Problematic Mobile Phone and Smartphone Use Scales: A Systematic Review

Do the core symptoms play key roles in the development of problematic smartphone use symptoms

Aims

Previous research determined the core symptoms (loss of control and being caught in the loop) of problematic smartphone use (PSU), which are of great importance to understand the structure and potential intervention targets of PSU. However, the cross-sectional design fails to reveal causality between symptoms and usually conflates the between- and within-subjects effects of PSU symptoms. This study aims to determine whether the core symptoms of PSU, indeed, dominate the future development of PSU symptoms from longitudinal between- and within-subjects levels.

Materials and methods

In this study, 2191 adolescents were surveyed for 3 years for PSU symptoms. A cross-lagged panel model (CLPM) was used to explore longitudinal between-subjects causal relationships between symptoms, and a graphic vector autoregressive model (GVAR) was used to separate the between- and within-subjects effects and detect the longitudinal effect at the within-subject level.

Results

The results of CLPM indicated that the core symptoms (both loss of control and being caught in the loop) of PSU, indeed, dominate the future development of PSU symptoms at a longitudinal between-subjects level. From T1 to T2, the cross-lagged model showed that both the loss of control (out-prediction = 0.042) and being caught in the loop (out-prediction = 0.053) at T1 have the highest out-prediction over other symptoms at T2. From T2 to T3, the loss of control (out-prediction = 0.027) and being caught in the loop (out-prediction = 0.037) at T2 also have the highest out-prediction over other symptoms of PSU at T3. While, after separating the between- and within-subjects effects, only being caught in the loop at T1 played a key role in promoting the development of other PSU symptoms at T3 at the within-subjects level. The contemporaneous network showed intensive connection, while the cross-sectional between-subjects network is very sparse.

Conclusion

These findings not only confirm and extend the key roles of core symptoms in the dynamic aspect of PSU symptoms and PSU itself but also suggest that interventions should consider the core symptoms of PSU, individual- and group-level effects and that individualized intervention programs are needed in future.

Impact of Digital Literacy and Problematic Smartphone Use on Life Satisfaction: Comparing Pre- and Post-COVID-19 Pandemic

Although the impact of digital literacy (DL) and problematic smartphone use (PSU) on life satisfaction was verified in previous literature, little is known about how the impact of two given variables can be differentiated during the COVID-19 pandemic situation. Thus, the purpose of this study was to empirically analyze whether the influence of DL and PSU on life satisfaction has changed as a consequence of the COVID-19 pandemic. We applied a cross-sectional study design to analyze data obtained from a nationwide survey on smartphone overdependence conducted in 2019 and 2020 by the South Korean Ministry of Science and ICT and the National Information Society Agency. Large-scale data obtained from 41,883 individuals were analyzed using hierarchical regression analysis. The results show that the positive relationship between digital literacy and life satisfaction was further strengthened post-COVID-19 rather than pre-COVID-19. In addition, the results suggest that the negative relationship between PSU and life satisfaction is further strengthened during post-COVID-19 rather than pre-COVID-19. The findings indicate that the roles of digital literacy and PSU are more important after the COVID-19 pandemic.

Relationship between insecure attachment and mobile phone addiction: A meta-analysis

OBJECTIVE

Many studies have explored the relationship between insecure attachment and mobile phone addiction from different theoretical perspectives; however, the results have been different. This meta-analysis aimed to explore the relationship between insecure attachment and mobile phone addiction.

METHODS

Studies published before November 2021 were identified through a systematic online search. A total of 22 studies, including 38 independent effect sizes were included from a systematic search of multiple databases, with a total sample size of 11,810 cases. Stata Version 16.0 was used for meta-analysis.

RESULTS

The meta-analysis based on random-effects model showed that mobile phone addiction was highly positively associated with attachment anxiety (r = 0.395, 95%CI [0.345, 0.442]) and weakly positively correlated with attachment avoidance (r = 0.194, 95%CI [0.137, 0.250]). The relationship between attachment anxiety and mobile phone addiction and that between attachment avoidance and mobile phone addiction were both moderated by mobile phone addiction measures but not moderated by gender and attachment measures.

CONCLUSION

There is a positive correlation between mobile phone addiction and insecure attachment. In the future, measures to prevent mobile phone addiction should focus on insecure attachment individuals and help them construct a healthy attachment relationship and secure attachment model.

Mobile Device Usage before and during the COVID-19 Pandemic among Rural and Urban Adults

Technology has played a critical role during the COVID-19 pandemic. Despite affording a safe way for people to connect with others, the potential for problematic device usage (e.g., overuse, addiction) should be considered. The goal of this study was to examine mobile device use during the COVID-19 pandemic among rural and urban people in Canada. Based on an online survey conducted in the summer of 2021 in British Columbia (n = 465), participants self-reported spending more hours per day (M = 8.35 h) using technology during the pandemic compared to prior (M = 6.02 h), with higher increases among urban participants (p < 0.001). Mobile device usage scores were highest for reasons of social connectedness and productivity, with no rural/urban differences; however, urban participants reported higher use of mobile devices for their mental well-being (p = 0.001), but also reported higher, continuous use (p < 0.001), addiction (p < 0.001), and detrimental impacts on their physical health (p < 0.001) compared to rural participants. Because urban participants were more vulnerable to mobile device overuse and addiction during the pandemic, researchers and policy makers should consider the ongoing role and positive/negative impacts of mobile device use, paying particular attention to urban populations.

Nonimprovement in Chronic Fatigue Syndrome: Relation to Activity Patterns, Uplifts and Hassles, and Autonomic Dysfunction

OBJECTIVE

To test a model of nonimprovement in chronic fatigue syndrome (CFS) using self-report activity patterns (e.g., "push-crash"), uplifts and hassles, and a biological measure of cardiac autonomic function. Activity pattern impacts on symptoms and objective measures of autonomic and physical activity were also examined.

METHODS

This prospective study in CFS collected all data remotely, including 6 months of weekly web diaries that recorded symptom ratings, activity patterns, and hassles and uplifts. In addition, 6 months of weekly heart monitoring and 3 months of daily waking actigraphy data were collected. Improvement or nonimprovement status was assessed using semistructured interviews at the 6-month follow-up.

RESULTS

A total of 148 individuals (87.2% female) were enrolled, and 12.2% were lost to follow-up. Participants reporting nonimprovement ( n = 92), as compared with improvement ( n = 38), showed greater autonomic dysfunction (lower heart rate variability, group difference = 5.93 [SE = 2.73] milliseconds; p = .032) and lower mean intensity of behavioral uplifts (group difference = 0.14 [SE = 0.16]; p = .043), but no significant differences in any activity pattern, including push-crash, limiting activity, and healthy pacing.

CONCLUSIONS

This study provided evidence for linking patient-reported nonimprovement to a biological variable indexing autonomic dysfunction and a behavioral measure indicating a deficit in psychological uplifts. These findings suggest a possible marker of illness trajectory that could potentially advance the biomedical underpinnings of CFS.Trial Registration:ClinicalTrials.gov ID: NCT02948556.

Longitudinal Cross-Lagged Analysis Between Mobile Phone Dependence, Friendships, and Depressive Symptoms Among Korean Adolescents

This study examined reciprocal longitudinal effects between mobile phone dependence, friendships, and depressive symptoms using 3-year longitudinal data from the Korean Children and Youth Panel Survey. An autoregressive cross-lagged model was applied to a sample of 1,737 adolescents. Results suggested that unidirectional relationships exist between the three variables: friendships reduce mobile phone dependence (B = -0.068, p = 0.058; B = -0.118, p < 0.001) and depressive symptoms increase mobile phone dependence (B = 0.082, p = 0.001; B = 0.128, p < 0.001); however, mobile phone dependence does not affect friendships and depressive symptoms. In addition, this study provided evidence of the negative bidirectional relationship between friendships and depressive symptoms. We suggest that, to prevent or treat adolescents' mobile phone dependence, a practical approach regarding friendships and depressive symptoms is needed.

Trajectory of problematic smartphone use among adolescents aged 10-18 years: The roles of childhood family environment and concurrent parent-child relationships

BACKGROUND AND AIMS

Adolescence is a period of high incidence of problematic smartphone use. Understanding the developmental trajectory of problematic smartphone use in adolescence and its influencing factors could guide the choice of timing for prevention and intervention. This study fitted the growth trajectory of problematic smartphone use among adolescents and examined its associations with the childhood family environment and concurrent parent-child relationships.

METHODS

Using a cohort sequential design, we investigated 2,548 Chinese adolescents and their parents three times in three years. Multiple group multiple cohort growth models were used to fit the growth trajectory.

RESULTS

The quadratic growth trajectory of problematic smartphone use in adolescents aged 10-18 years showed a clear increasing trend, with a possible decreasing trend in late adolescence or early adulthood. Early life socioeconomic status, childhood family unpredictability, and the concurrent parent-child relationship had unique impacts on the development of problematic smartphone use during adolescence.

DISCUSSION AND CONCLUSIONS

Early adolescence is a favorable time for problematic smartphone use prevention and intervention. A supportive family environment should be maintained throughout the different developmental stages of children and adolescents.

Is Problematic Internet and Smartphone Use Related to Poorer Quality of Life? A Systematic Review of Available Evidence and Assessment Strategies

Purpose of Review

Previous studies have explored the links between problematic Internet use (PIU) or problematic smartphone use (PSU) and quality of life (QOL). In this systematic review, we (i) describe the instruments used to assess QOL or health-related quality of life (HRQOL) in these studies, (ii) critically examine the content validity of the instruments used, and (iii) examine the relationships between PIU, PSU, QOL, and HRQOL.

Recent Findings

We identified 17 PIU and 11 PSU studies in a systematic search. Evidence suggests that PIU and PSU negatively correlate with either QOL or HQOL and most of their domains (especially mental and physical health). Multiple instruments were used to assess QOL or HRQOL in these studies. Our analysis showed an important heterogeneity in the domains covered by these instruments.

Summary

Because of the widespread prevalence of PIU and PSU, which tend to be linked with lower QOL or HRQOL, in particular poor mental and physical health, a more systematic public health campaign is required to target the healthy use of these communication devices. Prevention programs should also target vulnerable individuals, focusing on the most affected domains of QOL and HRQOL (i.e., physical and psychological health). Among the existing instruments, the World Health Organization Quality of Life for adults and the Pediatric Quality of Life Inventory for adolescents (aged 13-18 years) proved to be the most relevant, although new measurement instruments are needed to target domains that are specifically relevant in the context of PIU and PSU (e.g., physical and psychological health domains such as sleep, loneliness, and quality of familial relations).

Translation and Psychometric Testing of the Arabic Version of the Problematic Media Use Measure Short Form for Children

Background. There is growing concerns that excessive use of media among children will become problematic. Research on the management of children’s problematic use of media would be improved if screening tools are widely applied. Problematic Media Use Measure Short Form (PMUM-SF) was developed to screen problematic use of media among 4- to 11-year-old US children. Purpose. The study is aimed at developing and validating a cross-cultural version of the PMUM-SF for use in Arabic-talking parents of children from age 3 to 13 years. Design. Cross-cultural adaptation and cross-sectional psychometric testing study. Methods. Using the World Health Organization (WHO) framework for instrument translation and adaptation, the instrument was translated, back translated, pretested, and reviewed by a committee. The PMUM-SF was tested in 180 parents of children aging from 3 to 13 years. Results. The results demonstrated that the Arabic version of the PMUM-SF had high reliability (Cronbach’s alpha was 0.90); it has good convergent and predictive validity. The factor structure of the Arabic version of PMUM-SF was confirmed through exploratory and confirmatory factor analysis (comparative fit index $\left(\text{CFI}\right)=0.93$ ; goodness of fit index $\left(\text{GFI}\right)=0.90$ ; incremental fit index $\left(\text{IFI}\right)=0.93$ ). Conclusion. Because the Arabic version of the PMUM-SF seems to be reliable and valid in assessing problematic use of media of children in Arabic-speaking parents, the use of this translated version is recommended in future research.

Examining the Interplay of Smartphone Use Disorder, Mental Health, and Physical Symptoms

The current study examined antecedents and possible consequences of smartphone use disorder (SmUD). In particular, we aimed to increase the understanding of the interplay of SmUD, mental health, and physical symptoms. Studies found that SmUD is associated with diverse psychological and physical health impairments, ranging from depression and anxiety to headaches and sleep disturbances. Based on existing works, we assumed that mental problems mediate the relationship between SmUD and bodily problems. We conducted a cross-sectional random-quota online survey among 938 German smartphone owners aged 14 to 64 years. An instrument based on the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was used to measure SmUD severity. The data was analyzed using structural equation modeling. We identified a rate of 4.0% potentially disordered users. Males and younger participants showed more signs of SmUD. As expected, SmUD severity was found to be associated with physical (more frequent headaches, sleep disturbances, gastrointestinal problems) as well as psychological (higher levels of loneliness, stress, depression/anxiety) health impairments. Investigating the interplay of these variables showed that depression and anxiety, and stress partially mediated the relationship between SmUD severity and physical symptoms. Taken together, our results confirm that increased SmUD severity is associated with mental problems as well as with somatic symptoms. We assume complex (and presumably circular) relationships, which future studies should examine in more detail. SmUD prevention and intervention programs should follow a broad approach that considers decreases in physical and mental health, possibly causing or resulting from SmUD.

The Illusion of Agency in Human–Computer Interaction

This article makes the case that our digital devices create illusions of agency. There are times when users feel as if they are in control when in fact they are merely responding to stimuli on the screen in predictable ways. After the introduction, the second section of the article offers examples of illusions of agency that do not involve human–computer interaction in order to show that such illusions are possible and not terribly uncommon. The third and fourth sections of the article cover relevant work from empirical psychology, including the cues that are known to generate the sense of agency. The fifth section of the article shows that our devices are designed to deliver precisely those cues. In the sixth section, the argument is completed with evidence that users frequently use their smartphones without the sort of intentional supervision involved in genuine agency. This sixth section includes the introduction of Digital Environmental Dependency Syndrome (DEDS) as a possible way of characterizing extended use of the smartphone without genuine agency. In the final section of the article, there is a discussion of questions raised by the main claim, including suggestions for reducing occurrences of illusions of agency through software design.

Associations between problematic smartphone use and behavioural difficulties, quality of life, and school performance among children and adolescents

BACKGROUND

European studies on determinants and factors associated with problematic smartphone use (PSU) in children and adolescents are still sparse. This study reports the current amount of PSU symptoms and the presence of (clinically relevant) PSU in German children and adolescents. We also investigated associations between socio-demographic factors, different smartphone usage patterns, and daily smartphone usage time and the amount of PSU symptoms in this group. In addition, associations of PSU symptoms and high smartphone usage times (> 2 h/day) with behavioural problems, quality of life (QoL), and school performance were investigated.

METHODS

Within the framework of the LIFE Child study, 564 children and adolescents aged 10-18 years provided information on PSU symptoms (using the Smartphone Addiction Proneness Scale), daily smartphone usage time, smartphone activities, behavioural strengths and difficulties (using the Strengths and Difficulties Questionnaire), QoL (using the KIDSCREEN-27), and school performance. Multiple regression analyses were applied to assess associations.

RESULTS

In the present sample, PSU was present in 13 children (2.3%). Older age, female gender, high daily smartphone usage time of > 2 h, and intensive smartphone use for social networking, gaming, or watching video clips were significantly associated with more PSU symptoms. Children and adolescents reporting more PSU symptoms also showed lower QoL, more behavioural difficulties, and poorer school performance, independently of age, gender, socio-economic status, and daily smartphone usage time. In contrast, daily smartphone usage time per se showed only weak or non-significant associations with these aspects of health and behaviour.

CONCLUSION

Intensive smartphone use for entertainment may increase the risk of developing PSU symptoms. Furthermore, the results indicate that PSU symptoms (more than long smartphone usage times per se) are associated with more behavioural difficulties and poorer QoL.

Duration, frequency, and time distortion: Which is the best predictor of problematic smartphone use in adolescents? A trace data study

Problematic smartphone use (PSU) during adolescence has been associated with negative short- and long-term consequences for personal well-being and development. Valid and reliable predictors and indicators of PSU are urgently needed, and digital trace data can add valuable information beyond self-report data. The present study aimed to investigate whether trace data (duration and frequency of smartphone use), recorded via an app installed on participants’ smartphone, are correlated with self-report data on smartphone use. Additionally, the present study aimed to explore which usage indicators, i.e., duration, frequency, and time distortion of smartphone use, better predict PSU levels cross-sectionally and longitudinally, one year later. Results from a sample of 84 adolescents showed that adolescents tend to rely on the frequency of smartphone use when reporting on the time they spent with the smartphone. Traced duration of smartphone use as well as time distortion, i.e., over-estimation, are significant predictors of PSU. Methodological issues and theoretical implications related to predictors and indicators of PSU are discussed.

The Influence of Sociodemographic Factors on Mobile Device Use among Young Children in Putrajaya, Malaysia

Technology is evolving rapidly around the world, and the use of mobile devices is increasing every day. Today, everyone owns a mobile device, including young children. Parents provide and allow young children to use mobile devices for various purposes. Due to the fact of these circumstances, children begin to become comfortable with the use of mobile devices, and they are prone to excessive use. Therefore, the purpose of this study was to examine the influence of sociodemographic factors on excessive mobile device use among young children. Sociodemographic variables, including the child’s gender, the child’s age when starting to use a mobile device, the parent’s educational level, household income, type of application used, and the purpose of giving a mobile device to the child, were selected as predictive factors. A cross-sectional survey study design with a quantitative approach was conducted. A simple random sampling technique was employed, and a total of 364 parents completed the adapted questionnaire, namely, the Problematic Mobile Phone Use Scale (PMPUS). Data were statistically analyzed using descriptive and binary logistic regression analysis. The findings revealed that gender, age of the child when starting to use mobile devices, and purpose of parents providing mobile devices significantly contributed to 77.7% of the variance to make children users with a problem. However, the parent’s educational level, household income, and type of application did not significantly contribute to the problem of mobile device use. Later, this study discusses the research implication, limitation, and recommendation for future research based on the finding.

The Validity and Reliability of the Serbian Version of the Smartphone Addiction Scale—Short Version

Background and Objectives: Smartphone use has been rapidly increasing worldwide, which has brought possible smartphone addiction into the focus of research. In order to identify potential smartphone addicts, several scales were developed to assess smartphone addiction. Among them, the Smartphone Addiction Scale was frequently used. The study aimed to test the reliability and validity of the Serbian version of the SAS-SV and estimate smartphone addiction prevalence among medical students. Materials and Methods: The study was conducted in December 2018 on a convenience sample of 323 third-year medical students. The cross-cultural adaptation was performed following the well-established guidelines for cross-cultural adaptation of self-reported measures. Exploratory factor analysis was used to examine the structure of the questionnaire. Factor extraction was performed by principal component analysis with Varimax rotation. For test–retest reliability, students completed the questionnaire twice within seven days. Results: The Serbian version of the SAS-SV showed good internal consistency (Cronbach’s alpha = 0.89) and excellent reliability for test–retest scores (ICC = 0.94, 95% CI = 0.92–0.96). Factor analysis supported the extraction of one factor, which explained 51.538% of the variance. To explore convergent validity furthermore, the SAS-SV was correlated with time indicators of smartphone use. According to cut-off values for the SAS-SV score, 19.5% of students could be regarded as “addicted”, and often spent more time on smartphones and social networks on working days and weekends than “not addicted” students. Conclusions: The Serbian version of the SAS-SV is a reliable and valid instrument for detecting smartphone addiction among university students. Further research on this issue is encouraged to enable a better understanding of this ever-increasing public health issue.

Validation of a questionnaire on problematic use of smartphones among a rural population of West Bengal

Background

While a smartphone can be a hugely productive tool, excessive use of this device can interfere with work, education, our physical and mental health, and productivity. Nowadays, we do not just use our smartphones, but we rely on them.

Objectives

The present study aims to develop and validate an instrument measuring the problematic use of smartphones among adults in a rural area of West Bengal, India.

Methods

The questionnaire on problematic use of smartphone is a self-designed tool. The items were selected by literature review. The psychometric properties of the questionnaire were assessed by content validity, construct validity, and reliability. Exploratory factor analysis was performed to identify the factors.

Results

Forty-two items were generated by literature review. After final analysis, the main questionnaire contained 28 items with 5 domains, namely "impulsive use of phone," "dependence," "impaired control," "denial," "decreased productivity," and "emotional attachment." The Cronbach's alpha value for three domains was found to be >0.7 and >0.8 for the other three domains.

Conclusion

Excessive mobile phone use is associated with various adverse consequences which is emerging as a public health problem in a large number of population in India. Problematic use of smartphone questionnaire is a valid and reliable tool to assess the pattern of mobile use among Indian population.

Difficulties in Establishing "Truth" Conditions in the Assessment of Addictive Smartphone Use in Young Adults

The smartphone revolution has placed powerful, multipurpose devices in the hands of youth across the globe, prompting worries about the potential negative consequences of these technologies on mental health. Many assessment tools have been created, seeking to classify individuals into problematic and non-problematic smartphone users. These are identified using a cutoff value: a threshold, within the scale range, at which higher scores are expected to be associated with negative outcomes. Lacking a clinical assessment of individuals, the establishment of this threshold is challenging. We illustrate this difficulty by calculating cutoff values for the Short Version of the Smartphone Addiction Scale (SAS-SV) in 13 Spanish-speaking samples in 11 countries, using common procedures (i.e., reliability, validity, ROC methodology). After showing that results can be very heterogeneous (i.e., they lead to diverse cutoff points and rates of addiction) depending on the decisions made by the researchers, we call for caution in the use of these classifications, particularly when researchers lack a clinical definition of true addiction-as is the case with most available scales in the field of behavioral addictions-which can cause an unnecessary public health alert.

Digital Phenotyping: an Epistemic and Methodological Analysis

Some claim that digital phenotyping will revolutionize understanding of human psychology and experience and significantly promote human wellbeing. This paper investigates the nature of digital phenotyping in relation to its alleged promise. Unlike most of the literature to date on philosophy and digital phenotyping, which has focused on its ethical aspects, this paper focuses on its epistemic and methodological aspects. The paper advances a tetra-taxonomy involving four scenario types in which knowledge may be acquired from human "digitypes" by digital phenotyping. These scenarios comprise two causal relations and a correlative and constitutive relation that can exist between information generated by digital systems/devices on the one hand and psychological or behavioral phenomena on the other. The paper describes several modes of inference involved in deriving knowledge within these scenarios. After this epistemic mapping, the paper analyzes the possible knowledge potential and limitations of digital phenotyping. It finds that digital phenotyping holds promise of delivering insight into conditions and states as well producing potentially new psychological categories. It also argues that care must be taken that digital phenotyping does not make unwarranted conclusions and is aware of potentially distorting effects in digital sensing and measurement. If digital phenotyping is to truly revolutionize knowledge of human life, it must deliver on a range of fronts, including making accurate forecasts and diagnoses of states and behaviors, providing causal explanations of these phenomena, and revealing important constituents of human conditions, psychology, and experience.

A systematic review and meta-analysis of discrepancies between logged and self-reported digital media use

There is widespread public and academic interest in understanding the uses and effects of digital media. Scholars primarily use self-report measures of the quantity or duration of media use as proxies for more objective measures, but the validity of these self-reports remains unclear. Advancements in data collection techniques have produced a collection of studies indexing both self-reported and log-based measures. To assess the alignment between these measures, we conducted a pre-registered meta-analysis of this research. Based on 106 effect sizes, we found that self-reported media use correlates only moderately with logged measurements, that self-reports were rarely an accurate reflection of logged media use and that measures of problematic media use show an even weaker association with usage logs. These findings raise concerns about the validity of findings relying solely on self-reported measures of media use.

Smartphone Addiction and Anxiety in Adolescents - A Cross-sectional Study

Objectives: The overuse of smartphones affects physical, social, and psychological well-being. However, research on smartphone addiction and anxiety disorders is scarce. Therefore, the objective of this study was to investigate the association between anxiety and smartphone addiction risk in Korean adolescents. Methods: This study used a cross-sectional survey method. We used the Revised Children's Manifest Anxiety Scale to assess anxiety symptoms and we used the Korean Smartphone Addiction Proneness Scale index to evaluate the degree of high-risk or at-risk for smartphone addiction. Results: Analyses were performed for 1733 adolescents, including 771 boys and 962 girls. The high-risk or at-risk group for smartphone addiction accounted for 20.1% (p < .0001). Total anxiety scale score, as well as physiological anxiety, oversensitivity, and social concern categories were statistically different among levels of smartphone addiction risk (all ps < .0001). Multivariate analysis showed that poor self-reported health level, higher risk of smartphone addiction, having fewer close friends, caffeine drink consumption, female sex, and alcohol use were associated with greater anxiety. Conclusions: Management of smartphone addiction seems to be essential for proper psychological health. There is an urgent need to develop a way to prevent smartphone addiction on a social level.

The Developing Brain in the Digital Era: A Scoping Review of Structural and Functional Correlates of Screen Time in Adolescence

The widespread diffusion of screen-based devices in adolescence has fueled a debate about the beneficial and detrimental effects on adolescents’ well-being and development. With the aim of summarizing the existing literature on the associations between screen time (including Internet-related addictions) and adolescent brain development, the present scoping review summarized evidence from 16 task-unrelated and task-related neuroimaging studies, published between 2010 and 2020. Results highlight three important key messages: (i) a frequent and longer duration of screen-based media consumption (including Internet-related addictive behaviors) is related to a less efficient cognitive control system in adolescence, including areas of the Default Mode Network and the Central Executive Network; (ii) online activities act as strong rewards to the brain and repeated screen time augments the tendency to seek short-term gratifications; and (iii) neuroscientific research on the correlates between screen time and adolescent brain development is still at the beginning and in urgent need for further evidence, especially on the underlying causality mechanisms. Methodological, theoretical, and conceptual implications are discussed.

Longitudinal relationships among problematic mobile phone use, bedtime procrastination, sleep quality and depressive symptoms in Chinese college students: a cross-lagged panel analysis

BACKGROUND

Cross-sectional and longitudinal studies have found that problematic mobile phone use, bedtime procrastination, sleep quality, and depressive symptoms are strongly associated. However, studies are inconsistent regarding whether problematic mobile phone use predicts depressive symptoms or vice versa, and sleep factors have been infrequently focused on in this regard. In addition, few studies have examined the longitudinal associations and directions of effects between these factors. Therefore, this study aims to explore the longitudinal relationship among problematic mobile phone use, bedtime procrastination, sleep quality, and depressive symptoms in college students.

METHODS

Overall, 1181 college students completed questionnaires on problematic mobile phone use, bedtime procrastination, sleep quality, and depressive symptoms at two time points 12 months apart. A cross-lagged model was used to examine the longitudinal relationship between these factors.

RESULTS

Cross-lagged analyses showed significant bidirectional relationships of problematic mobile phone use with bedtime procrastination and depressive symptoms. Additionally, there were also significant bidirectional relationships of sleep quality with bedtime procrastination and depressive symptoms. Problematic mobile phone use predicted subsequent sleep quality one-way, and bedtime procrastination predicted subsequent depressive symptoms one-way.

CONCLUSIONS

This study further expands our understanding of the longitudinal and bidirectional relationships among problematic mobile phone use, bedtime procrastination, sleep quality and depressive symptoms and helps school mental health educators design targeted interventions to reduce problematic mobile phone use, sleep problems, and depressive symptoms among college students.

Bedtime Smart Phone Usage and Its Effects on Work-Related Behaviour at Workplace

The over usage and over dependency on digital devices, like smartphones, has been considered as a growing international epidemic. The increased dependency on gadgets, especially smartphones for personal and official uses, has also brought many detrimental effects on individual users. Hence it is vital to understand the negative effects of smartphone usage on human. Therefore, this study aims to investigate the effects of bedtime smartphone usage on work performances, interpersonal conflicts, and work engagement, via the mediating role of sleep quality among employees. Using a cross-sectional study design, a questionnaire-based field survey was conducted on 315 employees who participated as respondents. The results confirmed the negative effects of bedtime smartphone usage on sleep quality. Along with it, the effects of sleep quality on work performances, work engagements and interpersonal conflicts were also proven to be statistically significant. Regarding the mediating role of sleep quality, it was empirically evident that sleep quality mediates the relationship between bedtime smartphone usage with work performances and interpersonal conflicts. The findings revealed that bedtime smartphone usage reduces sleep quality among the employees, resulting in lower work performances and engagements while contributing to higher interpersonal conflicts. The findings concluded that smartphone usage before sleep increases the prospects of employees to be less productive, less engaged, and have more workplace conflicts. The findings warrant the continued managerial as well as academic research attention, as the smartphones are now used by many organisations to run businesses as well.

Problematic Smartphone and Social Media Use Among Bangladeshi College and University Students Amid COVID-19: The Role of Psychological Well-Being and Pandemic Related Factors

Background: Smartphone and social media use are an integral part of our daily life. Currently, the impact of excessive smartphone and social media use during the COVID-19 pandemic is poorly understood. The present study aimed to investigate problematic smartphone use (PSPU) and problematic social media use (PSMU) among Bangladeshi college and university students during the COVID-19 pandemic. Methods: A cross-sectional study was carried out involving 5,511 Bangladeshi college and university students (male: 58.9%; mean age: 21.2 years [SD = 1.7]; age range: 18-25) during the social-distancing in the COVID-19 pandemic (July 2020). A self-reported survey containing questions regarding socio-demographic, lifestyle, and home quarantine activities along with four psychometric scales was completed by participants. Results: The mean scores of PSPU and PSMU were 20.8 ± 6.8 (out of 36) and 14.7 ± 4.8 (out of 30). Based on a hierarchical regression analysis, PSPU and PSMU were positively associated with lower age, poor sleep, social media use, watching television, anxiety, and depression. Additionally, PSMU was linked to being female, living with nuclear family, having urban residence, irregular physical exercise, poor engagement with academic studies, and avoiding earning activities, whilst being male, being married, living with lower-income family, and alcohol consumption were linked to PSMU. Conclusions: The findings indicate that PSPU and PSMU were linked to poor psychological well-being (i.e., anxiety and depression) and other factors (especially lower age, poor sleep) during the pandemic, further suggesting the need for interventions including virtual awareness programs among college and university students.

Adaptation and Psychometric Analysis of the Test of Mobile Phone Dependence-Brief Version in Italian Adolescents

Since the diffusion of recent models of mobile phones, anyone with an internet connection can communicate continuously and search for information. This raises some questions about the possible consequences of problematic mobile phone use (PMPU) in a complex life phase such as adolescence. Therefore, we performed a psychometric analysis of the brief version of the Test of Mobile Phone Dependence (TMD) in Italy. The sample comprised 575 Italian adolescents aged 11 to 18 years. Data were collected using the TMD-brief, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Short Form. Regarding test dimensionality, the best-fit measurement model included four factors: "Abstinence"; "Abuse and interference with other activities"; "Tolerance"; and "Lack of control" (Satorra-Bentler χ2 (48) = 185.96, p < 0.01; robust root mean square error of approximation (RMSEA) = 0.079 (90% confidence interval (CI): 0.067; 0.091); robust TLI = 0.904; robust comparative fit index (CFI) = 0.930). The Italian version of the TMD-brief was found to have good reliability and psychometric properties, and a four-factorial structure. PMPU predicted significant sleep disturbances and this relationship was moderated by clinical personality traits. Findings from this study support the use of the Italian version of the TMD-brief as a screening tool to investigate PMPU in Italian adolescents.

Smartphone addiction, risk factors and its adverse effects in nursing students: A systematic review and meta-analysis

BACKGROUND

Smartphones are technological devices that have a great impact on people's daily lives changing their habits and behaviors. The utilities and capabilities of these devices are increasing and the foresight is that this tendency will grow in the next years. However, the problematic use of the smartphone has increased dangerously, interfering with the clinical practice of healthcare professionals.

OBJECTIVE

To conduct a systematic review and a meta-analysis to estimate the prevalence of smartphone addiction, also known as nomophobia, in nursing students and to identify its related factors and its negative effects.

DESIGN

Systematic Review and Meta-analysis.

DATA SOURCES

The literature search was done in CINAHL, Proquest, Pubmed, Scopus and Web of Science databases.

REVIEW METHODS

The search equation was "(nomophobia OR smartphone) AND nurs* student*". n = 16 articles were identified.

RESULTS

The meta-analytic estimation of nomophobia or smartphone addiction was 22% (CI95% 18%-26%] in a sample of n = 2780 nursing students. Smartphone usability is very extended during the clinical practice by nursing students. They indicated using the device or watching other students distracted with their smartphone. Some variables related to excessive use in nursing students are lower sleep quality, lower self-esteem, higher social distress, lower perceived social support or lower communication skills between others.

CONCLUSIONS

The main use of the smartphone by nursing students is for communication with other people and some of them indicate that it can be a distraction.

Test for Mobile phone dependence: psychometric properties and confirmatory factor analysis

The Test of Mobile Phone Dependence (TMD) is a questionnaire designed for appraising the main dimensions of problematic smartphone use in adolescence. This study evaluates the factor structure and psychometric properties of the TMD on a sample of 813 Italian middle and high school students. The original three-factor model (Abstinence, Lack of Control, and Tolerance) of the TMD was tested through a Confirmatory Factor Analysis. The results of the goodness of fit indices indicated a satisfactory solution. The overall TMD score showed a good level of internal consistency and good construct validity with the duration of use, age of possession of the first mobile phone, perceived self-efficacy, gender, and participants’ age. The relationship between TMD and Nomophobia was also explored. Overall, the results indicate that the TMD is a valid and reliable assessment tool in Italian culture. However, reliability issues emerged on the subfactor Lack of Control. This indicates that the scores on this subfactor should be treated with caution.

A test of the pathway model of problematic smartphone use

BACKGROUND AND AIMS

Problematic smartphone use (PSU) has been described as a growing public health issue. In the current study, we aimed to provide a unique and comprehensive test of the pathway model of PSU. This model posits three distinct developmental pathways leading to PSU: (1) the excessive reassurance pathway, (2) the impulsive pathway and (3) the extraversion pathway.

METHODS

Undergraduate students (n = 795, 69.8% female, mean age = 23.80 years, sd = 3.02) completed online self-report measures of PSU (addictive use, antisocial use and dangerous use) and the psychological features (personality traits and psychopathological symptoms) underlying the three pathways.

RESULTS

Bayesian analyses revealed that addictive use is mainly driven by the excessive reassurance pathway and the impulsive pathway, for which candidate etiopathological factors include heightened negative urgency, a hyperactive behavioural inhibition system and symptoms of social anxiety. Dangerous and antisocial use are mainly driven by the impulsive pathway and the extraversion pathway, for which candidate etiopathological factors include specific impulsivity components (lack of premeditation and sensation seeking) and primary psychopathy (inclination to lie, lack of remorse, callousness and manipulativeness).

DISCUSSION AND CONCLUSIONS

The present study constitutes the first comprehensive test of the pathway model of PSU. We provide robust and original results regarding the psychological dimensions associated with each of the postulated pathways of PSU, which should be taken into account when considering regulation of smartphone use or tailoring prevention protocols to reduce problematic usage patterns.

Problematic Mobile Phone Use by Hong Kong Adolescents

Background

Recently there have been growing concerns about problematic mobile phone use by adolescent populations. This study aimed to address this concern through a study of severity and correlates of problematic mobile phone use with a sample of Hong Kong adolescents.

Methods

Data were collected from a sample of adolescents from three local secondary schools (ranging from high to low academic achievement levels) using a measuring scale (PCPU-Q, Yen et al., 2009) designated for Chinese adolescents. Participants were allocated into groups of “problematic users” and “non-problematic users” based on the number of occurrence of symptoms due to excessive and maladaptive use of mobile phone and possible functional impairments caused by problematic mobile phone use. A group of “at-risk users” was identified. A sample-based examination on distribution of these three groups of users was conducted via frequency counts and percentage calculation. A series of t-test were performed to make comparisons between “problematic” and “non-problematic” groups on selected personality and health related variable. Risk and protective factors were identified via correlational analysis and logistic regression analysis.

Results

Under a more stringent cut-off criterion of four or more reported symptoms (out of seven) plus one or more reported functional impairments (out of five), 22.9% of the adolescents participating in this study could be classified as problematic mobile phone users. However, a more lenient criterion (only 4 or more reported symptoms without consideration of functional impairment) reported a substantially more severe prevalence rate (29.3%). A new group of “at-risk” adolescents (6.4%) was identified with such a discrepancy of prevalence rate. Gender difference, some risk and protective factors were also identified for developing this technology-related problem.

Discussion and Conclusions

Adolescents who are vulnerable to suffer from this technology-related problem deserve more attention from helping professionals. Results of this study throw some insights on how to identify problematic mobile phone user applying a criterion-referenced approach. This study echoes a recent call for adopting a developmental perspective in understanding this problem and conducting research in this area. Anchored on present findings, effective interventions to tackle this rising problem among adolescents are suggested.

Altered Functional Connectivity of the Salience Network in Problematic Smartphone Users

Smartphones provide convenience in everyday life. Smartphones, however, can elicit adverse effects when used excessively. The purpose of this study was to examine the underlying neurobiological alterations that arise from problematic smartphone use. We performed resting state seed-based functional connectivity (FC) analysis of 44 problematic smartphone users and 54 healthy controls. This analysis assessed the salience, central executive, default mode, and affective networks. Compared to controls, problematic smartphone users showed enhanced FC within the salience network and between the salience and default mode network. Moreover, we observed decreased FC between the salience and central executive network in problematic smartphone users, compared to controls. These results imply that problematic smartphone use is associated with aberrant FC in key brain networks. Our results suggest that changes in FC of key networks centered around the salience network might be associated with problematic smartphone use.

High cellphone use associated with greater risk of depression among young women aged 15-24 years in Soweto and Durban, South Africa

BACKGROUND

The ubiquity of cellular phone (cellphone) use in young people's daily lives has emerged as a priority area of concern for youth mental health.

OBJECTIVE

This study measured the prevalence of depression and its association with high cellphone use among youth in Soweto and Durban, South Africa.

METHODS

We analysed cross-sectional, baseline survey data among youth aged 16-24 who participated in a dual-site cohort study, 'AYAZAZI', conducted from 2014 to 2017. The primary outcome was depression using the 10-item Center for Epidemiologic Studies Depression Scale, with a score of ≥ 10 indicating probable depression. Cellphone use was measured via self-reported average number of hours of active use, with 'high cellphone use' defined as daily usage of ≥ 8. Multivariable logistic regression models assessed the independent relationship between high cellphone use and probable depression, adjusting for potential confounders.

RESULTS

Of 425 participants with a median age of 19 years (IQR = 18-21), 59.5% were young women. Overall, 43.3% had probable depression, with a higher prevalence among women (49.0% vs. 34.9%, P = .004). Nearly all (94.6%) owned a cellphone. About one-third (29.5%) reported spending ≥ 8 hours per day using their cellphone (39.3% of women vs. 14.9% of men, P < .001). In the overall adjusted model, youth reporting high daily cellphone use had higher odds of probable depression (aOR: 1.83, 95% CI: 1.16-2.90). In gender-stratified models, high daily cellphone use was associated with probable depression among women (aOR: 2.51, 95% CI: 1.47-4.31), but not among men (aOR: 0.87, 95% CI: 0.35-2.16).

CONCLUSIONS

Among a cohort of South African youth, we found a high prevalence of probable depression and high cellphone use (30%). The findings indicate a need for intersectoral initiatives focused on meaningful mental health support for South African youth to support positive growth and development.

Associations between Problematic Smartphone Use, Unhealthy Behaviors, and Mental Health Status in Korean Adolescents: Based on Data from the 13th Korea Youth Risk Behavior Survey (2017)

OBJECTIVE

We aimed to assess the associations between problematic smartphone use, unhealthy behaviors, and mental health status among adolescents.

METHODS

The data for this cross-sectional study were obtained from the 13th Korea Youth Risk Behavior Survey (2017). From among the 62,276 adolescents who participated in this nationwide web-based survey, 54,603 (87.7%) who used smartphones were selected as the study population. Unhealthy behaviors included smoking, drinking, physical inactivity, skipping breakfast, and fast food consumption. For the examination of mental health status, we considered sleep disturbances, stress, depressive symptoms, suicidal ideation, and suicide attempts. The associations between problematic smartphone use, unhealthy behaviors, and mental health were analyzed using multiple logistic regression analyses.

RESULTS

More than four hours of use on weekdays (31.3%) and weekends (61.3%) and the use of smartphones for communication (46.9%) were associated with unhealthy behaviors and mental health problems. Furthermore, adolescents who experienced conflicts with family (22.3%) and friends (25.8%) and academic problems (3.4%) were likely to have health problems.

CONCLUSION

The results suggest that problematic smartphone use may disrupt adolescents' health. Therefore, there is a need for prevention programs for problematic smartphone use at home and at school to improve adolescents' health.

Self-Perception of Dependence as an Indicator of Smartphone Addiction-Establishment of a Cutoff Point in the SPAI-Spain Inventory

Background: In recent years, the abusive use of the smartphone has reached a situation that could be considered pathological. In this sense, different instruments to assess this problematic use or addiction to the smartphone are used. One of these instruments is the Smartphone Addition Inventory (SPAI), which has been validated in the Spanish language (SPAI-Spain). The main difficulty of these scales is to establish a cut-off point that determines such mobile addiction. On the other hand, self-perception was used in different addictions as a predictor of the problem. Aim: The objective of this study was to establish the cut-off point in the scores of the SPAI-Spain, using as a reference the self-perception of addiction values. Methods: A receiver operating characteristics (ROC) analysis was carried out, establishing as the cut-off point the one that presented a higher value of Youden J, indicative of its sensitivity and specificity. Results: 2958 participants from the university community completed the SPAI–Spain questionnaire. Differences in SPAI–Spain scores were found among age groups and gender, even though not all of them were statistically significant. When using the self-perception of smartphone addiction as the benchmark value, a score of 44 was established as the cutting point of the SPAI-Spain questionnaire, with a Youden J corresponding to 0.416. Conclusions: The implementation of a cut-off point of the SPAI-Spain questionnaire makes it an instrument that allows early identification of those individuals at risk of addiction, as well as the establishment of preventive and/or intervention measures.