Types of problematic smartphone use based on psychiatric symptoms

Unveiling the grip of mobile phone addiction: an in-depth review

Mobile Phone Addiction represents an emergent addictive disorder that gravely jeopardizes the physical and mental health of adolescents worldwide, necessitating exhaustive research. Current reviews of MPA are in dire need of updates and enhancements. Therefore, this review aggregates the extant research spanning the past two decades on the prevalence, pathogenesis, comorbidities, assessment, and treatment of MPA, aiming to furnish a reference for future investigations into this condition.

Predicting Smartphone Addiction Trajectories in Korean Adolescents: A Longitudinal Analysis of Protective and Risk Factors Based on a National Survey from 2018 to 2020

This longitudinal study aimed to identify the role of psychosocial factors affecting smartphone addiction (SA) among Korean adolescents and predict the trajectory of SA based on the Korean Children and Youth Panel Survey (KCYPS) 2018 to 2020. The dependent variable was SA score as measured by the Korean Smartphone Addiction Propensity Scale (SAPS), and the independent variables were psychosocial factors (attention, grit, life satisfaction, self-esteem, aggression, depression, social withdrawal and physical symptom). Generalized estimating equation (GEE) analysis (adjusted for covariates) results indicated that attention (B = -0.346, P < .001), grit (B = -0.402, P < .001), life satisfaction (B = -0.150, P < .001), and self-esteem (B = -0.099, P < .001) were protective factors for reducing SA score. Conversely, aggression (B = 0.222, P < .001) and depression (B = 0.067, P = .005) were predicted to be risk factors for increasing SA score. A better understanding of the relationship between behavioral addiction and psychosocial development factors in adolescence will assist in the development of more effective prevention and treatment strategies.

Enhancing response inhibition behavior through tDCS intervention in college students with smartphone addiction

Smartphone addiction, emerging from excessive use of smartphones, poses a challenge to inhibitory control functions within society. This research employed transcranial direct current stimulation (tDCS) as an intervention alongside the stop signal task (SST) to explore behavioral distinctions between individuals with smartphone addiction and a non-addicted control group, focusing on the efficacy of tDCS intervention. The participant cohort comprised 80 individuals, divided into an addiction group (39 participants, with 19 receiving active tDCS and 20 receiving sham tDCS) and a control group (41 participants, with 20 receiving active tDCS and 21 receiving sham tDCS), with anodal stimulation applied over the right dorsolateral prefrontal cortex (dlPFC) and cathodal placement over the left arm. The findings indicate that university students struggling with smartphone addiction exhibit reduced inhibitory control compared to their non-addicted peers, while maintaining similar levels of general cognitive control. Remarkably, tDCS interventions were observed to enhance inhibitory control in both groups. Although the improvement in the addiction group appeared more pronounced numerically than in the control group, no significant interaction with group was noted. However, a higher percentage of participants in the smartphone addiction (SA) group exhibited enhanced response inhibition under active tDCS. This study demonstrates the inhibitory control deficits in individuals addicted to smartphones and underscores the potential of tDCS in enhancing response inhibition. It provides a valuable reference for future tDCS research targeting smartphone addiction and highlights the importance of developing healthier smartphone usage habits.

Exploring the impact of smartphone addiction on decision-making behavior in college students: an fNIRS study based on the Iowa Gambling Task

The pervasive use of smartphones, while enhancing accessibility to information and communication, has raised concerns about its potential negative effects on physical and mental health, including the impairment of decision-making abilities. This study investigates the influence of smartphone addiction on decision-making in college students. A sample of 80 individuals aged 17 to 26 was selected and divided into two groups based on their Smartphone Addiction Scale-Short Version (SAS-SV) scores. Participants underwent the Iowa Gambling Task (IGT) to evaluate their decision-making in risky and uncertain conditions, while fNIRS recorded their prefrontal cortex activity. The study found that individuals prone to smartphone addiction tend to make riskier choices in risky situations. However, when faced with decisions based on ambiguity, the smartphone addiction group showed increased brain activity in the dlPFC (specifically in channels 4, 9, and 11) compared to when making risky decisions. Despite this increased brain activation, there was no observable difference in behavior between the addiction-prone and control groups in ambiguous scenarios. Notably, the left dlPFC (e.g., channel 4) exhibited significantly higher activation in the addiction group compared to the control group. Findings suggest that smartphone addiction can detrimentally influence decision-making, behaviorally and neurologically, particularly in uncertain contexts. This study supports the classification of smartphone addiction as a genuine addiction and underscores its significance in psychiatric research. In essence, our research underscores the adverse effects of excessive smartphone use on decision-making processes, reinforcing the necessity to treat smartphone addiction as a pressing public health issue.

Excessive Smartphone Use is Associated with Depression, Anxiety, Stress, and Sleep Quality of Australian Adults

Problematic smartphone use has been associated with poorer mental health in different population groups; however, little is known about how levels of smartphone use were associated with mental health outcomes of adults in Australia. Using data from a cross-sectional survey among Australian adults aged 18-59 years (n = 655, Mean = 24.55 [SD = 5.59] years; 66% female), the current study aimed to examine association between problematic smartphone use and different psychological outcomes. Participants completed measures of problematic smartphone use with Mobile Phone Problem Use Scale (MPPUS), mental health outcomes with Depression, Anxiety, and Stress Scale (DASS-21), and Pittsburgh Sleep Quality Index (PSQI), in addition to some socio-demographics. Smartphone use was categorised into three groups: low-moderate, moderate-high, and high-severe. A total of 160 adults (24.4%) reported high-severe smartphone use. Multivariable linear regression analyses showed that smartphone use was inversely associated with psychological outcomes in a dose-dependent manner with high-severe smartphone uses having the most adverse effects. Compared to low-moderate use, average depression score was 3.5 points higher for moderate-high smartphone use (β = 3.51, 95% CI: 1.63-5.40) and 6.9 points higher for high-severe smartphone use (β = 6.91, 95% CI: 4.74-9.07). Similarly, average stress score was 3.4 points higher for moderate-high smartphone use (β = 3.40, 95% CI: 1.75-5.06) and 7.0 points higher for high-severe smartphone use (β = 7.02, 95% CI: 5.11-8.93). Similar association estimates were found for anxiety and sleep quality. Reducing smartphone use has the potential to optimise depression, anxiety, stress, and sleep quality; however, longitudinal research is warranted to establish directionality of the association.

Exploring the Impact of Smartphone Addiction on Risk Decision-Making Behavior among College Students Based on fNIRS Technology

Smartphone Addiction is a social issue caused by excessive smartphone use, affecting decision-making processes. Current research on the risky decision-making abilities of smartphone addicts is limited. This study used the functional Near-Infrared Spectroscopy (fNIRS) brain imaging technique and a Sequential Risk-Taking Task experimental paradigm to investigate the decision-making behavior and brain activity of smartphone addicts under varying risk levels. Using a mixed experimental design, the research assessed decision-making ability and brain activation levels as dependent variables across two groups (addiction and control), two risk amounts (high and low), and two outcomes (gain and loss). The study included 42 participants, with 25 in the addiction group and 17 in the control group. Results indicated that risk level significantly impacted the decision-making ability of smartphone addicts, with high-risk levels leading to weaker decision-making ability and increased risk-taking. However, at low-risk levels, decision-making abilities between addicts and healthy individuals showed no significant difference. Furthermore, brain imaging results using fNIRS revealed stronger brain activation in the dorsolateral Prefrontal Cortex (dlPFC) region for smartphone addicts under loss outcome conditions, with no significant differences between the two groups in terms of brain activation at varying risk volumes. These findings are critical in promoting healthy smartphone use, guiding clinical treatment, and advancing brain mechanism research.

Self-Control and Digital Media Addiction: The Mediating Role of Media Multitasking and Time Style

Introduction

As being an initiating actions and resisting short-term temptations, self-control is negatively related to digital media addiction. However, many studies indicate that there are variables that may mediate this relationship. The present study investigated the mediating role of media multitasking and time style in the relationship between self-control and digital media addiction.

Methods

The study included N= 2193 participants with a mean age of M = 23.26 (SD = 6.98) from seven countries: Brazil, Hong Kong, Israel, Italy, Poland, Turkey, and the United States. The authors used the Brief Self-Control Scale, the Media Multitasking Scale, the Time Styles Scale, the Problematic Smartphone Use Scale, the Problematic Internet Use Scale, and the Problematic Facebook Use Scale.

Results

Results revealed that self-control was negatively related to all assessed types of problematic digital media use, namely problematic Internet use, problematic smartphone use, and problematic Facebook use. Media multitasking was found to be a significant mediator of the relationship between self-control and problematic digital media use.

Discussion

High self-control can be preventative against uncontrolled and automatic social media checking, whereas low self-control fosters the habit of continuously remaining current.

Associations of active and passive smartphone use with measures of youth mental health during the COVID-19 pandemic

Smartphone use provides a significant amount of screen-time for youth, and there have been growing concerns regarding its impact on their mental health. While time spent in a passive manner on the device is frequently considered deleterious, more active engagement with the phone might be protective for mental health. Recent developments in mobile sensing technology provide a unique opportunity to examine behaviour in a naturalistic manner. The present study sought to investigate, in a sample of 451 individuals (mean age 20.97 years old, 83% female), whether the amount of time spent on the device, an indicator of passive smartphone use, would be associated with worse mental health in youth and whether an active form of smartphone use, namely frequent checking of the device, would be associated with better outcomes. The findings highlight that overall time spent on the smartphone was associated with more pronounced internalizing and externalizing symptoms in youth, while the number of unlocks was associated with fewer internalizing symptoms. For externalizing symptoms, there was also a significant interaction between the two types of smartphone use observed. Using objective measures, our results suggest interventions targeting passive smartphone use may contribute to improving the mental health of youth.

Problematic Smartphone Use and Social Media Fatigue: The Mediating Role of Self-Control

Background

Excessive social media consumption leads to addiction and affects mental health. It is a phenomenon that is difficult to avoid. Previous research on the effects of excessive Internet use shows that people who engage in social media (SM) without restraint experience over-involvement, over-disclosure, technostress, and social media fatigue (SMF). SMF, conceptualized as an emotional and cognitive feeling of being overwhelmed, manifests itself in mindless browsing of content, limiting the amount of time spent on SM, or quitting SM altogether. Self-control, although present in the technology addiction literature and psychology research, has been rarely described in relation to both excessive SM use and SMF. Therefore, the main goal of the present study was to verify whether there is a direct relationship between problematic smartphone use and SMF, and whether this association is mediated by self-control.

Methods

The study included 210 respondents (M = 25.85, SD = 9.84) living in different Polish cities. The survey was conducted online, and the respondents consented to participate in the study. They completed the following measures: the Mobile Phone Problematic Use, the Self-Control Scale, the Social Media Fatigue Scale, and a brief questionnaire with socio-demographic data.

Results

Statistical analysis was performed to verify the relationship between problematic mobile phone use, level of self-control, and SMF. The outcomes indicate that there are significant interrelationships between the three studied variables. The association between problematic smartphone use and SMF is mediated by self-control.

Conclusion

A lack of impulse-inhibition skills, such as compulsive checking of notifications, can be a significant factor in SM exhaustion, fatigue, or frustration. SMF can also be understood as a natural defensive response, triggered in situations where individuals are overwhelmed, when the self-control is insufficient to stop the compulsion to use SM, and the use of a smartphone for this purpose is excessively engaging.

Problematic use of social media: The influence of social environmental forces and the mediating role of copresence

People's dependence on technology in the digital environment has increasingly become the focus of academic and social attention. Social media, in particular, with the functions of connecting with others and maintaining interactions, has become an inseparable part of people's lives. Although the formation of problematic use of social media has been extensively discussed by scholars, it is mainly confined to the individual level and lacks a macro perspective from the external environment. This study draws on the perspective of institutional theory and introduces copresence as a mediating role, aiming to investigate the influence mechanism of social environmental forces on individuals' problematic use of social media. An online survey (N = 462) was conducted to collect data and test the research model. Our data were analyzed using the structural equation modeling (SEM) approach. Results show that social environmental forces exert an impact on problematic use of social media through the sense of copresence, and only mimetic force can directly affect behavior outcomes while the other two forces can not. Besides, social environmental forces have a relationship with people's sense of copresence while using social media. Among them, mimetic force and normative force positively correlate with copresence while coercive force is negatively related to copresence. Furthermore, copresence is found to influence problematic use of social media positively. Practical and theoretical implications are discussed.

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.

Ultrasound biomicroscopy study of accommodative state in Smartphone abusers

Background

Addiction to Smartphone usage has psychological and physical impacts. However, the state of spasm of accommodation is unclear in Smartphone abusers.

Methods

We performed a cross-sectional study among adults aged 18–35 years between October 2016 and December 2018. Forty participants were Smartphone abusers according to the Smartphone addiction questionnaire, and 40 participants were non users. We measured auto refraction precycloplegia and postcycloplegia at far for all participants to evaluate the state of spasm of accommodation. We assessed the ultrasound biomicroscopy (UBM) parameters including anterior chamber angle (ACA).

Results

There was a significant difference in the odds of having spasm of accommodation between Smartphone abusers compared to non-users (OR = 6.64, 95% CI = 1.73–25.47; adjusted OR = 14.63, 95% CI = 2.99–71.62). The Smartphone abusers and non-users groups had a superior ACA median of 30.45^° ± 8.3^° vs. 26.75^° ± 6.6^° (P = 0.04) precycloplegia at far and 31.70^° ± 11.8^° vs. 31.45^° ± 8.3^° (P = 0.15) postcycloplegia at far, respectively, demonstrated by the Mann-Whitney U test. There was significant higher difference in the precycloplegic nasal ACA at far in the Smartphone abusers group than the non-users group (mean precycloplegic nasal ACA difference = 3.57^°, 95% CI = 0.76^° - 6.37^°), demonstrated by the independent t test. Similarly, there was significant higher difference in the postcycloplegic nasal ACA at far (mean postcycloplegic nasal ACA difference = 4.26^°, 95% CI = 1.33^° - 7.19^°).

Conclusions

Smartphone abusers are in a condition of accommodation spasm. As a result, cycloplegic refraction should be done for Smartphone abusers.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12886-022-02557-x.

Fatigue due to smartphone use? Investigating research trends and methods for analysing fatigue caused by extensive smartphone usage: A review

BACKGROUND: The easy accessibility of smartphones has led to a fivefold increase in their use. People use smartphones almost anywhere, including during travelling and studying. During the global COVID-19 pandemic, the average smartphone screen time has increased from 2.25 to 4.8 hours per day. In India, smartphone usage increased by 68%, and the average screen time increased from 2.42 to 6.9 hours. This dependency on smartphones has led to smartphone addiction. Inappropriate postures during the prolonged use of smartphones can exert adverse effects such as musculoskeletal disorders, digital eye strain, loss of focus and attention. OBJECTIVES: This study was undertaken to understand the effects of prolonged smartphone utilisation and explored fatigue measurement techniques. METHODS: A total of 130 studies examining the effects of smartphone utilisation published in the previous 10 years were identified from the following databases: IEEE, Science Direct, PubMed, PubMed Central, and Google Scholar are reviewed. This study was conducted from September 2019 to January 2021. RESULTS: One in every four adolescents were prone to smartphone addiction, which causes poor mental health. Moreover, India’s research on the effects of excessive smartphone usage is limited. CONCLUSIONS: Studies are required to establish the correlation between fatigue levels and smartphone usage patterns.

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 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).

Caudate nucleus volume mediates the link between glutamatergic neurotransmission and problematic smartphone use in youth

BACKGROUND AND AIMS

Problematic smartphone use (PSU) is growing rapidly among teens. It has similar presentations as other behavioral addictions in terms of excessive use, impulse control problems, and negative consequences. However, the underlying neurobiological mechanisms remain undiscovered. We hypothesized that structural changes in the striatum might serve as an important link between alteration in glutamate signaling and development of PSU.

METHODS

Among 88 participants, twenty (F:M, 12:8; age 16.2 ± 1.1) reported high scores in the smartphone addiction proneness scale (SAPS) with a cut-off score of 42; the other 68 (F:M, 19:49; age 15.3 ± 1.7) comprised the control group. Sociodemographic data and depression, anxiety, and impulsivity traits were measured. Striatal volumes (caudate, putamen, and nucleus accumbens) were estimated from T1 imaging data. Serum glutamate levels were estimated from peripheral blood samples. Group comparisons of each data were performed after controlling for age and gender. Mediation analyses were conducted to test the indirect effects of glutamate level alteration on PSU through striatal volumetric alteration.

RESULTS

The PSU group showed a decrease in both caudate volumes than the control group. Left caudate volume was positively correlated with serum glutamate level, and negatively with impulsivity traits and SAPS scores. The mediation model revealed a significant indirect effect of serum glutamate on SAS scores through the reduced left caudate volume.

DISCUSSION AND CONCLUSIONS

This study suggests that altered glutamatergic neurotransmission may be associated with PSU among teens, possibly through reduced left caudate volume. Current findings might support neural mechanisms of smartphone addiction.

Perceived Challenges and Online Harms from Social Media Use on a Severity Continuum: A Qualitative Psychological Stakeholder Perspective

Evidence suggests that problematic use of gaming, the internet, and social media among adolescents is on the rise, affecting multiple psycho-emotional domains. However, research providing a comprehensive and triangulated stakeholder perspective of perceived harms is lacking. How are adolescent online harms experienced and conceptualized by students, parents, and teachers? The present study comprised part of a qualitative needs assessment investigation with the use of focus groups and individual interviews among key stakeholder groups assessing perceived impacts with a focus on the negative consequences and perceived harms. The study’s sample consisted of students (N = 42, M_age = 13.5, SD = 2.3), parents (N = 9, M_age = 37, SD = 5.6) and teachers (N = 9, M_age = 34, SD = 4.9) from the UK. Data were analysed with thematic analysis. Findings focused primarily on social media use impacts and indicated that processes underlying impacts experienced by adolescents may be conceptualized on a severity continuum. Stakeholder consensus on perceptions of challenges and perceived harms formed the second theme, with impacts further analysed as relating to time displacement, peer judgement, sensory overload and context of the adolescent with functional (performance, task switching, use of multiple devices), cognitive (loss or deterioration of attentional focus, attention deficit), and emotional consequences (stress, anxiety, obsessive-compulsive/checking behaviours). A third theme formed was individual vulnerabilities predisposing poor mental health outcomes. The final theme related to impacts dependent on context and meaning attached. Findings suggest a consideration of a spectrum approach encompassing a broader range of potential psychological challenges and perceived harms beyond safety concerns and addiction in understanding problematic adolescent online experiences. Understanding perceived harms can aid the objective setting of interventions and consideration of mental health literacy in school curricula.

Predictors of Habitual and Addictive Smartphone Behavior in Problematic Smartphone Use

OBJECTIVE

Smartphones have become common, and problematic smartphone use (PSU) is increasing. Predictors of PSU should be identified to prevent it. Little is known about the role of content types of smartphone use as predictors of PSU. Therefore, we aimed to evaluate the predictors of two proposed concepts of PSU, namely habitual smartphone behavior (SB) and addictive SB, within the context of the application (app) categories.

METHODS

We studied 1,039 smartphone users using online surveys conducted between January 2 and 31, 2019. We employed multiple regression analysis to identify the predictors of habitual and addictive SB. We controlled for sex and age (mean=39.20).

RESULTS

Common predictors of habitual and addictive SB were the use of social networking services, games, entertainment apps, and average weekend smartphone usage time. The predictors of habitual SB were the use of web and lifestyle apps, weekly usage frequency, and sex (female) and the predictors of addictive SB were the use of shopping apps and sleep duration.

CONCLUSION

This study revealed the need to consider habitual and addictive SB in evaluating PSU. The predictors in terms of the content types of smartphone usage can be used to develop monitoring and prevention services for PSU.

Excessive Smartphone Use and Self-Esteem Among Adults With Internet Gaming Disorder: Quantitative Survey Study

Background

Smartphone overuse can harm individual health and well-being. Although several studies have explored the relationship between problematic or excessive smartphone use and mental health, much less is known about effects on self-esteem, which is essential in having a healthy life, among adults with mental health disorders, including internet gaming disorder. Furthermore, given that smartphone usage differs by gender, little is known about gender differences in the relationship between smartphone overuse and self-esteem.

Objective

The objective of this study was to assess self-esteem among individuals with mental health disorders and explore the relationship with excessive smartphone use.

Methods

Participants were selected based on their responses to the internet gaming disorder assessment, which includes 9 items developed based on Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria, from among a Korean cohort of smartphone users aged 20-40 years, resulting in a sample of 189 participants (men:120, women: 69). The Rosenberg self-esteem scale and the Korean smartphone addiction proneness scale were utilized to assess the outcome self-esteem with excessive smartphone use as the primary independent variable. Guided by the Bowlby attachment theory and prior studies, we selected several covariates. Generalized linear regression analyses, as well as subgroup analyses by gender, were performed.

Results

Among adults with internet gaming disorder, the average Korean smartphone addiction proneness scale score was significantly higher in women than that in men (41.30 vs. 37.94; P=.001), and excessive smartphone use was significantly more prevalent in women than it was in men (30.43% vs. 20.83%; P=.02). Our findings from the generalized linear regression analyses indicated that an increase in Korean smartphone addiction proneness scale score had a negative relationship with self-esteem among those with internet gaming disorder (β=–0.18, P=.001). Furthermore, our interaction models showed that, among those with internet gaming disorder, more men than women had lower self-esteem associated with an increase in Korean smartphone addiction proneness scale score and a high degree of smartphone overuse (β=–0.19, P=.004; β=–3.73, P<.001).

Conclusions

Excessive smartphone use was found to be adversely associated with self-esteem among young and middle-aged adults with internet gaming disorder; notably, more men than women were negatively influenced (regarding self-esteem) by smartphone overuse. Based on our findings, more efforts should be made to reduce excessive or problematic smartphone use by considering developing public health interventions or policy, particularly among those with mental health disorders such as internet gaming disorder.

Development of the Smartphone Addiction Risk Rating Score for a Smartphone Addiction Management Application

Smartphone usage characteristics are useful for identification of the risk factors for smartphone addiction. Risk rating scores can be developed based on smartphone usage characteristics. This study aimed to investigate the smartphone addiction risk rating (SARR) score using smartphone usage characteristics. We evaluated 593 smartphone users using online surveys conducted between January 2 and January 31, 2019. We identified 102 smartphone users who were addicted to smartphones and 491 normal users based on the Korean Smartphone Addiction Proneness Scale for Adults. A multivariate logistic regression analysis was used to identify significant risk factors for smartphone addiction. The SARR score was calculated using a nomogram based on the significant risk factors. Weekend average usage time, habitual smartphone behavior, addictive smartphone behavior, social usage, and process usage were the significant risk factors associated with smartphone addiction. Furthermore, we developed the SARR score based on these factors. The SARR score ranged between 0 and 221 points, with the cut-off being 116.5 points. We developed a smartphone addiction management application using the SARR score. The SARR score provided insights for the development of monitoring, prevention, and prompt intervention services for smartphone addiction.

Dr. Answer AI for prostate cancer: Clinical outcome prediction model and service

Objectives

The importance of clinical outcome prediction models using artificial intelligence (AI) is being emphasized owing to the increasing necessity of developing a clinical decision support system (CDSS) employing AI. Therefore, in this study, we proposed a “Dr. Answer” AI software based on the clinical outcome prediction model for prostate cancer treated with radical prostatectomy.

Methods

The Dr. Answer AI was developed based on a clinical outcome prediction model, with a user-friendly interface. We used 7,128 clinical data of prostate cancer treated with radical prostatectomy from three hospitals. An outcome prediction model was developed to calculate the probability of occurrence of 1) tumor, node, and metastasis (TNM) staging, 2) extracapsular extension, 3) seminal vesicle invasion, and 4) lymph node metastasis. Random forest and k-nearest neighbors algorithms were used, and the proposed system was compared with previous algorithms.

Results

Random forest exhibited good performance for TNM staging (recall value: 76.98%), while k-nearest neighbors exhibited good performance for extracapsular extension, seminal vesicle invasion, and lymph node metastasis (80.24%, 98.67%, and 95.45%, respectively). The Dr. Answer AI software consisted of three primary service structures: 1) patient information, 2) clinical outcome prediction, and outcomes according to the National Comprehensive Cancer Network guideline.

Conclusion

The proposed clinical outcome prediction model could function as an effective CDSS, supporting the decisions of the physicians, while enabling the patients to understand their treatment outcomes. The Dr. Answer AI software for prostate cancer helps the doctors to explain the treatment outcomes to the patients, allowing the patients to be more confident about their treatment plans.

Use of Instagram by Pre-Service Teacher Education: Smartphone Habits and Dependency Factors

It is increasingly common to upload photographs on the Internet of sports practices carried out. However, this behavior can be related to smartphone addiction, which has become a global problem. In turn, the intensive use of the Instagram social network has begun to be linked to addictive behaviors on mobile devices. The purposes of this paper were to analyze the Instagram usage habits of future primary school teachers, to determine the influence of sociodemographic factors on intensive Instagram use and smartphone addiction, and to determine the influence of intensive Instagram use on smartphone addiction. For this purpose, a transversal design was adopted where two standardized scales were applied to a sample of university students of the Primary Education Degree of the University of Granada, Spain (n = 385). The results showed that the type of image most uploaded to this social network was the selfie, well above sport. Furthermore, the structural equation model highlighted the significant influence of the intensive use of Instagram and smartphone addiction. Finally, the implications and findings of this study are discussed, highlighting the importance of generating healthy habits regarding the use of technology.

The Psychology of Addictive Smartphone Behavior in Young Adults: Problematic Use, Social Anxiety, and Depressive Stress

This review enhances the existing literature on relationships between problematic smartphone use (PSU), psychopathology, addictive personality, and online social engagement as regards young adults, giving attention to predictive determinants of addictive behavior in smartphone usage. My article cumulates previous research findings on the psychology of addictive smartphone behavior in terms of problematic use, social anxiety, and depressive stress by focusing on the relationship among mobile social media usage, smartphone addiction risk, mental health issues, and individual well-being. The inspected collected findings prove that depression and social anxiety constitute risk determinants for greater PSU and that particular categories of smartphone applications are positively related to well-being. State anxiety and motivations represent significant predictors of PSU. High PSU affects participation in social engagement. As limitations in the current review, my results point towards relevant avenues of research on social consequences of teenagers' smartphone problematic use. Future directions should clarify whether compulsive smartphone use adversely affects both mental and physical health in the long run.