Table 1 Characteristics of analyzed original studies

Asfour et al., 2016 [59]

USA

Cross-sectional

Adolescents; (general population)

575 (45%)

13.8 ± 0.64 years

Time spent engaging in SB was calculated using five questions that inquired about time spent watching TV, playing video games, text messaging, Internet use and time spent on the telephone

Internalizing symptoms subscale of 112-item The Youth Self-Report [60]

0 for ST

Increased SB were associated with higher levels of externalizing symptoms (β = 2.03, SE = 0.32, p < .001), but not internalizing symptoms (β = 0.93, SE = 0.57, p = .1)

Asztalos et al., 2015 [61]^a

Belgium

Cross-sectional

Adults (general population)

4344 (52%)

43.55 ± 11.05 years

Self-report - International Physical Activity Questionnaire (IPAQ) [62]

10-items for anxiety symptoms of Symptom Check List (SCL)(e.g. [63])

+ for sitting time

Sitting were positively associated with anxiety both in model adjusted for demographic (gender, age, education) (β = 0.037; p = .018) as well as adjusted for demographics and MVPA (β = 0.033; p = .038)

Bampton et al., 2015 [64]^a

Canada

Cross-sectional

Older adults (≥ 55 yr) (general population)

358 (66%)

66.5 ± 8.0 years

Total and Domain Specific Measure of Sitting [5]

Generalized Anxiety Disorder scale (GAD-2) [65]

+ for sitting time (+ for high sedentary time/low resistance group)

Low sedentary time/high RT group reported lower anxiety symptoms compared to high sedentary time/low RT group (M_diff = − 0.67, p = .001). The low sedentary time/low RT group reported lower anxiety symptoms than high sedentary time/low RT group (M_diff = − 0.57, p = .018)

Cao et al., 2011 [66]

China

Cross-sectional

Adolescents (general population)

5003 (48%)

13.13 ± 0.97 years

Self-report to an open-ended question: how many hours per day, on average, the participants spent on the sedentary activities outside school hours on a usual weekday, as well as a weekend day (TV viewing, computer usage) [6]. ST was categorized as ≤2 h/d and > 2 h/d

41-item Screen for Child Anxiety Related Emotional Disorders (SCARED) [67]

+ for ST

High screen time (> 2 h/day) was a risk factor for anxiety symptoms both in crude model (OR = 1.39, 95% CI: [1.22, 1.60], p < .001) as well as in adjusted for gender, grade, family type, perceived socioeconomic status, BMI, fruit and vegetable or fizzy drinks intake (OR = 1.36, 95% CI: [1.18, 1.57], p < .001)

de Wit et al., 2011 [68]

Netherlands

Cross-sectional

Adults (general population)

2353 (65.45%)

41.2 ± 13.0 years

Self-report - the daily number of hours a person spent on watching TV or computer use in leisure time

Composite International Diagnostic Interview (CIDI, WHO ver. 2.1) [69]

+ for TV viewing; 0 for computer use

Anxiety was related to spending more time watching TV (β = 0.051, p < .05; β = 0.103, p < .001, respectively) but not to time of computer use (β = 0.001, p = .971; β = 0.036, p = .155, respectively) in leisure time

de Wit et al., 2015 [70]

Netherlands, Austria, Belgium, Ireland, Italy, Poland, Spain, UK, Denmark

Cross-sectional

Adult pregnant women (general population)

98 (100%)

31.6 ± 5.8 years

Actigraph GT3X, GT1M or Actitrainer accelerometer [activity were calculated as time spent sedentary (< 100 cpm)]

Pregnancy-related worries were measured with the 13-item Cambridge Worry Scale (CWS) [71]

0 for ASB

Pregnancy-related worries were not significantly associated with sedentary behaviors

Dillon et al., 2018 [72]

Ireland

Cross-sectional

Adults (general population)

397 (54%)

59.6 ± 5.5

A triaxial, GENEActiv accelerometer (ActivInsights Ltd., Kimbolton, Cambridgeshire, UK)

Anxiety subscale of the 14-item Hospital Anxiety and Depression Scale [73]

+ for ASB

Participants with moderate to severe anxiety symptoms had significantly more minutes of SB daily than those with low levels/ no symptoms of anxiety (p = .04)

Edwards & Loprinzi, 2016 [41]

USA

RCT

Adults (general population)

39 (59%)

Control: 22.08 ± 2.75; Intervention: 21.69 ± 2.71

GT9X accelerometers [21] and Digi-Walk SW-200 pedometer [74]

Overall Anxiety Severity and Impairment Scale (OASIS) [75]

+ for ASB

A statistically significant time x group interaction effect for OASIS scores F(1,37) = 11.13, p = .002). Mean and SE OASIS scores were significantly higher after the one-week sedentary behaviors-inducing intervention (M = 5.35, SE = 0 .86) compared to scores from before the intervention (M = 3.88, SE = 0.69) which means that an increase was observed in anxiety levels when participants increased their SB

Feng et al., 2014 [76]^a

China

Cross-sectional

Young adults (general population)

1106 (43%)

18.90 ± 0.9 years

Self-report ST measured with one item: ‘How many hours per day do you spend on computer, including internet use, watching TV/video programs and playing games on a usual weekday and weekend day, respectively?’ The ST was categorized as ≤2 h/d and > 2 h/d

Self-rating anxiety scale (SAS) [77]

0 for ST

No statistically significant associations were found between ST and anxiety both for ≤2 h/day (OR = 1.52, 95% CI: [0.87, 2.64], p > .05) as well as for > 2 h/day ST levels

Gaskin et al., 2016 [78]

Australia

Cross-sectional

Prostate cancer survivors (chronic illness)

98 with complete data; 49 with no complete data

67.3 ± 8.0 with complete data; 62.1 ± 8.6 with no complete data

Hip-mounted ActiGraph GT1 M accelerometer (Pensacola, FL) units

Memorial Anxiety Scale for Prostate Cancer (MAX-PC) – three subcales (prostate cancer anxiety, prostate-specific antigen anxiety, fear of recurrence) and a total anxiety scale [79]

0 for ASB

Prostate cancer anxiety (B = 0.01, 95% CI: [− 0.03, 0.04], p = .78), prostate-specific antigen anxiety (B = 0.00, 95% CI: [− 0.00, 0.00], p = .96), fear of recurrence (B = − 0.01, 95% CI: [− 0.02, 0.01], p = .44) and a total anxiety (B = − 0.00, 95% CI: [− 0.05, 0.04], p = .94) were not significantly associated with SB

Gibson et al., 2017 [80]^a

United Kingdom

Cross-sectional

Adults (general population)

42 (55%)

38.0 ± 11.5

ActivPAL mini, an inclinometer-based activity monitor

Anxiety subscale of The 14-item Hospital Anxiety and Depression Scale [73]

+ for ASB + for sitting time

Those with < 8 h of SB per day on weekdays had significantly lower levels of anxiety compared with those who were sitting > 8 h or > 10 h per day. The main effect for weekday sitting time on anxiety (F(1, 41) = 3.05, p = .040, η² = 0.18)

Gunnell et al., 2016 [81]^a

Canada

Longitudinal

Adolescents (general population)

1160 (61%) - Time 1

13.54 ± 1.12 years

Self-report questionnaire - 6-items querying how many hours per day subjects typically engaged in TV viewing/video game playing/computer use). The first 3 items assess ST during weekdays and the last 3 items inquired about weekend days

10-items Multidimensional Anxiety Scale for Children-10 (MASC-10) [82]

0 for ST

Initial symptoms of anxiety and ST did not predict change in ST and anxiety, respectively

Hiles et al., 2017 [83]

Netherlands

Longitudinal

Adults (general population)

2932 (66%) at baseline

41.9 ± 13.1

Self-report single question – sedentary behavior as an average hours of sitting on a weekday.

21-item Beck Anxiety Inventory (BAI; [84])

0 for anxiety- > sitting time change

Anxiety at the baseline did not predict SB at a 2-year follow up (B = 0.02, p = .561)

Janney et al., 2013 [85]^a

USA

RCT

Adults with a diagnosis of schizophrenia/schizoaffective disorder with BMI > 27 (chronic illness)

46 (63%)

45.6 ± 9.8 years

ActiGraph AM-7164 accelerometer (ActiGraph, Ft. Walton Beach, FL). Sedentary was established as ≤100 cpm

PANSS (one item for anxiety) [86]

0 for ASB

No association was observed between SB and PANSS psychiatric symptoms (PANSS or subscale: p ≥ .59). There were no significant associations for the PANSS questions asking about anxiety (r_s = .22, p = .15 for sedentary minutes and r_s = .15, p = .32 for percentage of sedentary time)

Kovess-Mastefy et al., 2015 [87]

German, Netherlands, Lithuania, Romania, Bulgaria, Turkey

Cross-sectional

Schoolchildren (general population)

3184

8.72 years

Parents were asked how long their child spends playing video games on average during the week. Low video game use was defined as 0–60 min per week; moderate use was defined as 61–300 min, and high use was > 300 min.

GAD indexes of self-reported mental health computerized cartoon-like assessment tool ‘Dominic Interactive’ for children [88]

0 for video game playing

Playing video games (1–5, and 5+ vs. 1 or less h) was not associated with GAD (OR = 1.08, 95% CI: [0.69, 1.7]; OR = 0.95, 95% CI: [0.53, 1.69], p > .05, respectively)

Kroeders et al., 2013 [89]^a

Australia

Cross-sectional

Stroke patients (chronic illness)

19 (53%)

66.2 ± 19.3 years

PAL2 electronic device - dual axis accelerometer

Anxiety subscale from Irritability, Depression and Anxiety (IDA) scale [90]

- for sitting time

Patients with anxiety symptoms compared with those without symptoms tended to spend more time lying (mean 64% vs. 43%), less time sitting (mean 33% vs. 51%), and less time standing or walking (mean 2% vs. 6%). The difference between these groups in time spent lying bordered on significance (t(17) = − 2.0; p = .06)

Liu et al., 2016 [91]^a

China

Cross-sectional

Secondary school pupils/adolescents (general population)

13,659 (49%)

15.18 ± 1.89 years

The Youth Risk Behavior Survey (YRBS) questionnaire [92] ‘How many hours do you watch television or play VG/CU (including activities such as Nintendo, Game box, Xbox, computer games, and the internet) on a typical school day?’ The ST was categorized as: non-ST (0 h/day), occasional ST (> 2 h/day), moderate ST (> 1 to ≤2 h/day), high ST (> 2 h/day)

The Multidimensional Anxiety Scale for Children (MASC) [82, 93]

+ for TV viewing; + for VG/CU time

More than 2 h per school day of TV watching was associated with higher risk of anxiety in boys (OR = 1.43, 95% CI: [1.05, 1.95]) compared with no TV exposure. School day with high VG/CU time (> 2 h) was associated with higher risks of anxiety in boys (OR = 1.40, 95% CI: [1.061.86]) compared with no VG/CU

Maras et al., 2015 [94]^a

Canada

Cross-sectional

Adolescents (general population)

2482 (58%)

14.10 ± 1.57 years

The Leisure-Time Sedentary Activities 6-item questionnaire measured how many hours per day subjects typically engage in: TV viewing/video game playing, computer use). The first 3 items assess screen-based activities during a typical weekday and the last 3 items screen time accrued on a typical weekend day.

The Multidimensional Anxiety Scale for Children-10 (MASC-10)

+ for ST (hours per day of TV viewing; recreational computer use; video games); + for video game playing; 0 for TV viewing; 0 for computer

Duration of screen time (β = 0.07, p < .001) and VG playing (β = 0.11, p < .001) was associated with severity of anxiety.

Mesquita et al., 2017 [95]

Netherlands

Prospective observational study

Adults with COPD before/after pulmonary rehabilitation (chronic illness)

90 (40%)

67.0 ± 8.0

CIRO activity monitor (CAM or the MOX Activity Monitor (Maastricht Instruments B.V in Maastricht, the Netherlands)

Anxiety subscale of the 14-item Hospital Anxiety and Depression Scale [73]

0 for anxiety- > ASB change

Baseline anxiety levels were unrelated to changes in minutes of SB (pre-post rehabilitation, Spearman R = −.08

Opdenacker, & Boen, 2008 [96]^a

Belgium

Longitudinal

Adults (general population)

66

2 groups, aged M = 38.8 ± 11.4 years; and 39.9 ± 9.9 years

Self-report - International Physical Activity Questionnaire (IPAQ) [62]

The Spielberger state-trait anxiety inventory (STAI) [21]

0 for sitting time

Sitting time was not associated with anxiety (r = 0.46, p = .623).

Padmapriya et al., 2016 [97]^a

Singapore

Cross-sectional

Pregnant women (general population)

257 with state anxiety symptoms; 270 with trait anxiety symptoms

29.5 ± 5.7 with state anxiety symptoms; 29.5 ± 5.6 with trait anxiety symptoms

Two categories of self-reported total sitting time per day and TV viewing time per day: < 7 h of total sitting time per day and < 2 h of TV viewing time per day were identified as lower tertiles; ≥7 h of total sitting per day and ≥ 2 h of TV viewing time per day were defined as higher total sitting time and TV time

The Spielberger state-trait anxiety inventory (STAI)

+ for TV viewing

Women with higher TV viewing time had higher state anxiety compared to women with lower TV viewing time in crude analysis (OR = 1.56, 95% CI: [1.14, 2.14], p = .006)

Park et al., 2017 [98]^a

United Kingdom

Cross-sectional

Older adults (residents from assisted living facilities), (chronic illness)

87

77.5 ± 8.2

Accelerometers (GT3X+, WGT3X-BT; ActiGraph (Pensacola, FL, USA)

Anxiety subscale of the 14-item Hospital Anxiety and Depression Scale [73]

- for ASB

SB was negatively associated with anxiety (r = −.39, p < .01)

Rebar et al., 2014 [99]^a

Australia

Cross-sectional

Adults (general population)

1104 (55%)

58 (range 48–66)

10-item Workforce Sitting Questionnaire [100]

Anxiety subscale from 21-item Depression, Anxiety, and Stress Scale (DASS-21) [101]

+ for overall sitting time + for computer sitting 0 for leisure/work/TV sitting

Overall sitting time (b = 0.03, p < .05) and computer use (b = 0.03, p < .05) were significantly associated with anxiety. Leisure (b = 0.01, p > .05), work (b = 0.02, p > .05), and TV (b = 0.00, p > .05) were not associated with anxiety

Sanchez-Villegas et al., 2008 [102]

Spain, USA

Longitudinal

Adults (general population)

10,381

27 years

Self-report sedentary index: hours per week spent on watching television and/or using computer.

Self-reported anxiety: ‘Have you ever been diagnosed of anxiety by a health professional?’ - classified as an incident case of anxiety

0 for ST

There was no significant association between the sedentary index and anxiety risk (p = .17)

Straker et al., 2013 [103]^a

Australia

Longitudinal

Adolescents (general population)

643 (54%)

14.0 ± 0.2 years

Screen Based Media – Self-report recall electronic diary/questionnaire MARCA - clusters: C1. instrumental computer gamers; C2. multi-modal e-gamers; C3. computer e-gamers [104]

Internalizing symptoms index of 112-item the Youth Self-Report [59]

+ for game playing

C1 males reported less internalizing behavioral problems than C2 (difference − 1.7, 95% CI: [− 3.5, 0.1], p = .065) or C3 males (difference − 2.6, 95% CI: [− 4.9, − 0.3], p = .027)

Teychenne & Hinkley, 2016 [105]^a

Australia

Cross-sectional

Adult women with children aged 2–5 years (general population)

575 (100%)

37.18 ± 4.62 years

Self-report –of women’s own activities, including time spent on TV/DVD/video viewing, computer/e-games/hand held device use on a typical weekday and weekend day

7-items related to symptoms of anxiety experienced in the past week: a subscale (HADS-A) of the Hospital Anxiety and Depression Scale (HADS) [106]

+ for computer /device use + for total ST; 0 for TV viewing

TV viewing was not associated with anxiety symptoms (B = 0.109, p = .188) but computer/device use (B = 0.212, p = .011) and overall screen time (B = 0.109, p = .025) were positively associated with heightened anxiety symptoms in models adjusted for key demographic and behavioral covariates (including MVPA)

Uijtdewilligen et al., 2011 [107]

Netherlands

Longitudinal

Adolescents (general population)

217 (58%)

M: 13.0 ± 0.6 years; F: 12.9 ± 0.6 years

Acti-Graph accelerometers (Model GT1M, ActiGraph, LLC, Fort Walton Beach, FL)

Facilitating anxiety index of Achievement Motivation Test (AMT) [108]

+ for ASB

In males, a higher score on facilitating anxiety (B = 5.13, 95% CI: [0.08, 10.19], p < .05) was associated with more minutes spent sedentary in adulthood.

Vallance et al., 2015 [109]^a

Canada; Australia

Cross-sectional

Adults (general population)

197 (overall 180–45%)

64.3 ± 10.3

Acitgraph GT3X+ accelerometer (Actigraph, LLC, Pensacola, FL)

Spielberger’s State Anxiety Inventory (STAI) - 10 items

0 for ASB

No significant associations emerged for sedentary time and psychological health outcomes (including anxiety) [Wilks’ λ = 0.956, F(9382.3) = 0.788, p = .628]

van Roekel et al., 2016 [110]^a

Netherlands

Cross-sectional

Adults treated for stage I–III colorectal cancer (chronic illness)

145 (37.2%)

70.0 ± 8.7 years

The triaxial MOX activity monitor (MMOXX1, upgraded version of the CAM monitor)

Anxiety subscale of the 14-item Hospital Anxiety and Depression Scale [73]

0 for ASB (0 for sedentary per 1 h/day)

Substituting sedentary time with physical activity was not significantly associated with lower anxiety (β = −0.7, 95% CI: [− 1.7, 0.3])

Vancampfort et al., 2018 [111]

China, Ghana, India, Mexico, Russia, South Africa

Cross-sectional

Adults (general population)

42,469 (50.1%)

43.8 ± 14.4

Self-report sitting time – total time usually spent (expressed in minutes per day) sitting or reclining including at work, at home, getting to and from places, or with friends (e.g., sitting at a desk, sitting with friends, travelling in car, bus, train, reading, playing cards or watching television)

Self-reported anxiety by the question ‘Overall in the past 30 days, how much of a problem did you have with worry or anxiety’ with response alternatives: none, mild, moderate, severe, extreme. Those who answered severe or extreme were considered to have anxiety

+ for sitting time

Anxiety was significantly associated with higher mean time spent sitting (b = 24.16, 95% CI: [6.95, 41.38], p < .01)

Wu et al., 2015 [112]

China

Cross-sectional

Adults (general population)

4747 (58.4%) - 16.3% with anxiety

19.2 ± 1.41 years

Self-report screen time measured with one item: ‘How many hours per day do you spend on the computer (including playing video or computer games or computer for something) and watching TV/video programs on a usual weekday and weekend day, respectively?’ ST was categorized as ≤2 h/d and > 2 h/d

Self-rating anxiety scale (SAS) [77]

+ for ST

High screen time > 2 h/day (OR = 1.38, 95% CI: [1.15, 1.65], p < .001) was significantly positively associated with anxiety in crude model as well as in a model adjusted for gender, age, residential background, BMI, perceived family economy and perceived study burden (OR = 1.49, 95% CI: [1.24, 1.79], p < 0.001)