Development and validation of a smartphone addiction scale (SAS)

Attention deficit hyperactivity symptoms predict problematic mobile phone use

Attention-deficit-hyperactivity disorder (ADHD) is the most commonly diagnosed childhood disorder characterised by inattention, hyperactivity/impulsivity, or both. Some of the key traits of ADHD have previously been linked to addictive and problematic behaviours. The aim of the present study was to examine the relationship between problematic mobile phone use, smartphone addiction risk and ADHD symptoms in an adult population. A sample of 273 healthy adult volunteers completed the Adult ADHD Self-Report Scale (ASRS), the Mobile Phone Problem Usage Scale (MPPUS), and the Smartphone Addiction Scale (SAS). A significant positive correlation was found between the ASRS and both scales. More specifically, inattention symptoms and age predicted smartphone addiction risk and problematic mobile phone use. Our results suggest that there is a positive relationship between ADHD traits and problematic mobile phone use. In particular, younger adults with higher level of inattention symptoms could be at higher risk of developing smartphone addiction. The implication of our findings for theoretical frameworks of problematic mobile phone use and clinical practice are discussed.

Thy-AuNP-AgNP Hybrid Systems for Colorimetric Determination of Copper (II) Ions Using UV-Vis Spectroscopy and Smartphone-Based Detection

A colorimetric probe based on a hybrid sensing system of gold nanoparticles (AuNPs), silver nanoparticles (AgNPs), and thymine (Thy) was developed for easy and rapid detection of copper (II) ions (Cu2+) in solution. The underlying principle of this probe was the Cu2+-triggered aggregation of the nanoparticle components. Color change of the sensing solution (from red to purple) was clearly observed with naked eyes. The experimental parameters, including pH and concentration of tris buffer, thymine concentration and AgNP dilution ratios, were investigated and optimized. Once optimized, the limits of detection were found to be 1, 0.09 and 0.03 ppm for naked eyes, smartphone application and UV-vis spectrophotometer, respectively. Furthermore, determination of Cu2+ was accomplished within 15 min under ambient conditions. For quantitative analysis, the linearity of detection was observed through ranges of 0.09−0.5 and 0.03−0.5 ppm using smartphone application and UV-vis spectrophotometer, respectively, conforming to the World Health Organization guideline for detection of copper at concentrations < 2 ppm in water. This developed hybrid colorimetric probe exhibited preferential selectivity toward Cu2+, even when assessed in the presence of other metal ions (Al3+, Ca2+, Pb2+, Mn2+, Mg2+, Zn2+, Fe3+, Ni2+, Co2+, Hg2+ and Cd2+). The developed procedure was also successfully applied to quantification of Cu2+ in real water samples. The recovery and relative standard deviation (RSD) values from real water sample analysis were in the ranges of 70.14−103.59 and 3.21−17.63%, respectively. Our findings demonstrated a successful development and implementation of the Thy-AuNP-AgNP hybrid sensing system for rapid, simple and portable Cu2+ detection in water samples using a spectrophotometer or a smartphone-based device.

Smartphones, the Epidemic of the 21st Century: A Possible Source of Addictions and Neuropsychiatric Consequences

Background and Objectives: Phonoholism is the excessive and harmful use of a smartphone. We are now observing this phenomenon among adults more often. Using a smartphone for several hours may lead to somatic and psychological symptoms, such as headaches and depression. The aim of this study is to assess the prevalence of phonoholism and to assess the association between smartphone overuse and neuropsychiatric disorders. Materials and Methods: A total of 368 people (70.1% were woman), aged between 19 and 82 years (average age 26.1), took part in an anonymous questionnaire consisting of the following elements: Hospital Anxiety and Depression Scale (HADS), Mobile Phone Problem Use Scale (MPPUS-9), and original questions regarding headaches and sleep quality, along with a subjective assessment of the use of smartphones and an objective evaluation based on data from the applications “Stay Free” and “Screen Time”. Results: A total of 61 respondents (16.6%) obtained a score on the MPPUS-9 scale, which revealed their problematic use of mobile devices. Patients with phonoholism had significantly more headaches (85% vs. 58.7%, p = 0.027). Subjects with phonoholism had significantly shorter mean sleep duration (7.14 h vs. 7.42 h, p = 0.0475) and were less likely to feel sleepy during the day (43.33% vs. 59.73%, p = 0.0271). The group with phonoholism had significantly higher scores on the HADS-A anxiety scale (8.29 vs. 10.9, p = 0.015), but a statistical significance was not confirmed for depressive symptoms. Conclusions: The excessive use of the telephone negatively affects both somatic and mental health and can pose a significant clinical problem.

Sleep latency and sleep disturbances mediates the association between nighttime cell phone use and psychological well-being in college students

To examine sleep latency and sleep disturbance as mediators between nighttime cell phone use variables (cell phone use for unstructured leisure activities and for accessing emotionally charged media content before sleep: CPU_BeforeBed and CPU_Arousal) and psychological well-being (PWB) of college students. 521 (74% female) undergraduate students from a large public university were surveyed using a validated self-report quantitative questionnaire assessing CPU variables, sleep quality, and PWB. Pearson correlation analyses were used to compute the correlation between CPU_BeforeBed, CPU_Arousal, sleep latency, and sleep disturbance. Ordinary least-squares regressions were conducted to assess the estimates of the relationships within the models. One-way ANOVA was used to see the difference between the groups. The partial eta squared was used to determine the effect size between the groups. The PROCESS method was used to perform mediation analyses. The sample consisted of undergraduate students between 18 and 29 years old, with an average age of 20 years (SD = 3.18). The sample was diverse in terms of ethnicity (49% Caucasian, 24% Latinx, 19% Asian, 3% African American, 1% Native American, 3% identified as "other") and the number of years the participants had been attending a 2 year or 4 year higher institution (38% incoming freshman, 19% sophomore, 17% junior, 14% senior, and 13% returning senior). The correlation between CPU_BeforeBed and PWB (α = - 0.044, p = 0.615), and the correlation between CPU_Arousal and PWB (α = - 0.061, p = 0.228) were not statistically significant. However, the correlation between sleep latency and PWB (α = - 0.140, p = 0.001), and the correlation between sleep disturbance and PWB (α = - 0.121, p = 0.005) were statistically significant. The mediation effect of sleep latency on the association between CPU_BeforeBed and PWB (Effect = - 0.0325, SE = 0.0145, p < 0.05), and the mediation effect of sleep disturbance on the association between CPU_Arousal and PWB (Effect = - 0.0214, SE = 0.0086, p < 0.05) were statistically significant. Sleep latency and sleep disturbance act as a mediator on the association between CPU_BeforeBed and PWB, and the association between CPU_Arousal and PWB. However, CPU_BeforeBed and CPU_Arousal did not have a direct impact on their PWB. These findings may help college students in regulating CPU habits before going to bed. These findings may also help medical practitioners make informed decisions about the use of cell phones for patients with sleep-related disorders.

Supplementary Information

The online version contains supplementary material available at 10.1007/s41105-022-00388-3.

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.

Does the Type of Smartphone Usage Behavior Influence Problematic Smartphone Use and the Related Stress Perception?

Problematic smartphone use (PSU) is defined as the inability to control the time spent on smartphones, which has long-term negative impacts on daily life. The use-and-gratifications approach is applied to smartphones and describes the extent to which users devote themselves to smartphones to obtain gratifications. These gratifications can be represented in the types of use (process, social, and habitual). This study examines the associations between PSU and the different types of use and their effects on perceived stress and self-perceived PSU. N = 108 subjects participated (65 women, 41 men, 2 diverse, mean age = 31.8; range 17–70). They completed the Mobile Phone Problem Use Scale (MPPUS-19), Perceived Stress Scale (PSS-10), a questionnaire on types of use, and a self-created scale for self-perceived PSU. Multiple linear regressions and correlations were calculated and show a relationship between PSU and perceived stress. All three types of use were shown to be predictors of PSU. For stress perception, only process use is a predictor. Both PSU and stress perception are predictors of the self-perceived PSU. Both stress and PSU interact with each other, and the different types of use determine how stressful smartphone use is perceived to be.

Why people listen: Motivations and outcomes of podcast listening

The aim of this preregistered study was to identify dispositional predictors of podcast listening and examine the associations between aspects of podcast listening, dispositional predictors, and psychological outcomes. Three hundred and six adults from a range of countries completed an online questionnaire that assessed individual difference predictors (the Big Five personality factors, curiosity, need for cognition, need to belong, age, and gender), aspects of podcast listening (amount, format, setting, device, and social aspects), and potential outcomes (autonomy, competence, relatedness, meaning, mindfulness, and smartphone addiction). As predicted, openness to experience, interest-based curiosity, and need for cognition positively predicted podcast listening. Contrary to predictions, need to belong negatively predicted podcast listening, and time spent listening to podcasts was not associated with autonomy, competence, relatedness, meaning, mindfulness, or smartphone addiction. However, certain aspects of podcast listening (e.g., parasocial relationships and social engagement) were related to positive outcomes and to our predictor variables. Furthermore, neuroticism negatively predicted podcast listening. Overall, the findings support the idea that informational motives can play a role in podcast listening, and that some aspects of listening are associated with positive outcomes.

Cortical surface variation in individuals with excessive smartphone use

Excessive smartphone use has been repeatedly related to adverse effects on mental health and psychological well-being in young adults. The continued investigation of the neurobiological mechanism underlying excessive smartphone use - sometimes also referred to as "smartphone addiction" (SPA) - is considered a top priority in system neuroscience research. Despite progress in the past years, cortical morphology associated with SPA is still poorly understood. Here, we used structural magnetic resonance imaging (MRI) at 3 T to investigate two cortical surface markers of distinct neurodevelopmental origin such as the complexity of cortical folding (CCF) and cortical thickness (CTh) in individuals with excessive smartphone use (n = 19) compared to individuals not fulfilling SPA criteria (n-SPA; n = 22). SPA was assessed using the Smartphone Addiction Inventory (SPAI). CCF and CTh were investigated using the Computational Anatomy Toolbox (CAT12). SPA individuals showed lower CCF in the right superior frontal gyrus as well as in the right caudal (cACC) and rostral anterior cingulate cortex (rACC) compared to n-SPA individuals (TFCE, uncorrected at p < 0.001). Following a dimensional approach, across the entire sample CCF of the right cACC was significantly associated with SPAI total score, as well as with distinct SPAI subdimensions, particularly time spent with the device, compulsivity, and sleep interference in all participants (n = 41; p < 0.05, FDR-corrected). Collectively, these findings suggest that SPA is associated with aberrant structural maturation of regions important for cognitive control and emotional regulation. This article is protected by copyright. All rights reserved.

Smartphone usage and addiction among undergraduate dental students in Malaysia: A cross-sectional study

BACKGROUND

Behavioral addiction to smartphones is a common phenomenon in the present digital age, wherein indulgence in these devices is compulsive and impacts physical, social, and psychological health of the population. The smartphones effect on a dental student's life is detrimental to their academics, health, and efficiency in providing clinical patient care. To assess use and addiction of smartphones among dental students under six major domains and to compare this based on their gender, ethnicity, and year of study.

MATERIALS AND METHODS

A cross-sectional study using a validated questionnaire, Smartphone addiction scale was conducted among 349 undergraduate students (N = 349) at a private dental school in Malaysia.

RESULTS

Overall results are presented as mean scores under six domains with total score as 142.40 (33.65). The total scores compared between two genders did not show statistical difference, however on comparing individual domains, females (25.25) had higher mean score for daily life disturbance (P = 0.013) and males (30.17) for cyberspace-oriented relationship (P = 0.001). Chinese students had higher scores with respect to withdrawal (32.45) and cyberspace-oriented relationship (29.48) as compared to other ethnicities. Year 4 students show higher scores than other years in daily life disturbance (27.44), tolerance (16.81), and overuse (16.51).

CONCLUSION

Our research presents the extent and pattern of smartphone of usage and addiction among the undergraduate students at a dental school in Malaysia. The indicators of addiction highlighted in the study are pivotal in spreading awareness regarding this overuse and addiction as well as planning further research in this area.

Does Amount of Information Support Aesthetic Values?

Obtaining information from the world is important for survival. The brain, therefore, has special mechanisms to extract as much information as possible from sensory stimuli. Hence, given its importance, the amount of available information may underlie aesthetic values. Such information-based aesthetic values would be significant because they would compete with others to drive decision-making. In this article, we ask, "What is the evidence that amount of information support aesthetic values?" An important concept in the measurement of informational volume is entropy. Research on aesthetic values has thus used Shannon entropy to evaluate the contribution of quantity of information. We review here the concepts of information and aesthetic values, and research on the visual and auditory systems to probe whether the brain uses entropy or other relevant measures, specially, Fisher information, in aesthetic decisions. We conclude that information measures contribute to these decisions in two ways: first, the absolute quantity of information can modulate aesthetic preferences for certain sensory patterns. However, the preference for volume of information is highly individualized, with information-measures competing with organizing principles, such as rhythm and symmetry. In addition, people tend to be resistant to too much entropy, but not necessarily, high amounts of Fisher information. We show that this resistance may stem in part from the distribution of amount of information in natural sensory stimuli. Second, the measurement of entropic-like quantities over time reveal that they can modulate aesthetic decisions by varying degrees of surprise given temporally integrated expectations. We propose that amount of information underpins complex aesthetic values, possibly informing the brain on the allocation of resources or the situational appropriateness of some cognitive models.

Body Dissatisfaction and Disordered Eating Behaviors: The Mediation Role of Smartphone Addiction and Depression

This study aimed to determine whether smartphone addiction and depression sequentially mediate the relationship between body dissatisfaction and disordered eating behaviors (e.g., restrained eating, emotional eating and external eating). A total of 5986 participants (54.1% females, average age = 19.8 years, age range = 17–32) completed the Satisfaction and Dissatisfaction with Body Parts Scale, the Three-Factor Eating Questionnaire, the Smartphone Addiction Scale and the Patient Health Questionnaire-9. Mediational analysis showed that, after controlling for age, sex and body mass index, body dissatisfaction was related to disordered eating behaviors through (a) the mediating effect of smartphone addiction, (b) the mediating effect of depression, and (c) the serial mediating effect of smartphone addiction and depression. In conclusion, our study showed for the first time that smartphone addiction and depression can be sequential mediator variables in the association between body dissatisfaction and disordered eating. However, this study is a cross-sectional study; future longitudinal studies could further test the causal associations between these study variables.

Association between the Perceived Household Financial Decline Due to COVID-19 and Smartphone Dependency among Korean Adolescents

This cross-sectional study identified the association between COVID-19-related perceived household financial decline and smartphone dependency among adolescents in South Korea. Data from the 2020 Youth Risk Behavior Survey of Korea was used and 54,809 middle and high school students were included. COVID-19-related perceived household financial decline was categorized as no financial decline, mild, moderate, and severe. Smartphone dependency was calculated by 10 questions and was largely categorized as yes and no, and as normal, low, and high (prevalence rate: 25.0%). Binary and multinomial regression analyses were performed to analyze the association. The more severe the financial decline, the more pronounced the risk of high-risk smartphone dependency (mild financial decline: odds ratio (OR) 1.11, 95% CI 0.96-1.28; moderate: OR 1.22, 95% CI 1.04-1.43; severe: OR 2.56, 95% CI 2.06-3.17). Poor family relationships (OR 1.06, 95% CI 1.03-1.10) and severe social conflict (OR 2.99, 95% CI 2.50-3.58) were also related to smartphone dependency. The ORs were 2.63 with more than three bathrooms and 1.63 with their own bedroom. Smartphone dependency among adolescents is closely related to COVID-19-related perceived household financial decline. As smartphone dependency relates to complicated psychological issues, further evaluation is necessary, especially for vulnerable adolescents.

Relationship of Sleep Quality and Oxidative Stress Level in Smartphone Users; Study in Faculty of Medicine Student, Universitas Baiturrahmah

BACKGROUND: Excessive smartphones can affect sleep quality, reducing sleep duration. This lack of sleep will impact various health and increase levels of free radicals in the body, affecting various cell functions. AIM: The aim of the study was to measure the relationship between sleep quality due to smartphone use and serum malondialdehyde (MDA) levels. MATERIALS AND METHODS: This was a quasi-experimental with pre- and post-test group study. Sleep quality was assessed with Pittsburgh Sleep Quality Index (PSQI), and the smartphone addiction was assessed based on Smartphone Addiction Scale (SAS) score. The subjects were divided into four groups (n = 6) based on their PSQI and SAS score. The first group was the subjects with normal sleep and non-smartphone addict. The second group was the subjects with normal sleep but smartphone addict. The third group was the subjects with abnormal sleep and non-smartphone addict. Furthermore, fourth was the subjects with abnormal sleep and smartphone addiction. All the subjects were asked to sleep usually and used the smartphone as necessary a day before the study started. Blood plasma was collected from the subject before and after the study for MDA measurement. Plasma MDA was determined using the thiobarbituric acid test. RESULTS: Smartphone use can reduce sleep quality and duration, resulting in sleep deprivation. There was no increase in MDA concentration (p > 0.05) in the ordinary and non-addictive or smartphone-addicted sleep group. Meanwhile, the group that stayed up late and was neither addictive nor addictive showed an increase in MDA levels and was statistically significant (p < 0.05). CONCLUSION: Adequate sleep can reduce blood serum MDA levels and smartphone use does not affect MDA levels.

Functionalities Review of Digital Wellbeing Apps: Towards Research-informed Design Implications for Interventions Limiting Smartphone Use

Background

Much research in human-computer interaction has focused on well-being and how it can be better supported through a range of technologies, from affective interfaces to mindfulness systems. At the same time, we have seen a growing number of commercial digital well-being apps. However, there has been limited scholarly work reviewing these apps.

Objective

This paper aims to report on an autoethnographic study and functionality review of the 39 most popular commercial digital well-being apps on Google Play Store and 17 apps described in academic papers.

Methods

From 1250 apps on Google Play Store, we selected 39 (3.12%) digital well-being apps, and from Google Scholar, we identified 17 papers describing academic apps. Both sets of digital well-being apps were analyzed through a review of their functionalities based on their descriptions. The commercial apps were also analyzed through autoethnography, wherein the first author interacted with them to understand how these functionalities work and how they may be experienced by users in their daily lives.

Results

Our findings indicate that these apps focus mostly on limiting screen time, and we advanced a richer conversation about such apps, articulating the distinctions among monitoring use, tracking use against set limits, and 4 specific interventions supporting limited use.

Conclusions

We conclude with 6 implications for designing digital well-being apps, namely calling to move beyond screen time and support the broader focus of digital well-being; supporting meaningful use rather than limiting meaningless use; leveraging (digital) navigation in design for friction; supporting collaborative interaction to limit phone overuse; supporting explicit, time-based visualizations for monitoring functionality; and supporting the ethical design of digital well-being apps.

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.

Smartphone Addiction and Eysenck's Personality Traits Among Chinese Adolescents: A Meta-Analysis

With the quickly rising popularity of smartphone among adolescents over the past decade, studies have begun to investigate the relationship between smartphone addiction and Eysenck's personality traits. Despite numerous studies on this topic, however, findings have been mixed and there is a lack of consensus regarding this relationship. Thus, this meta-analysis aimed to explore the relationship between smartphone addiction and Eysenck's personality traits in Chinese adolescents, as well as its possible moderators. Through literature search and screening, 33 studies were included, comprising 79 independent effect sizes with a total of 17, 737 subjects. A random effects model was selected, and it was found that smartphone addiction was positively associated with psychoticism (r = 0.16, p < 0.001) and neuroticism (r = 0.32, p < 0.001), but not significantly associated with extroversion (r = -0.06, p = 0.079). The moderating effect test showed that sex and year of study publication had significant influences on the relationship between smartphone addiction and psychoticism, and the year of study publication had a significant influence on the relationship between smartphone addiction and neuroticism. This study is the first meta-analysis on the relationship between smartphone addiction and Eysenck's personality traits among adolescents in China, and the results have helped to clarify the controversy of previous studies regarding this relationship.

The effect of internet addiction and smartphone addiction on sleep quality among Turkish adolescents

Background: Sleep quality plays a principal role in the protection of health. There is an increasing number of studies in the literature demonstrating that internet addiction and smartphone addiction impair sleep quality. However, the number of studies on Turkish adolescents is very limited. Therefore, this study examined the effects of internet addiction and smartphone addiction on sleep quality among Turkish adolescents. Methods: Participants in this cross-sectional study were 910 adolescents aged 13-18 years. Data were collected with the Short Internet Addiction Test, Smartphone Addiction Scale, and Pittsburgh Sleep Quality Index. In addition, a questionnaire was used to gather information about the demographic, socioeconomic, and health-related characteristics. Pearson's Chi-square test, Chi-square test for trend, Mann-Whitney U test, logistic regression analysis, and Spearman's correlation analysis were used in the analysis. Results: The sleep quality of 58.7% of the adolescents was poor. Additionally, girls and adolescents ≥16 years old had poor sleep quality. Sleep quality deteriorated as perceived health status and perceived economic status of family deteriorated. Compared to participants with normal internet addiction scores, poor sleep quality was 1.83 (95% CI [1.22-2.74]) times higher in those with problematic internet addiction and 1.99 (95% CI [1.23-3.87]) times higher in those with pathological internet addiction. One point increase in Smartphone Addiction Scale total score increased poor sleep quality 1.01 (95% CI [1.00-1.02]) times. Sleep quality scale were positively correlated with the smartphone addiction and internet addiction. However, there was no positive correlation between habitual sleep efficiency subcomponent of sleep quality and smartphone addiction and internet addiction. Conclusions: Internet addiction and smartphone addiction were associated with poor sleep quality in adolescents. Older adolescents (≥16 years), gender (female), poor health perception, and perception of moderate economic status of the family were other factors associated with poor sleep quality.

Development and validation of the smartphone addiction risk children questionnaire (SARCQ)

Smartphone abuse interferes with all activities in daily life. Young people who tend to have a smartphone addiction (SA) also have social, familiar and academic problems. Furthermore, smartphone provides immediate access to communication as well as avoids experiencing social anxiety. This research aims to evaluate the factorial structure of Smartphone Addiction Risk Children Questionnaire (SARCQ), a specific questionnaire created to assess the risk of SA in primary school children (8–11 years). An exploratory factor analysis before and a confirmatory factor analysis after were performed in order to establish the factorial structure of the questionnaire. Results showed a two-factor structure explaining 49.30% of total variance. The outstanding dimensions are: “I'm not afraid with you” (INAWY) and “Linus blanket” (LB). SARCQ will be useful to assess the risk of SA in childhood in order to operate early effective therapeutic interventions.

The association of smartphone addiction, sleep quality and perceived stress amongst Jordanian dental students

INTRODUCTION

Smartphone addiction has been associated with sleeping problems and psychological anxiety. However, little is known about the association of smartphone addiction, sleep quality and perceived stress amongst university students particularly in dentistry. This study investigated the association of these variables amongst dental students in a Jordanian dental faculty.

MATERIALS AND METHODS

A sample of 420 undergraduate dental students enrolled for academic year 2017/2018 at the Jordan University of Science and Technology participated in this study. They were given a set of self-administered questionnaires which consisted of questions regarding demographic information, characteristics of smartphone use, assessment of smartphone addiction, sleep quality as well as perceived stress.

RESULTS

The mean Smartphone Addiction Scale (SAS) score amongst Jordanian dental students was high (109.9 ± 23.8). The correlation between SAS and Global Pittsburg Sleep Quality Index (PSQI) score was significant (r = 0.137, P =0.005) indicating that the higher the smartphone addiction level, the poorer the quality of sleep. Similarly, a significant correlation was found between Perceived Stress Scale-10 (PSS-10) score and Global PSQI score (r = 0.348, P < 0.001) which implied that students who have higher perceived stress experienced poorer sleep quality. Year 3 students (clinical year), smartphone addiction and perceived stress were determinants of sleep quality.

CONCLUSIONS

Dental students who have high levels of smartphone addiction or high perceived stress levels experienced poor sleep quality. Identifying smartphone addicts amongst students as well as stressors are imperative measures to allow timely assistance and support in the form of educational campaigns, counselling, psychotherapy and stress management.

Age, gender, peers, life skills and quality of life influence risk of cell phone addiction among college teachers in Karnataka, India : a state level epidemiological analysis

BACKGROUND

Cell phones are an integral part of modern day life and have become companions for individuals irrespective of age, gender and socio-economic status. In this study, we assessed the factors affecting risk of cell phone addiction among teachers attending Life Skills Training and Counselling Services (LSTCS) program in Karnataka.

METHODS

This cross sectional secondary data analysis utilised data from baseline assessment of trainees attending a Life Skills Training and Counselling Services program (LSTCP). Various factors hypothesised to be affecting risk of cell phone addiction (outcome) was analysed using univariate and multivariable logistic regression analysis. All the analysis was done using STATA 12.0 software.

RESULTS

Multivariable logistic regression analysis was conducted with risk of cell phone addiction as outcome. A conceptual framework of hypothesized exposure variables was developed based on expert consultation and literature review. Overall, data of 1981 participants was utilized. Gender (AOR=1.91; 95% CI=1.27-2.77), number of peers (AOR=1.01; 95 CI=1-1.008) and social quality of life (AOR=1.01; 95% CI=1.00-1.03) were associated with increased risk of cell phone addiction. Age (AOR=0.98; 95%CI=0.96-1.00), empathy (AOR=0.96;95%;CI=0.93-0.99), communication skills(AOR=0.92, 95%;CI=0.88-0.96) and physical quality of life (AOR=0.96; 95% CI=0.95-0.98) were associated with reduced risk of cell phone addiction.

CONCLUSIONS

This study on precursors of risk of cell phone addiction, conducted mostly among apparently healthy individuals, provide important insights into interventions to reduce risk of cell phone addiction. The complexity of associations between peers, gender, quality of life and risk of cell phone addiction needs further exploration.

Mindful Parenting and Parent Technology Use: Examining the Intersections and Outlining Future Research Directions

Popular media attention and scientific research in both mindful parenting and technology use in the context of parenting has expanded in the 21st century; however, these two streams of research have largely evolved separately from one another. Thus, in this conceptual paper, we integrate the research on mindful parenting with that on parents’ technology use and parenting to examine how parent technology use may impact or be linked with aspects of mindful parenting. Mindful parenting theory outlines five key components: listening with full attention, self-regulation in the parent–child relationship, emotional awareness of self and child, nonjudgmental acceptance of self and child, and compassion for self and child. Parent technology use, in particular the use of mobile devices, has the potential to impact all five elements of mindful parenting. However, the relationship between mindful parenting and technology is complex, and there can be both positive and negative implications of parent technology use on mindful parenting. On the positive side, technology use might help parents regulate their emotions; access support; and develop more empathy, acceptance, and compassion for themselves and their children. Yet, parent technology use also has the potential to create distractions and disrupt parent–child interactions, which may make it more difficult for parents to listen with full attention, maintain awareness of their own and their child’s emotions, and calmly respond to child behaviors with intentionality. Technology use may also create more opportunities for social comparisons and judgement, making it more difficult for parents to accept their children nonjudgmentally and have compassion for their children as they are. Future research is needed to understand the conditions under which technology use can hinder or promote mindful parenting and how interventions can promote mindful parenting skills and a positive uses of technology.

Psychopathological Symptoms and Personality Traits as Predictors of Problematic Smartphone Use in Different Age Groups

The study investigates psychopathological symptoms and the Big Five personality traits as predictors of “problematic smartphone use” (PSU) in different generational groups. The generational groups were selected to analyze whether the different life stages and developmental tasks that need to be completed have an impact on PSU. The groups were divided into digital immigrants, digital natives, and Generation Y and Z as subgroups of digital natives. A total of 399 subjects participated (312 women, 86 men, 1 diverse; mean age = 25.9; range 14–67; 44 digital immigrants, 355 digital natives, 35 Generation Y, and 320 Generation Z). They completed the ICD-10 Symptom Rating (ISR), the Big Five Inventory-10 (BFI-10), and the Mobile Phone Problematic Use Scale (MPPUS). The results show differences between digital immigrants and digital natives in the expression of PSU, neuroticism, conscientiousness, depression, anxiety, and compulsivity. Concerning Generations Y and Z, differences were only found in the expression of the PSU. Regression revealed that symptoms for obsessive-compulsive disorders, depression, conscientiousness, and gender were significant predictors of PSU. Moderations have shown that being a digital immigrant/native moderates the impact of eating disorders on PSU. Belonging to Generation Y/Z moderates the influence of conscientiousness and depression on PSU. Thus, it shows that in different generations, different factors seem to play a role in the development and maintenance of PSU.

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.

The Effects of Smartphone and Internet Gaming Addiction on Eating Attitudes Among University Students

OBJECTIVE

Smartphone addiction is a public health problem increasing with the technologic developments. It particularly affects the university students negatively in terms of psychological, physical, academic achievement and social relations. This study aims to investigate the relation of eating attitudes between smartphone addiction and internet gaming disorder, also the relation of smartphone addiction with obesity.

METHODS

This cross-sectional and prospective study is consisted of 358 volunteer university students. Socio-demographic data form, Short Form of Smartphone Addiction Scale (SF-SAS), Eating Attitude Test (EAT), and internet gaming disorder scale were administered to the participants.

RESULTS

Mean age of the participants was 22.27±3.10 years and 59.8% (n=214) were female. In terms of the variables "body mass index, body weight, faculty of the student, economic status of the family, and the people they live with together" were significantly different from controls. Also "monthly mobile phone invoice, EAT score, SF-SAS scores" were statistically different. A significant difference was found among "body weight groups" in terms of both EAT score and SF-SAS. According to the linear regression model variables of "gender, smartphone addiction, and school year" were determined as the predictors for EAT.

CONCLUSION

Our current study has revealed the relation between smartphone addiction and eating attitudes, and obesity. Smartphone addiction may lead to an increase in body weight, by affecting eating attitudes. Therefore, the effect of eating behavior disorders in the emergence of the smartphone addiction should be considered. Multi-disciplinary solutions are required to prevent this addiction that may increase over time.

Altered resting-state functional connectivity of the dorsal anterior cingulate cortex with intrinsic brain networks in male problematic smartphone users

The excessive use of smartphones is associated with various medical complications and mental health problems. However, existing research findings on neurobiological mechanisms behind problematic smartphone use are limited. In this study, we investigated functional connectivity in problematic smartphone users, focusing on the default mode network (DMN) and attentional networks. We hypothesized that problematic smartphone users would have alterations in functional connectivity between the DMN and attentional networks and that such alterations would correlate with the severity of problematic smartphone use. This study included 30 problematic smartphone users and 35 non-problematic smartphone users. We carried out group independent component analysis (group ICA) to decompose resting-state functional magnetic resonance imaging (fMRI) data into distinct networks. We examined functional connectivity using seed-to-seed analysis and identified the nodes of networks in group ICA, which we used as region of interest. We identified greater functional connectivity of the dorsal anterior cingulate cortex (dACC) with the ventral attention network (VAN) and with the DMN in problematic smartphone users. In seed-to-seed analysis, problematic smartphone users showed atypical dACC-VAN functional connectivity which correlated with the smartphone addiction proneness scale total scores. Our resting-state fMRI study found greater functional connectivity between the dACC and attentional networks in problematic smartphone users. Our findings suggest that increased bottom-up and interoceptive attentional processing might play an important role in problematic smartphone use.

Vulnerability and Relationship Satisfaction

The present study aimed to investigate the mediating role of smartphone addiction in the association between vulnerability and relationship satisfaction among younger adults living in Turkey. The relationship assessment scale, the smartphone addiction scale-short version, the psychological vulnerability scale, and the social vulnerability scale were applied to 326 university students. Structural equation modelling showed that vulnerability has a significantly direct effect on relationship satisfaction, and smartphone addiction can partially mediate the impact of vulnerability on relationship satisfaction. The bootstrapping techniques confirmed that smartphone addiction had a partial mediation effect between vulnerability and relationship satisfaction. These data may help clinicians and researchers to better understand the consequences of vulnerability and underlying the processes of smartphone addiction and relationship satisfaction.

Excessive smartphone use and its correlations with social anxiety and quality of life among medical students in a public university in Malaysia: A cross-sectional study

INTRODUCTION

Smartphone usage has significantly increased in the last decade among young adults has significantly increased in the last decade. While its benefits are undeniable, its negative implications are increasingly emerging. Studies are needed to investigate the effects of excessive smartphone use on a young person's life. This study aimed to determine the prevalence of excessive smartphone use among medical students and its relations with social anxiety, self-esteem, and quality of life.

METHODS

A cross-sectional study was conducted among medical students from Universiti Kebangsaan Malaysia (UKM) in UKM Medical Center. A total of 273 students have consented to participate and completed self-reported questionnaires encompassing sociodemographic information, the Short Version Smartphone Addiction Scale (SAS-SV), the Social Interaction Anxiety Scale (SIAS), the World Health Organization Quality of Life (WHOQOL-BREF) and the Rosenberg Self-esteem Scale (RSES). Sociodemographic data, SIAS score, WHOQOL-BREF score and the Rosenberg Self-esteem Scale score were treated as independent variables. Smartphone addiction Scale score was treated as the dependent variable. Bivariate analysis was used to explore the relationship between independent and dependent variables using the Fisher exact test, Pearson Chi-Square and Pearson correlation coefficient. Multiple linear regression analysis was used to analyze the variables with a p-value of < 0.05 from the Pearson correlation coefficient test.

RESULTS

The percentage of excessive smarphone use among UKM medical students is 48%. The bivariate analysis showed that excessive smartphone use has a small but significant positive correlation with social anxiety (r = 0.173, p = 0.004) and negative correlations with physical health (r = -0.133, p = 0.028), psychological wellbeing (r =-0.135, p = 0.026), social relationships (r = -0.232, p = 0.001), environment (r = -0.260, p = 0.001) and self-esteem (r = -0.128, p = 0.035). In the multiple regression analysis, a better environment predicted a reduced risk for smartphone addiction (β = -0.233, p = 0.013).

CONCLUSION

Almost half of the students were found to have smartphone overdependence. Excessive smartphone use has shown a significant relationship with an increased risk for social anxiety, reduction in self-esteem, and quality of life among medical students. A closer look into the possible intervention is needed in the future to curb the negative effects arising from excessive smartphone use.

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.

Exploring Stress and Problematic Use of Short-Form Video Applications among Middle-Aged Chinese Adults: The Mediating Roles of Duration of Use and Flow Experience

The pervasiveness of smartphones and the popularity of short-form video applications (SVAs), such as TikTok, among middle-aged Chinese adults have raised concerns about problematic SVAs use. Although a plethora of research has examined problematic smartphone use among teenagers and young adults, scarce attention has been paid to the middle-aged group. This study integrates the psychopathological approach and the compensatory use approach to explicate problematic SVAs use among middle-aged Chinese adults. We aim to examine the relationship between stress and problematic SVAs use via the mediating roles of duration of use and flow experience. A total of 194 middle-aged adults from across the nation participated in an online survey. The results showed that stress was positively associated with problematic SVAs use. We also found that duration of use positively mediated the relationship between stress and problematic SVAs use. Furthermore, a serial mediation effect of duration of use and flow experience was found. The findings suggest that the aforementioned two approaches are complementary to each other in explicating problematic SVAs use, but the compensatory use approach explains more than the psychopathological approach does. Flow experience extends the original compensatory use approach and demonstrates the importance of incorporating techno-psychological predictors in understanding problematic SVAs use.

Smartphone Abuse Amongst Adolescents: The Role of Impulsivity and Sensation Seeking

Adolescence is the stage of development where the reward and emotional regulation systems are yet to be adjusted and where most excessive behaviors start, like smartphone abuse. In addition, in this evolutionary period adolescents are more susceptible to behavioral changes through specific interventions or educational programs. Thus, it is fundamental to analyze the personality profile of those adolescents showing excessive mobile phone usage to properly approach later prevention strategies. Impulsivity is one of the most repeated variables associated with teenage addictions, although it has been observed that not all impulsive behaviors need to be detrimental. The aim of this study is to analyze how impulsivity affects smartphone addiction directly, but also indirectly, by assessing its association with sensation seeking variables (thrill and adventure seeking, experience seeking, disinhibition, and boredom susceptibility) which are in turn decisive when using these technologies improperly. The sample was made up of 614 adolescents aged 13-18 attending secondary education from Burgos, Spain. Dickman Impulsivity Inventory, Sensation Seeking Scale, and Ad-hoc questionnaire on adolescent self-perception as to smartphone use were applied. Results show that 41.4% of participants admit to abusing smartphones sometimes, while 18.3% admit to abusing them more frequently and 24% to, at least ever, having defined themselves as smartphone addicts. Stepwise regression analysis revealed that gender (female), dysfunctional impulsivity and sensation seeking (disinhibition and thrill and adventure seeking) evidence 15.7% of variance in smartphone abuse. In addition, sensation seeking (thrill and adventure seeking, disinhibition, and boredom susceptibility) were found to mediate the relationship between dysfunctional impulsivity and smartphone abuse. Therefore, dysfunctional impulsivity was directly connected with teenage smartphone abuse, but also had an indirect stronger association through thrill and adventure seeking, disinhibition and boredom susceptibility.

Examination of the relationship between smartphone addiction and cyberchondria in adolescents

In this descriptive and correlational study, it was aimed to examine the relationship between adolescents' smartphone addiction and cyberchondria. Data were obtained from 384 adolescent high school students in Istanbul between December 2020 and January 2021, using a Personal Information Form, the Smartphone Addiction Scale, and Cyberchondria Severity Scale. The data were collected through face-to-face interviews with the students. The adolescents' smartphone use duration was 3.67 ± 1.66 years. Almost all (97.9%) connected to the internet via smartphones and 39.3% spent 3-4 h per day on the internet. It was determined that 61.7% of them checked their phones as soon as they woke up in the morning and 75.3% of them before going to bed in the evening. For those whose smartphone use duration is high, their cyberchondria also increases. The authors suggest that nurses should understand smartphone addiction and cyberchondria to identify and apply nursing interventions when necessary in adolescents.

Smartphone Addiction and Associated Health Outcomes in Adult Populations: A Systematic Review

BACKGROUND

Smartphones play a critical role in increasing human-machine interactions, with many advantages. However, the growing popularity of smartphone use has led to smartphone overuse and addiction. This review aims to systematically investigate the impact of smartphone addiction on health outcomes.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to carry out the systematic review. Five electronic databases including Medline, Web of Science, PsycINFO, PubMed, and Scopus were searched to identify eligible studies. Eligible studies were screened against predetermined inclusion criteria and data were extracted according to the review questions. This review is registered in PROSPERO (CRD42020181404). The quality of the articles was assessed using the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies.

RESULTS

A total of 27 of 2550 articles met the inclusion criteria. All of the studies were cross-sectional and focused on physical, mental, and neurological health outcomes. The majority of the studies focused on mental health outcomes and consistent associations were observed between smartphone addiction and several mental health outcomes. Anxiety and depression were commonly found to mediate mental health problems. A wide range of physical health sequelae was also associated with smartphone addiction. Furthermore, there was an association between smartphone addiction and neurological disorders.

CONCLUSIONS

Our findings suggest that there are consistent associations between smartphone addiction and physical and mental health, especially mental health. Social awareness campaigns about smartphone addiction and its impact on physical and mental health are needed. Further studies, especially randomized controlled trials, are warranted to validate the impacts of smartphone addiction.

The Italian Version of Smartphone Addiction Inventory (SPAI-I) for Adolescents: Confirmatory Factor Analysis and Relation with Self-Control and Internalized-Externalized Symptoms

The increased smartphone use in adolescence has led clinicians and researchers to carry out in-depth studies on the matter. Adolescents seem to be at risk of smartphone addiction because they are yet to develop self-control in smartphone use. This psychometric study aimed at examining the levels of validity evidence for the Smartphone Addiction Inventory-Italian (SPAI-I) version for adults, among adolescents. Confirmatory Factor Analysis confirmed the factor structure of the SPAI-I version for adults among adolescents but not the exploratory factor structure for adults of the original Smartphone Addiction Inventory (SPAI). Convergent validity was assessed by examining the relationship between SPAI-I, self-control, and internalized and externalized problems. A total of 446 Italian adolescents (mean age = 16.04, SD = 1.72, 36.3% males) completed the Self-Restraint Subscale of the Adolescent Self-Consciousness and the Strengths and Difficulties Questionnaires—with a specific focus on the subscales of internalized and externalized problems. Present findings suggested that the SPAI-I version could be used to assess smartphone overuse among adolescents according to a multidimensional perspective.

The effect of smartphone addiction on physical activity level in sports science undergraduates

BACKGROUND

Smartphones are thought to have many negative effects on interpersonal relationships, physical-mental health, and general functionality as well as bring many conveniences to our daily lives. This study aimed to determine the effect of smartphone addiction on physical activity level in sports science undergraduates. Secondly, comparing the physical activity level in students by gender was aimed.

METHOD

A total of 300 (134 female, 166 male) healthy university students were included in this study. The mean age of the subjects was 21.36 ± 2.33 years. The universe of the study consisted of volunteer students (Coaching Education, Physical Education and Sports Teaching, Sports Management, Recreation Departments) at the Faculty of Sport Sciences. Participants' demographic information was obtained and their physical activity levels were questioned with International Physical Activity Questionnaires (IPAQ) and smartphone addictions with the Smartphone Addiction Scale- Short Version (SAS-SV). The significance level was accepted as p < .05 in statistical evaluations.

RESULTS

According to IPAQ scores, physical activity levels of the participants were as follows; 65.3% were adequate, 32.7% low and 2% inactive. One-hundred and twenty-six participants (42%) were smartphone addicts according to the SAS-SV results. When the departments were examined within themselves, it was found that IPAQ and SAS-SV scores were negatively correlated for Physical Education and Sports Teaching (r = - 0.262; p = .021) and Sports management (r = - 0.295; p = .01).

The correlation between mobile phone addiction and coping style among Chinese adolescents: a meta-analysis

BACKGROUND

Mobile phone addiction has become a social problem that affects the healthy growth of adolescents, and it may be correlated with coping style. The aim of this study was to investigate the relationship between mobile phone addiction and coping style and the influencing factors for adolescents.

METHODS

A meta-analysis was conducted by searching China National Knowledge Infrastructure (CNKI), WANFANG DATA and Chongqing VIP Information Co., Ltd. (VIP), PubMed, Web of Science, Embase, and PsycINFO. Stata 16.0 was used to analyse the overall effect and test the moderating effect.

RESULTS

Thirty-three studies were included, involving a total of 20,349 subjects. There was no significant correlation between adolescents' mobile phone addiction and positive coping style (r =  - 0.02, 95% CI =  - 0.06 to 0.02, P > 0.05), but there was a moderate positive correlation between adolescents' mobile phone addiction and negative coping style (r = 0.31, 95% CI = 0.26 to 0.36, P < 0.001). The moderating effect analysis showed that the effect of dissertations on mobile phone addiction and positive coping style among adolescents was significantly larger than that of journal articles. The Smartphone Addiction Scale for College Students (SAS-C) showed the largest effect on mobile phone addiction and positive coping style among adolescents. The time of publication significantly positively moderated the relationship between mobile phone addiction and negative coping style among adolescents. The Simplified Coping Style Questionnaire (SCSQ) showed the largest effect on adolescents' mobile phone addiction and negative coping style. However, the correlation between adolescents' mobile phone addiction and coping style was not affected by age or gender.

CONCLUSIONS

There was a close relationship between mobile phone addiction and coping style among adolescents. In the future, longitudinal research should be carried out to better investigate the dynamic changes in the relationship between mobile phone addiction and coping style.

The Effect of Nursing Students' Smartphone Addiction and Phubbing Behaviors on Communication Skill

The aim of the study was to examine the effect of nursing students' smartphone addiction and phubbing behaviors on their communication skills. This study was conducted with 587 undergraduate nursing students. Sociodemographic data were evaluated using percentages and means. The relationship between smartphone addiction and communication skills and the relationship between phubbing behaviors and communication skills were evaluated with Pearson's correlation analysis. The effect of nursing students' smartphone addiction and phubbing behaviors on their communication skills was evaluated using multiple regression analysis. The mean age of the nursing students in the study was 20.47 ± 1.91 years, and 69.3% (n = 407) of the students were female. When the relationship between the communication skills of undergraduate nursing students and other variables was analyzed, it was found that there was a moderate, significant, and negative correlation with smartphone addiction (β = -0.314, P < .001) as well as with the status of phubbing behaviors (β = -0.503, P < .001). It was determined that there was a significant negative relationship between the communication skills of undergraduate nursing students and their smartphone addiction and the status of phubbing behaviors.