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

A Study of Magnitude and Psychological Correlates of Smartphone Use in Medical Students: A Pilot Study with A Novel Telemetric Approach

CONTEXT

Smartphone use is being investigated as a potential behavioral addiction. Most of the studies opt for a subjective questionnaire-based method. This study evaluates the psychological correlates of excessive smartphone use. It uses a telemetric approach to quantitatively and objectively measure participants' smartphone use.

METHODOLOGY

One hundred forty consenting undergraduate and postgraduate students using an Android smartphone at a tertiary care teaching hospital were recruited by serial sampling. They were pre-tested with the Smartphone Addiction Scale-Short Version, Big five inventory, Levenson's Locus of Control Scale, Ego Resiliency Scale, Perceived Stress Scale, and Materialism Values Scale. Participants' smartphones were installed with tracker apps, which kept track of total smartphone usage and time spent on individual apps, number of lock-unlock cycles, and total screen time. Data from tracker apps were recorded after 7 days.

RESULTS

About 36 % of participants fulfilled smartphone addiction criteria. Smartphone Addiction Scale score significantly predicted time spent on a smartphone in the 7-day period (β = 0.234, t = 2.086, P = 0.039). Predictors for time spent on social networking sites were ego resiliency (β = 0.256, t = 2.278, P = 0.008), conscientiousness (β = -0.220, t = -2.307, P = 0.023), neuroticism (β = -0.196, t = -2.037, P = 0.044), and openness (β = -0.225, t = -2.349, P = 0.020). Time spent gaming was predicted by success domain of materialism (β =0.265, t = 2.723, P = 0.007) and shopping by ego resiliency and happiness domain of materialism.

CONCLUSIONS

Telemetric approach is a sound, objective method for evaluating smartphone use. Psychological factors predict overall smartphone usage as well as usage of individual apps. Smartphone Addiction Scale scores correlate with and predict overall smartphone usage.

Prevalence and Pattern of Phantom Ringing and Phantom Vibration among Medical Interns and their Relationship with Smartphone Use and Perceived Stress

BACKGROUND

Phantom sensations like phantom vibration (PV) and phantom ringing (PR)- the sensations of vibration and ringing of the phone when they are not, respectively-are among the latest in the category of "techno-pathology" to receive global attention. This study was conducted with the aim to estimate the prevalence of such sensations among medical interns and their association with perceived stress levels and smartphone usage pattern.

MATERIALS AND METHODS

Ninety-three medical interns using smartphone were recruited for the study. Data were collected anonymously using semi-structured questionnaire, perceived stress scale (PSS), and smartphone addiction scale-short version (SAS-SV). Data were analyzed using descriptive statistics, Chi-square test, independent t-test, ANOVA, and Pearson's correlation coefficient.

RESULTS

Fifty-nine percent students had a high level of stress, whereas 40% had problematic smartphone use. Sixty percent students experienced PV, whereas 42% experienced PR and both were significantly associated with higher frequency of phone use and the use of vibration mode. Mean SAS-SV score was significantly lower in students who did not perceive PR/PV, whereas mean PSS score was significantly lower in students who did not perceive PV.

CONCLUSION

This study confirms findings from other national and international researches about the experience of cell phone phantom sensations and their relationship with the pattern of phone use and stress level. It also brings to light high levels of stress and problematic smartphone use among medical students during the internship.

Addiction-like Behavior Associated with Mobile Phone Usage among Medical Students in Delhi

BACKGROUND

Mobile phone addiction is a type of technological addiction or nonsubstance addiction. The present study was conducted with the objectives of developing and validating a mobile phone addiction scale in medical students and to assess the burden and factors associated with mobile phone addiction-like behavior.

MATERIALS AND METHODS

A cross-sectional study was conducted among undergraduate medical students aged ≥18 years studying in a medical college in New Delhi, India from December 2016 to May 2017. A pretested self-administered questionnaire was used for data collection. Mobile phone addiction was assessed using a self-designed 20-item Mobile Phone Addiction Scale (MPAS). Data were analyzed using IBM SPSS Version 17.

RESULTS

The study comprised of 233 (60.1%) male and 155 (39.9%) female medical students with a mean age of 20.48 years. MPAS had a high level of internal consistency (Cronbach's alpha 0.90). Bartlett's test of sphericity was statistically significant (P < 0.0001), indicating that the MPAS data were likely factorizable. A principal component analysis found strong loadings on items relating to four components: harmful use, intense desire, impaired control, and tolerance. A subsequent two-stage cluster analysis of all the 20-items of the MPAS classified 155 (39.9%) students with mobile phone addiction-like behavior that was lower in adolescent compared to older students, but there was no significant difference across gender.

CONCLUSION

Mobile phone use with increasing adoption of smartphones promotes an addiction-like behavior that is evolving as a public health problem in a large proportion of Indian youth.

Predictors of Problematic Smartphone Use: An Examination of the Integrative Pathways Model and the Role of Age, Gender, Impulsiveness, Excessive Reassurance Seeking, Extraversion, and Depression

Background: The progression of mobile phone technology has led to the development of multi-functional smartphones providing access to features such as social media, e-mail, and videos alongside the basic functions of a mobile phone. Increasing amounts of research has explored the potential addictive nature of smartphones to develop a theoretical framework that describes personality factors related to problematic use. The present study examined the Integrative Pathways Model and the effect of age, gender, impulsiveness, excessive reassurance seeking, extraversion, and depression on problematic smartphone use. Method: A total of 147 smartphone users (mean age = 30.96, SD = 12.97, 69.4% female) completed an online survey comprising of measures of problematic smartphone use, excessive reassurance seeking, extraversion, depression, and impulsiveness. Results: Age, impulsiveness, excessive reassurance seeking, and depression were all significantly related to problematic smartphone use, however extraversion was not significantly related. Furthermore, age and impulsiveness were significant independent predictors of problematic smartphone use. No gender differences were found. Conclusions: The findings presented several factors that predict problematic smartphone use, implications and suggestions for future research are discussed.

Predicting the Time Spent Playing Computer and Mobile Games among Medical Undergraduate Students Using Interpersonal Relations and Social Cognitive Theory: A Cross-Sectional Survey in Chongqing, China

Background: Computer and mobile games are widely used among undergraduate students worldwide, especially in China. Our objective was to predict the time spent playing computer and mobile games based on interpersonal relations and social cognitive theory constructs (i.e., expectation, self-efficacy, and self-control). Methods: The cross-sectional survey was conducted in two medical universities using a sample of 1557 undergraduate students recruited by cluster sampling. The five-point Likert questionnaire was jointly developed by researchers from Chongqing Medical University and Jackson State University. Results: Approximately 30% and 70% of the students played computer and mobile games, respectively. The daily times spent by participants on computer games were 25.61 ± 73.60 min (weekdays) and 49.96 ± 128.60 min (weekends), and 66.07 ± 154.65 min (weekdays) and 91.82 ± 172.94 min (weekends) on mobile games. Students with high scores of interpersonal relations but low scores of self-efficacy spent prolonged time playing computer games on weekdays and weekends (p < 0.05 for all). Students with low scores of expectation spent prolonged time playing computer games on weekdays (p < 0.05). Students with high scores of interpersonal relations but low scores of self-efficacy and self-control spent prolonged time playing mobile games on weekdays and weekends (p < 0.05 for all). Conclusions: The prevalence and duration of playing mobile games were higher than those of playing computer games among medical undergraduate students in Chongqing, China. This study determined the interpersonal relations, self-efficacy, self-control, and expectation of the students at the time of playing computer and mobile games. Future studies may consider studying the interaction among game-related behaviours, environments, and personality characteristics.

Psychometric Properties and Factor Structures of Chinese Smartphone Addiction Inventory: Test of Two Models

There has been a growing concern of excessive smartphone use that interferes with people’s daily functioning, most notably among youngsters. The Smartphone Addiction Inventory (SPAI) was constructed to assess this type of information technology addiction. Although the SPAI was developed in a Taiwanese adolescent sample, this measure has not been validated on Chinese youngsters in other regions. Moreover, the initial evidence yielded a four-factor structure, but recent findings obtained an alternative five-factor structure. As no studies have systematically compared these two factor structures, which of the models fits the data better remained unknown. This study aimed to evaluate the empirical validity of both the four- and five-factor structures of the SPAI in a sample of university students from Mainland China (n = 463). Four psychometric properties of the SPAI were examined. First, the structural validity of both factor models was evaluated with confirmatory factor analysis. Satisfactory fit was found for both the five-factor model (RMSEA = 0.06, SRMR = 0.05, CFI = 0.99, TLI = 0.99) and the four-factor model (RMSEA = 0.07, SRMR = 0.06, CFI = 0.98, TLI = 0.98), but the five-factor model demonstrated an overall better model fit. Second, the five-factor model yielded good internal consistencies (all Cronbach α’s > 0.70). Third, concurrent validity of the SPAI was supported by its moderately strong correlations with four widely adopted criterion variables (i.e., loneliness, social anxiety, depression, and impulsivity). Lastly, the convergent validity of the SPAI was demonstrated by its strong, positive correlation with a popular, validated measure of Internet addiction. This study is the first to demonstrate the validity of the newly proposed five-factor model of the SPAI in a sample of Mainland Chinese youngsters.

Smartphone addiction risk and daytime sleepiness in Korean adolescents

AIM

Smartphone overuse can cause not only mobility problems in the wrists, fingers and neck but also interference with sleep habits. However, research on smartphone addiction and sleep disturbances is scarce. Therefore, we aimed to investigate daytime sleepiness in association with smartphone addiction risk in Korean adolescents.

METHODS

A cross-sectional survey method was used in this study. The Pediatric Daytime Sleepiness Scale was used to assess daytime sleepiness, and the Korean Smartphone Addiction Proneness Scale index was used to evaluate the degree of risk for smartphone addiction.

RESULTS

The analyses were performed in 1796 adolescents using smartphones, including 820 boys and 976 girls. The at-risk smartphone users made up 15.1% of boys and 23.9% of girls. Our multivariate analyses demonstrated that students who were female, consumed alcohol, had lower academic performance, did not feel refreshed in the morning and initiated sleep after 12 am were at a significantly higher risk of smartphone addiction. The at-risk smartphone user group was independently associated with the upper quartile Pediatric Daytime Sleepiness Scale score in students with the following factors: Female gender, alcohol consumption, poor self-perceived health level, initiating sleep after 12 am, longer time taken to fall asleep and duration of night sleep less than 6 h.

CONCLUSIONS

The quality of sleep in adolescence affects growth, emotional stability and learning skills. Therefore, the management of smartphone addiction seems to be essential for proper sleeping habits. There is a critical need to develop a means of preventing smartphone addiction on a social level.

Investigating Associations Between Changes in Mobile Phone Use and Emotions Using the Experience Sampling Method: Pilot Study

Background

The use of mobile phones has become, especially for young people, an integrated part of everyday life. Using the experience sampling method (ESM) may provide further insight on the association between mobile phone use and mental health.

Objective

The objective of this study was to examine associations between mobile phone use and subtle changes in mental state.

Methods

The ESM-based PsyMate app was installed on the mobile phones of 2 healthy 20-year-old participants. Over a period of 3 months, participants rated their mental states at 10 semirandom moments in the flow of daily life. Each assessment included present state emotions, environmental circumstances, and phone use.

Results

Multilevel regression analyses indicated that an increase in mobile phone use was associated with a small increase in negative affect (particularly feeling bored and feeling lonely; P<.001) and small decreases in positive affect (P=.002) and concentration (P=.001). Treating the data as 2 separate N=1 studies revealed that the association with negative affect was present in both participants, whereas the associations with positive affect and concentration were evident in only 1 of the 2 participants.

Conclusions

This pilot study suggests that mobile phone use may be associated with person-specific and group-level changes in emotional state. A larger study is required to study these associations, possible causality, and factors driving underlying heterogeneity in the pattern of associations.

Trial registration

ClinicalTrials.gov NCT03221985; https://clinicaltrials.gov/ct2/show/NCT03221985 (archived by WebCite at http://www.webcitation.org/6zJnp61Wj)

The relationship between addiction to smartphone usage and depression among adults: a cross sectional study

BACKGROUND

Addiction to smartphone usage is a common worldwide problem among adults, which might negatively affect their wellbeing. This study investigated the prevalence and factors associated with smartphone addiction and depression among a Middle Eastern population.

METHODS

This cross-sectional study was conducted in 2017 using a web-based questionnaire distributed via social media. Responses to the Smartphone Addiction Scale - Short version (10-items) were rated on a 6-point Likert scale, and their percentage mean score (PMS) was commuted. Responses to Beck's Depression Inventory (20-items) were summated (range 0-60); their mean score (MS) was commuted and categorized. Higher scores indicated higher levels of addiction and depression. Factors associated with these outcomes were identified using descriptive and regression analyses. Statistical significance was set at P < 0.05.

RESULTS

Complete questionnaires were 935/1120 (83.5%), of which 619 (66.2%) were females and 316 (33.8%) were males. The mean ± standard deviation of their age was 31.7 ± 11  years. Majority of participants obtained university education 766 (81.9%), while 169 (18.1%) had school education. The PMS of addiction was 50.2 ± 20.3, and MS of depression was 13.6 ± 10.0. A significant positive linear relationship was present between smart phone addiction and depression (y = 39.2 + 0.8×; P < 0.001). Significantly higher smartphone addiction scores were associated with younger age users, (β = - 0.203, adj. P = 0.004). Factors associated with higher depression scores were school educated users (β = - 2.03, adj. P = 0.01) compared to the university educated group and users with higher smart phone addiction scores (β =0.194, adj. P < 0.001).

CONCLUSIONS

The positive correlation between smartphone addiction and depression is alarming. Reasonable usage of smart phones is advised, especially among younger adults and less educated users who could be at higher risk of depression.

Validation of a Spanish Questionnaire on Mobile Phone Abuse

Mobile phone addiction has attracted much attention recently and is showing similarity to other substance use disorders. Because no studies on mobile phone addiction had yet been conducted in Spain, we developed and validated a questionnaire (Cuestionario de Abuso del Teléfono Móvil, ATeMo) to measure mobile phone abuse among young adults in Spanish. The ATeMo questionnaire was designed based on relevant DSM-5 diagnostic criteria and included craving as a diagnostic symptom. Using stratified sampling, the ATeMo questionnaire was administered to 856 students (mean age 21, 62% women). The MULTICAGE questionnaire was administered to assess history of drug abuse and addiction. Using confirmatory factor analysis, we found evidence for the construct validity of the following factors: Craving, Loss of Control, Negative Life Consequences, and Withdrawal Syndrome, and their association with a second order factor related to mobile phone abuse. The four ATeMO factors were also associated with alcoholism, internet use, and compulsive buying. Important gender differences were found that should be considered when studying mobile phone addictions. The ATeMo is a valid and reliable instrument that can be used in further research on mobile phone abuse.

Problematic smartphone use and relations with negative affect, fear of missing out, and fear of negative and positive evaluation

For many individuals, excessive smartphone use interferes with everyday life. In the present study, we recruited a non-clinical sample of 296 participants for a cross-sectional survey of problematic smartphone use, social and non-social smartphone use, and psychopathology-related constructs including negative affect, fear of negative and positive evaluation, and fear of missing out (FoMO). Results demonstrated that FoMO was most strongly related to both problematic smartphone use and social smartphone use relative to negative affect and fears of negative and positive evaluation, and these relations held when controlling for age and gender. Furthermore, FoMO (cross-sectionally) mediated relations between both fear of negative and positive evaluation with both problematic and social smartphone use. Theoretical implications are considered with regard to developing problematic smartphone use.

The Role of Empathy and Life Satisfaction in Internet and Smartphone Use Disorder

Recent studies have yielded initial evidence for an association between Internet Use Disorder (IUD), empathy, and life satisfaction. In the present study we sought to replicate these previous findings, and then to extend this research by also examining the relationship between empathy, life satisfaction, and the related phenomenon of Smartphone Use Disorder (SUD). The present study included independent samples from China (N = 612, 162 females) and Germany (N = 304, 207 females), with the same set of questionnaires administered to both samples. IUD was measured with Pawlikowski's s-IAT and SUD was assessed with the short version of Kwon's Smartphone Addiction Scale. The Interpersonal Reactivity Index (IRI) was used to assess individual differences in empathy. Please note that for the German sample data on the empathy quotient (EQ) are also available. Life satisfaction data were collected using items from the SOEP-Questionnaire (Socio-Economic Panel, Germany). In both of our samples we replicated previous findings showing the association between higher IUD, lower empathy, and lower life satisfaction scores. In addition, individuals with higher SUD showed higher scores on the IRI Personal Distress scale in China and Germany, while further associations between IRI dimensions and SUD were only found in the Chinese sample. Personal Distress is known to be highly correlated with the personality trait of Neuroticism, hence higher stress/negative emotionality in tense social situations is related to SUD. In the present study we confirm earlier findings showing the relationship between empathy, life satisfaction, and IUD, and extend some of these findings to SUD. We also emphasize the importance of cross-cultural studies when investigating IUD/SUD in the context of empathy and life satisfaction.

The effect of smartphone usage on the upper extremity performance among Saudi Youth, KSA

The current study aims to investigate the effect of smartphone usage on the upper extremity performance among Saudi youth. A goniometer to measure the Range of Motion (ROM), the Smartphone Addiction Scale (SAS), McGill Pain scale and Chattanooga stabilizer were used to perform the current study on a sample of 300 university students from Al-Imam Mohammed Bin Saud University. The results have shown that smartphone addiction is negatively correlated to the elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder adduction, and both shoulder internal and external rotation. Furthermore, the results have shown that McGill pain scores were positively correlated to elbow flexion, shoulder flexion, shoulder extension, shoulder abduction, shoulder adduction, and both shoulder internal and external rotation. The study has concluded that smartphone usage among Saudi youth negatively affects the upper extremity and causes a significant increase in the pain intensity. The study has recommended that there is an urgent need for a significant awareness campaign to warn the community regarding the impact of using smartphones for long periods of time.

The validation of Implicit Association Test measures for smartphone and Internet addiction in at-risk children and adolescents

Background Potential concerns are increasing that smartphone and Internet addictions may have deleterious effects on the mental health. Despite the recognition of the important role that implicit associations may have over explicit processes in addiction, such implicit associations have not been comprehensively investigated with respect to Internet addiction. Therefore, we modified the Implicit Association Test (IAT) for smartphone and Internet addictions and investigated its validity in children and adolescents. Methods In this experimental study, 78 at-risk children and adolescents ranging in age from 7 to 17 years completed an IAT modified with pictures captured from the most popular Internet games among youth. Furthermore, measures of Internet and smartphone addictions, mental health and problem behaviors, impulsive tendencies, self-esteem, daily stress, and quality of life were assessed simultaneously. Results Significant correlations were found between IAT D2SD scores and standardized scales for Internet (r = .28, p < .05) and smartphone (r = .33, p < .01) addictions. There were no significant correlations between IAT parameters and other scales measuring the constructs that are less relevant to the features of addiction, such as daily stress levels, impulsivity, and quality of life. Multiple regression analysis revealed that the IAT D2SD was independently and positively associated with smartphone addiction (p = .03) after controlling for other clinical correlates. Conclusions This study demonstrated good convergent and discriminant validity of this IAT as a novel measurement relating to Internet and smartphone addictions. Further longitudinal and prospective studies are needed to evaluate its potential utility in clinical and community settings.

Tracking Depression Dynamics in College Students Using Mobile Phone and Wearable Sensing

There are rising rates of depression on college campuses. Mental health services on our campuses are working at full stretch. In response researchers have proposed using mobile sensing for continuous mental health assessment. Existing work on understanding the relationship between mobile sensing and depression, however, focuses on generic behavioral features that do not map to major depressive disorder symptoms defined in the standard mental disorders diagnostic manual (DSM-5). We propose a new approach to predicting depression using passive sensing data from students' smartphones and wearables. We propose a set of symptom features that proxy the DSM-5 defined depression symptoms specifically designed for college students. We present results from a study of 83 undergraduate students at Dartmouth College across two 9-week terms during the winter and spring terms in 2016. We identify a number of important new associations between symptom features and student self reported PHQ-8 and PHQ-4 depression scores. The study captures depression dynamics of the students at the beginning and end of term using a pre-post PHQ-8 and week by week changes using a weekly administered PHQ-4. Importantly, we show that symptom features derived from phone and wearable sensors can predict whether or not a student is depressed on a week by week basis with 81.5% recall and 69.1% precision.

Smartphone use and smartphone addiction in middle school students in Korea: Prevalence, social networking service, and game use

This study aimed to examine smartphone use patterns, smartphone addiction characteristics, and the predictive factors of the smartphone addiction in middle school students in South Korea. According to the Smartphone Addiction Proneness Scale scores, 563 (30.9%) were classified as a risk group for smartphone addiction and 1261 (69.1%) were identified as a normal user group. The adolescents used mobile messengers for the longest, followed by Internet surfing, gaming, and social networking service use. The two groups showed significant differences in smartphone use duration, awareness of game overuse, and purposes of playing games. The predictive factors of smartphone addiction were daily smartphone and social networking service use duration, and the awareness of game overuse.

Internet Communication Disorder and the structure of the human brain: initial insights on WeChat addiction

WeChat represents one of the most popular smartphone-based applications for communication. Although the application provides several useful features that simplify daily life, a growing number of users spend excessive amounts of time on the application. This may lead to interferences with everyday life and even to addictive patterns of use. In the context of the ongoing discussion on Internet Communication Disorder (ICD), the present study aimed to better characterize the addictive potential of communication applications, using WeChat as an example, by examining associations between individual variations in tendencies towards WeChat addiction and brain structural variations in fronto-striatal-limbic brain regions. To this end levels of addictive tendencies, frequency of use and structural MRI data were assessed in n = 61 healthy participants. Higher tendencies towards WeChat addiction were associated with smaller gray matter volumes of the subgenual anterior cingulate cortex, a key region for monitoring and regulatory control in neural networks underlying addictive behaviors. Moreover, a higher frequency of the paying function was associated with smaller nucleus accumbens volumes. Findings were robust after controlling for levels of anxiety and depression. The present results are in line with previous findings in substance and behavioral addictions, and suggest a similar neurobiological basis in ICD.

Problematic Mobile Phone Use and Addiction Across Generations: the Roles of Psychopathological Symptoms and Smartphone Use

Contemporary technological advances have led to a significant increase in using mobile technologies. Recent research has pointed to potential problems as a consequence of mobile overuse, including addiction, financial problems, dangerous use (i.e. whilst driving) and prohibited use (i.e. use in forbidden areas). The aim of this study is to extend previous findings regarding the predictive power of psychopathological symptoms (depression, anxiety and stress), mobile phone use (i.e. calls, SMS, time spent on the phone, as well as the engagement in specific smartphone activities) across Generations X and Y on problematic mobile phone use in a sample of 273 adults. Findings revealed prohibited use and dependence were predicted by calls/day, time on the phone and using social media. Only for dependent mobile phone use (rather than prohibited), stress appeared as significant. Using social media and anxiety significantly predicted belonging to Generation Y, with calls per day predicted belonging to Generation X. This finding suggests Generation Y are more likely to use asynchronous social media-based communication, whereas Generation X engage more in synchronous communication. The findings have implications for prevention and awareness-raising efforts of possibly problematic mobile phone use for educators, parents and individuals, particularly including dependence and prohibited use.

P851-Padrões de uso do smartphone potencialmente disfuncionais em adultos portugueses

A globalização da informação em múltiplos domínios da vida dos indivíduos congrega vantagens e riscos. O presente estudo propôs-se avaliar a existência de padrões de uso do smartphone potencialmente disfuncionais junto de uma amostra de conveniência constituída por 164 participantes adultos. Os participantes responderam a: versão portuguesa do Smartphone Addiction Inventory; questionário sociodemográfico; questionário de sintomas clínicos sugestivos de uso problemático/dependência de smartphones. Ainda que a maioria dos participantes (90.9%) não apresente sintomas de perturbação associada ao uso de smartphones, 6.7% apresenta sintomas moderados e 2.4% sintomas graves. Os resultados sugerem a importância da realização de rastreios neste domínio.

Adaptação do Smartphone Addiction Inventory para a população portuguesa

O presente estudo teve como objetivo adaptar linguística e culturalmente para a população portuguesa o Smartphone Addiction Inventory. Participaram 164 indivíduos, com idade média de 29.09 anos (DP=10.15), com nível de escolaridade maioritariamente do ensino superior (84.2%). Procedeu-se à tradução/adaptação do instrumento, em articulação com a equipa que desenvolveu a versão original. Os participantes responderam à versão portuguesa do SPAI, a um breve questionário sociodemográfico e a um questionário de avaliação de sintomas clínicos sugestivos de uso problemático e de dependência de smartphones. A versão portuguesa do SPAI revela apresentar boa fidelidade e razoável validade interna e externa.

Gaming Device Usage Patterns Predict Internet Gaming Disorder: Comparison across Different Gaming Device Usage Patterns

Gaming behaviors have been significantly influenced by smartphones. This study was designed to explore gaming behaviors and clinical characteristics across different gaming device usage patterns and the role of the patterns on Internet gaming disorder (IGD). Responders of an online survey regarding smartphone and online game usage were classified by different gaming device usage patterns: (1) individuals who played only computer games; (2) individuals who played computer games more than smartphone games; (3) individuals who played computer and smartphone games evenly; (4) individuals who played smartphone games more than computer games; (5) individuals who played only smartphone games. Data on demographics, gaming-related behaviors, and scales for Internet and smartphone addiction, depression, anxiety disorder, and substance use were collected. Combined users, especially those who played computer and smartphone games evenly, had higher prevalence of IGD, depression, anxiety disorder, and substance use disorder. These subjects were more prone to develop IGD than reference group (computer only gamers) (B = 0.457, odds ratio = 1.579). Smartphone only gamers had the lowest prevalence of IGD, spent the least time and money on gaming, and showed lowest scores of Internet and smartphone addiction. Our findings suggest that gaming device usage patterns may be associated with the occurrence, course, and prognosis of IGD.

Accident risk associated with smartphone addiction: A study on university students in Korea

Background and aims The smartphone is one of the most popular devices, with the average smartphone usage at 162 min/day and the average length of phone usage at 15.79 hr/week. Although significant concerns have been made about the health effects of smartphone addiction, the relationship between smartphone addiction and accidents has rarely been studied. We examined the association between smartphone addiction and accidents among South Korean university students. Methods A total of 608 college students completed an online survey that included their experience of accidents (total number; traffic accidents; falls/slips; bumps/collisions; being trapped in the subway, impalement, cuts, and exit wounds; and burns or electric shocks), their use of smartphone, the type of smartphone content they most frequently used, and other variables of interests. Smartphone addiction was estimated using Smartphone Addiction Proneness Scale, a standardized measure developed by the National Institution in Korea. Results Compared with normal users, participants who were addicted to smartphones were more likely to have experienced any accidents (OR = 1.90, 95% CI: 1.26-2.86), falling from height/slipping (OR = 2.08, 95% CI: 1.10-3.91), and bumps/collisions (OR = 1.83, 95% CI: 1.16-2.87). The proportion of participants who used their smartphones mainly for entertainment was significantly high in both the accident (38.76%) and smartphone addiction (36.40%) groups. Discussion and conclusions We suggest that smartphone addiction was significantly associated with total accident, falling/slipping, and bumps/collisions. This finding highlighted the need for increased awareness of the risk of accidents with smartphone addiction.

Peer relationship and adolescent smartphone addiction: The mediating role of self-esteem and the moderating role of the need to belong

Background and aims Adolescent smartphone addiction has received increased attention in recent years, and peer relationship has been found to be a protective factor in adolescent smartphone. However, little is known about the mediating and moderating mechanisms underlying this relation. The aim of this study was to investigate (a) the mediating role of self-esteem in the association between student-student relationship and smartphone addiction, and (b) the moderating role of the need to belong in the indirect relationship between student-student relationship and adolescent smartphone addiction. Methods This model was examined with 768 Chinese adolescents (mean age = 16.81 years, SD = 0.73); the participants completed measurements regarding student-student relationship, self-esteem, the need to belong, and smartphone addiction. Results The correlation analyses indicated that student-student relationship was significantly negatively associated with adolescent smartphone addiction, and the need to belong was significantly positively associated with adolescent smartphone addiction. Mediation analyses revealed that self-esteem partially mediated the link between student-student relationship and adolescent smartphone addiction. Moderated mediation further indicated that the mediated path was weaker for adolescents with lower levels of the need to belong. Discussion and conclusion High self-esteem could be a protective factor against smartphone addiction for adolescents with a strong need to belong as these students appeared to be at elevated risk of developing smartphone addiction.

Gender differences in factors associated with smartphone addiction: a cross-sectional study among medical college students

BACKGROUND

Smartphones are becoming increasingly indispensable in everyday life for most undergraduates in China, and this has been associated with problematic use or addiction. The aim of the current study was to investigate the prevalence of smartphone addiction and the associated factors in male and female undergraduates.

METHODS

This cross-sectional study was conducted in 2016 and included 1441 undergraduate students at Wannan Medical College, China. The Smartphone Addiction Scale short version (SAS-SV) was used to assess smartphone addiction among the students, using accepted cut-offs. Participants' demographic, smartphone usage, and psycho-behavioral data were collected. Multivariate logistic regression models were used to seek associations between smartphone addiction and independent variables among the males and females, separately.

RESULTS

The prevalence of smartphone addiction among participants was 29.8% (30.3% in males and 29.3% in females). Factors associated with smartphone addiction in male students were use of game apps, anxiety, and poor sleep quality. Significant factors for female undergraduates were use of multimedia applications, use of social networking services, depression, anxiety, and poor sleep quality.

CONCLUSIONS

Smartphone addiction was common among the medical college students investigated. This study identified associations between smartphone usage, psycho-behavioral factors, and smartphone addiction, and the associations differed between males and females. These results suggest the need for interventions to reduce smartphone addiction among undergraduate students.

Study protocol of the internet user Cohort for Unbiased Recognition of gaming disorder in Early adolescence (iCURE), Korea, 2015-2019

INTRODUCTION

In 2013, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) proposed nine internet gaming disorder (IGD) diagnostic criteria as a condition warranting further empirical and clinical research. The aim of this study is to clarify the natural and clinical courses of IGD proposed DSM-5 in adolescents and to evaluate its risk and protective factors.

METHODS AND ANALYSIS

The Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence (iCURE) study is an ongoing multidisciplinary, prospective, longitudinal cohort study conducted in 21 schools in Korea. Participant recruitment commenced in March 2015 with the goal of registering 3000 adolescents. The baseline assessment included surveys on emotional, social and environmental characteristics. A parent or guardian completed questionnaires and a structured psychiatric comorbidity diagnostic interview regarding their children. Adolescents with the Internet Game Use-Elicited Symptom Screen total scores of 6 or higher were asked to participate in the clinical diagnostic interview. Two subcohorts of adolescents were constructed: a representative subcohort and a clinical evaluation subcohort. The representative subcohort comprises a randomly selected 10% of the iCURE to investigate the clinical course of IGD based on clinical diagnosis and to estimate the false negative rate. The clinical evaluation subcohort comprised participants meeting three or more of the nine IGD criteria, determined by clinical diagnostic interview, to show the clinical course of IGD. Follow-up data will be collected annually for the 3 years following the baseline assessments. The primary endpoint is 2-year incidence, remission and recurrence rates of IGD. Cross-sectional and longitudinal associations between exposures and outcomes as well as mediation factors will be evaluated.

ETHICS AND DISSEMINATION

This study is approved by the Institutional Review Board of the Catholic University of Korea. Results will be published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ClinicalTrials.gov (identifier: NCT02415322).

Examining how dependence on smartphones at work relates to Chinese employees’ workplace social capital, job performance, and smartphone addiction

This research examines how dependence on smartphones for various goals at work, such as understanding, orientation, and communication, relates to employees’ job performance, workplace social capital, and smartphone addiction. Data were collected from a survey of 527 workers in urban China. Regression results indicated that dependence on smartphones for understanding and communication at work has no influence on individuals’ job performance. Only dependence on smartphones for orientation was positively associated with their job performance. Dependence on smartphones for communication has positive association with employees’ workplace social capital. Most interestingly, we found that dependence on smartphones for understanding and orientation was positively associated with smartphone addiction; however, dependence on smartphones for communication has no influence on smartphone addiction. Theoretical and practical implications are discussed.

Visual Fatigue Induced by Viewing a Tablet Computer with a High-resolution Display

Purpose

In the present study, the visual discomfort induced by smart mobile devices was assessed in normal and healthy adults.

Methods

Fifty-nine volunteers (age, 38.16 ± 10.23 years; male : female = 19 : 40) were exposed to tablet computer screen stimuli (iPad Air, Apple Inc.) for 1 hour. Participants watched a movie or played a computer game on the tablet computer. Visual fatigue and discomfort were assessed using an asthenopia questionnaire, tear film break-up time, and total ocular wavefront aberration before and after viewing smart mobile devices.

Results

Based on the questionnaire, viewing smart mobile devices for 1 hour significantly increased mean total asthenopia score from 19.59 ± 8.58 to 22.68 ± 9.39 (p < 0.001). Specifically, the scores for five items (tired eyes, sore/aching eyes, irritated eyes, watery eyes, and hot/burning eye) were significantly increased by viewing smart mobile devices. Tear film break-up time significantly decreased from 5.09 ± 1.52 seconds to 4.63 ± 1.34 seconds (p = 0.003). However, total ocular wavefront aberration was unchanged.

Conclusions

Visual fatigue and discomfort were significantly induced by viewing smart mobile devices, even though the devices were equipped with state-of-the-art display technology.

The effect of smartphone addiction on hand joints in psoriatic patients: an ultrasound-based study

BACKGROUND

Distal interphalangeal (DIP) arthritis is a frequent form of psoriatic arthritis being often linked to nail psoriasis. Modern society is characterized by overuse of smartphones. Indeed, literature has recently focalized on research into smartphone addiction and health-related problems.

OBJECTIVES

As smartphone addiction is able to determine overuse and repeated movements of DIP joints and nails, the aim of this study was to evaluate the impact of smartphone use on hand joints of young psoriatic patients.

METHODS

An observational study involving four different groups such as non-smartphone-addicted (SA) psoriatic patients, SA psoriatic patients, non-SA controls and SA controls was performed. Each subject underwent an ultrasound examination of both hands by three independent and blinded to group assignment radiologists. A specific score was used to evaluate the inflammatory state of the analysed joints.

RESULTS

The total ultrasound score was statistically significantly higher in SA controls respect to non-SA controls (3.4 vs. 1.4; P < 0.05) as well as in SA psoriasis patients compared to non-SA psoriatic subjects (15.2 vs. 6.7; P < 0.01). Higher mean of ultrasound score was found for left hand in controls (both SA or not) and for right hand in psoriatic subjects (both SA or not), however without reaching statistical significance.

CONCLUSIONS

Smartphone overuse was found to be linked with higher signs of inflammation of musculoskeletal structures of hands joints in both psoriasis and controls through ultrasound examination. Therefore, smartphone overuse may be a factor which facilitate or speed up the possible development of psoriatic arthritis.

Development of short-form and screening cutoff point of the Smartphone Addiction Inventory (SPAI-SF)

Smartphone addiction is considered a form of technological addiction that has attracted increasing attention. The present study developed and validated the short-form Smartphone Addiction Inventory (SPAI-SF) and established cutoff point for screening smartphone addiction based on diagnostic criteria established by psychiatric interview. A total of 268 participants completed an online survey that collected demographic data, smartphone use behaviours, and responses to the 26-item SPAI. Each participant also completed a psychiatric interview. Confirmatory factor analysis (CFA) revealed that the 10-item SPAI-SF replicated the structure of original 26-item SPAI accurately, yielding a four-factor model consisting of compulsive behaviour, functional impairment, withdrawal, and tolerance. For maximal diagnostic accuracy, a cutoff point of 24/25 best discriminated cases of smartphone addiction from diagnostic negatives. The present findings suggest that both the 26-item SPAI and SPAI-SF manifest the four constructs of behavioural addiction and the characteristics of smartphone addiction. The cutoff point determined by psychiatrists' diagnostic interview will be useful for clinical screening and epidemiologic research.

Parental Mediation Regarding Children's Smartphone Use: Role of Protection Motivation and Parenting Style

Parental mediation is a type of behavior that could protect children against the negative uses and effects of smartphones. Based on protection motivation theory, this research (a) predicted parental mediation based on parents' threat and efficacy perceptions and (b) predicted threat and efficacy perceptions based on parenting styles and parents' addiction to smartphone use. An online survey of 448 parents of fourth to sixth graders was conducted. Results showed that both restrictive and active parental mediation were predicted by perceived severity, response efficacy, and self-efficacy. With regard to parenting styles, (a) authoritative parenting was positively related to perceived severity as well as response- and self-efficacy, whereas (b) permissive parenting was negatively related to self-efficacy. In addition, parents' addiction was a negative predictor of perceived severity, but a positive predictor of perceived susceptibility.

Smart phone usage and addiction among dental students in Saudi Arabia: a cross sectional study

Purpose The main aim of this research is to explore measures of smart phone usage, smart phone addiction, and their associations with demographic and health behavior-related variables among dental students in Saudi Arabia. Methods A Cross sectional study involving sample of 205 dental students from Qaseem Private College were surveyed for smart phone use and addiction using the short version of the Smartphone Addiction Scale for Adolescents (SAS-SV). Results Smart phone addiction was seen in 136 (71.9%) of the 189 students. The findings from our study revealed that high stress levels, low physical activity, higher body mass index (BMI), longer duration of smart phone usage, higher frequency of usage, shorter time period until first smart phone use in the morning and social networking sites (SNS) were associated significantly with the smart phone addiction. Conclusion The current research gives the information about the extent of smart phone over usage and addiction among the dental students in Saudi Arabia with indication of the predictors of addiction and the need for further research in the area with comprehensible interpretation to spread the awareness of the smart phone addiction.

Comparing the Self-Report and Measured Smartphone Usage of College Students: A Pilot Study

OBJECTIVE

Nowadays smartphone overuse has become a social and medical concern. For the diagnosis and treatment, clinicians use the self-report information, but the report data often does not match actual usage pattern. The paper examines the similarity and variance in smartphone usage patterns between the measured data and self-reported data.

METHODS

Together with the self-reported data, the real usage log data is collected from 35 college students in a metropolitan region of Northeast Asia, using Android smartphone monitoring application developed by the authors.

RESULTS

The unconscious users underestimate their usage time by 40%, in spite of 15% more use in the actual usage. Messengers are most-used application regardless of their self-report, and significant preference to SNS applications was observed in addict group. The actual hourly pattern is consistent with the reported one. College students use more in the afternoon, when they have more free time and cannot use PCs. No significant difference in hourly pattern is observed between the measured and self-report.

CONCLUSION

The result shows there are significant cognitive bias in actual usage patterns exists in self report of smartphone addictions. Clinicians are recommended to utilize measurement tools in diagnosis and treatment of smartphone overusing subjects.

Latent-level relations between DSM-5 PTSD symptom clusters and problematic smartphone use

Common mental health consequences following the experience of potentially traumatic events include Posttraumatic Stress Disorder (PTSD) and addictive behaviors. Problematic smartphone use is a newer manifestation of addictive behaviors. People with anxiety severity (such as PTSD) may be at risk for problematic smartphone use as a means of coping with their symptoms. Unique to our knowledge, we assessed relations between PTSD symptom clusters and problematic smartphone use. Participants (N = 347), recruited through Amazon's Mechanical Turk (MTurk), completed measures of PTSD and smartphone addiction. Results of the Wald tests of parameter constraints indicated that problematic smartphone use was more related to PTSD's negative alterations in cognitions and mood (NACM) than to PTSD's avoidance factor, Wald χ²(1, N = 347) = 12.51, p = 0.0004; and more to PTSD's arousal compared to PTSD's avoidance factor, Wald χ²(1, N = 347) = 14.89, p = 0.0001. Results indicate that problematic smartphone use is most associated with negative affect and arousal among trauma-exposed individuals. Implications include the need to clinically assess problematic smartphone use among trauma-exposed individuals presenting with higher NACM and arousal severity; and targeting NACM and arousal symptoms to mitigate the effects of problematic smartphone use.

To use or not to use? Compulsive behavior and its role in smartphone addiction

Global smartphone penetration has led to unprecedented addictive behaviors. To develop a smartphone use/non-use pattern by mobile application (App) in order to identify problematic smartphone use, a total of 79 college students were monitored by the App for 1 month. The App-generated parameters included the daily use/non-use frequency, the total duration and the daily median of the duration per epoch. We introduced two other parameters, the root mean square of the successive differences (RMSSD) and the Similarity Index, in order to explore the similarity in use and non-use between participants. The non-use frequency, non-use duration and non-use-median parameters were able to significantly predict problematic smartphone use. A lower value for the RMSSD and Similarity Index, which represent a higher use/non-use similarity, were also associated with the problematic smartphone use. The use/non-use similarity is able to predict problematic smartphone use and reach beyond just determining whether a person shows excessive use.