Perceived connections between information and communication technology use and mental symptoms among young adults - a qualitative study

Screen viewing patterns and their association with mental wellbeing and psychological distress: a cross-sectional study amongst university students

BACKGROUND

Dependency on screen viewing (SV) has reached unprecedented levels, and mental health issues are becoming a major public health concern. However, the associations between SV, including variations in purposes, devices, and timing, and mental health remain unclear. This study aims to provide insights into these associations among university students.

METHODS

This analysis used baseline data from a longitudinal cohort study among first-year university students matriculating in the 2021-2022 academic year. Self-reported data on sociodemographics, health behaviors and mental health outcomes alongside anthropometric measurements were collected. Unadjusted and adjusted logistic regression analyses were conducted.

RESULTS

The average age of the 997 valid students was 20.2 years, with 59.6% being female and 41.4% male. Students spent 14.3 h daily on SV, with females reporting higher SV than males. Daily SV was predominant for study purposes (7.6 h/day). Computer usage was the highest (7.0 h/day), while TV usage was the lowest (1.7 h/day). Poor mental wellbeing was reported by 33.6% of students, while 13.9% experienced psychological distress. Compared to students with low total SV, those with high levels were more likely to have poor mental wellbeing [OR (95% CI): 1.40 (0.99, 1.98)] and psychological distress [1.56 (1.00, 2.44)]. High levels of recreational and study related SV were significantly associated with poor mental wellbeing [1.81 (1.27, 2.56)] and psychological distress [1.75 (1.11, 2.83)], respectively. Those with high levels of computer time were more likely to have poor mental wellbeing [1.44 (1.01, 2.06)], and high weekend day SV was associated with greater odds of psychological distress [2.16 (1.17, 4.06)].

CONCLUSIONS

SV among university students was high, as was the high prevalence of poor mental wellbeing and psychological distress. Greater SV was associated with poor mental wellbeing and psychological distress. Differences according to purpose of SV were noted. Although recreational SV was associated with poor mental wellbeing, study related SV was associated with psychological distress. Variations across different devices and timing were also noted. This highlights the need for further longitudinal research to understand the impact of SV on mental health and to guide interventions for promoting mental health of university students globally.

Impact of mobile phones and wireless devices use on children and adolescents' mental health: a systematic review

Growing use of mobiles phones (MP) and other wireless devices (WD) has raised concerns about their possible effects on children and adolescents' wellbeing. Understanding whether these technologies affect children and adolescents' mental health in positive or detrimental ways has become more urgent following further increase in use since the COVID-19 outbreak. To review the empirical evidence on associations between use of MP/WD and mental health in children and adolescents. A systematic review of literature was carried out on Medline, Embase and PsycINFO for studies published prior to July 15th 2019, PROSPERO ID: CRD42019146750. 25 observational studies published between January 1st 2011 and 2019 were reviewed (ten were cohort studies, 15 were cross-sectional). Overall estimated participant mean age and proportion female were 14.6 years and 47%, respectively. Substantial between-study heterogeneity in design and measurement of MP/WD usage and mental health outcomes limited our ability to infer general conclusions. Observed effects differed depending on time and type of MP/WD usage. We found suggestive but limited evidence that greater use of MP/WD may be associated with poorer mental health in children and adolescents. Risk of bias was rated as 'high' for 16 studies, 'moderate' for five studies and 'low' for four studies. More high-quality longitudinal studies and mechanistic research are needed to clarify the role of sleep and of type of MP/WD use (e.g. social media) on mental health trajectories in children and adolescents.

Estimating bidirectional effects between social connectedness and mental health in adolescent students: Addressing biases due to endogeneity

Research on the bidirectional relationship between social connectedness and health/mental health in adolescents is scarce, with most studies on adults. Some of the existing studies exploited the availability of longitudinal data to provide evidence of the existence of a causal relationship, either from social connectedness to health or establish a bidirectional relationship. There are at least two weaknesses associated with earlier research to assess the size of the effects. As acknowledged in the literature, one relates to attributing causality to empirical findings, due to well-known but inadequately addressed endogeneity biases. The other relates to failure to account for potentially important covariates, sometimes due to data limitations, or because such variables are not frequently used in sociological research. Existing research predominantly finds that the strongest path is from social connectedness to health/mental health, with effect estimates modest in size. I followed a quasi-experimental strategy by modelling adolescent students' perceptions of social connectedness and mental health perceptions as potentially endogenous variables when estimating bidirectional effects. An instrumental variables (IV) modelling approach was followed, supplemented with a recently developed alternative approach to testing the exclusion restrictions of individual instruments. I exploited the rich information available in the PISA 2018 multi-country dataset, which allows for conditioning for a wide array of information on adolescent students' personal circumstances, self-reported personality-related attributes, relationships with parents; and school characteristics. I found that (1) accounting for endogeneity biases is important; and (2) as opposed to findings reported in the literature, the dominant effect is from mental health perceptions to social connectedness for both male and female participants. The policy relevance of the findings is that adolescent mental health should be the primary focus of interventions, i.e., identifying and treating mental health symptoms as a primary intervention and as a precursor to improving the social connectedness of adolescents.

Examining the Association Between Digital Stress Components and Psychological Wellbeing: A Meta-Analysis

Extant research suggests that digital stress (DS) and its various components (Hall et al. in Psychol Assess 33(3):230-242, 2021) may mediate the association between social media use and psychosocial distress among adolescents and young adults. Yet no systematic review and meta-analysis has been conducted to examine the direct associations among DS components (i.e., approval anxiety, availability stress, fear of missing out [FOMO], connection overload, and online vigilance) and psychological outcomes. Thus, we aimed to comprehensively synthesize and quantify the association between these five DS components and psychosocial distress, and to examine whether these associations were statistically different from one another. Our search of PubMed, PsycINFO, and Communication and Mass Media Complete yielded a wide range of article abstracts across the five DS components. After reviewing inclusion and exclusion criteria, 7, 73, 60, 19, and 16 studies were included for availability stress, approval anxiety, FOMO, connection overload, and online vigilance, respectively. The results suggested that all five digital stress components had significant medium association with psychosocial distress (r = .26 to .34; p < .001). Age and sex did not significantly moderate the association between most digital stress components and psychosocial distress. However, age moderated the association between connection overload and psychosocial distress. Our findings further suggested no statistical differences among the associations between the five digital stress components and psychosocial distress. Notwithstanding its limitations, our outcomes help integrate the disparate effect sizes in the literature, indicate the strength of associations, and suggest directions for clinical intervention and future research.

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.

Why Haven't You Texted Me Back? Adolescents' Digital Entrapment, Friendship Conflict, and Perceived General Health

OBJECTIVE

Many adolescents feel pressure to be constantly available and responsive to others via their smartphones and social media. This phenomenon has been understudied using quantitative methods, and no prior study has examined adolescents' specific stress about meeting digital availability expectations within a best friendship, or entrapment. The present study offers an important preliminary examination of this unique digital stressor in a developmental context by examining prospective associations between digital entrapment, psychosocial adjustment, and health in adolescence.

METHOD

Students in a rural, lower-income school district in the southeastern US (n = 714; 53.8% female; 45.9% White, 22.7% Black, 24.0% Hispanic/Latino) completed self-report measures of digital entrapment, perceived general health, friendship conflict, and depressive symptoms at two timepoints, one year apart.

RESULTS

Digital entrapment, which 76.3% of the sample reported experiencing, was associated prospectively with higher levels of friendship conflict and worse perceived general health one year later among boys, but not girls. Findings suggest that digital entrapment is an extremely common experience for adolescents that may disproportionally affect boys. Entrapment was not prospectively associated with depressive symptoms.

CONCLUSIONS

Results offer insight into how boys may have different social media experiences significant to their development and health, while much work exploring gender differences in social media use thus far has elucidated negative effects for girls. Boys may perceive and respond to novel social norms of digital environments differently such that digital entrapment has the potential to be detrimental to their friendships and health.

Engaging in the good with technology: a framework for examining positive technology use

The focus on the negative side of technology has become a prominent factor in the understanding of the interactions between humans and technology. However, there is a positive side to technology use that has been less investigated in scientific research. Well-being researchers have determined that it is not just the absence of negative emotions or experiences, but rather the presence and frequency of positive ones that matter most. Therefore, despite the scarcity of research on the positive side of technology, the present conceptual paper focuses on how technology may be used for the good to produce psychological benefits (e.g., greater happiness, lower loneliness, higher peer endorsement). Based on existing literature, we posit at least three directions for good interactions with technology: (1) "seeing good" by focusing on positive visual cues through technology use; (2) "feeling good" by focusing on good feelings that arise from technology use; and (3) "doing good" by focusing on positive actions that can be enacted via technology use. Based on the synthesis of these three components, we propose a framework for technology laden engagement in the good, dubbed as, the Engagement in the Good with Technology (EGT) Framework. Through this framework, we explain how these three distinct aspects of seeing, feeling, and doing good can co-occur and be interrelated, and in turn potentially lead to upward spirals of positive outcomes.

Validation of a Chinese Version of the Digital Stress Scale and Development of a Short Form Based on Item Response Theory Among Chinese College Students

Purpose

In 2021, Hall et al developed the Digital Stress Scale (DSS), but its psychometric characteristics were only tested using classical test theory (CTT). In this study, we use item response theory (IRT) and CTT to develop and verify a Chinese version of the DSS and its short version, which can improve the reliability and effectiveness of the digital stress measurement tool for Chinese college students.

Methods

In this study, we developed a Chinese version of the DSS (DSS-C) and recruited 1506 Chinese college students as participants to analyze its psychometric characteristics based on CTT and item response theory methods. First, we used CTT, including common method bias, construct validity, criterion-related validity, internal consistency, test-retest reliability and measurement invariance. Then, we adopted the IRT approach to examine the item parameters, item characteristics, item information, differential item function, test information, and test reliability of the DSS-C. Finally, a short form (DSS-C-S) was constructed, and the psychometric characteristics of the DSS-C-S were examined.

Results

(1) The five-factor structure of the DSS-C was verified. The DSS-C shows good internal reliability, test-retest reliability, criterion-related validity and measurement invariance between urban college students and rural college students. (2) All 24 items had reasonable discrimination parameters and location parameters and were DIF-free by gender. Except for Items 4 and 10, all the other items had high information and measurement reliability at medium θ levels. (3) Compared with the DSS-C, the 22-item short form also has good reliability and validity and maintains sufficient measurement accuracy while reducing items of poor quality.

Conclusion

Both the DSS-C and the DSS-C-S have good psychometric characteristics and are accurate and effective tools for measuring the digital stress of Chinese college students.

Screen time and mental health in college students: Time in nature as a protective factor

Objective: To examine how time spent on handheld screens was related to internalizing mental health symptoms in college students and whether time spent in nature was associated with fewer mental health symptoms. Participants: Three hundred seventy-two college students (Mage = 19.47 ± 1.74, 63.8% female; 62.8% college freshman). Methods: College students completed questionnaires for research credit in their psychology courses. Results: Screen time significantly predicted higher anxiety, depression, and stress. Spending time outdoors ("green time") significantly predicted lower stress and depression, but not lower anxiety. Green time moderated the relationship, such that college students who spent less time outside (1SD below mean) had consistent rates of mental health symptoms across hours of screentime, but individuals who spent average/above average (mean, 1SD above mean) time outside had fewer mental health symptoms at lower levels of screentime. Conclusions: Promoting green time in students may be an effective way of improving stress and depression.

Investigate the relationship between cell-phone over-use scale with depression, anxiety and stress among university students

BACKGROUND

Cell phones have increased dramatically as a new communication technology in the modern world. This study aimed to determine the relationship between cell phone over use scale with depression, anxiety and stress among university students in Khorramabad, Iran.

METHODS

In this descriptive-analytical and cross-sectional study, 212 students were randomly selected from the Lorestan University of Medical Sciences by a combination of stratified and clustered random sampling. Data were collected by two standard questionnaires including, Cell-phone Over-use Scale (COS) and Depression, Anxiety and Stress (DASS-21) and were analyzed using SPSS V.22.

RESULTS

Based on the results, 72.2% of the students were exclusively male, which a majority of them were in age of 21-23 years (46.2%), and 92.5% were single. Based on the multiple linear regression and after adjustment for the confounding effect, there was a significant relationship between cell phone over use scale on student's stress (t = 2.614, P = 0.010), and student's anxiety (t = 2.209, P = 0.028); however there was not a significant relationship between cell phone over use scale on student's depression (t = 1.790, P = 0.075).

CONCLUSIONS

Harmful use of cell phones can aggravate psychological disorders such as anxiety, stress and depression and by controlling this factor can increase the level of mental health and improve the quality of life in students.

TRIAL REGISTRATION

Lorestan University of Medical Sciences. ID: IR.LUMS.REC.1397-1-99-1253.

Effects of limiting digital screen use on well-being, mood, and biomarkers of stress in adults

Studies have linked higher digital screen use with poorer mental health. However, there is limited experimental evidence to suggest a causal relationship. In this trial, we aimed to investigate the effects of limiting recreational digital screen use on mental well-being, mood, and biomarkers of stress in healthy young and middle-aged adults. We randomly allocated 89 families (including 164 adults) to participate in an extensive screen media reduction intervention or control. Participants in the intervention group were instructed to decrease their recreational screen use to less than 3 hours/week/person. Intervention compliance was assessed using applications and tv-monitors. Overall subjective mental well-being and mood, and collected daily biomarkers of stress (salivary cortisol and cortisone) was assessed at baseline and 2-week follow-up. Reducing recreational digital screen use resulted in significantly improved self-reported well-being and mood in adults allocated to the intervention compared to control. We observed no intervention effects for biomarkers of stress. (ClinicalTrials.gov: NCT04098913, 23/09/2019).

Cell phone use distracts young adults from academic work with limited benefit to self-regulatory behavior

We aim to uncover theoretical mechanisms associated with potential negative (i.e., multitasking) and positive (i.e., self-regulation) aspects of cell phone use (CPU) for academic performance in young adults. We hypothesized that, according to the Switch-Load Theory, repeated CPU during academic activities (CPU_Multitasking) would relate negatively, whereas, according to Zimmerman's Theory of Self-Regulated Learning, CPU for self-regulated learning behaviors (CPU_SRLBehavior) would relate positively to the academic performance of undergraduate students. 525 (75.4% female) undergraduate students from a large public university participated in this study during fall 2019 by completing validated quantitative surveys accessing their CPU and academic performance. Spearman's rho was used to compute the correlations and hierarchical regression was used to analyze the variance. Spearman rank-order coefficient showed that CPU_Multitasking relates negatively, but CPU_SRLBehavior is unrelated to the college GPA of undergraduate students. Hierarchical regression showed that CPU_Multitasking was not a significant predictor of academic performance. Young adults who switch to their cell phones during class or study-related activities are more likely to have lower performance in exams as CPU_Multitasking costs time and efficiency (Switch Load Theory). Young adults who use their cell phones for self-regulated learning behavior are less likely to have an impact on their academic performance as CPU_SRLBehavior helps regulate habits but not learning processes. With the known theoretical mechanisms for CPU multitasking and SRL Behavior, this study provides a guiding document for educational computing system practitioners to explore more theory-driven empirical approaches in the field of CPU and academic success.

Established Adults, Who Self-Identify as Smartphone and/or Social Media Overusers, Struggle to Balance Smartphone Use for Personal and Work Purposes

Smartphone ownership and use continues to proliferate, allowing people to easily access online communication, entertainment, and information. Importantly, individuals can perceive that they overuse their smartphone and/or the social media applications (apps) they access on their devices. Much of the research on smartphone overuse has focused on youth and emerging adults, with little research focusing on individuals in the established adulthood stage of life. This study examines smartphone use among established adults who perceive that they overuse their smartphone and/or social media. As part of a larger study, we conducted in-depth interviews with 21 individuals (30-45 years old) who self-identified as smartphone and/or social media overusers. Data were collected through a pre-survey, 1-hour interview, and smartphone use screenshots. Audio-recorded interviews were transcribed and then coded using NVivo software. Participants' average age was 35.9 years (SD = 4.1). The majority of the sample were female (67%), White (76%), and had a master's degree or higher (76%). Participants spent an average of 215 min on their smartphone daily, primarily using social media, video conferencing, and texting apps. Issues with smartphone use occurred when there was an unclear separation between work and personal use. Participants felt pressure to always respond quickly to work emails. An effort was made to limit smartphone use for work and during family time to be present for their family. Established adults strive to balance smartphone use for personal and work purposes. Creating boundaries for how and when established adults use their smartphone may help them find this balance.

Social media use in female adolescents: Associations with anxiety, loneliness, and sleep disturbances

Social Media Disorder (SMD) is characterised by the intense and excessive use of social media. Although previous studies have shown that SMD was associated with poor mental health, research across types of usage and platforms remain limited. Here, we conducted an initial investigation of social media usage across platforms and its relation to anxiety, sleep and loneliness in female adolescents. Forty one 16- to 19-year-old British female adolescents were administered online questionnaires. Intensity of social media activity across Facebook, Instagram, Snapchat and Twitter was measured with the Social Media Disorder Scale. Anxiety was indicated by the Beck Anxiety Inventory Trait, loneliness was examined via a short three-point questionnaire and sleep quality was measured via both the Pittsburgh Sleep Quality Index and self-reported seven-day sleep diaries. Results showed that, compared to those without SMD, users with SMD experienced elevated levels of loneliness and had less sleep on average, and during the weekdays in particular. Only frequency of posting on Facebook, but not general usage, was associated with poorer sleep quality. These preliminary findings showed that social media disorder across platforms and usage could potentially have different associations to mental health and sleep.

Is the Technology Era Aging You? A Review of the Physiologic and Psychologic Toll of Technology Use

BACKGROUND

Technology use is at an all-time high and its potential impact on psychological and physiologic health should be explored.

OBJECTIVE

The objective of this narrative review was to identify the role of technology use on health and well-being.

MATERIALS AND METHODS

Authors performed a review of PubMed and publications of the World Health Organization, Department of Defense, and Centers for Disease Control and Prevention to determine the impact of technology regarding electromagnetic radiation (EM), posture and mobility, sleep disturbance, and psychological stress and well-being.

RESULTS

Studies on the impact of EM were conflicting, with about 45% reporting negative consequences and 55% reporting no effect. Radiofrequency EM (RF-EM) may more significantly affect fibroblasts and immature cells. Device use was implicated in worsening cognitive focus, imbalance, and sleep. Social media use affects self-esteem and mental health and is associated with up to 33% presence of addiction. Effects seem to be dose related and more pronounced in younger ages.

CONCLUSION

Technology use significantly affects sleep, mental health, and cognitive function. Seeking psychological help, limiting social media use, and reducing use before sleep may partially mitigate these effects. The impact of EM is undetermined, but the WHO lists RF-EM as a potential carcinogen.

Is psychological distress the key factor in the association between problematic social networking sites and poor sleep quality?

BACKGROUND AND AIMS

Problematic Social Networking Sites Use (PSNSU) has been indicated as potentially detrimental for users' mental and sleep health. The present study tested whether PSNSU is directly associated with poor sleep quality and indirectly via psychological distress (stress, anxiety, depression) in a healthy adult sample of Social Networking Sites (SNSs) users.

DESIGN

Cross-sectional study among Italian adults who completed online questionnaires between December 2020 and January 2021.

SETTING

Italy.

PARTICIPANTS

A convenient sample of N = 726 SNSs users (51.8% females; mean age = 28.59 years, SD = 8.19 years).

MEASUREMENTS

Self-report data were collected on problematic social networking sites use, sleep quality, psychological distress (stress, anxiety, depression), and socio-demographics.

FINDINGS

PSNSU was not directly associated with poor sleep quality. Depression and stress mediated such association.

CONCLUSION

Healthcare providers should consider psychological distress and PSNSU when encountering sleep problems, with consideration of the potentially important role of users' age and mental health status.

WhatsApp and Gynecologist-Patient Interaction: Development and Validation of a Questionnaire to Assess the Stress Perceived by the Doctor

OBJECTIVE

 Construction and validation of the WhatsApp Stress Scale (WASS), a questionnaire designed for physicians that measures how the use of smartphones and related software communication applications affects the quality of life of gynecologists who use this tool to communicate with patients.

METHODS

 The present cross-sectional observational study analyzed 60 gynecologists according to weekly WhatsApp usage time for communication with patients and compared the data with the perception of the doctor on the use of this virtual interaction as a stressor. Physicians were equally divided into three groups: < 2 hours, 2 to 5 hours, and > 5 hours. The authors created a questionnaire in Likert scale format. The study proceeded in three phases: development of the questionnaire items, pretesting, constructing, and validity and reliability testing using factor analysis, Cronbach α coefficient, and paired t-test.

RESULTS

 A 9-item instrument using a 5-point Likert scale was created and administered to the participants in 3 different times: T0, T1 (15 minutes after the end of T0), and T2 (15 days later). All questionnaire items possessed adequate content validity indices and the internal consistency of the instrument was satisfactory (Cronbach α 0.935; 95% confidence interval [CI]: 0.744-0.989; p = 0.0001). No statistically significant differences were observed in the responses between the rounds of testing, indicating good test-retest reliability. A positive association between the high frequency of WhatsApp usage for communication with patients and the stress perceived by the doctor was shown.

CONCLUSION

 The WASS is a valid and reliable instrument for assessing the use of messaging applications to communicate with patients as a stressor perceived by gynecologists.

Nighttime cell phone use and sleep quality in young adults

Young adults are particularly vulnerable to sleep disturbances related to their cell phone use (CPU). The purpose of this study was to test Sleep Displacement and Psychological Arousal theories of CPU-led sleep disruption in relation in a sample of university students. CPU for unstructured leisure activities before sleep (CPU_BeforeBed), as well as CPU for accessing explicit or emotionally charged media content before sleep (CPU_Arousal), were both measured. 525 (75% female) undergraduate students from a large public institution participated in this study during fall 2019. The data were collected using a battery of validated self-report questionnaires. Questionnaires included the Pittsburgh Sleep Quality Index scale, which was used to measure sleep latency and sleep difficulty, and a contemporary questionnaire developed to measure CPU_BeforeBed and CPU_Arousal. A crude odds ratio analysis was implemented to analyze findings. Sleep Displacement data showed higher odds of sleep latency occurring with CPU_BeforeBed [Exp (B) = 1.091, p < 0.001]. Psychological Arousal data showed higher odds of sleep difficulty occurring with CPU_Arousal [Exp (B) = 1.065, p < 0.001]. CPU_BeforeBed significantly predicted sleep latency [Exp (B) = 1.062, p < 0.01], and CPU_Arousal significantly predicted the sleep difficulty [Exp (B) = 1.069, p < 0.001] of undergraduate students. Young adults who used cell phones before sleep and access emotionally charged content before going to bed were more likely to report trouble sleeping. They took more time to fall asleep at night as their sleep hours were compressed due to CPU. These findings support the Sleep Displacement and Arousal theories of sleep disruption and provide further insight into possible mechanisms for sleep disturbance in young adults.

Conceptualizing Digital Stress in Adolescents and Young Adults: Toward the Development of an Empirically Based Model

Existing literature provides a complicated picture of the relationship between digital media use and psychological outcomes. Both correlational and some experimental studies suggest that social media use specifically can be associated with diminished psychological functioning in adolescents and young adults. However, these effect sizes are not large, and must be considered in light of studies that suggest some positive outcomes associated with some uses of digital media, and a range of moderators of the identified associations. Although a growing body of evidence suggests that digital stress may be an important intervening factor between digital media use and psychosocial outcomes, this literature is complicated by multiple nomenclatures for similar or identical constructs. Our review of the literature suggests four potentially related components of digital stress, including availability stress, approval anxiety, fear of missing out, and communication overload. This conceptualization is consistent with recent published frameworks for understanding digital media's influence on peer relationships. Clinicians working with adolescents and young adults are encouraged to assess digital media use in the context of clients' overall psychological and social functioning, and in consideration of clients' specific uses of media. Future research is needed to examine the associations among components of digital stress and clinical outcomes, and to provide valid measures to assess digital stress in research and clinical settings.

The Relationship Among Anxiety, Depression, and Problematic Smartphone Use in University Students: The Mediating Effect of Psychological Inflexibility

OBJECTIVE

The number of studies that reveal the relationship between problematic smartphone use (PSU) and various health problems is increasing. In this study, we aimed to examine the relationship among PSU, depression, and anxiety and the mediating effect of psychological inflexibility (PI) in this relationship in university students.

METHODS

This study was conducted with 412 university students aged between 18-35 years studying at a state university. All participants completed the Acceptance and Action Questionnaire-II, Beck Depression Inventory, Beck Anxiety Inventory, and Smartphone Addiction Scale-Short Version. PROCESS macro in SPSS was used for mediation analysis.

RESULTS

Our analyses showed that both depression and anxiety were independent predictors of PSU even after controlling for each other. Our findings show that PI is the mediator variable in the effect of depression and anxiety on PSU.

CONCLUSION

Mental health professionals working with problematic smartphone use among university students should consider psychological inflexibility as well as depression and anxiety.

Social Media Use and Sleep Disturbance among Adolescents: A Cross-Sectional Study

Objective: Recently, social media use has become prevalent in the daily lives of many adolescents. This study was performed to address adolescents' sleep quality and depression in relation to social media use. Method : This cross-sectional cluster-sampling study was directed on 576 high school students in 2019 in Hamadan, Iran. Three standard self-reported questionnaires were used for recording sleep patterns (Pittsburgh Sleep Questionnaire Index (PSQI)), depression (Beck), and Electronic Media Use. Data was analyzed using SPSS. P-values less than 0.05 were considered as being significant. Results: Among the adolescents 290 (50.3%) were female and the age median was 17. The average time of all Smart devices used was 7.5±4.4 hours per day. Among all students 62.3 % (359) said that they had their cell phone on in their bedroom when they sleep. In boys, the amount of social media use was significantly more than girls and poor sleep quality had a statically significant relationship with social media use (P-Value = 0.02). Additionally, there was a reverse correlation between the average use of electronic devices and sleep duration (Spearman's rho = 0.17; P-Value = 0.03), and a direct correlation between the average use in social media and depression (Spearman's rho = 0.171; P-Value < 0.001). Conclusion: In this important age group a high level of electronic devices use and its relationship with sleep quality, daily dysfunction, sleep duration and depression is worthy of issue awareness among health managers, parents and teachers for providing interventional programs, based on standard updated guidelines, in order to reduce the problem and familiarize adolescents and their parents, at home or school, with restrictions on using devices to view and participate in social media.

Depression screening using mobile phone usage metadata: a machine learning approach

OBJECTIVE

Depression is currently the second most significant contributor to non-fatal disease burdens globally. While it is treatable, depression remains undiagnosed in many cases. As mobile phones have now become an integral part of daily life, this study examines the possibility of screening for depressive symptoms continuously based on patients' mobile usage patterns.

MATERIALS AND METHODS

412 research participants reported a range of their mobile usage statistics. Beck Depression Inventory-2nd ed (BDI-II) was used to measure the severity of depression among participants. A wide array of machine learning classification algorithms was trained to detect participants with depression symptoms (ie, BDI-II score ≥ 14). The relative importance of individual variables was additionally quantified.

RESULTS

Participants with depression were found to have fewer saved contacts on their devices, spend more time on their mobile devices to make and receive fewer and shorter calls, and send more text messages than participants without depression. The best model was a random forest classifier, which had an out-of-sample balanced accuracy of 0.768. The balanced accuracy increased to 0.811 when participants' age and gender were included.

DISCUSSIONS/CONCLUSION

The significant predictive power of mobile usage attributes implies that, by collecting mobile usage statistics, mental health mobile applications can continuously screen for depressive symptoms for initial diagnosis or for monitoring the progress of ongoing treatments. Moreover, the input variables used in this study were aggregated mobile usage metadata attributes, which has low privacy sensitivity making it more likely for patients to grant required application permissions.

Smartphones and Varsity Athletes: A Complicated Relationship

Varsity athletes are a group of high performers situated within a demographic notable for smartphone usage and media-multitasking. Surprisingly, little research has examined the impact of smartphones in the lives of varsity athletes. The purpose of this exploratory, qualitative study was to begin addressing this gap by investigating varsity athletes' experiences with smartphones. Varsity athletes (n = 21) from nine different sports participated in one of five focus groups, and data emerging from these discussions were subjected to an inductive thematic analysis. Results indicate that smartphones are a mainstay of varsity athletes' experiences, as the athletes regularly use their smartphones to manage roles and demands across multiple contexts (e.g., sport, school, home). Themes pertained to concurrent negative (e.g., stress, distraction, disengagement) and positive (e.g., self-regulation, social connectedness) implications of smartphone usage, making it clear that athletes' relationship with their smartphone is a complicated one. Findings contribute to the limited studies of smartphone usage among athletes, and support the notion that implications of usage exist along a continuum, rather than in distinct categories of "good" and "bad". Results can inform practical guidelines for optimising athletes' use of smartphones in and around the sport context.

Examining the Correlation Between Depression and Social Behavior on Smartphones Through Usage Metadata: Empirical Study

BACKGROUND

As smartphone has been widely used, understanding how depression correlates with social behavior on smartphones can be beneficial for early diagnosis of depression. An enormous amount of research relied on self-report questionnaires, which is not objective. Only recently the increased availability of rich data about human behavior in digital space has provided new perspectives for the investigation of individual differences.

OBJECTIVE

The objective of this study was to explore depressed Chinese individuals' social behavior in digital space through metadata collected via smartphones.

METHODS

A total of 120 participants were recruited to carry a smartphone with a metadata collection app (MobileSens). At the end of metadata collection, they were instructed to complete the Center for Epidemiological Studies-Depression Scale (CES-D). We then separated participants into nondepressed and depressed groups based on their scores on CES-D. From the metadata of smartphone usage, we extracted 44 features, including traditional social behaviors such as making calls and sending SMS text messages, and the usage of social apps (eg, WeChat and Sina Weibo, 2 popular social apps in China). The 2-way ANOVA (nondepressed vs depressed × male vs female) and multiple logistic regression analysis were conducted to investigate differences in social behaviors on smartphones among users.

RESULTS

The results found depressed users received less calls from contacts (all day: F_1,116=3.995, P=.048, η₂=0.033; afternoon: F_1,116=5.278, P=.02, η₂=0.044), and used social apps more frequently (all day: F_1,116=6.801, P=.01, η₂=0.055; evening: F_1,116=6.902, P=.01, η₂=0.056) than nondepressed ones. In the depressed group, females used Weibo more frequently than males (all day: F_1,116=11.744, P=.001, η₂=0.092; morning: F_1,116=9.105, P=.003, η₂=0.073; afternoon: F_1,116=14.224, P<.001, η₂=0.109; evening: F_1,116=9.052, P=.003, η₂=0.072). Moreover, usage of social apps in the evening emerged as a predictor of depressive symptoms for all participants (odds ratio [OR] 1.007, 95% CI 1.001-1.013; P=.02) and male (OR 1.013, 95% CI 1.003-1.022; P=.01), and usage of Weibo in the morning emerged as a predictor for female (OR 1.183, 95% CI 1.015-1.378; P=.03).

CONCLUSIONS

This paper finds that there exists a certain correlation between depression and social behavior on smartphones. The result may be useful to improve social interaction for depressed individuals in the daily lives and may be insightful for early diagnosis of depression.

Screening for Depression in Mobile Devices Using Patient Health Questionnaire-9 (PHQ-9) Data: A Diagnostic Meta-Analysis via Machine Learning Methods

PURPOSE

Depression is a symptom commonly encountered in primary care; however, it is often not detected by doctors. Recently, disease diagnosis and treatment approaches have been attempted using smart devices. In this study, instrumental effectiveness was confirmed with the diagnostic meta-analysis of studies that demonstrated the diagnostic effectiveness of PHQ-9 for depression using mobile devices.

PATIENTS AND METHODS

We found all published and unpublished studies through EMBASE, MEDLINE, MEDLINE In-Process, and PsychINFO up to March 26, 2021. We performed a meta-analysis by including 1099 subjects in four studies. We performed a diagnostic meta-analysis according to the PHQ-9 cut-off score and machine learning algorithm techniques. Quality assessment was conducted using the QUADAS-2 tool. Data on the sensitivity and specificity of the studies included in the meta-analysis were extracted in a standardized format. Bivariate and summary receiver operating characteristic (SROC) curve were constructed using the metandi, midas, metabias, and metareg functions of the Stata algorithm meta-analysis words.

RESULTS

Using four studies out of the 5476 papers searched, a diagnostic meta-analysis of the PHQ-9 scores of 1099 people diagnosed with depression was performed. The pooled sensitivity and specificity were 0.797 (95% CI = 0.642-0.895) and 0.85 (95% CI = 0.780-0.900), respectively. The diagnostic odds ratio was 22.16 (95% CI = 7.273-67.499). Overall, a good balance was maintained, and no heterogeneity or publication bias was presented.

CONCLUSION

Through various machine learning algorithm techniques, it was possible to confirm that PHQ-9 depression screening in mobiles is an effective diagnostic tool when integrated into a diagnostic meta-analysis.

Problematic Gaming and Sleep: A Systematic Review and Meta-Analysis

Problematic gaming has been linked to poor sleep outcomes; however, these associations have not yet been synthesized quantitatively. This review employed a meta-analysis to investigate the relationship between problematic gaming and sleep-related outcomes. A search of Medline, Embase, Web of Science, PsycINFO, and Google Scholar identified a total of 763 studies, including 34 studies (n = 51,901 participants) eligible for inclusion. Papers were included if available in any European language, addressed problematic gaming, contained original data, and provided sufficient data for calculation of effect sizes. Two researchers independently extracted data using pre-defined fields including quality assessment. Sleep-related outcomes were meta-analyzed for sleep parameters that were reported by 5 or more papers. Significant overall effects were found for sleep duration (g = -0.238, 95% CI = -0.364, -0.112), poor sleep quality (OR = 2.02, 95% CI = 1.47, 2.78), daytime sleepiness (OR = 1.57, 95% CI = 1.00, 2.46) and sleep problems (OR = 2.60, 95% CI = 1.94, 3.47). Between-study heterogeneity was detected for all meta-analyses. Subgroup analyses showed a higher inverse effect size for adolescent samples compared to adult or non-specific age samples in terms of sleep duration. For daytime sleepiness, a larger effect size was found for studies based on single-item sleep measures compared to multi-item sleep measures. For sleep problems, the subgroup analysis showed the opposite with a higher effect size for studies based on single-item sleep measures than multi-item sleep measures. Across all sleep parameters, problematic gamers consistently reported a more adverse sleep status than non-problematic gamers. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/; record ID: CRD42020158955.

Interplay between social media use, sleep quality, and mental health in youth: A systematic review

Social media applications are increasingly prominent among youth. This systematic review provides a comprehensive assessment of the literature on the relationship between active social media use, sleep quality, and common mental health outcomes (anxiety, depression, and psychological distress) among youth. MEDLINE, PsychINFO, EMBASE and Scopus were searched for observational studies investigating this relationship among youth (aged 16-25). Thirty-six cross-sectional studies and six prospective cohort studies met the inclusion criteria. Among cross-sectional studies, significant associations between excessive social media use with poor mental health outcomes (n = 33), poor sleep quality (n = 24), and significant associations between poor sleep quality and negative mental health (n = 16) were found. In longitudinal studies, frequent social media use was a risk factor for both poor mental health (n = 6) and poor sleep outcomes (n = 5). Some studies showed sleep quality mediating the relationship between social media use and negative mental health outcomes in youth. Overall, included evidence links excessive social media use to poor sleep quality and negative mental health in youth. Given the public health implications of sleep problems, excessive social media use warrants further investigation to clarify the directionality and strength of their associations with poor sleep quality and negative mental health outcomes.

Relationship between screen time and sleep among Finnish preschool children: results from the DAGIS study

STUDY OBJECTIVES

To examine the associations between screen time, the time spent on different screen devices, and sleep in a sample of Finnish preschool children.

METHODS

The current study analyzed cross-sectional data from the DAGIS study carried out in Finland in 2015-2016 on 736 children aged 3-6 years. Parents reported in a 7-day diary the durations the child used screen devices daily, with separate details about watching TV or DVDs, using tablets or smartphones, and using computers. In addition, parents reported children's bedtimes and wake-up times, which were further used in calculating sleep duration. Parents answered questions regarding their child's sleep consistency. Statistical analyses included adjusted general linear modeling.

RESULTS

An hourly increase in total screen time was associated with 11 min later bedtime (p < 0.001) and 10 min shorter sleep duration (p < 0.001). More TV/DVD watching was associated with later bedtimes (p = 0.016) and a shorter sleep duration (p = 0.001). More smartphone/tablet use was associated with later bedtimes (p = 0.005), later wake-up times (p = 0.038), and weaker sleep consistency (p = 0.024). More computer use was associated with later bedtimes (p = 0.046). Results did not differ between genders.

CONCLUSIONS

Increased screen time was associated with later bedtimes and shorter sleep duration among preschool children. Adverse associations with sleep outcomes were found for each screen device. Attention should be paid to promoting balanced use of screens and regular sleep habits in young children.

Relationships Between the Usage of Televisions, Computers, and Mobile Phones and the Quality of Sleep in a Chinese Population: Community-Based Cross-Sectional Study

BACKGROUND

No study has comprehensively investigated the association between the usage of typical screen-based electronic media devices and sleep quality in a Chinese population with individuals in a wide range of ages.

OBJECTIVE

This study aimed to understand the characteristics of television (TV) viewing, computer usage, and mobile phone usage in a representative Chinese population in Macau and to examine their roles in predicting the variations in sleep quality.

METHODS

This cross-sectional study was an analysis of 1500 Macau residents aged 15 to 90 years based on a community-based health needs assessment study entitled, "Healthy Living, Longer Lives." Data collection was conducted in 7 districts of Macau from 2017 to 2018 through face-to-face interviews. The durations of daily TV viewing, computer usage, and mobile phone usage were recorded in a self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality.

RESULTS

The prevalence of TV, computer, and mobile phone usage was 78.4% (1176/1500), 51.6% (769/1490), and 85.5% (1276/1492), respectively. The average daily hours of usage were 1.75 (1.62), 1.53 (2.26), and 2.85 (2.47) hours, respectively. Females spent more time watching TV (P=.03) and using mobile phones (P=.02) and less time on the computer (P=.04) as compared to males. Older adults were more likely to watch TV while young people spent more time using the computer and mobile phones (P for all trends<.001). The mean PSQI global score was 4.79 (2.80) among the participants. Females exhibited significantly higher PSQI scores than males (5.04 vs 4.49, respectively; P<.001). No linear association was observed between the PSQI score and the amount of time spent on the 3 electronic devices (P=.58 for PSQI-TV, P=.05 for PSQI-computer, and P=.52 for PSQI-mobile phone). Curve estimation showed significant quadratic curvilinear associations in PSQI-TV (P=.003) and PSQI-computer (P<.001) among all the participants and in PSQI-mobile phone among youths (age, 15-24 years; P=.04). After adjustment of the gender, age, body mass index, demographics, and lifestyle factors, more than 3 hours of TV viewing and 4 hours of computer usage or mobile phone usage was associated with 85% (95% CI 1.04-1.87; P=.008), 72% (95% CI 1.01-2.92; P=.045), and 53% (95% CI 1.06-2.22; P=.03) greater odds of having poor sleep quality (PSQI score>5), respectively.

CONCLUSIONS

The mobile phone was the most popular screen-based electronic device used in the Macau population, especially among young people. "J" shape associations were observed between sleep quality and the duration of TV viewing, computer usage, and mobile phone usage, indicating that the extreme use of screen-based electronic devices predicted poorer sleep status, whereas moderate use would be acceptable.

Independent and combined associations between screen time and physical activity and perceived stress among college students

Although both screen time (ST) and physical activity (PA) are associated with stress, independent and combined associations between ST and PA, and perceived stress among college students, have remained unclear. The present study included 1137 undergraduate medical students from a university in Shenyang, Northeast China. PA and perceived stress were measured using the International Physical Activity Questionnaire (IPAQ)-Long Form and the Chinese Perceived Stress Scale (CPSS), respectively. ST and students' characteristics were determined using a self-administered questionnaire. Data were analyzed using the independent t-test, Pearson Chi-squared test, and logistic regression. After adjusting for potential confounding factors, females reporting high ST (HST, ST > 6 h/day) were more likely to experience stress than those reporting low ST (LST, ST ≤ 6 h/day) (OR = 1.557), while those reporting light- and moderate-intensity PA (LMPA) were more likely to experience stress than those reporting vigorous-intensity PA (VIPA) (OR = 1.674). Analysis of the combined effects of PA and ST showed that, among female students, those reporting both LST and LMPA (OR = 2.174), both HST and VIPA (OR = 2.088), and both HST and LMPA (OR = 2.797) were more likely to experience stress compared to those reporting both LST and VIPA (the reference category). The present study confirmed that LST and VIPA were independently and concurrently associated with significantly lower stress among college students, suggesting that promoting PA and reducing ST might be an effective way to reduce perceived stress among college students.

Correlates of social media fatigue and academic performance decrement

Purpose

The current study aims to investigate if different measures related to online psychosocial well-being and online behavior correlate with social media fatigue.

Design/methodology/approach

To understand the antecedents and consequences of social media fatigue, the stressor-strain-outcome (SSO) framework is applied. The study consists of two cross-sectional surveys that were organized with young-adult students. Study A was conducted with 1,398 WhatsApp users (aged 19 to 27 years), while Study B was organized with 472 WhatsApp users (aged 18 to 23 years).

Findings

Intensity of social media use was the strongest predictor of social media fatigue. Online social comparison and self-disclosure were also significant predictors of social media fatigue. The findings also suggest that social media fatigue further contributes to a decrease in academic performance.

Originality/value

This study builds upon the limited yet growing body of literature on a theme highly relevant for scholars, practitioners as well as social media users. The current study focuses on examining different causes of social media fatigue induced through the use of a highly popular mobile instant messaging app, WhatsApp. The SSO framework is applied to explore and establish empirical links between stressors and social media fatigue.

"Everybody's responsibility": Conceptualization of youth mental health in Kenya

There is increasing interest in providing resilience-building interventions in low- and middle-income countries (LMIC), but limited evidence on how young people and their carers process mental health and related supports. The aim of this study was to establish stakeholders' conceptualization of youth mental health in a disadvantaged area of Kenya through focus groups with 7 young people aged 14-17 years and their parents, 9 teachers and 11 practitioners or community leads. The four identified themes related to definitions of both mental well-being and mental health problems; a range of contributing factors related to identity resolution, parenting, poverty and social media; attribution of responsibility at different socio-ecological levels; and required awareness, supports and interventions at these levels. Stakeholders, notably young people, are thus essential in the development and planning of user-led and culturally appropriate interventions in LMIC.

Perception of Sleep Disturbances due to Bedtime Use of Blue Light-Emitting Devices and Its Impact on Habits and Sleep Quality among Young Medical Students

Introduction

The use of blue light-emitting devices (smartphones, tablets, and laptops) at bedtime has negative effects on sleep due to light stimulation and/or problematic excessive use. We aimed to evaluate, among young medical students, if the perception of sleep disturbances due to bedtime use of these devices is consistent with healthier habits and a better sleep quality.

Materials and methods

294 medical students in medicine and pharmacy from the Faculty of Medicine and Pharmacy of Rabat, Morocco, took part in this anonymous and voluntary cross-sectional study and answered an electronic questionnaire. Student and Mann–Whitney U tests were used to compare variables between 2 groups based on their perception of sleep disturbances. The level of significance was p ≤ 0.05.

Results

286 students (97.3%) used a blue light-emitting smart device at bedtime before sleep, and sleep quality was poor (Pittsburgh Sleep Quality Index, PSQI > 5) in 101 students (35.3%). The perception of sleep disturbances due to this night usage was reported by 188 of them (65.7%). In this group, 154 (81.9%) used their device with all the lights turned off in the room (p=0.02), 34 (18.1%) put devices under pillows (p=0.04), 114 (60.6%) interrupted sleep to check messages (p < 0.001), and the mean duration use of these technologies at bedtime was 2 h ± 23 min per night (p=0.02). Also, the mean sleep duration was 6.3 hours ± 1.25 (p=0.04), 119 (63.3%) presented fatigue on waking more than one time per week (p=0.04), and 76 (40.4%) presented poor sleep quality (75.2% of the students with PSQI > 5) (p=0.005).

Conclusions

Despite the perception of sleep disturbances due to bedtime use of blue light-emitting devices, unhealthy sleep habits tend to be frequent in young medical students and worrying because it is associated to significant poor sleep quality.

Media use during adolescence: the recommendations of the Italian Pediatric Society

Background

The use of media device, such as smartphone and tablet, is currently increasing, especially among the youngest. Adolescents spend more and more time with their smartphones consulting social media, mainly Facebook, Instagram and Twitter because. Adolescents often feel the necessity to use a media device as a means to construct a social identity and express themselves. For some children, smartphone ownership starts even sooner as young as 7 yrs, according to internet safety experts.

Material and methods

We analyzed the evidence on media use and its consequences in adolescence.

Results

In literature, smartphones and tablets use may negatively influences the psychophysical development of the adolescent, such as learning, sleep and sigh. Moreover, obesity, distraction, addiction, cyberbullism and Hikikomori phenomena are described in adolescents who use media device too frequently. The Italian Pediatric Society provide action-oriented recommendations for families and clinicians to avoid negative outcomes.

Conclusions

Both parents and clinicians should be aware of the widespread phenomenon of media device use among adolescents and try to avoid psychophysical consequences on the youngest.

Overnight smartphone use: A new public health challenge? A novel study design based on high-resolution smartphone data

Background

Round-the-clock use of smartphones holds a potential for awakenings and/or shorter sleep duration, which may have adverse health consequences. We aim to describe overnight smartphone activity among young adults and to characterize those with smartphone interrupted sleep in terms of sleep impairment and mental and physical health indicators.

Methods

We use unique objective high-resolution information on timing of smartphone activity (based on >250,000 phone actions) continuously monitored over a four-week period among 815 young adults combined with indicators of mental and physical health.

Results

We find substantial overnight smartphone activity. More than 12% had smartphone activity in the middle of the night (3 to 5 hours after self-reported bedtime) and 41% had smartphone interrupted sleep on at least one weekday during a 4-week period. Those with frequent smartphone interrupted sleep had on average 48 minutes shorter self-reported sleep duration and higher body mass index, whereas there were no differences in physical or mental health symptoms.

Conclusions

The substantial smartphone activity during bed hours among young adults may pose a public health challenge and especially the relation to overweight warrants close attention.

The association between smartphone use, stress, and anxiety: A meta-analytic review

Research investigating the various mental, physical, and social effects of smartphone use has proliferated in the previous decade. Two variables of interest in this literature are the levels of anxiety and stress associated with smartphone use. The current meta-analysis aimed to provide the first quantitative review of this literature, as well as determine potential moderators that might influence this relationship. A total of 39 independent samples (N = 21, 736) were used to compute a summary effect size of r = .22, p < .001, CI [.17-.28] indicating a small-to-medium association between smartphone use and stress and anxiety. Significant moderators included the year in which the article was published, as well as whether problematic or nonproblematic phone use was assessed. In addition, studies using validated measures of smartphone use indicated a (nonsignificantly) larger association than studies using nonvalidated measures. Strengths and limitations of the meta-analysis, as well as future directions of research are discussed.

Media devices in pre-school children: the recommendations of the Italian pediatric society

Background

Young children are too often exposed to mobile devices (MD) and most of them had their own device. The adverse effects of a early and prolonged exposure to digital technology on pre-school children has been described by several studies.

Aim of the study is to analyze the consequences of MD exposure in pre-school children.

Methods

We analyzed the documented effects of media exposure on children’s mental and physical health.

Results

According to recent studies, MD may interfere with learning, children development, well being, sleep, sight, listening, caregiver-child relationship.

Discussion

Pediatricians should be aware of both the beneficial and side effects of MD and give advice to the families, according to children’s age.

Conclusion

In according to literature, the Italian Pediatric Society suggest that the media device exposure in childhood should be modulated by supervisors.

Measurement Invariance of the Short Version of the Problematic Mobile Phone Use Questionnaire (PMPUQ-SV) across Eight Languages

The prevalence of mobile phone use across the world has increased greatly over the past two decades. Problematic Mobile Phone Use (PMPU) has been studied in relation to public health and comprises various behaviours, including dangerous, prohibited, and dependent use. These types of problematic mobile phone behaviours are typically assessed with the short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ⁻SV). However, to date, no study has ever examined the degree to which the PMPU scale assesses the same construct across different languages. The aims of the present study were to (i) determine an optimal factor structure for the PMPUQ⁻SV among university populations using eight versions of the scale (i.e., French, German, Hungarian, English, Finnish, Italian, Polish, and Spanish); and (ii) simultaneously examine the measurement invariance (MI) of the PMPUQ⁻SV across all languages. The whole study sample comprised 3038 participants. Descriptive statistics, correlations, and Cronbach's alpha coefficients were extracted from the demographic and PMPUQ-SV items. Individual and multigroup confirmatory factor analyses alongside MI analyses were conducted. Results showed a similar pattern of PMPU across the translated scales. A three-factor model of the PMPUQ-SV fitted the data well and presented with good psychometric properties. Six languages were validated independently, and five were compared via measurement invariance for future cross-cultural comparisons. The present paper contributes to the assessment of problematic mobile phone use because it is the first study to provide a cross-cultural psychometric analysis of the PMPUQ-SV.

Is smartphone addiction really an addiction?

Aims In light of the rise in research on technological addictions and smartphone addiction in particular, the aim of this paper was to review the relevant literature on the topic of smartphone addiction and determine whether this disorder exists or if it does not adequately satisfy the criteria for addiction. Methods We reviewed quantitative and qualitative studies on smartphone addiction and analyzed their methods and conclusions to make a determination on the suitability of the diagnosis "addiction" to excessive and problematic smartphone use. Results Although the majority of research in the field declares that smartphones are addictive or takes the existence of smartphone addiction as granted, we did not find sufficient support from the addiction perspective to confirm the existence of smartphone addiction at this time. The behaviors observed in the research could be better labeled as problematic or maladaptive smartphone use and their consequences do not meet the severity levels of those caused by addiction. Discussion and conclusions Addiction is a disorder with severe effects on physical and psychological health. A behavior may have a similar presentation as addiction in terms of excessive use, impulse control problems, and negative consequences, but that does not mean that it should be considered an addiction. We propose moving away from the addiction framework when studying technological behaviors and using other terms such as "problematic use" to describe them. We recommend that problematic technology use is to be studied in its sociocultural context with an increased focus on its compensatory functions, motivations, and gratifications.

Social Media Use Before Bed and Sleep Disturbance Among Young Adults in the United States: A Nationally Representative Study

Study Objectives

Social media (SM) use has been positively associated with disturbed sleep among young adults. However, previous studies have not elucidated the specific importance of SM use immediately before bed. We aimed to determine the independent association of SM use during the 30 minutes before bed and disturbed sleep while controlling for covariates including total SM use throughout the day.

Methods

We assessed a nationally representative sample of 1763 US young adults aged 19-32. Participants estimated to what extent they used SM in the 30 minutes before bed. We assessed sleep disturbance using the brief Patient-Reported Outcomes Measurement Information System (PROMIS®) Sleep Disturbance measure. After testing the proportional odds assumption, we used ordered logistic regression to compute the independent association between SM use before bed and sleep disturbance controlling for covariates, including total SM use.

Results

Compared with those who rarely or very rarely check SM in the 30 minutes before bed, those who often or very often check SM at that time had an adjusted odds ratio of 1.62 (95% confidence interval = 1.31-2.34) for increased sleep disturbance. Additionally, we found a significant linear trend in the odds ratios between the frequency of checking SM in the 30 minutes before bed and increased sleep disturbance (p = .007). Results were consistent in all sensitivity analyses.

Conclusions

SM use in the 30 minutes before bed is independently associated with disturbed sleep among young adults. Future work should use qualitative and experimental methods to further elucidate the directionality of-and mechanisms underlying-this association.

Smartphone addiction, daily interruptions and self-reported productivity

The advent of the smartphone has dramatically altered how we communicate, navigate, work and entertain ourselves. While the advantages of this new technology are clear, constant use may also bring negative consequences, such as a loss of productivity due to interruptions in work life. A link between smartphone overuse and loss of productivity has often been hypothesized, but empirical evidence on this question is scarce. The present study addressed this question by collecting self-report data from N = 262 participants, assessing private and work-related smartphone use, smartphone addiction and self-rated productivity. Our results indicate a moderate relationship between smartphone addiction and a self-reported decrease in productivity due to spending time on the smartphone during work, as well as with the number of work hours lost to smartphone use. Smartphone addiction was also related to a greater amount of leisure time spent on the smartphone and was strongly related to a negative impact of smartphone use on daily non-work related activities. These data support the idea that tendencies towards smartphone addiction and overt checking of the smartphone could result in less productivity both in the workplace and at home. Results are discussed in relation to productivity and technostress.

Measurements of Radiofrequency Radiation with a Body-Borne Exposimeter in Swedish Schools with Wi-Fi

Introduction

Wireless access to the Internet is now commonly used in schools. Many schools give each student their own laptop and utilize the laptops and wireless fidelity (Wi-Fi) connection for educational purposes. Most children also bring their own mobile phones to school. Since children are obliged by law to attend school, a safe environment is important. Lately, it has been discussed if radiofrequency (RF) radiation can have long-term adverse effects on children’s health.

Method

This study conducted exposimetric measurements in schools to assess RF emissions in the classroom by measuring the teachers’ RF exposure in order to approximate the children’s exposure. Teachers in grades 7–12 carried a body-borne exposimeter, EME-Spy 200, in school during 1–4 days of work. The exposimeter can measure 20 different frequency bands from 87 to 5,850 MHz.

Results

Eighteen teachers from seven schools participated. The mean exposure to RF radiation ranged from 1.1 to 66.1 µW/m². The highest mean level, 396.6 µW/m², occurred during 5 min of a lesson when the teacher let the students stream and watch YouTube videos. Maximum peaks went up to 82,857 µW/m² from mobile phone uplink.

Discussion

Our measurements are in line with recent exposure studies in schools in other countries. The exposure levels varied between the different Wi-Fi systems, and if the students were allowed to use their own smartphones on the school’s Wi-Fi network or if they were connected to GSM/3G/4G base stations outside the school. An access point over the teacher’s head gave higher exposure compared with a school with a wired Internet connection for the teacher in the classroom. All values were far below International Commission on Non-Ionizing Radiation Protection’s reference values, but most mean levels measured were above the precautionary target level of 3–6 µW/m² as proposed by the Bioinitiative Report. The length of time wireless devices are used is an essential determinant in overall exposure. Measures to minimize children’s exposure to RF radiation in school would include preferring wired connections, allowing laptops, tablets and mobile phones only in flight mode and deactivating Wi-Fi access points, when not used for learning purposes.

High and low use of electronic media during nighttime before going to sleep: A comparative study between adolescents attending a morning or afternoon school shift

This study compared the effects of time spent on electronic media devices during nighttime before going to sleep on the sleep-wake cycle, daytime sleepiness, and chronotype in 568 Mexican students (288 girls, mean age = 14.08) attending a double school shift system (287 from morning shift and 281 from afternoon shift). Students completed anonymous self-report questionnaires. Results suggest that high exposure to an electronic media device may have an impact on their sleep-wake cycle, regardless of their school shift. Adolescents from the afternoon shift reported more time spent on devices. Those from the morning shift reported daytime sleepiness with the use of MP3 player, and from the afternoon shift with the use of computer, MP3 player, and television. Both school shifts reported an intermediate chronotype with all electronic media devices, but the afternoon shift with a tendency towards eveningness with the use of the computer, smartphone, and MP3 player.

A socioeconomic related 'digital divide' exists in how, not if, young people use computers

Government initiatives have tried to ensure uniform computer access for young people; however a divide related to socioeconomic status (SES) may still exist in the nature of information technology (IT) use. This study aimed to investigate this relationship in 1,351 Western Australian children between 6 and 17 years of age. All participants had computer access at school and 98.9% at home. Neighbourhood SES was related to computer use, IT activities, playing musical instruments, and participating in vigorous physical activity. Participants from higher SES neighbourhoods were more exposed to school computers, reading, playing musical instruments, and vigorous physical activity. Participants from lower SES neighbourhoods were more exposed to TV, electronic games, mobile phones, and non-academic computer activities at home. These patterns may impact future economic, academic, and health outcomes. Better insight into neighbourhood SES influences will assist in understanding and managing the impact of computer use on young people's health and development.