The smartphone addiction scale: development and validation of a short version for adolescents

Reconsidering the associations between self-reported alcohol use disorder and mental health problems in the light of co-occurring addictions in young Swiss men

BACKGROUND

Alcohol use disorder (AUD) is known to co-occur with other addictions, as well as with mental health problems. However, the effects of other addictions co-occurring with AUD on mental health problems were rarely studied and not considering them may bias estimates of the association between AUD and mental health problems. This study investigated which role co-occurring addictions play for the cross-sectional associations between self-reported AUD and mental health problems.

METHOD

Participants were 5516 young Swiss men (73.0% of those that gave written informed consent) who completed a self-report questionnaire. Using short screening questionnaires, we assessed three substance use disorders (alcohol, cannabis and tobacco), seven behavioural addictions (internet, gaming, smartphone, internet sex, gambling, work, exercise) and four mental health problems (major depression, bipolar disorder, attention deficit hyperactivity disorder (ADHD) and social anxiety disorder). Differences in the proportions of mental health problems were tested using logistic regressions between (1) participants with no AUD and AUD, (2) participants with no AUD and AUD alone and (3) participants with no AUD and AUD plus at least one co-occurring addiction.

RESULTS

Overall, (1) participants with AUD had higher proportions of major depression (Odds ratio (OR [95% confidence interval]) = 3.51 [2.73, 4.52]; ADHD (OR = 3.12 [2.41, 4.03]); bipolar disorder (OR = 4.94 [3.38, 7.21]) and social anxiety (OR = 2.21 [1.79, 2.73])) compared to participants with no AUD. Considering only participants with AUD alone compared to participants with no AUD (2), differences in proportions were no longer significant for major depression (OR = 0.83 [0.42, 1.64]), bipolar disorder (OR = 1.69 [0.67, 4.22]), social anxiety (OR = 1.15 [0.77, 1.73]) and ADHD (OR = 1.65 [1.00, 2.72]) compared to participants with no AUD. In contrast, (3) proportions of mental health problems were considerably higher for participants with AUD plus at least one other addiction when compared to participants with no AUD, with OR's ranging from 2.90 [2.27, 3.70] for social anxiety, 4.03 [3.02, 5.38] for ADHD, 5.29 [4.02, 6.97] for major depression to 6.64 [4.44, 9.94] for bipolar disorder.

CONCLUSIONS

AUD was associated with all four measured mental health problems. However, these associations were mainly due to the high proportions of these mental health problems in participants with AUD plus at least one co-occurring addiction and only to a lesser degree due to participants with AUD alone (i.e. without any other co-occurring addictions). Hence, estimates of the association between AUD and mental health problems that do not consider other addictions may be biased (i.e. overestimated). These findings imply that considering addictions co-occurring with AUD, including behavioural addictions, is important when investigating associations between AUD and mental health problems, and for the treatment of AUD and co-morbid disorders.

Smartphone addiction may be associated with adolescent hypertension: a cross-sectional study among junior school students in China

BACKGROUND

Hypertension in children and adolescents is on the rise worldwide, especially in China. The prevalence of hypertension is related to many factors, such as obesity. In the era of smart phones, it is important to study the negative health effects of mobile phones on blood pressure. The purpose of this study was to investigate the prevalence of hypertension and its association with smartphone addiction among junior school students in China.

METHODS

A school-based cross-sectional study was conducted, including total 2639 junior school students (1218 boys and 1421 girls), aged 12-15 years old (13.18 ± 0.93 years), enrolled in the study by random cluster sampling. Height, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured following standard protocols, and the body mass index (BMI) was calculated. Overweight/obesity and hypertension were defined according to sex- and age-specific Chinese children reference data. The Smartphone Addiction Scale short version (SAS-SV) and the Pittsburgh Sleep Quality Index (PSQI) were used to assess smartphone addiction and sleep quality among the students, respectively. Multivariate logistic regression models were used to seek associations between smartphone addiction and hypertension.

RESULTS

The prevalence of hypertension and smartphone addiction among participants were 16.2% (13.1% for females and 18.9% for males) and 22.8% (22.3% for females and 23.2% for males), respectively. Obesity (OR = 4.028, 95% CI: 2.829-5.735), poor sleep quality (OR = 4.243, 95% CI: 2.429-7.411), smartphone addiction (OR = 2.205, 95% CI: 1.273-3.820) were significantly and independently associated with hypertension.

CONCLUSIONS

Among the junior school students surveyed in China, the prevalence of hypertension was high, which was related to obesity, poor sleep quality and smartphone addiction. These results suggested that smartphone addiction may be a new risk factor for high blood pressure in adolescents.

The association of problematic smartphone use with family well-being mediated by family communication in Chinese adults: A population-based study

BACKGROUND AND AIMS

Few studies have investigated the effects of problematic smartphone use (PSU) in the family context. We studied the association of PSU as a predictor with family well-being and the potential mediating role of family communication in Hong Kong Chinese adults.

METHODS

We analyzed data of 5,063 randomly selected adults [mean age (SD) = 48.1 (18.2) years; 45.0% men] from a dual landline and mobile telephone survey in 2017. PSU was assessed by the Smartphone Addiction Scale-Short Version with higher scores indicating higher levels. Family well-being was assessed by three questions on perceived family health, harmony, and happiness (3Hs) with higher scores indicating greater well-being. Perceived sufficiency and quality of family communication were rated. Multivariable regression analyses examined (a) associations of PSU with family 3Hs and well-being and (b) mediating role of family communication, adjusting for sociodemographic variables.

RESULTS

PSU was negatively associated with perceived family health (adjusted β = -0.008, 95% CI = -0.016, -0.0004), harmony (adjusted β = -0.009, 95% CI = -0.017, -0.002), happiness (adjusted β = -0.015, 95% CI = -0.022, -0.007), and well-being (adjusted β = -0.011, 95% CI = -0.018, -0.004). Perceived family communication sufficiency (adjusted β = -0.007, 95% CI = -0.010, -0.005) and quality (adjusted β = -0.009, 95% CI = -0.014, -0.005) mediated the association of PSU with family well-being, with 75% and 94% of total effects having mediated, respectively.

DISCUSSION AND CONCLUSIONS

PSU was negatively associated with family well-being, which was partially mediated by family communication. Such findings provide insights for health programs to prevent PSU and improve family well-being.

The Role of Cognitive Emotion Regulation Strategies on Problematic Smartphone Use: Comparison between Problematic and Non-Problematic Adolescent Users

Prior work has suggested that individuals with deficits in emotion regulation skills are prone to compulsive behaviour and to following maladaptive coping strategies, such as smartphone overuse, to manage negative moods. Adolescence is a vulnerable developmental stage for deficits in emotion regulation, and these are linked to excessive smartphone use. The present study is the first to examine the links between the use of specific cognitive emotion regulation (CER) strategies and problematic smartphone use in a sample of adolescents. A total of 845 Spanish adolescents (455 females) completed the Spanish versions of the Cognitive Emotion Regulation Questionnaire and the Smartphone Addiction Scale, along with a socio-demographic survey. The adolescents were divided into two groups: Non-problematic smartphone users (n = 491, 58.1%) and problematic smartphone users (n = 354, 41.9%). Significant group differences were found, with the problematic users reporting significantly higher scores for all maladaptive CER strategies, including higher self-blame, rumination, blaming of others and catastrophising. The results from logistic regression analyses show that rumination, catastrophising and blaming of others were the most important variables for distinguishing between the two groups, along with gender and parental control outside the home. In summary, these findings suggest the importance of specific maladaptive CER strategies in problematic smartphone use and provide insight for relevant targets for intervention designs.

Inhibitory Control in Excessive Social Networking Users: Evidence From an Event-Related Potential-Based Go-Nogo Task

Inhibitory control is a core executive function module that monitors and suppresses inappropriate behavior. Inhibitory deficits have been observed in different addiction types (e.g., smoking, alcohol, drug and gambling). The excessive use of social networking sites (SNSs) has attracted increasing attention; however, it is unknown whether inhibitory control is impaired in excessive SNS users. This study used event-related potentials in an SNS-related Go-Nogo task to investigate inhibitory control in excessive SNS users. Although the behavioral data did not show any significant differences between groups, the N1 amplitude was larger following SNS images than control images in excessive SNS users. Furthermore, excessive users showed larger N2 amplitude and smaller Nogo-P3 amplitude than non-excessive users irrespective of stimuli. These findings suggested that excessive SNS users are inefficient in allocating monitoring resources in the Go-Nogo task (reflected by enhance N2) and show difficulty in late inhibitory control procedure (reflected by reduced Nogo-P3) compared to non-excessive users. Also, excessive SNS users pay more attention to SNS-related images compared to non-SNS-related images (reflected by the N1). Interventions for this specific population should focus on limiting exposure to SNS cues and enhancing inhibitory control.

Association between high adolescent smartphone use and academic impairment, conflicts with family members or friends, and suicide attempts

This study aims to evaluate the association between smartphone use and suicide attempts, independent of possible confounders, including conflicts with family/friends and poor academic performance due to smartphone use. Data were obtained from the 2017 Korea Youth Risk Behavior Web-based Survey, a nationally representative survey of middle- and high-school students (N = 62,276). Time spent using a smartphone was divided into four categories: less than 1 h, 1–2 h, 3–4 h, and 5 h or more a day. The association of conflicts with family due to smartphone use, conflicts with friends due to smartphone use, and poor academic performance due to smartphone use with suicide attempts and time spent using a smartphone were analyzed using multiple and binary logistic regression analyses, respectively. The relationship between time spent on a smartphone and suicide attempts was analyzed using a multiple logistic regression analysis. All analyses were also stratified according to the main purpose of smartphone use (process purposes/social purposes). Conflicts with family/friends due to smartphone use was significantly associated with suicide attempts (P <0.001). The variables of conflicts with family, conflicts with friends and poor academic performance were also proportionally related to higher smartphone use (P <0.001). The use of a smartphone was significantly associated with suicide attempts in a multiple logistic regression analysis (adjusted odds ratio for smartphone use 5 h or more a day 2.16; 95% CI 2.07–2.26; P <0.001), and the association was more prominent with smartphone use for process purposes. Conflicts with family, conflicts with friends, poor academic performance, and suicide attempts were related to higher smartphone use in Korean adolescents. Time spent on a smartphone was positively related to suicide attempts, even after adjusting for conflicts with family members or friends and poor academic performance due to smartphone use.

Internet Addiction, Smartphone Addiction, and Hikikomori Trait in Japanese Young Adult: Social Isolation and Social Network

Background: As the number of internet users increases, problems related to internet overuse are becoming more and more serious. Adolescents and youth may be particularly attracted to and preoccupied with various online activities. In this study, we investigated the relationship of internet addiction, smartphone addiction, and the risk of hikikomori, severe social withdrawal, in Japanese young adult. Methods: The subjects were 478 college/university students in Japan. They were requested to complete the study questionnaire, which consisted of questions about demographics, internet use, the Internet Addiction Test (IAT), the Smartphone Addiction Scale (SAS)-Short Version (SV), the 25-item Hikikomori Questionnaire (HQ-25), etc. We investigated the difference and correlation of the results between two groups based on the purpose of internet use or the total score of each self-rating scale, such as screened positive or negative for the risk of internet addiction, smartphone addiction, or hikikomori. Results: There was a trend that males favored gaming in their internet use while females used the internet mainly for social networking via smartphone, and the mean SAS-SV score was higher in females. Two-group comparisons between gamers and social media users, according to the main purpose of internet use, showed that gamers used the internet longer and had significantly higher mean IAT and HQ-25 scores. Regarding hikikomori trait, the subjects at high risk for hikikomori on HQ-25 had longer internet usage time and higher scores on both IAT and SAS-SV. Correlation analyses revealed that HQ-25 and IAT scores had a relatively strong relationship, although HQ-25 and SAS-SV had a moderately weak one. Discussion: Internet technology has changed our daily lives dramatically and altered the way we communicate as well. As social media applications are becoming more popular, users are connected more tightly to the internet and their time spent with others in the real world continues to decrease. Males often isolate themselves from the social community in order to engage in online gaming while females use the internet as to not be excluded from their communications online. Mental health providers should be aware of the seriousness of internet addictions and hikikomori.

Clinical Characteristics of Diagnosis for Internet Gaming Disorder: Comparison of DSM-5 IGD and ICD-11 GD Diagnosis

The American Psychiatric Association (APA) included internet game disorder (IGD) in section III of the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) on the condition that it guaranteed more clinical research and experience. The World Health Organization (WHO) also included Game Disorder (GD) in the 11th final revision of the International Classification of Diseases (ICD-11) and recently recognized it as a diagnosis code. This study aims to compare clinical characteristics and gaming behavior patterns between the IGD diagnosis criteria proposed by the DSM-5 and the GD diagnosis criteria proposed by the ICD-11 based on clinical cohort data (c-CURE: clinic-Cohort for Understanding of internet addiction Rescue factors in Early life) obtained in the Republic of Korea. Psychologists and psychiatrists conducted semi-structured interviews with children/adolescents and their caregivers to identify IGD (Diagnostic Interview for Internet, Game, SNS, etc. Addiction, DIA), and comorbid psychiatric disorders (Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version-Korean version, K-SADS-PL). The cohort was divided into three IGD diagnosis groups (Normal, DSM5, DSM5 + ICD11) based on DSM-5 and ICD-11 diagnosis criteria. Internet usage pattern and addiction characteristics and psychiatric comorbidities were compared among the three IGD diagnosis groups. The Normal group consisted of 115 subjects, the DSM5 group contained 61 subjects, and the DSM5 + ICD11 group amounted to 12 subjects. The DSM5 + ICD11 group had a lower age of starting use of Internet/games/smartphones than other groups and the average time of Internet/game/smartphone use during weekdays/weekends was the highest. Also, in the eight items scored, excluding ‘deceiving’ and ‘craving’, the rate of threshold was highest in the DSM5 + ICD11 group, followed by the DSM5 group and the Normal group. On the other hand, ‘deceiving’ and ‘craving’ were the highest in DSM5, followed by DSM5 + ICD11 and Normal. The DSM5 + ICD11 group had significantly higher rates of depressive disorder, oppositional defiant disorder (ODD) and conduct disorder (CD) compared to other groups. This study provides implications for the clinical characteristics of IGD diagnosis in the field by comparing the DSM-5 IGD diagnosis criteria with the ICD-11 GD diagnosis criteria. Furthermore, this study provides empirical evidence that ICD-11 GD emphasizes serious symptoms such as functional impairment caused by excessive Internet/game/smartphone use over a long time, and it supports the validity of the ICD-11 GD diagnosis.

Over-connected? A qualitative exploration of smartphone addiction among working adults in China

BACKGROUND

Smartphones currently dominate people's lives and interests due to their increased affordability and functionality. However, the negative aspects of smartphone use, such as smartphone addiction, have recently been brought up. This study utilized a qualitative approach to explore the symptoms of smartphone addiction among working adults in China and the psychological factors that affect such addiction.

METHODS

Semi-structured interviews, either face to face or via Skype (online), were conducted with 32 Chinese workers. The collected data were analyzed using a thematic analysis approach in Nvivo 10 software.

RESULTS

This study identified four typical symptoms of smartphone addiction, namely, withdrawal (e.g., experiencing negative feelings when having no access to smartphones), salience (e.g., constant checking and thinking about smartphones), conflict (e.g., smartphone use interferes with family and work life), and phantom phone signals (e.g., illusory perception of a phone vibrating or ringing). Conscientiousness, neuroticism, and extroversion increase the likelihood of smartphone addiction. Notably, this study found that conscientious workers are likely to develop smartphone addiction, a finding that is contrary to those of the majority of existing studies on technological addiction.

CONCLUSIONS

This study revealed various smartphone addiction symptoms among young Chinese workers, and these include withdrawal, salience, conflicts, and phantom phone signals. Conscientious, neurotic, and extroverted employees are likely to exhibit these symptoms.

Problematic smartphone use in young Swiss men: Its association with problematic substance use and risk factors derived from the pathway model

BACKGROUND AND AIMS

This study aimed to examine associations between risk factors suggested in the pathway model proposed by Billieux et al., demographic and substance use variables, and problematic smartphone use (PSU).

METHODS

The analytical sample consisted of 5,096 Swiss men (mean age = 25.5 years, SD = 1.26). Multiple linear regression analyses were conducted with PSU as dependent and the following as independent variables: (a) Billieux's pathway model variables (depression, social anxiety, ADHD, aggression-hostility, and sensation seeking); (b) substance use variables [alcohol: at-risk risky single-occasion drinking (RSOD); at-risk volume drinking; tobacco use: daily smoking; illicit drug use: more than weekly cannabis use; having used at least one other illicit drug besides cannabis over the preceding 12 months]; and (c) sociodemographic variables (age, language region, and education).

RESULTS

All pathway-model variables except sensation seeking were significant predictors of PSU, especially symptoms of social anxiety (β = 0.196) and ADHD (β = 0.184). At-risk RSOD was positively (β = 0.071) associated with PSU, whereas both frequent cannabis use (β = -0.060) and daily cigarette smoking (β = -0.035) were negatively associated with PSU. Higher-achieved educational levels and being from the German-speaking part of Switzerland predicted PSU.

DISCUSSION AND CONCLUSIONS

The findings of this study can be used to develop tailored interventional programs that address the co-occurrence of certain risky behaviors (e.g., at-risk RSOD and PSU) and target individuals who might be particularly prone to PSU. Such interventions would need to ensure that addressing one problem (e.g., decreasing PSU) does not lead to some other compensatory behavior (e.g., frequent cigarette smoking).

Problematic smartphone use associated with greater alcohol consumption, mental health issues, poorer academic performance, and impulsivity

BACKGROUND

This study sought to examine the occurrence of the problematic use of smartphones in a university sample and associated physical and mental health correlates, including potential relationships with risky sexual practices.

METHODS

A 156-item anonymous online survey was distributed via e-mail to a sample of 9,449 university students. In addition to problematic smartphone usage, current use of alcohol and drugs, psychological and physical status, and academic performance were assessed.

RESULTS

A total of 31,425 participants were included in the analysis, of whom 20.1% reported problematic smartphone use. Problematic use of smartphones was associated with lower grade point averages and with alcohol use disorder symptoms. It was also significantly associated with impulsivity (Barratt scale and ADHD) and elevated occurrence of PTSD, anxiety, and depression. Finally, those with current problems with smartphone use were significantly more sexually active.

CONCLUSIONS

Problematic use of smartphones is common and has public health importance due to these demonstrable associations with alcohol use, certain mental health diagnoses (especially ADHD, anxiety, depression, and PTSD), and worse scholastic performance. Clinicians should enquire about excessive smartphone use as it may be associated with a range of mental health issues. Research is needed to address longitudinal associations.

Transitions in Problematic Internet Use: A One-Year Longitudinal Study of Boys

OBJECTIVE

Longitudinal studies may help elucidate the factors associated with Problematic Internet Use (PIU); however, little prospective research has been conducted on the subject. The aim of the current study was to prospectively examine PIU in children/adolescents and identify the possible risk factors associated with transitions in PIU severity.

METHODS

650 middle-school boys were surveyed at two points one year apart and assessed for PIU using the Internet Addiction Proneness Scale for Youth (KS-II) and on other psychological characteristics.

RESULTS

We found that 15.3% at baseline and 12.4% at one year met the criteria for at-risk/high-risk PIU (ARHRPIU). Both the persistent-ARHRPIU and emerging-ARHRPIU groups revealed greater depressive, motor impulsive, and smart-phone-addiction tendencies than the remitting-ARHRPIU group or the persistent low-risk group. In addition, we found that individuals exhibiting higher hyperkinetic attention-deficit/hyperactivity disorder (ADHD) scores were less likely to remit from ARHRPIU, and that individuals exhibiting more ADHD-related cognitive dysfunction and reporting fewer Internet-game-free days were more likely to demonstrate an emergence of ARHRPIU.

CONCLUSION

The present findings support previous studies in that specific negative-health features are linked to transitions in ARHRPIU. Furthermore, these findings suggest that intervention is needed and may be best targeted at specific groups of youths.

Temporal Stability of Smartphone Use Data: Determining Fundamental Time Unit and Independent Cycle

Background

Assessing human behaviors via smartphone for monitoring the pattern of daily behaviors has become a crucial issue in this century. Thus, a more accurate and structured methodology is needed for smartphone use research.

Objective

The study aimed to investigate the duration of data collection needed to establish a reliable pattern of use, how long a smartphone use cycle could perpetuate by assessing maximum time intervals between 2 smartphone periods, and to validate smartphone use and use/nonuse reciprocity parameters.

Methods

Using the Know Addiction database, we selected 33 participants and passively recorded their smartphone usage patterns for at least 8 weeks. We generated 4 parameters on the basis of smartphone use episodes, including total use frequency, total use duration, proactive use frequency, and proactive use duration. A total of 3 additional parameters (root mean square of successive differences, Control Index, and Similarity Index) were calculated to reflect impaired control and compulsive use.

Results

Our findings included (1) proactive use duration correlated with subjective smartphone addiction scores, (2) a 2-week period of data collection is required to infer a 2-month period of smartphone use, and (3) smartphone use cycles with a time gap of 4 weeks between them are highly likely independent cycles.

Conclusions

This study validated temporal stability for smartphone use patterns recorded by a mobile app. The results may provide researchers an opportunity to investigate human behaviors with more structured methods.

Problematic Use of Mobile Phones in Australia…Is It Getting Worse?

Rapid technological innovations over the past few years have led to dramatic changes in today's mobile phone technology. While such changes can improve the quality of life of its users, problematic mobile phone use can result in its users experiencing a range of negative outcomes such as anxiety or, in some cases, engagement in unsafe behaviors with serious health and safety implications such as mobile phone distracted driving. The aims of the present study are two-fold. First, this study investigated the current problem mobile phone use in Australia and its potential implications for road safety. Second, based on the changing nature and pervasiveness of mobile phones in Australian society, this study compared data from 2005 with data collected in 2018 to identify trends in problem mobile phone use in Australia. As predicted, the results demonstrated that problem mobile phone use in Australia increased from the first data collected in 2005. In addition, meaningful differences were found between gender and age groups in this study, with females and users in the 18-25 year-old age group showing higher mean Mobile Phone Problem Use Scale (MPPUS) scores. Additionally, problematic mobile phone use was linked with mobile phone use while driving. Specifically, participants who reported high levels of problem mobile phone use, also reported handheld and hands-free mobile phone use while driving.

The Psychology of Smartphone: The Development of the Smartphone Impact Scale (SIS)

Smartphones are changing lives in a number of ways. However, the psychological literature has primarily focused on smartphone overuse, neglecting the impacts that are not strictly related to problematic use. The present research was aimed to develop a comprehensive self-report scale that accounts for the cognitive, affective, social, and behavioral impacts of smartphones in everyday life-the Smartphone Impact Scale (SIS). Study 1 (N = 407) yielded a preliminary version of the scale, which was refined in Study 2 (N = 601). The SIS is a 26-item scale that measures seven dimensions of smartphone impact. Results revealed meaningful associations between its subscales, psychosocial constructs, and daily usage of smartphones and apps. The SIS broadens the view of human-smartphone interaction by extending the concept of problematic smartphone use to further dimensions (e.g., emotion regulation) and introducing a proper measurement of underinvestigated smartphone impacts (e.g., tasks support). The implications of each SIS subscale are discussed.

The relationship between anxiety symptom severity and problematic smartphone use: A review of the literature and conceptual frameworks

In the present paper, we examine the literature studying relations between problematic smartphone use (PSU) and anxiety symptom severity. We first present background on the health advantages and disadvantages of using a smartphone. Next, we provide caveats in distinguishing healthy smartphone use from unhealthy PSU, and we discuss how PSU is measured. Additionally, we discuss theoretical frameworks explaining how some people develop PSU, including Uses and Gratifications Theory, and Compensatory Internet Use Theory. We present our own theoretical model of how PSU is specifically related to anxiety. We discuss and review mental health constructs associated with PSU severity, based on prior literature. Next, we systematically review the research on PSU severity in relation to anxiety symptoms, given the recent growth of studies on this research question. Finally, we offer implications and recommendations for future research in this area.

Worry and anger are associated with latent classes of problematic smartphone use severity among college students

BACKGROUND

Problematic smartphone use (PSU) is associated with depression and anxiety symptom severity throughout the literature. However, many important psychopathology constructs have not been examined for associations with PSU severity. Worry and anger are two psychopathology constructs receiving little empirical scrutiny in relation to PSU, but theoretically should demonstrate significant relationships. Furthermore, few studies have used person-centered analyses, such as mixture modeling, to analyze possible latent subgroups of individuals based on PSU symptom ratings.

METHOD

We conducted a web survey of 300 American college students, using the Smartphone Addiction Scale-Short Version, Penn State Worry Questionnaire-Abbreviated Version, and Dimensions of Anger Reactions-5 Scale.

RESULTS

Conducting mixture modeling using latent profile analysis, we found most support for a three-class model of latent groups of individuals based on their PSU item ratings. Adjusting for age and sex, worry and anger scores were significantly higher in the more severe PSU classes.

DISCUSSION

Results are discussed in the context of uses and gratifications theory, as well as compensatory internet use theory, in terms of individual differences explaining excessive technology use.

LIMITATIONS

Limitations include the non-clinical nature of the sample.

CONCLUSIONS

Worry and anger may be helpful constructs in understanding the phenomenology of PSU, and psychological interventions for worry and anger may offset PSU.

Application of Diagnostic Interview for Internet Addiction (DIA) in Clinical Practice for Korean Adolescents

The increased prevalence of Internet Gaming Disorder (IGD) and the inclusion of IGD in DSM-5 and ICD-11 emphasizes the importance of measuring and describing the IGD symptoms. We examined the psychometric properties of the Diagnostic Interview for Internet Addiction (DIA), a semi-structured diagnostic interview tool for IGD, and verified the application of DIA in clinical practice for Korean adolescents. The DIA is conducted in a manner that interviews both adolescents and their caregivers, and each item has a standardized representative question and various examples. It consists of 10 items based on the DSM-5 IGD diagnostic criteria, which is cognitive salience, withdrawal, tolerance, difficulty in regulating use, loss of interest in other activities, persistent use despite negative results, deception regarding Internet/games/SNS use, use of Internet/games/SNS to avoid negative feelings, interference with role performance, and craving. The study included 103 adolescents divided into three subgroups (mild risk, moderate risk, and addicted group) based on the total score of DIA. Demographic and clinical characteristics were compared among the DIA subgroups using the chi-square test and analysis of variance (ANOVA), and correlation analysis was used to examine the associations of IGD symptoms with clinical variables (e.g., impulsivity, aggression, depression, anxiety, self-esteem). The DIA total score was significantly correlated with Internet and smartphone addiction, depression, state anxiety, self-esteem, impulsivity, aggression, and stress. Furthermore, the moderate risk and addicted group showed significantly higher levels of Internet and smartphone addiction, anxiety, depression, impulsivity, aggression, stress, and lower self-esteem compared with the mild risk group. The Junior Temperament and Character Inventory (JTCI), which measures temperament and character traits, revealed that the mild risk group had higher levels of persistence and self-directedness than did the addicted group. Our findings confirmed the psychometric properties of DIA and the application of the DIA classifications in Korean adolescents.

Smartphone Addiction in Japanese College Students: Usefulness of the Japanese Version of the Smartphone Addiction Scale as a Screening Tool for a New Form of Internet Addiction

OBJECTIVE

Smartphone use is pervasive among youth in Japan, as with many other countries, and is associated with spending time online and on social media anywhere at any time. This study aimed to test a Japanese version of the Smartphone Addiction Scale-Short Version (SAS-SV) among Japanese college students.

METHODS

The subjects of this study were 602 college students in Japan. The study questionnaire consisted of questions about demographics (age, gender etc.), possession of a smartphone, internet use [length of internet use on weekdays and weekend, favorite social networking service (SNS) etc.], Young's Internet Addiction Test (IAT), and the Smartphone Addiction Scale-Short Version (SAS-SV) translated into Japanese.

RESULTS

There was a total of 573 respondents (180 male, 393 female) who completed the questionnaire (mean 19.3±1.3 years). LINE was the most popular social media platform (52.0%) followed by Twitter (36.3%). The overall Internet Addiction Test (IAT) score was 45.3±13.2, with 4.5% classified as having severe addiction (IAT ≥70). The mean SAS-SV scores were 24.4±10.0 for males and 26.8±9.9 for females. Based on proposed cutoff scores, 22.8% of males and 28.0% of females screened positive for smartphone addiction. The total scores of the SAS-SV and the IAT was correlated significantly.

CONCLUSION

As the number of smartphone users becomes higher, problems related to smartphone use also become more serious. Our.

RESULTS

suggest that the Japanese version of SAS-SV may assist in early detection of problematic use of smartphones.

Association of excessive smartphone use with psychological well-being among university students in Chiang Mai, Thailand

Background

Despite the pervasive use of smartphones among university students, there is still a dearth of research examining the association between smartphone use and psychological well-being among this population. The current study addresses this research gap by investigating the relationship between smartphone use and psychological well-being among university students in Thailand.

Methods

This cross-sectional study was conducted from January to March 2018 among university students aged 18–24 years from the largest university in Chiang Mai, Thailand. The primary outcome was psychological well-being, and was assessed using the Flourishing Scale. Smartphone use, the primary independent variable, was measured by five items which had been adapted from the eight-item Young Diagnostic Questionnaire for Internet Addiction. All scores above the median value were defined as being indicative of excessive smartphone use.

Results

Out of the 800 respondents, 405 (50.6%) were women. In all, 366 (45.8%) students were categorized as being excessive users of smartphones. Students with excessive use of smartphones had lower scores the psychological well-being than those who did not use smartphone excessively (B = -1.60; P < 0.001). Female students had scores for psychological well-being that were, on average, 1.24 points higher than the scores of male students (P < 0.001).

Conclusion

This study provides some of the first insights into the negative association between excessive smartphone use and the psychological well-being of university students. Strategies designed to promote healthy smartphone use could positively impact the psychological well-being of students.

The role of childhood emotional maltreatment and body image dissatisfaction in problematic smartphone use among adolescents

Growing empirical evidence has identified specific psychological and contextual risk factors associated with problematic smartphone use (PSU). However, the potential direct and indirect impact of childhood emotional maltreatment (CEM) on PSU remains largely unexplored, despite the established role of CEM in the onset of other excessive, problematic, and addictive behaviors. Consequently, the purpose of the present study was to test the direct and indirect relationships of emotional abuse and neglect (two facets of CEM) with PSU via specific mediational pathways including body image dissatisfaction (BID), social anxiety, and depression. The sample comprised 443 adolescents who completed a questionnaire that included assessment tools of aforementioned variables. Multiple mediation model results indicated that CEM was directly and indirectly associated with PSU via BID, depression, BID-related depression, and BID-related social anxiety. Results suggested that emotionally traumatic experiences were associated with PSU in adolescents and that this relationship may partially be explained by BID and psychosocial risk factors. The present study draws caution to the amplifying roles of CEM and BID on increased PSU. The results of the study have important clinical and public health implications, but additional research is needed before interventions can be developed and implemented on the basis of present results.

Prevalence of smartphone addiction and its effects on sleep quality: A cross-sectional study among medical students

AIMS

The study aims to assess the prevalence of smartphone addiction and its effects on sleep quality among medical students.

STUDY SETTING AND DESIGN

A cross-sectional study was carried out by convenience sampling of medical students at a tertiary care hospital in South India.

MATERIALS AND METHODS

Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, 4^th Edition, Text Revision axis I disorders research version was used for screening past and current psychiatric illness. A semi-structured pro forma was used to obtain demographic details. Smartphone Addiction Scale-Short Version was used to assess smartphone addiction in the participants. Sleep quality was assessed using Pittsburgh's Sleep Quality Index (PSQI).

RESULTS

Among 150 medical students, 67 (44.7%) were addicted to smartphone usage. Despite the preponderance of male students (31 [50%]) being addicted, there was no statistically significant gender difference in smartphone addiction (P = 0.270). The PSQI revealed poor sleep quality in 77 (51.3%) which amounts to half of the participants. Smartphone addiction was found to be statistically significantly associated with poor sleep quality (odds ratio: 2.34 with P < 0.046).

CONCLUSIONS

The prevalence of smartphone addiction among younger population is higher compared to those of contemporary studies. No gender difference in smartphone addiction could be made out in the current study. Smartphone addiction was found to be associated with poor sleep quality. The findings support screening for smartphone addiction which will be helpful in early identification and prompt management.

Bad Choices Make Good Stories: The Impaired Decision-Making Process and Skin Conductance Response in Subjects With Smartphone Addiction

Introduction: Smartphone Addiction (SA) has caused negative consequences and functional impairments in college students, such as reduction of academic performance and impairment in sleep quality. Studies have shown that individuals with chemical and behavioral dependencies have a bias in decision-making process, which leads to short-term advantageous choices even if they cause long-term harm. This bias in decision-making process is accompanied by a change in somatic markers and is associated with the development and maintenance of addictive behavior. The decision-making process and the measurement of physiological parameters have not yet been analyzed in SA. The neuropsychological and physiological characterization of the SA can contribute to its approach with the other dependency syndromes and to its recognition as a disease. Objective: we aimed to evaluate the decision-making process under risk and under ambiguity in individuals with SA and to measure the physiological parameters that accompany this process. Method: We compared the performance in the Iowa Gambling Task (IGT), Game of Dice Task (GDT) and skin conductance response (SCR) between 50 individuals with SA and 50 controls. Results: Smartphone dependents presented a profile of impairment in decision-making under ambiguity, without impairment in decision-making under risk. They demonstrated lower SCR before disadvantageous choices, higher SCR after rewards and lower SCR after punishments during decision-making, which suggests difficulty in recognizing disadvantageous alternatives, high sensitivity to rewards, and low sensitivity to punishments. Conclusion: The impairment in the decision-making process in smartphone dependents is similar to that found in other chemical and behavioral addictions, such as alcohol addiction, gambling disorders and pathological buy. The impairment in decision under ambiguity with preservation of decision under risk may reflect dysfunction of implicit emotional processes without dysfunction of explicit cognitive process. This profile can contribute to the recognition of SA as a behavioral dependence and to guide specific preventive and therapeutic strategies.

Short version of the Smartphone Addiction Scale in Chinese adults: Psychometric properties, sociodemographic, and health behavioral correlates

BACKGROUND AND AIMS

Problematic smartphone use (PSU) is an emerging but understudied public health issue. Little is known about the epidemiology of PSU at the population level. We evaluated the psychometric properties of the Smartphone Addiction Scale - Short Version (SAS-SV) and examined its associated sociodemographic factors and health behaviors in Chinese adults in Hong Kong.

METHODS

A random sample of 3,211 adults aged ≥18 years (mean ± SD: 43.3 ± 15.7, 45.3% men) participated in a population-based telephone survey in Hong Kong and completed the Chinese SAS-SV. Multivariable linear regressions examined the associations of sociodemographic factors, health behaviors, and chronic disease status with SAS-SV score. Data were weighted by age, sex, and education attainment distributions of the Hong Kong general population.

RESULTS

The Chinese SAS-SV is internally consistent (Cronbach's α = .844) and stable over 1 week (intraclass correlation coefficient = .76, p < .001). Confirmatory factor analysis supported a unidimensional structure established by previous studies. The weighted prevalence of PSU was 38.5% (95% confidence interval: 36.9%, 40.2%). Female sex, younger age, being married/cohabitated or divorced/separated (vs. unmarried), and lower education level were associated with a higher SAS-SV score (all ps <.05). Current smoking, weekly to daily alcohol drinking, and physical inactivity predict greater PSU after controlling for sociodemographic factors and mutual adjustment.

DISCUSSION AND CONCLUSIONS

The Chinese SAS-SV was found valid and reliable for assessing PSU in Hong Kong adults. Several sociodemographic and health behavioral factors were associated with PSU at the population level, which may have implication for prevention of PSU and future research.

Mobile Phone Use and Mental Health. A Review of the Research That Takes a Psychological Perspective on Exposure

The purpose of this study was to carry out a review of observational studies that consider links between mobile phone use and mental health from a psychological or behavioral perspective. Systematic literature searches in PubMed and PsycINFO for articles published until 2017 were done. Exclusion criteria included: papers that considered radiofrequency fields, attention, safety, relational consequences, sexual behavior, cyberbullying, and reviews, qualitative, and case or experimental studies. A total of 4738 papers were screened by title and abstract, 404 were retrieved in full text, and 290 were included. Only 5% had any longitudinal design. Self-reporting was the dominating method of measurement. One third of the studies included children or youth. A majority of adult populations consisted of university students and/or self-selected participants. The main research results included associations between frequent mobile phone use and mental health outcomes, such as depressive symptoms and sleep problems. Mobile phone use at bedtime was associated with, e.g., shorter sleep duration and lower sleep quality. "Problematic use" (dependency) was associated with several negative outcomes. In conclusion, associations between mobile phone use and adverse mental health outcomes are found in studies that take a psychological or behavioral perspective on the exposure. However, more studies of high quality are needed in order to draw valid conclusions about the mechanisms and causal directions of associations.

Linking Internet Communication and Smartphone Use Disorder by taking a closer look at the Facebook and WhatsApp applications

Introduction

Smartphones are ubiquitous in the digital society. Although this powerful device is useful because it supports and simplifies many tasks in everyday life, a growing number of researchers is concerned that smartphones might have detrimental effects on the human brain and related psychological processes. Evidence indicates that social media platforms such as WhatsApp and Facebook are essential drivers of smartphone usage. Thus, a critical, yet unexplored issue is how excessive use of those platforms is related to Smartphone Use Disorder (SUD). Furthermore, since the roles of life satisfaction and fear of missing out (FoMo) have been demonstrated to be of particular importance for Internet Use and Internet Communication Disorder, those constructs were examined in the context of SUD.

Methods

In total, n = 2299 participants filled in questionnaires assessing SUD, WhatsApp and Facebook Use Disorder, FoMO, life satisfaction, and reported owning a WhatsApp and Facebook account.

Results

The study revealed that SUD was linked to WhatsApp Use Disorder, and to a lesser extent, to Facebook Use Disorder. Associations between SUD and WhatsApp Use Disorder were most strongly pronounced in females. Additionally, FoMo predicted SUD, WhatsApp, Facebook Use Disorder, and (fully) mediated the relationship between life satisfaction and those variables.

Conclusion

The findings of the present study suggest that WhatsApp use plays an important role to understand SUD. Regarding the mediating role of FoMO, the present work might help disentangle inconsistent results on the link between life satisfaction and (excessive) social networking sites use.

•

SUD is linked to WhatsApp (WUD) and Facebook Use Disorder (FUD).

•

The association between SUD and WUT is stronger than with FUD.

•

FoMO (fully) mediates the link between life satisfaction and SUD, WUD and FUD.

Predicting Suicidal Ideation in College Students with Mental Health Screening Questionnaires

OBJECTIVE

The present study aimed to identify risk factors for future SI and to predict individual-level risk for future or persistent SI among college students.

METHODS

Mental health check-up data collected over 3 years were retrospectively analyzed. Students were categorized as suicidal ideators and non-ideators at baseline. Logistic regression analyses were performed separately for each group, and the predicted probability for each student was calculated.

RESULTS

Students likely to exhibit future SI had higher levels of mental health problems, including depression and anxiety, and significant risk factors for future SI included depression, current SI, social phobia, alcohol problems, being female, low self-esteem, and number of close relationships and concerns. Logistic regression models that included current suicide ideators revealed acceptable area under the curve (AUC) values (0.7-0.8) in both the receiver operating characteristic (ROC) and precision recall (PR) curves for predicting future SI. Predictive models with current suicide non-ideators revealed an acceptable level of AUCs only for ROC curves.

CONCLUSION

Several factors such as low self-esteem and a focus on short-term rather than long-term outcomes may enhance the prediction of future SI. Because a certain range of SI clearly necessitates clinical attention, further studies differentiating significant from other types of SI are necessary.

Addicted to cellphones: exploring the psychometric properties between the nomophobia questionnaire and obsessiveness in college students

A potential new clinical disorder is arising due to the addiction to cellphones called nomophobia-or feelings of discomfort or anxiety experienced by individuals when they are unable to use their mobile phones or utilize the conveniences these devices provide. However, before being able to officially classify this disorder as clinically relevant, more research needs to be conducted to determine how nomophobia relates to existing disorders. In a sample of 397 undergraduate students, the present study examined the relationship between the Nomophobia Questionnaire (NMP-Q) and the Obsessiveness Content Scale (OBS) of the Minnesota Multiphasic Personality Inventory-2 (the MMPI-2). Confirmatory factor analysis (CFA) was used to test whether the OBS Content Scale would be related to a one-factor NMP-Q solution (Fig. 1) or a four-factor NMP-Q solution (Fig. 2). Convergent and divergent validity were also investigated. The four-factor model was a better fit than the one-factor model as indicated by most fit indices. The findings showed that the OBS latent variable was correlated with all of the four NMP-Q latent variables. Mixed support was found for convergent validity, but high support was found for the divergent validity of the NMP-Q factors. This study contributes to a growing body of literature seeking to better understand the addictive nature of cellphones and takes a new perspective on addiction research and obsessiveness. These findings provide a better understanding between pre-existing assessments of personality disorders (e.g., obsessiveness) that are emerging from the overuse of mobile phones or the excessive fear of losing one's cell phone.

How Is Smartphone Addiction Related to Interaction Anxiety of Prospective Teachers?

The main purpose of this research is to determine the relationship between prospective teachers’ smartphone addiction and interaction anxiety. For this purpose, quantitative research was carried out within the relational screening model. The population of the research was composed of senior students and pedagogical formation students from Inonu University Faculty of Education in Turkey. The sample consisted of a total of 330 prospective teachers, including 117 Faculty of Education and 213 pedagogical formation students. Data of the study were obtained via The Smartphone Addiction Scale-Short Version (SAS-SV) and The Interaction Anxiousness Scale (IAS). As a result of the research, it was seen that the scores of prospective teachers’ on smartphone use was at the lower level and the scores of interaction anxiety were close to the lower level of anxiety. There was also a statistically significant positive correlation between prospective teachers’ smartphone addiction and interaction anxiety.

Smartphone Addiction Inventory (SPAI): Translation, adaptation and validation of the tool in Spanish adult population

The wide functionality and the vast range of attributes offered by smartphones has led to a substantial increase in the average amount of time these devices are used per day. An excessive use of these tools has been shown to result in symptomatology similar to psychological disorders caused by substance addiction. In Spain, smartphone use has risen exponentially but the effects of this increase remain unclear. Therefore, an instrument is required to help determine the extent of smartphone addiction in the Spanish population. The Smartphone Addiction Inventory (SPAI) is a valid and reliable mean to identify and measure smartphone addiction and so, the aim of this research is the translation and adaptation of SPAI to Spanish, as well as the analysis of its psychometric properties in a Spanish adult population of 2,958 adults, at the University of Valencia. A multiphase-interactive model has been used, based on classical translation-back-translation methods to translate and adapt the SPAI. Moreover, a confirmatory factor analysis to verify that the inventory showed acceptable goodness of fit indices (χ2293 = 4795.909, Comparative Fit Index = 0.927, Tucker-Lewis Index = 0.919, Root Mean Square Error of approximation = 0.072, and Standardised Root Mean square Residual = 0.051) has been carried out. Also good reliability has been found for the global inventory (Cronbach's alpha = 0.949), and each of its corresponding factors: compulsive behaviour, functional impairment, abstinence, and tolerance (Cronbach's alpha = 0.856, 0.888, 0.855, and 0.712, respectively). Hence, the SPAI has been adequately translated and adapted for its use in Spain and therefore it is a useful tool for evaluating the degree of smartphone addiction in the Spanish adult population.

Loneliness, Individualism, and Smartphone Addiction Among International Students in China

Due to economic growth and educational development, China has become a popular study destination in recent years. However, little is known about this ever-expanding and diverse higher-education population in China. Rapidly adopted globally, smartphones may help international students adjust their life abroad and cope with bad feelings, while negative influence of smartphone addiction becomes a recent concern. To fill the gap, this study explores the levels of loneliness of international students in China. Integrating cultural dimensions theory and relevant research on smartphone addiction, the present study adopted online survey as main research method to examine the relationship between individualism, loneliness, smartphone use, and smartphone addiction. In total, 438 international students voluntarily participated in the survey. The participants were from 67 countries and have been studying in China for months. The results show international students in China as a high-risk population for both severe loneliness and smartphone addiction, with 5.3 percent of the participants experiencing severe loneliness and more than half of the participants exhibiting smartphone addiction symptoms. This study reveals predicting power of cultural individualism in explaining loneliness and significant mediation effects of loneliness and smartphone use. Those international students with lower degree of individualism showed higher degree of loneliness, which led to higher degree of smartphone use and smartphone addiction. Loneliness was found to be the strongest predictor for smartphone addiction. These findings should be noticed for prevention, intervention, and treatment for smartphone addiction among international students. Implications for academicians and practitioners are discussed.

Correlation among smartphone addiction, craniovertebral angle, scapular dyskinesis, and selected anthropometric variables in physiotherapy undergraduates

Objectives

Smartphone addiction has been indicated to reduce the craniovertebral angle, thereby causing a forward head posture and increasing scapular dyskinesis. This study determined the correlation among smartphone addiction level, craniovertebral angle, scapular dyskinesis, and selected anthropometric variables in physiotherapy undergraduates.

Methods

Seventy-seven participants were recruited from the Department of Physiotherapy, College of Medicine, University of Lagos, through a purposive sampling technique. The smartphone addiction level was assessed with the short version Smartphone Addiction Scale (English version). Craniovertebral and scapular dyskinesis were assessed using the photographic method. Descriptive and inferential statistics were used to analyse the data at an alpha level of 0.05.

Results

The analysis in this study revealed that many undergraduates are addicted to using smartphones. There was no significant difference in the addiction level (p = 0.367) and in scapular dyskinesis (p = 0.129) between male and female participants. However, there was a significant difference in craniovertebral angle (p = 0.032) between male and female participants. There was a significant relationship among smartphone addiction, craniovertebral angle (r = 0.306, p = 0.007), and scapular dyskinesis (r = 0.363, p = 0.007) in male and female participants.

Conclusion

A high level of smartphone addiction reduces the craniovertebral angle and increases scapular dyskinesis. Therefore, the smartphone addiction level should be assessed in all patients with neck and shoulder pain to plan appropriate management.

How are smartphones associated with adolescent materialism?

This study examined whether smartphone addiction predicted adolescent materialism and whether self-esteem mediated the relation between smartphone addiction and adolescent materialism. Moreover, this study tested whether this mediating process was moderated by student–student relationship. Our theoretical model was tested among 748 middle school students in China (mean age = 16.80, standard deviation = .73). The results indicated that smartphone addiction was positively related to adolescent materialism. Mediation analysis showed that self-esteem mediated this relation. Moderated mediation test further revealed that the mediated path was moderated by student–student relationship.

Translation of the short version of the Smartphone Addiction Scale into Brazilian Portuguese: cross-cultural adaptation and testing of measurement properties

BACKGROUND

Smartphone use has been constantly increasing. Smartphone addiction can lead to changes in the emotional state and musculoskeletal system of users. To identify smartphone addicts, the Smartphone Addiction Scale-Short Version was developed; however, this scale has not been translated into Brazilian Portuguese and tested for its measurement properties.

OBJECTIVE

To translate and cross-culturally adapt the Smartphone Addiction Scale-Short Version into Brazilian Portuguese; to assess the internal consistency, reliability and construct validity of the scale among university students.

METHODS

The cross-cultural adaptation was performed following the guidelines for cross-cultural adaptation of self-report measures, and data were collected via online surveys administered to 59 university students over 18 years of age for test-retest. To test the measurement properties of the final version of the Smartphone Addiction Scale-Short Version, a convenience sample including 130 university students was used.

RESULTS

The Smartphone Addiction Scale-Short Version showed good reliability for test-retest scores (ICC_3,1=0.82; 95% CI=0.70-0.89) and good internal consistency considering all 10 items (Cronbach's alpha=0.95). The construct validity was calculated comparing the Smartphone Addiction Scale-Short Version score to data from a questionnaire prepared by the authors of this study, including frequency per day (r=0.35; p<0.001), leisure time on the smartphone (r=0.33; p<0.001), and time working on the smartphone (r=0.18; p=0.04) that were significantly positively associated with higher Smartphone Addiction Scale-Short Version scores. The results show a high prevalence of smartphone addiction among university students (33.1%).

CONCLUSION

It can be concluded that the Brazilian Portuguese version of the Smartphone Addiction Scale-Short Version is a reliable and valid tool for screening smartphone addiction in university students.