Relationship between attention-deficit/hyperactivity disorder and sedentary behavior in adolescence: a cross-sectional study

  • Vivien Suchert
  • Anya Pedersen
  • Reiner Hanewinkel
  • Barbara IsenseeEmail author
Short Communication


Existing studies reveal that high levels of sedentary behavior are associated with more inattention and hyperactivity problems. Since most previous studies used screen time as an indicator of sedentary behavior and assessed symptoms of attention-deficit/hyperactivity disorder (ADHD) by short screening measures which do not allow to distinguish between subtypes of ADHD, the current study aimed to investigate association between different types of sedentary behavior and symptoms and subtypes of ADHD. The current cross-sectional study analyzed data of 913 students (46.1% girls) aged 13–17 years (M = 15.0, SD = 0.6). Using a self-administered questionnaire, screen-based and non-screen-based sedentary behavior and ADHD symptoms were assessed. Linear and logistic regression analyses were conducted. All analyses were adjusted for age, gender, moderate to vigorous physical activity and body mass index. Screen time was related to the total ADHD score (p < 0.001) as well as to the subscales inattention (p ≤ 0.016) and hyperactivity/impulsivity (p ≤ 0.008). Sedentary time without screens was virtually not associated with ADHD. As far as ADHD symptoms are considered as a correlate of sedentary behavior, the type of activity which is pursued sedentarily seems to matter: screen time, but not other non-screen-based sedentary activities should be considered as being a risk factor for ADHD.


ADHD Sedentary behavior Screen time Adolescents 



The “läuft.” trial is a cooperation project between the läuft Study Group, “Institut für Qualitätsentwicklung an Schulen Schleswig-Holstein” and “Landesvereinigung für Gesundheitsförderung in Schleswig-Holstein e. V.”. The läuft. Study Group: Franziska Clemens, Reiner Hanewinkel, Julia Hansen, Barbara Isensee, Maike Johannsen, Vivien Suchert (Institute for Therapy and Health Research, Kiel, Germany); Claus Krieger, Katrin Steinvoord (University of Hamburg, Germany); Ingeborg Sauer, Burkhard Weisser (University of Kiel, Germany). We wish to extend special thanks to Malin Bachmann, Martin Bäuning, Anja Biehler, Teresa Frerichs, Christina Helling, Leonie Herde, Stefan Homann, Toska Jakob, Christiane Kampen, Jacqueline Kloß, Corinna Köhler, Alexandra Krahl, Hanife Özbek, Esther Pohanke, Sina-Aline Reck, Luise Rehermann, Eva Schulenburg, Jessica Schwarz, Inken Tödt and Nadine Witzel who supported us in data acquisition as well as to the teachers and students that participated in the study.


The “läuft.” physical activity trial was funded by German Cancer Aid in the Priority Program Primary Prevention of Cancer (Nutrition and Physical Activity, Reference Number: 110012). After a positive decision on applying for study support, the German Cancer Aid did not influence the collection, analysis or interpretation of data or the writing of the article and decision to submit it.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures were in accordance with ethical standards of the institutional research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.


  1. Bauer KW, Friend S, Graham DJ, Neumark-Sztainer D (2012) Beyond screen time: assessing recreational sedentary behavior among adolescent girls. J Obes 2012:183194CrossRefPubMedGoogle Scholar
  2. Biddle SJ, Asare M (2011) Physical activity and mental health in children and adolescents: a review of reviews. Br J Sports Med 45(11):886–895CrossRefPubMedGoogle Scholar
  3. Biddle SJ, Gorely T, Marshall SJ (2009) Is television viewing a suitable marker of sedentary behavior in young people? Ann Behav Med 38(2):147–153CrossRefPubMedGoogle Scholar
  4. Biederman J, Faraone SV (2005) Attention-deficit hyperactivity disorder. Lancet 366(9481):237–248CrossRefPubMedGoogle Scholar
  5. Brodersen NH, Steptoe A, Williamson S, Wardle J (2005) Sociodemographic, developmental, environmental, and psychological correlates of physical activity and sedentary behavior at age 11 to 12. Ann Behav Med 29(1):2–11CrossRefPubMedGoogle Scholar
  6. Chan PA, Rabinowitz T (2006) A cross-sectional analysis of video games and attention deficit hyperactivity disorder symptoms in adolescents. Ann Gen Psychiatry 5:16CrossRefPubMedPubMedCentralGoogle Scholar
  7. Christakis DA, Zimmerman FJ, DiGiuseppe DL, McCarty CA (2004) Early television exposure and subsequent attentional problems in children. Pediatrics 113(4):708–713CrossRefPubMedGoogle Scholar
  8. Cole TJ (1990) The LMS method for constructing normalized growth standards. Eur J Clin Nutr 44(1):45–60PubMedGoogle Scholar
  9. Cortese S, Moreira-Maia CR, St FD, Morcillo-Penalver C, Rohde LA, Faraone SV (2016) Association between ADHD and obesity: a systematic review and meta-analysis. Am J Psychiatry 173(1):34–43CrossRefPubMedGoogle Scholar
  10. Döpfner A, Görtz-Dorten G, Lehmkuhl D (2008) Diagnostik-System für psychische Störungen im Kindes- und Jugendalter nach ICD-10 und DSM-IV, DISYPS-II. Verlag Hans Huber, BernGoogle Scholar
  11. Doshi JA, Hodgkins P, Kahle J, Sikirica V, Cangelosi MJ, Setyawan J et al (2012) Economic impact of childhood and adult attention-deficit/hyperactivity disorder in the United States. J Am Acad Child Adolesc Psychiatry 51(10):990–1002CrossRefPubMedGoogle Scholar
  12. Erhart M, Dopfner M, Ravens-Sieberer U (2008) Psychometric properties of two ADHD questionnaires: comparing the Conners’ scale and the FBB-HKS in the general population of German children and adolescents—results of the BELLA study. Eur Child Adolesc Psychiatry 17(Suppl 1):106–115CrossRefPubMedGoogle Scholar
  13. Erhart M, Herpertz-Dahlmann B, Wille N, Sawitzky-Rose B, Holling H, Ravens-Sieberer U (2012) Examining the relationship between attention-deficit/hyperactivity disorder and overweight in children and adolescents. Eur Child Adolesc Psychiatry 21(1):39–49CrossRefPubMedGoogle Scholar
  14. Gapin JI, Labban JD, Etnier JL (2011) The effects of physical activity on attention deficit hyperactivity disorder symptoms: the evidence. Prev Med 52(Suppl 1):S70–S74CrossRefPubMedGoogle Scholar
  15. Kromeyer-Hauschild K, Wabitsch M, Kunze P, Geller F, Geiß HC, von Hippel A et al (2001) Perzentile für den Body-mass-Index für das Kindes- und Jugendalter unter Heranziehung verschiedener deutscher Stichproben. Monatsschrift Kinderheilkd 149(8):807–818CrossRefGoogle Scholar
  16. Landhuis CE, Poulton R, Welch D, Hancox RJ (2007) Does childhood television viewing lead to attention problems in adolescence? Results from a prospective longitudinal study. Pediatrics 120(3):532–537CrossRefPubMedGoogle Scholar
  17. Levine ME, Waite BM (2000) Television viewing and attentional abilities in fourth and fifth grade children. J Appl Dev Psychol 21(6):667–679CrossRefGoogle Scholar
  18. Lingineni RK, Biswas S, Ahmad N, Jackson BE, Bae S, Singh KP (2012) Factors associated with attention deficit/hyperactivity disorder among US children: results from a national survey. BMC Pediatr 12:50CrossRefPubMedPubMedCentralGoogle Scholar
  19. Mannuzza S, Klein RG (2000) Long-term prognosis in attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 9(3):711–726PubMedGoogle Scholar
  20. McWilliams L, Sayal K, Glazebrook C (2013) Inattention and hyperactivity in children at risk of obesity: a community cross-sectional study. BMJ Open 3(5):e002871CrossRefPubMedPubMedCentralGoogle Scholar
  21. Özmert E, Toyran M, Yurdakok K (2002) Behavioral correlates of television viewing in primary school children evaluated by the child behavior checklist. Arch Pediatr Adolesc Med 156(9):910–914CrossRefPubMedGoogle Scholar
  22. Parkes A, Sweeting H, Wight D, Henderson M (2013) Do television and electronic games predict children’s psychosocial adjustment? Longitudinal research using the UK Millennium Cohort Study. Arch Dis Child 98(5):341–348CrossRefPubMedPubMedCentralGoogle Scholar
  23. Pate RR, O’Neill JR, Lobelo F (2008) The evolving definition of “sedentary”. Exerc Sport Sci Rev 36(4):173–178CrossRefPubMedGoogle Scholar
  24. Pate RR, Mitchell JA, Byun W, Dowda M (2011) Sedentary behaviour in youth. Br J Sports Med 45(11):906–913CrossRefPubMedGoogle Scholar
  25. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164(6):942–948CrossRefPubMedGoogle Scholar
  26. Polanczyk GV, Willcutt EG, Salum GA, Kieling C, Rohde LA (2014) ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol 43(2):434–442CrossRefPubMedPubMedCentralGoogle Scholar
  27. Prochaska JJ, Sallis JF, Long B (2001) A physical activity screening measure for use with adolescents in primary care. Arch Pediatr Adolesc Med 155(5):554–559CrossRefPubMedGoogle Scholar
  28. Sedentary Behaviour Research Network (2012) Letter to the editor: standardized use of the terms “sedentary” and “sedentary behaviours”. Appl Physiol Nutr Metab 37(3):540–542CrossRefGoogle Scholar
  29. Suchert V, Isensee B, Hansen J, Johannsen M, Krieger C, Müller K et al (2013) “läuft.”—a school-based multi-component program to establish a physically active lifestyle in adolescence: study protocol for a cluster-randomized controlled trial. Trials 14(1):416CrossRefPubMedPubMedCentralGoogle Scholar
  30. Suchert V, Hanewinkel R, Isensee B (2015) Sedentary behavior and indicators of mental health in school-aged children and adolescents: a systematic review. Prev Med 76:48–57CrossRefPubMedGoogle Scholar
  31. Swing EL, Gentile DA, Anderson CA, Walsh DA (2010) Television and video game exposure and the development of attention problems. Pediatrics 126(2):214–221CrossRefPubMedGoogle Scholar
  32. Telford C, Green C, Logan S, Langley K, Thapar A, Ford T (2013) Estimating the costs of ongoing care for adolescents with attention-deficit hyperactivity disorder. Soc Psychiatry Psychiatr Epidemiol 48(2):337–344CrossRefPubMedGoogle Scholar
  33. Thapar A, Cooper M (2016) Attention deficit hyperactivity disorder. Lancet 387(10024):1240–1250CrossRefPubMedGoogle Scholar
  34. Thomas R, Sanders S, Doust J, Beller E, Glasziou P (2015) Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics 135(4):e994–1001CrossRefPubMedGoogle Scholar
  35. Tremblay MS, LeBlanc AG, Kho ME, Saunders TJ, Larouche R, Colley RC et al (2011) Systematic review of sedentary behaviour and health indicators in school-aged children and youth. Int J Behav Nutr Phys Act 8:98CrossRefPubMedPubMedCentralGoogle Scholar
  36. van Egmond-Frohlich AW, Weghuber D, de Zwaan M (2012) Association of symptoms of attention-deficit/hyperactivity disorder with physical activity, media time, and food intake in children and adolescents. PLoS ONE 7(11):e49781CrossRefPubMedPubMedCentralGoogle Scholar
  37. Weiss G, Hechtman LT (2000) Hyperactive children grown up: ADHD in children, adolescents, and adults. Guilford Press, New YorkGoogle Scholar
  38. Wilens TE, Faraone SV, Biederman J (2004) Attention-deficit/hyperactivity disorder in adults. J Am Med Assoc 292(5):619–623CrossRefGoogle Scholar
  39. Zabinski MF, Norman GJ, Sallis JF, Calfas KJ, Patrick K (2007) Patterns of sedentary behavior among adolescents. Health Psychol 26(1):113–120CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Wien 2017

Authors and Affiliations

  • Vivien Suchert
    • 1
  • Anya Pedersen
    • 2
  • Reiner Hanewinkel
    • 1
  • Barbara Isensee
    • 1
    Email author
  1. 1.Institute for Therapy and Health Research (IFT-Nord)KielGermany
  2. 2.Clinical Psychology and PsychotherapyUniversity of KielKielGermany

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