The relationship between problematic smartphone use and psychiatric symptoms among adolescents who applied to psychiatry clinics

Gender differences in symptom interactions between problematic smartphone use and social anxiety in adolescents: a network analysis

BACKGROUND

Increased prevalence of problematic smartphone use (PSU) in adolescents, results in a cycle of interaction between PSU and social anxiety. However, it is still unknown whether PSU and social anxiety symptoms have interacted among adolescents and whether there are gender differences in these symptoms. Therefore, this study investigated the gender differences in the symptom interactions between PSU and social anxiety via symptom network analysis.

METHODS

This study included 2918 adolescents (52.71% boys; Mage = 14.73, SDage = 1.39) from junior and senior high schools in China. The Mobile Phone Addiction Index and Social Anxiety Scale were used to evaluate symptomatology and networks. Network analysis and network comparison tests were used to determine the network structure, centrality, bridge symptoms and gender differences in the PSU-social anxiety network among adolescents.

RESULTS

The most influential symptoms were "productivity loss" and "afraid of negative evaluation". "Afraid of negative evaluation" was the bridge through which PSU was related to social anxiety. Gender differences were not found in network strength but occurred in network structure. Although girls reported more social anxiety, boys had a tighter network structure. The correlation between PSU and social anxiety was greater in boys than in girls. The "inability to control craving" was particularly critical for girls, while "feeling anxious and lost" was prominent for boys.

CONCLUSIONS

The current study highlights the symptom interactions between PSU and social anxiety among adolescents and the gender differences in network structures. Further intervention that targets "afraid of negative evaluation" may disassociate the interaction between PSU and social anxiety symptoms. In particular, changing girls' cognitive ability (e.g., inhibition) and boys' negative emotions are potentially effective means of intervention. The limitations of the cross-sectional design and data-driven methodology necessitate interpreting the results with caution.

The effect of digital game addiction on aggression and anger levels in adolescents: A cross-sectional study

PURPOSE

In this study, it was aimed to determine the effect of digital game addiction on aggression and anger levels in adolescents.

DESIGN AND METHODS

The participants of this cross-sectional study were adolescents. Data were collected using a socio-demographic questionnaire, Game Addiction Scale, and Buss-Perry Aggression Scale. Descriptive statistics, t-test, Anova, correlation and linear regression analysis were used in the analysis of the data.

RESULTS

In this study, game addiction and aggression levels of adolescents were determined as moderate. The game type that adolescents played the most was determined as war games with 35 %. The mean score of the Game Addiction Scale for male adolescents, those with medium and high income levels, those who play digital games for >8 h a day and every day, was found to be significantly higher. In this study, a positive and moderately significant correlation was found between Game Addiction Scale and Aggression Total Scale and Anger subscale (p < 0.05). Especially male gender (β = 0.273), high income status (β = -0.089), long time playing digital games (β = 0.173) and playing digital games every day (β = 0.360) were determined as predictors that increase game addiction.

CONCLUSIONS

Digital game addiction can trigger aggression and anger in adolescents. Nurses play a crucial role in screening and identifying adolescents at risk of game addiction to prevent aggression and anger.

PRACTICE IMPLICATIONS

According to the findings of this research, it is necessary to provide training and counseling to prevent digital game addiction in schools and to plan strategies by psychiatric nurses.

Network analysis of social anxiety and problematic mobile phone use in Chinese adolescents: A longitudinal study

Social anxiety is a common comorbid factor of problematic mobile phone use, but the relationship between them from the inside structure has been underexplored. This two-wave longitudinal study aims to identify the central symptoms of problematic mobile phone use and social anxiety, respectively, as well as the bridge symptoms between the two disorders. Furthermore, this study examined the time and gender differences. A total of 3,294 Chinese adolescents were recruited during two waves (T1: January 2023; T2: August 2023), and completed the questionnaires of social anxiety and problematic mobile phone use. Through network analysis, the results showed that 1) the central symptom of problematic mobile phone use was "loss of control" both at T1 and T2, 2) the central symptom of social anxiety was "fear of negative evaluation" both at T1 and T2, and 3) the bridge symptom between social anxiety and problematic mobile phone use was "withdrawal" both at T1 and T2. Moreover, the network comparison test indicated that the nodes of social anxiety were more strongly associated with "craving", "loss of control", and "negative life consequences" of problematic mobile phone use at T2 than at T1. The nodes of social anxiety were more strongly associated with "negative life consequences" of problematic mobile phone use for boys than for girls, while the "fear of negative evaluation" was more strongly associated with "loss of control" for girls than for boys. These findings provide new scientific basis for interventions targeting adolescents who are susceptible to social anxiety and problematic mobile phone use.

Associations of problematic smartphone use with depressive symptoms and suicidal ideation in university students before and after the COVID-19 outbreak: A meta-analysis

BACKGROUND AND AIM

Problematic smartphone use (PSU) has been suggested to present with depressive symptoms and suicidal ideation (SI) as well as sleep disturbance, lack of social support, and emotional isolation. The aim of this systematic review and meta-analysis was to evaluate the association between PSU with depressive symptoms and SI in university students, and to determine the potential influence of the coronavirus disease 2019 (COVID-19) outbreak.

METHODS

Observational studies pertinent to our research were identified through comprehensive searches of the PubMed, Embase, Cochrane Library, and Web of Science databases. To account for potential heterogeneity, the random-effects models were employed to aggregate the findings.

RESULTS

Eighteen datasets from 17 case-control studies, including 24,019 university students, were included. Among them, 8,775 (36.5 %) had PSU. A higher prevalence of depressive symptoms (odds ratio [OR]: 2.40, 95 % confidence interval [CI]: 2.19 to 2.63, p < 0.001; prediction interval: 1.95 to 2.96) was observed in university students with higher scores for PSU measures. A subgroup analysis showed a stronger association between PSU and depressive symptoms after the COVID-19 outbreak as compared to that before the outbreak (OR: 2.76 versus 2.16, p for subgroup difference = 0.002), which explained the heterogeneity. The association between PSU and depressive symptoms in university students was similar to those reported in studies from China and other countries, and in studies with different quality scores. Finally, a meta-analysis of three studies suggested that PSU was also associated with the prevalence of SI (OR: 2.18, 95 % CI: 1.77 to 2.68, p < 0.001; I2 = 0 %).

CONCLUSION

In university students, PSU may be a risk factor for depressive symptoms and SI, and the association between PSU and depressive symptoms became stronger after the COVID-19 outbreak.

Relationship between bruxism and smartphone overuse in young adults

OBJECTIVE

To evaluate the possible relationship between bruxism and smartphone overuse and assess the potential role of anxiety and depression in this relationship. The null hypothesis was that there was no significant difference between sleep bruxism (SB) and/or awake bruxism (AB) and non-bruxers in the level of smartphone overuse, anxiety, and depression.

METHODS

In total, 167 dental students were included in this study. They were evaluated using the American Academy of Sleep Medicine (AASM) criteria, Smartphone Addiction Scale (SAS), Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI). T-test and chi-square test were used to compare the means and percentages between groups.

RESULTS

A higher percentage of sleep bruxers were high smartphone users (60.3%) compared to non-SBs (44.2%). The frequencies of high smartphone users among participants with high anxiety and depression were higher than those with low anxiety and depression.

CONCLUSION

SB and high smartphone use were positively associated.

Smartphone addiction and postural alterations in the cervical region in adolescents

OBJECTIVE

To evaluate smartphone addiction and postural alterations in the cervical region in adolescents.

METHODS

A cross-sectional study with 281 adolescents (15 to 19 years old), attending the 1st to the 3rd grades of High School, carried out between September and October 2019 in the city of Fortaleza, Ceará, Brazil. Data collection took place in two stages. In the first, they answered four self-administered questionnaires: sociodemographic questionnaire, health conditions and smartphone use, Nordic Musculoskeletal Symptom Questionnaire (NMQ), Self-Report Questionnaire (SRQ-20) and the Smartphone Addiction Inventory (SPAI-BR). In the second stage, they were submitted to photogrammetry using the Postural Assessment Software (SAPO) and anthropometric assessment (weight and height). The software SPSS Statistics version 23.0 was used for data analysis.

RESULTS

Of the total number of adolescents, 63.3% (n=178) showed smartphone addiction, using it for 5.8 hours (±3.5) during the week and 8.7 (±4.0) hours on the weekend. When analyzing postural alignment in the anterior view, a significant reduction in the lateral head tilt was observed when typing on the smartphone (p=0.002) compared to the anatomical position (baseline). In the lateral view, an increase in head anteriorization was observed during smartphone use (p<0.05). There was an association between smartphone addiction and head anteriorization (p<0.05).

CONCLUSIONS

The use of the smartphone in the typing position causes postural alterations in the cervical region, especially in adolescents with smartphone addiction. Therefore, health promotion measures that alert adolescents to the adverse effects caused by prolonged smartphone use are necessary.

Emotion dysregulation factors associated with problematic smartphone use severity: The mediating role of fear of missing out

Based on current theoretical frameworks, there has been increasing research examining psychopathology leading to problematic smartphone use (PSU). However, less is known about the affective and cognitive processes linked to PSU. The present study aimed at analyzing the fear of missing out (FoMO) as a mediator in the association between emotion dysregulation and PSU severity. Participants were 343 U.S. undergraduate students (64.7  % female, Mage = 19.3, SD = 2.51) who completed online measures of emotion dysregulation, FoMO and PSU. A fully latent structural equation model was analyzed. Results indicate greater impulse control dysregulation was associated with heightened PSU via increased FoMO. Our findings present evidence suggesting emotion dysregulation and FoMO as affective and cognitive mechanisms associated with PSU, with FoMO serving a mediating role between impulse control and PSU severity. Clinical implications are discussed.

The association between problematic smartphone use and symptoms of anxiety and depression-a meta-analysis

BACKGROUND

Recent research links problematic smartphone use (PSU) and mental health problems. The purpose of this meta-analysis was to evaluate the relationship between PSU and symptoms of anxiety and/or depression.

METHODS

We searched for research literature published recently in PubMed and Google Scholar via a systematic literature search. Twenty-seven studies published since 2014 with 120 895 participants were included in the meta-analysis.

RESULTS

PSU was moderately but robustly associated with both anxiety, r = 0.29 (95% CI: 0.23-0.35), and depression, r = 0.28 (95% CI: 0.22-0.34), P < 0.001 for both. Homogeneity tests showed significant P-values for anxiety and depression, but without affecting the results. Neither the age of the participants, publication year nor the study quality could explain the heterogeneity. Furthermore, we found no evidence for publication bias, since Egger's regression test showed no significance for depression (P = 0.21) and anxiety (P = 0.35).

CONCLUSIONS

Our study shows that PSU can be viewed as an indicator of symptoms of anxiety and depression and a possible manifestation of these mental health problems in modern society. Furthermore, PSU as a maladaptive coping behavior may contribute by worsening these symptoms. PSU screening should thus become part of standard clinical psychological diagnostic procedures.

A Bibliometric Analysis to Identify Research Trends in Intervention Programs for Smartphone Addiction

Smartphone addiction is a serious social problem that necessitates research. To identify trends in intervention programs for smartphone addiction, distribution of research topics, and inter-relationships in academic research. We analyzed 104 studies published between 30 June 2022, and 31 August 2022, on the Web of Science (WoS). We applied the bibliometric method and identified the relationship and development trends of academic research in the field using descriptive analysis, the Latent Dirichlet Allocation (LDA), co-citation analysis, bibliographic coupling, and co-occurrence. There were four findings: First, intervention programs are classified into 10 types: psychological, social support, lifestyle, technological, family, medical care, educational, exercise, mindfulness, and meditation. Second, the volume of research on intervention programs increased every year. Third, China and South Korea had the highest research involvement. Finally, academic studies were split into either the human behavior or social science categories. Most of them defined the symptoms in terms of individual behavior and social relations, implying that smartphone addiction is not yet recognized as a disorder. Smartphone addiction has not yet been internationally recognized as a disorder, despite its impact on human physiology, psychology, and social behavior. Most related studies have been conducted in Asia, specifically in China and South Korea; Spain has the most outside Asia. Additionally, most of the research subjects were students, probably because of the convenience of sampling. As smartphones gain popularity among older adults, future studies could focus on smartphone addiction among individuals of varied ages.

Impact of Coding Educational Programs (CEP) on Digital Media Problematic Use (DMPU) and on Its Relationship with Psychological Dependence and Emotional Dysregulation

Alongside the positive effects linked to the introduction of digital technologies into our lives, particular dysfunctional behaviors in the use of digital tools have appeared, through which the expression of conditions such as addiction, difficulties in affective and behavioral self-regulation and mental health problems have been channeled. The present study aims to investigate, in a sample of young students aged m = 12.91 (ds = 0.56) years, whether Coding Educational Programs (CEP), deployed to 44.9% of the sample, is effective in psychological dependence, emotional self-regulation and Digital Media Problematic Use (DMPU), as self-assessed through questionnaires (DERS, DSRS, IAT, MPIQ and MPPUS). CEP had no effect on emotional dysregulation or on DMPU. They were effective in the time management of mobile phone use, with students rescheduling from daytime use on working days to daytime use on the weekend. Moreover, people who attended CEP more frequently used smartphones for orienting themselves and for obtaining information. In conclusion, CEP are effective in achieving a more functional and important use of smartphones and better time management. It is possible that CEP effect on metacognition could reduce DMPU if alternative ways to regulate emotions are available.

Review: Digital experiences and their impact on the lives of adolescents with pre-existing anxiety, depression, eating and nonsuicidal self-injury conditions - a systematic review

BACKGROUND

Published systematic reviews provide evidence linking positive and negative digital experiences to adolescent mental health. However, these reviews focus on the general public rather than the digital experiences of adolescents with different pre-existing mental health conditions and so may be limited in their clinical relevance. We review publications relating to anxiety, depression, eating disorders and nonsuicidal self-injury to identify common and condition-specific digital experiences and how these may be implicated in the origins and maintenance of these mental health conditions.

METHODS

A systematic literature search using a combination of mental health, digital experience (including social media use), and age of the target population terms was conducted on four databases. Detailed findings from the included studies were summarised using a combination of thematic and narrative methods.

RESULTS

Five qualitative and 21 quantitative studies met the eligibility criteria for inclusion (n = 5021). Nine studies included adolescents with depression, one with eating problems, two with nonsuicidal self-injury and 14 with multiple emotional health conditions. The review identified six themes related to the target populations' digital experiences: (a) social connectivity and peer support; (b) escape and/or distraction; (c) social validation and social comparison; (d) accessing/creation of potentially harmful content; (e) cyberbullying; and (f) difficulties with self-regulation during engagement with digital media.

CONCLUSIONS

Digital practices of adolescents with pre-existing clinical vulnerabilities are complex and encompass a range of positive and negative experiences, which appear to have common elements across different clinical populations. The literature is currently too limited to identify disorder-specific practices, with too few direct or indirect comparisons between conditions.

Heterogeneity of smartphone impact on everyday life and its relationship with personality and psychopathology: A latent profile analysis

BACKGROUND

The relationships between problematic smartphone use and psychological factors have been extensively investigated. However, previous studies generally used variable-centered approaches, which hinder an examination of the heterogeneity of smartphone impact on everyday life.

OBJECTIVE

In the present study, we capitalized on latent profile analysis to identify various classes of smartphone owners based on the impact associated with smartphone use (e.g., unregulated usage, preference for smartphone-mediated social relationships) and to compare these classes in terms of established psychological risk factors for problematic smartphone use.

METHOD

We surveyed 934 young adults with validated psychometric questionnaires to assess the impact of smartphones, psychopathological symptoms, self-esteem and impulsivity traits.

RESULTS

Smartphone users fall into four latent profiles: users with low smartphone impact, users with average smartphone impact, problematic smartphone users, and users favoring online interactions. Individuals distributed in the problematic smartphone user profile were characterized by heightened psychopathological symptoms (stress, anxiety, depression, obsessive-compulsive tendencies) and impulsivity traits. Moreover, users who preferred online interactions exhibited the highest symptoms of social anxiety and the lowest levels of self-esteem.

CONCLUSIONS

These findings further demonstrate the multidimensionality and heterogeneity of the impact of smartphone use, calling for tailored prevention and intervention strategies.

Unpacking the relation between children's use of digital technologies and children's well-being: A scoping review

Over the last decade, a substantial number of studies have addressed children's use of technologies and their impact on well-being. Nonetheless, there is still a lack of clarity on the operationalisation of technology use, well-being, and the relation between the two. This scoping review intended to shed lights on Digital Technologies Use, its operationalisation, and the relation between Digital Technologies Negative Use (DTNU) and children's well-being. For the scope of the special issue we focused on negative use. Results showed two conceptualisations of DTNU: compulsive/addictive use of devices and the Internet (e.g., Internet addiction) and negative online experiences/risky behaviours (e.g., cyberbullying). Well-being in relation to DTNU was mainly studied in terms of psycho/social dimensions (e.g., depression), and a gap in cognitive well-being studies was identified. Study designs were largely quantitative, and, in most studies, well-being was considered as a predictor of DTNU. Also, research with children under 12 years was lacking. Future research on DTNU should look at: how dimensions of addiction and negative online experiences relate; provide more evidence on cognitive well-being; explore the interplay of well-being multiple components relying on integrative conceptual frameworks. The recent notion of digital well-being should also be explored considering the results of this review.

Associations between smartphone use and mental health and well-being among young Swiss men

BACKGROUND AND AIMS

Intense use of smartphones is associated with mental health problems and low well-being. However, little is known about the mental health and well-being of non- and low-level users. This study investigated the possibly non-linear associations between time spent using a smartphone, including non-users, and mental health and well-being among young adults.

METHODS

Between 2016 and 2018, 5315 young Swiss men (M = 25.45 years old, SD = 1.25) completed a questionnaire assessing smartphone use, daily time spent using a smartphone, mental health and well-being (i.e. depression, social anxiety, attention deficit hyperactivity disorder, life satisfaction, stress) and potential confounding variables (social capital, personality, education). The associations of smartphone use and time spent using a smartphone (linear and quadratic associations) with mental health and well-being were tested using regression models.

RESULTS

Non-users (4.3%) reported worse mental health and well-being than smartphone users on all outcomes. Time spent using a smartphone was linearly associated with higher rates of social anxiety, depression, attention deficit hyperactivity disorder and lower levels of life satisfaction. The association with stress was non-linear, with significant linear and quadratic coefficients of time spent using a smartphone. Associations were partially attributable to confounding variables (i.e. social capital, personality, and education).

CONCLUSIONS

Non-users and intense users of smartphones have lower levels of mental health and well-being than low-level users. Although society and mental health professionals are deeply concerned about the potentially negative consequences of the ever-increasing use of smartphones, the present study suggested that not using a smartphone may also indicate problems.

Reactions to naturalistic smartphone deprivation among psychiatrically hospitalized adolescents

The standard of care among youth who are psychiatrically hospitalized typically involves smartphone confiscation for the duration of treatment. However, very little is known regarding how youth respond to this period of smartphone "deprivation," factors that may influence this response, and ensuing clinical effects. The present exploratory mixed-methods study sought to elucidate the experience of psychiatrically hospitalized adolescents as it relates to smartphone deprivation, and to evaluate the impact of this widespread treatment approach. Psychiatrically hospitalized adolescents (N = 181; Mean age = 15.29 years) completed qualitative and quantitative measures assessing the experience of smartphone deprivation during hospitalization. Associations among reactions to smartphone deprivation and smartphone and social media use patterns were explored. Analyses additionally evaluated whether reactions to smartphone deprivation were associated with clinical symptom severity (e.g., suicidal ideation, internalizing and externalizing symptoms) and readiness for psychotherapy. Negative reactions to smartphone deprivation were significantly positively correlated with daily smartphone hours, addictive patterns of use, and both negative and positive emotional responses to social media use. Reactions to smartphone deprivation were not associated with clinical symptom severity. However, negative reactions to smartphone deprivation were associated with lower readiness for therapy, while positive reactions were associated with greater readiness. This preliminary work illustrates the complexities of smartphone use in adolescents and the potential positive and negative effects of smartphone deprivation during psychiatric hospitalization. Future prospective research with adolescents should clarify optimal smartphone access during inpatient hospitalization.

Problematic smartphone use and functional somatic symptoms among adolescents: Mediating roles of depressive symptoms and peer relationships by gender

This study explored the relationship between problematic smartphone use and depressive symptoms, peer relationships, and functional somatic symptoms with a representative sample of Korean male and female adolescents using serial multiple mediation models. The results identified the mediating effect of depressive symptoms and peer relationships for males in the association between problematic smartphone use and FSS. The serial mediating effect of the two mediators was also verified in the model for males. However, in the model for females, only depressive symptoms mediated the relationship between problematic smartphone use and FSS. The findings suggest that parents and professionals should assess adolescents with problematic smartphone use for the risk of FSS when depressive symptoms develop. Schools should also provide programs to build positive peer relationships to reduce FSS.

Protective and risk factors of problematic smartphone use in preteens using panel study on Korean children

Background

Increased smartphone use by children and adolescents places them at higher risk of overdependence. The problematic smartphone use of preteens is rapidly increasing. The preteen period is one of considerable developmental change and the influence of problematic smartphone use should be identified by reflecting on this change and considering its social psychological factors.

Methods

This study employed a secondary analysis using data from the 10th (2017) to 11th (2018) wave of the Panel Study on Korean Children. STATA/BE 17 was used to analyze the panel logit model. Among the 1,286 participants aged 9-10 from the Panel Study on Korean Children, 342 with complete responses were selected as the participants of this study.

Results

The risk group for problematic smartphone use showed an increase from 126 in 2017 to 149 in 2018. Factors influencing risk of preteens' problematic smartphone use were the child's externalizing problems (p = 0.015) and permissive parenting behavior (p = 0.003). Protective factors influencing preteens' problematic smartphone use were peer communication (p = 0.023), parental supervision (p = 0.020), and authoritative parenting behavior (p = 0.001).

Conclusions

Preteens with externalizing problems are at a higher risk for problematic smartphone use and are therefore a group to be observed with caution. It is also required to guide them to form good relationships with friends. Finally, in the problematic smartphone use of preteens, parents are both a protective factor and a risk factor. Therefore, guidance is required so that children can behave properly.

Internet Addiction, Phubbing, Psychological Variables and Self-Perception of Mathematical Competence in College Students

Internet Addiction (IA) and phubbing are prevalent, disruptive behaviours among university students. The aim of this study was to explore the relationship between IA and Phubbing with psychological variables (impulsiveness, self-esteem, and psychological distress), academic performance and self-perception of mathematical competence (SMC), as well as possible gender differences. Results showed (n = 715; Mean Age = 21.7) gender differences in lack of planning, emotional investment and somatisation and IA correlated positively with app addiction, mobile addiction, and psychopathology. A total of 26.3% of IA can be explained by a lack of self-control, time and performance management, mobile phone addiction, anxiety and psychological distress. Finally, 71% of students believe that the use of new technologies has worsened their SMC and this is correlated with impaired communication, obsession with mobile phones, IA (Total Phubbing Scale) and impulsiveness. Our results indicate the importance of taking into account psychological variables that affect the development of IA, phubbing, and SMC in the university population.

Effects of psychiatric symptoms, age, and gender on fear of missing out (FoMO) and problematic smartphone use: A path analysis with clinical-based adolescent sample

BACKGROUND

Fear of missing out (FoMO) is a kind of anxiety that arises from FoMO on rewarding online social experiences that others might be having. Recent studies demonstrated that there is a strong relationship between FoMO and problematic smartphone use (PSU). In this study, we aimed to address the relationship between age, gender, psychiatric symptoms, PSU, and FoMO among a clinical-based adolescent sample.

METHODS

In total, 197 adolescents (136 boys, 12-18 years) who applied to psychiatry clinics were recruited in the study. Path analysis with observed variables was used to investigate the relationships of PSU and FoMO with each other and with psychiatric symptoms (somatization, obsession-compulsion, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism), age, and gender.

RESULTS

Path analysis showed that age (B₁ = 2.35, P < 0.001), somatization (B₁ = 1.19, P < 0.001), hostility (B₁ = 0.92, P = 0.001), and paranoid ideation (B₁ = 0.93, P = 0.005) have significant positive effect on PSU, when interpersonal sensitivity has a significant negative effect (B₁ = -1.47, P < 0.001). For FoMO, male gender (B₀ = 0.35, P < 0.001), anxiety (B₁ = 1.37, P < 0.001), and PSU have positive effects, whereas age (B₁ = -1.60, P < 0.001), depression (B₁ = -0.58, P = 0.004), and hostility (B₁ = -0.49, P = 0.001) have a negative effect.

CONCLUSIONS

Our study demonstrated that although PSU and FoMO are closely related to each other in previous studies, they have different associations with age, gender, and psychiatric symptoms among a clinical-based adolescent sample. The positive effects of PSU, anxiety on FoMO are predictable; however, the negative effect of age, hostility, and depression on FoMO was interesting. These relationships could be related to social exclusion-hostility and impulsivity-male gender/younger age associations in adolescence. In addition, we did not find a significant effect of FoMO on PSU, this could be related to the social and non-social use of smartphones, and should be reevaluated in clinical samples in the future.

Network analysis of depressive and anxiety symptoms in adolescents during and after the COVID-19 outbreak peak

BACKGROUND

This study examined the extent to which the network structure of anxiety and depression among adolescents identified during the peak of the COVID-19 pandemic could be cross-validated in a sample of adolescents assessed after the COVID-19 peak.

METHODS

Two cross-sectional surveys were conducted between February 20 and 27, 2020 and between April 11 and 19, 2020, respectively. Depressive and anxiety symptoms were assessed using the 20-item Center for Epidemiological Studies-Depression and 7-item Generalized Anxiety Disorder, respectively. Anxiety-depression networks of the first and second assessments were estimated separately using a sparse Graphical Gaussian Model combined with the graphical least absolute shrinkage and selection operator method. A Network Comparison Test was conducted to assess differences between the two networks.

RESULTS

The most central symptoms in the first and second survey networks were Depressed affect and Nervousness. Compared with connections in the first survey network, connections in the second survey network analysis between Relax-Nervousness-Depressed affect-Interpersonal problems (diff, contrast: second survey-first survey. diff=-0.04, P = 0.04; diff=-0.03, P = 0.03; diff=-0.03, P = 0.04), and Irritability-Somatic complaints (diff=-0.04, P = 0.02) were weaker while connections of Somatic complaints-Nervousness (diff=0.05, P<0.001), Somatic complaints-Depressed affect (diff=0.03, P = 0.009), and Irritability-Control worry-Restlessness (diff=0.02, P = 0.03; diff=0.05, P = 0.02) were stronger.

CONCLUSIONS

Depressed affect emerged as a robust central symptom and bridge symptom across Anxiety-Depression networks. Considering the negative impact of depression and anxiety on daily life, timely interventions targeting depressed affect should be implemented to reduce the co-occurrence of anxious and depressive symptoms among adolescents during the COVID-19 pandemic.

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.

Psychological distress, rumination and problematic smartphone use among Spanish adolescents: An emotional intelligence-based conditional process analysis

BACKGROUND

Problematic smartphone use (PSU) is a public health issue that is currently rising among adolescents. The Compensatory Internet Use Theory (CIUT) poses that difficulties in handling negative life circumstances could result in PSU. Furthermore, the Interaction of Person-Affect-Cognition-Execution (I-PACE) model suggests that the interaction between core characteristics and affective and cognitive responses could lead to PSU. The present study aimed to clarify the links between psychological distress and PSU by exploring rumination as a mediator and emotional intelligence (EI) as a moderator.

METHODS

A sample of 1882 adolescents (54% female, 46% male) completed measures of psychological distress, rumination, EI and PSU. The PROCESS macro was used to conduct a moderated mediation analysis.

RESULTS

The mediation results showed a significant indirect effect from psychological distress to PSU through rumination. Furthermore, EI was a significant moderator of this effect. Thus, in adolescents with higher EI, the effect of psychological distress on PSU through rumination was not significant.

LIMITATIONS

Cross-sectional data do not imply causality and further studies should use longitudinal designs. Self-report questionnaires may be susceptible to social desirability bias and future studies including other sources of information may help to minimize such bias.

CONCLUSIONS

This study contributes to the field of problematic digital technology usage, showing that the link between psychological distress and PSU depends on the EI levels, which might influence PSU indirectly through rumination. Furthermore, empirical evidence for the CIUT and I-PACE models was provided. Lastly, interventions aiming at training EI may aid in the prevention of PSU.

Understanding Adolescents' Perceptions and Aspirations Towards Their Relationship With Personal Technology: Survey Study

BACKGROUND

Understanding adolescents' relationship with technology is a pressing topic in this digital era. There seem to be both beneficial and detrimental implications that originate from use of technology by adolescents. Approximately 95% of adolescents have access to a smartphone, and several studies show a positive correlation between screen addiction and trends of anxiety and depression. At the same time, research shows that two-thirds of adolescents believe that technology is a necessity for connecting and making new friends.

OBJECTIVE

The aim of this formative study was to understand adolescents' perception of their own and others' relationship with personal technology.

METHODS

A survey was conducted with 619 adolescents ranging in age from 13 to 19 years. Adolescents were asked how they perceived the relationship with their personal technology, how they perceived others' (parents, siblings, or friends) relationship with personal technology, and how they wish to relate to their personal technology in the future.

RESULTS

"Essential," "Distractive," and "Addictive" were the most commonly selected descriptors to describe both adolescents' own relationship with technology (essential: 106/619, 17.1%; distractive: 105/619, 17%; addictive: 88/619, 14.2% ) and others' relationship as well (essential: 96/619, 15.6%; distractive: 88/619, 14.3%; addictive: 90/619, 14.5%). Adolescents selected "Provides an escape" more to describe their own relationship with technology. Whereas, they selected "It's just a tool" and "Creates Barrier" more to describe others' relationship with technology. These trends are consistent across ages and genders. In addition, adolescents' aspirations for their relationship with their personal technology varied across ages: 13 to 15-year olds' top choice was "best friend", 16 to 17-year olds' top choice was "I don't believe in personal connection with mobile technology," and 18 to 19-year olds' top choice was "My personal assistant."

CONCLUSIONS

Our 3-lens method allows us to examine how adolescents perceive their relationship with personal technology in comparison to others, as well as their future technological aspirations. Our findings suggest that adolescents see both communalities as well as differences in their own and others' relationships with technology. Their future aspirations for personal technology vary across age and gender. These preliminary findings will be examined further in our follow-up research.

Problematic Cellular Phone Use: A Factor Analysis

Background — Increasing access to smartphones has led some researches to focus in this regard. Objective — the current study aimed to determine psychometric properties of the Persian version of Problematic Cellular Phone Use Questionnaire (PCPU-Q) among medical student at Kerman University of Medical Sciences. Material and Methods — A cross-sectional study carried out on 351 medical students. Data collected using a questionnaire including demographic data and the Persian versions of PCPU-Q. The higher score indicates a greater problem. Data analyzed by SPSS 20 and Lisrel 8.8. Cronbach’s alpha and intraclass correlation coefficient (ICC) and exploratory/confirmatory factor analysis used for determining the reliability and construct validity of the questionnaire, respectively. Results — One hundred and seventy-two (49.0%) of the students had a problematic CPU. Cronbach’s alpha and ICC were 0.8 and 0.91, respectively. The model had acceptable goodness of fit indices in confirmatory factor analysis. Conclusion — The Persian version of PCPU-Q had good psychometric properties and can be useful for screening of problematic CPU among Iranian youth.

Factors related to smartphone addiction in adolescents from a region in Northeastern Brazil

Adverse effects on the physical and mental health of adolescents associated with excessive smartphone use have been reported. This paper aims to assess adolescent smartphone addiction and related factors in a region in Northeastern Brazil. This cross-sectional study was carried out in six State-run Professional Education Schools in Fortaleza, Ceará, Brazil, from September to October 2019 with 286 adolescents aged 15-19 years who completed five data collection instruments. Bivariate and multivariate analyses were performed to assess factors related to the outcome using SPSS version 23.0. Smartphone addiction prevalence rate was 70,3% and was associated with being underage (OR=0,583; p=0,001), fewer sleep hours (OR=0,715; p=0,020), longer use on weekends (OR=1,115; p=0,015), cervical pain (OR=2,206; p=0,020), and suspected common mental disorder (OR=1,272; p=0,000). A high smartphone addiction level was observed among adolescents in the sample and was related to multiple factors. Attention should be drawn to the importance of educational campaigns to guide adolescents, parents, educators, and health professionals about the risks of excessive smartphone use to the health of adolescents.

Smartphone Use and Its Addiction among Adolescents in the Age Group of 16-19 Years

Background:

Smartphone use is escalating among adolescents, thereby increasing the risk of its addiction among them.

Objective:

The objective of this study was to estimate the prevalence of smartphone use and its addiction among adolescents in 16–19 years of age group.

Materials and Methods:

An observational cross-sectional study was conducted among 496 students in the age group of 16–19 years. Relevant information was collected using a self-administered questionnaire and the Smartphone Addiction (SA) Scale. Chi-square test and logistic regression were applied to study the association between independent and dependent variables.

Results:

Smartphone use was found to be 83.9%. It was associated with age, area of residence, discipline, use of hands-free kit, and parents' education and income. The smartphone addiction rate was reported to be 37%. It was found to be associated with age, area of residence, place of education, duration of smartphone use, daily hours of use, perception that cellphone use is harmful to health, and parents' education and income.

Conclusion:

A high rate of SA among adolescents warrants effective strategies at local, state, and national level to address this growing health problem in this population.

Current Research and Viewpoints on Internet Addiction in Adolescents

PURPOSE OF REVIEW

This review describes recent research findings and contemporary viewpoints regarding internet addiction in adolescents including its nomenclature, prevalence, potential determinants, comorbid disorders, and treatment.

RECENT FINDINGS

Prevalence studies show findings that are disparate by location and vary widely by definitions being used. Impulsivity, aggression, and neuroticism potentially predispose youth to internet addiction. Cognitive behavioral therapy and medications that treat commonly co-occurring mental health problems including depression and ADHD hold considerable clinical promise for internet addiction.

SUMMARY

The inclusion of internet gaming disorder in the DSM-5 and the ICD-11 has prompted considerable work demonstrating the validity of these diagnostic approaches. However, there is also a movement for a conceptualization of the disorder that captures a broader range of media-use behaviors beyond only gaming. Efforts to resolve these approaches are necessary in order to standardize definitions and clinical approaches. Future work should focus on clinical investigations of treatments, especially in the USA, and longitudinal studies of the disorder's etiology.

Internet Addiction and Related Clinical Problems: A Study on Italian Young Adults

The considerable prominence of internet addiction (IA) in adolescence is at least partly explained by the limited knowledge thus far available on this complex phenomenon. In discussing IA, it is necessary to be aware that this is a construct for which there is still no clear definition in the literature. Nonetheless, its important clinical implications, as emerging in recent years, justify the lively interest of researchers in this new form of behavioral addiction. Over the years, studies have associated IA with numerous clinical problems. However, fewer studies have investigated what factors might mediate the relationship between IA and the different problems associated with it. Ours is one such study. The Italian version of the SCL-90 and the IAT were administered to a sample of almost 800 adolescents aged between 16 and 22 years. We found the presence of a significant association between IA and two variables: somatization (β = 7.80; p < 0.001) and obsessive-compulsive symptoms (β = 2.18; p < 0.05). In line with our hypothesis, the results showed that somatization predicted the relationship between obsessive-compulsive symptoms and IA (β = -2.75; t = -3.55; p < 0.001), explaining 24.5% of its variance (ΔR ² = 1.2%; F = 12.78; p < 0.01). In addition, simple slopes analyses revealed that, on reaching clinical significance (+1 SD), somatization showed higher moderation effects in the relationship between obsessive-compulsive symptoms and IA (β = 6.13; t = 7.83; p < 0.001). These results appear to be of great interest due to the absence of similar evidence in the literature, and may open the way for further research in the IA field. Although the absence of studies in the literature does not allow us to offer an exhaustive explanation of these results, our study supports current addiction theories which emphasize the important function performed by the enteroceptive system, alongside the more cited reflexive and impulsive systems.

The relationship between maladaptive personality functioning and problematic technology use in adolescence: A cluster analysis approach

In the last two decades, scientific research has explored the problematic use of internet, videogames and mobile phones. However, there is still little consistent knowledge regarding the co-occurrence of problematic technology use and the role of maladaptive personality characteristics in adolescence. The present study aimed to investigate adolescents' styles of technology use with a cluster analysis approach focusing on personality functioning. The sample comprised 408 Italian adolescents (46.3% males) aged 11 to 18 years (M _age  = 13.80; SD = 2.08). Data were collected using the Internet Addiction Test, the Videogame Dependency Scale, the Test of Mobile-Phone Dependence Brief Form and the Personality Inventory for DSM5 Brief Form. Results provided a four-cluster solution based on the co-occurrence of problematic technology use. The four clusters were labeled as follows: cluster 1: "Above average internet and mobile-phone use"; cluster 2: "Below average technology use"; cluster 3: "Above average videogame use"; and cluster 4: "Problematic technology use." Analyses on demographic variables (e.g., gender and age) demonstrated significant differences between the four groups. Adolescents with high levels of problematic technology use reported greater overall personality dysfunction than the other three groups. This finding supported our hypothesis on maladaptive personality functioning in adolescents at risk for addiction. Finally, the Antagonism domain played a specific role in differentiating the severity of adolescents' involvement in technology use. Further studies are needed to confirm our findings and to plan preventive interventions as well as therapeutic treatments.

Examining bi-directionality between Fear of Missing Out and problematic smartphone use. A two-wave panel study among adolescents

BACKGROUND

In recent years, the Fear of Missing Out (FoMO) construct has been the object of growing attention in digital technology research with previous studies finding support for the relationship between FoMO and problematic smartphone use (PSU) among adolescents and young adults. However, no previous studies clarified the causal link between FoMO and PSU using a longitudinal design.

METHODS

An auto-regressive, cross-lagged panel design was tested by using a longitudinal dataset with two waves of data collection (T0 and T1, one year apart). Participants included two hundred and forty-two adolescents (109 males and 133 females), with a mean age of 14.16 years, who filled out the Fear of Missing Out scale (FoMOs) and the Smartphone Addiction Scale (SAS). Moreover, participants filled out the Difficulties in Emotion Regulation Scale (DERS), at the first time-point of data collection.

RESULTS

The findings of the study show that FoMO (both FoMO-Fear and FoMO-Control subscales) and PSU are positively related at both time-points (i.e. at a cross-sectional level). However no cross-lagged associations between them were longitudinally supported. Females and older adolescents show higher FoMO-Fear at T1.

CONCLUSIONS

The findings of the present study suggest caution when causal links between FoMO and PSU are inferred.

Depression, anxiety and fear of missing out as correlates of social, non-social and problematic smartphone use

Few studies have examined mental health variables in relation to social vs. non-social smartphone use, and how such types of use relate to problematic smartphone use (PSU). We conducted a web survey of 316 American undergraduate students about severity of depression, anxiety, fear of missing out (FOMO), social and non-social smartphone use, and PSU. Using structural equation modeling, we found that compared to social smartphone use, non-social use was more strongly linked with severity of PSU (β = 0.18, p < .05) and FOMO (β = 0.24, p < .05). FOMO mediated relations between depression severity and non-social smartphone use (β = 0.09, p = .04). Furthermore, FOMO mediated relations between both depression (β = 0.23, p < .001) and anxiety (β = 0.16, p = .04) with PSU severity. We discuss non-social smartphone use as a possible avoidance strategy among anxious individuals, and the role of FOMO in individuals desiring social connectedness but also feeling socially anxious. Results are discussed in the context of a comprehensive theoretical model on pathways toward excessive internet use.

A Marketing Approach to a Psychological Problem: Problematic Smartphone Use on Adolescents

Background: Smartphones have become an indispensable part of the daily lives of adolescents in the 21st century, which is characterized by a highly digitized modern world. Besides their many advantages, smartphones might pave the way to compulsive usage and addictive experiences. To remedy this problem, this study proposes an authentic approach which integrates consumer behavior theories and techniques such as unhook and gamification. An education program has been designed based on these approaches to decrease the problematic smartphone use. Method: The participants of the education program consisted of 305 students (48.2% girls and 51.8% boys) with a mean age of 14.57 (SD = 0.74). The Demographic Form and Smartphone Addiction Scale for Adolescents (SASA) were conducted before the education program and three weeks after the education. Results: The results of the paired sample t-test analysis before and after the education program revealed that the SASA total scores decreased significantly (p < 0.01). There are significant differences in terms of gender, mothers’ education and class levels. Conclusion: This research emphasizes the role of an interdisciplinary approach to the addiction problem. The content used in the education program includes strategies that originally aimed at increasing consumption. The effectiveness of the program can be enhanced further in the future along with self-regulatory additions.

Social media usage and alexithymia in nursing students

PURPOSE

To determine the relationship between social media usage characteristics and alexithymia in nursing students.

DESIGN AND METHODS

The study was conducted with 272 nursing students between November and December 2018 in Turkey. Data were collected using an information form to determine the sociodemographic and social media usage characteristics of the students, and the Toronto Alexithymia Scale.

FINDINGS

According to the results of this study, nursing students use Instagram the most. As time spent on social media increases, the alexithymia score increases and students have difficulty recognizing their feelings.

PRACTICE IMPLICATIONS

As the use of social media by nursing students affects their mental process and behavior patterns, the results of social media applications, which witness a wide range of feelings, thoughts, attitudes, and behaviors, should be included in the nursing curriculum.

Association of problematic smartphone use with poor sleep quality, depression, and anxiety: A systematic review and meta-analysis

To quantitatively assess the association of problematic smartphone use (PSU) with poor sleep quality, depression, and anxiety, we reviewed current evidence from observational studies and performed a systematic review and meta-analysis. The EBSCO PsycARTICLES, EMBASE, PubMed and Web of Science databases were searched, and 14 studies were included for the systematic review and meta-analysis. We calculated odds risk and 95% confidence intervals (CIs), using random-effect or fixed-effect models. Heterogeneity was assessed using I² and chi² statistics. Subgroup analyses were conducted based on country, adjusted variables, the methods of statistical analysis, outcome measures and publication year. We found significantly increased risks of poor sleep quality, depression, and anxiety in people with PSU. Our findings highlight the necessity of managing the PSU. However, further studies are required to confirm the results due to the high heterogeneity and methodological limitations.

Predictive Risk Factors of Smartphone Addiction in Adolescents: A Systematic Review

Introduction: Smartphone addiction often occurs in adolescents. The purpose of this systematic review was to identify the predictors of smartphone addiction in adolescents.Methods: The method used in this systematic review consisted of 5 stages: (1) the identification of the instruments used in the literature (database search); (2) the identification of the relevant literature based on the title and abstract; (3) the inclusion and exclusion criteria; (4) getting the full-text literature and (5) grading based on the literature component and the analysis of the selected instruments. The databases used in the literature search were Scopus, PubMed, Science Direct and Springer Link from 2013 - 2018. The criteria for the included articles were that they used a cross-sectional design and involved adolescents as the sample.Results: 17 of 829 articles met the inclusion criteria. The predictors of smartphone addiction were broadly divided into 3, namely personal factors, interpersonal factors and behavioral factors. These 3 factors are related to one another.Conclusion: It is necessary to do further research within a case-control study to strengthen this systematic review.

Risk factors for problematic smartphone use in children and adolescents: a review of existing literature

BACKGROUND

The percentage of smartphone users-especially among minors-is growing, and so is the body of literature hinting at increasing rates of problematic smartphone use in children and adolescents. However, comprehensive reviews regarding this issue are still scarce.

OBJECTIVE

The main aim of this review was to provide an overview of studies focusing on specific risk factors predicting problematic smartphone use in children and adolescents.

METHODS

A literature search was conducted in Google Scholar and PubMed.

RESULTS

The search yielded 38 articles that met the criteria for inclusion in this review. Research regarding influencing factors such as gender, age, and social, family, and personality factors, as well as duration of use and use patterns, could be found. Results seem to cautiously suggest that using a smartphone for gaming and social networking might be risk factors, whereas having good friendships might constitute a protective factor. Also, female adolescents seem to be prone to a higher smartphone addiction risk than male adolescents. For family, school, and personality factors, results are still scarce, and more research is needed. Nevertheless, strict parenting, low self-control, and low self-esteem seem to increase risks for problematic use, whereas academic motivation and school success might decrease this risk.

CONCLUSION

A concise theoretical conceptualization of problematic smartphone use and corresponding standardized measures are needed to increase comparability of future studies and to thereby add to a clearer understanding of this contested concept.

A narrative Overview About Psychosocial Characteristics as Risk Factors of a Problematic Social Networks Use

Purpose of Review

Social networks use disorder describes the problematic use of social networking sites and online-communication applications. Social characteristic of social networks use emphasizes the special relevance of psychosocial factors and social cognitions in this context. The current review aims at summarizing findings on individual psychosocial characteristics to analyze the relevance of social processes as potential mechanisms of a social networks use disorder.

Recent Findings

The empirical overview illustrates that, aside from psychopathological factors, individual psychosocial characteristics and social cognitions as well as their interactions appear to be relevant risk factors for a problematic use of social networks. However, empirical findings are mixed.

Summary

We propose two hypotheses on the development of a potential social networks use disorder that might account for mixed results: the fear-driven/compensation-seeking hypothesis including compensatory use expectancies and the reward-driven hypothesis including positive use expectancies as key elements, both of which could lead to symptoms of social networks use disorder depending on interindividual differences in predisposing and reinforcing factors.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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