000328:Adult; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007223:Infant; D009035:Mothers / Q000523:psychology*; D012189:Retrospective Studies; D013315:Stress, Psychological / Q000523:psychology*; D013690:Television / Q000706:statistics & numerical data*; D013997:Time Factors