Accident risk associated with smartphone addiction: A study on university students in Korea

The effect of smartphone addiction on adolescent health: the moderating effect of leisure physical activities

BACKGROUND

Smartphone addiction is a growing concern, especially among adolescents, due to its negative impact on health. This study examines how leisure physical activity influence this relationship.

OBJECTIVE

This study aimed to investigate the relationship between smartphone addiction and adolescent health, examining the mediating role of loneliness and the moderating effect of leisure physical activity.

METHODS

A survey of 1271 Chinese university students was conducted using the PAPS Health and Fitness Scale, Smartphone Addiction Scale, and Leisure Time Exercise Scale.

RESULTS

Smartphone addiction negatively affects adolescent health. Loneliness mediates this relationship, while leisure physical activity moderates it. High levels of physical activity reduce the negative impact of loneliness on health (bsimple = -0.49, P < 0.001), whereas low levels enhance this impact (bsimple = -0.21, P < 0.001).

CONCLUSION

These research have practical implications for preventing and reducing smartphone addiction and offer a theoretical foundation for promoting healthier lifestyles among adolescents.

Tracked and self-reported nighttime smartphone use, general health, and healthcare utilization: results from the SmartSleep Study

STUDY OBJECTIVES

Nighttime smartphone use is an increasing public health concern. We investigated whether nighttime smartphone use is associated with general health and primary healthcare utilization.

METHODS

Four thousand five hundred and twenty individuals (age 35.6 ± 9.7 years, 35% male) provided self-reported information on smartphone use frequency, symptoms of depression, and general health (one-item perceived health and cross-symptom composite score). A subset of the study sample (n = 3221) tracked their nighttime smartphone use. Primary healthcare utilization, i.e. the number of weeks in which at least one service from the patient's general practitioner (GP) was billed in 2020, was extracted from Danish population registries. Statistical analysis comprised logistic and multiple linear regression, controlling for sociodemographics.

RESULTS

Three hundred and nineteen individuals (7%) reported using their smartphone almost every night or more. More frequent self-reported nighttime smartphone use was associated with poor general health across all measures. Using the smartphone almost every night or more was associated with 2.8 [95% CI: 1.9, 4.1] fold higher odds of reporting poor health and with an average of 1.4 [95% CI: 0.7, 2.1] additional GP utilizations per year compared to no use. Associations were also found for the cross-symptom composite score across all symptoms. Further adjustment for symptoms of depression attenuated some associations. Smartphone use towards the end of the sleep period (sleep-offset use) was associated with poorer self-reported general health, but not with healthcare utilization.

CONCLUSIONS

Nighttime smartphone use frequency is associated with poor general health and healthcare utilization. Further studies should investigate the underlying causal structure and nighttime smartphone use as a transdiagnostic intervention target.

Safety analysis of pedestrians distracted by mobile phones at street crossings: Field study in Nanjing

The growing public concern over traffic safety hazards caused by pedestrians' distracted behavior, particularly related to mobile phone usage at pedestrian crossings. Through video recording of pedestrians' street-crossing behaviors on 12 sidewalks across 9 urban road intersections in Nanjing city, 1778 valid pedestrian samples were collected. The study categorizes mobile phone use during the crossing into five distinct types: no use, voice call, screen gaze, screen gaze with operation, and listening to music with headphones. Then, the effects of gender, age and companion conditions on the mobile phone during the crossing were examined by chi-square tests. Utilizing binomial logistic and Relogit regression models, the study analyzed the impact and safety risks of distraction on crossing behavior. Additionally, a random parameters (RP) logit model with heterogeneity in means was used to investigate the determinants affecting mobile phone usage. Notably, individuals aged 18 to 30 years were identified as the random parameter, while factors such as being under 18 years old, having a companion without interaction, having a companion with interaction, weekdays, sidewalk length, and the total number of other pedestrians were identified as fixed parameters. The study also presented significant variables affecting the probability of mobile phone usage through marginal effects, highlighting the potential safety risks associated with mobile phone usage during street crossing. These findings emphasize the need for heightened pedestrian safety awareness and a reduction in distracted behaviors to enhance overall traffic safety.

Associations of eHealth literacy and knowledge with preventive behaviours and psychological distress during the COVID-19 pandemic: a population-based online survey

OBJECTIVES

To compare the associations of COVID-19 preventive behaviours and depressive and anxiety symptoms with eHealth literacy and COVID-19 knowledge among Korean adults.

DESIGN

A cross-sectional online survey was conducted in April 2020.

SETTING

Seoul metropolitan area in South Korea.

PARTICIPANTS

1057 Korean adults were recruited.

MAIN OUTCOME MEASURES

Associations between eHealth literacy, COVID-19 knowledge, COVID-19 preventive behaviours and psychological distress were computed using Pearson's correlation and logistic regression analyses. eHealth literacy, COVID-19 knowledge, COVID-19 preventive behaviours and psychological distress were weighted by sex and age distribution of the general population in Seoul Metropolitan area.

RESULTS

68.40% (n=723) perceived high eHealth literacy level (eHEALS ≥26), while 57.43% (n=605) had high levels of COVID-19 knowledge (score ≥25). No significant association between eHealth literacy and COVID-19 knowledge was identified (r=0.05, p=0.09). eHealth literacy and COVID-19 knowledge were significantly associated with COVID-19 preventive behaviours (aOR=1.99, 95% CI 1.51 to 2.62 L; aOR=1.81, 95% CI 1.40 to 2.34, respectively). High eHealth literacy was significantly associated with anxiety symptom (aOR=1.71, 95% CI 1.18 to 2.47) and depressive symptom (aOR=1.69, 95% CI 1.24 to 2.30). COVID-19 knowledge had negative and no associations with the symptoms (aOR=0.62, 95% CI 0.46 to 0.86; aOR=0.79, 95% CI 0.60 to 1.03, respectively). High eHealth literacy with low COVID-19 knowledge was positively and significantly associated with COVID-19 preventive behaviours (aOR=2.30, 95% CI 1.52 to 3.43), and anxiety (aOR=1.81, 95% CI 1.09 to 3.01) and depressive symptoms (aOR=2.24, 95% CI 1.41 to 3.55). High eHealth literacy with high COVID-19 knowledge were significantly associated with more preventive behaviours (aOR=3.66, 95% CI 2.47 to 5.42) but no significant associations with anxiety and depressive symptoms.

CONCLUSION

We identified that eHealth literacy and COVID-19 knowledge were not associated each other, and differently associated with individuals' COVID-19 preventive behaviours and psychological well-being. Public health strategies should pay attention to enhancing both eHealth literacy and COVID-19 knowledge levels in the public to maximise their COVID-19 preventive behaviours and mitigate their psychological distress during COVID-19 pandemic.

The unique role of smartphone addiction and related factors among university students: a model based on cross-sectional and cross-lagged network analyses

Smartphone addiction is a global problem affecting university students. Previous studies have explored smartphone addiction and related factors using latent variables. In contrast, this study examines the role of smartphone addiction and related factors among university students using a cross-sectional and cross-lagged panel network analysis model at the level of manifest variables. A questionnaire method was used to investigate smartphone addiction and related factors twice with nearly six-month intervals among 1564 first-year university students (M = 19.14, SD = 0.66). The study found that procrastination behavior, academic burnout, self-control, fear of missing out, social anxiety, and self-esteem directly influenced smartphone addiction. Additionally, smartphone addiction predicted the level of self-control, academic burnout, social anxiety, and perceived social support among university students. Self-control exhibited the strongest predictive relationship with smartphone addiction. Overall, self-control, self-esteem, perceived social support, and academic burnout were identified as key factors influencing smartphone addiction among university students. Developing prevention and intervention programs that target these core influencing factors would be more cost-effective.

Effect of physical exercise on sleep quality in college students: Mediating role of smartphone use

OBJECTIVE

To investigate the effect of physical exercise on sleep quality and the mediating effect of smartphone use behavior in college students.

METHODS

A cross-sectional study design was adopted. An online survey of 5,075 college students was conducted using the Physical Activity Rating Scale-3, the Pittsburgh Sleep Quality Index, and the Mobile Phone Addiction Tendency Scale.

RESULTS

The sleep quality of college students was poor, and the proportion of college students with good sleep quality was 23.567%. A significant correlation existed between sleep quality and physical exercise (r = -0.159, P < 0.001) and mobile phone addiction (r = 0.355, P < 0.001). Physical exercise can predict sleep quality in college students (β = -0.011, P < 0.001). Smartphone use plays a part in mediating the process by which physical exercise affects sleep quality.

CONCLUSION

Chinese college students have poor sleep quality. Physical exercise and smartphone use behavior are important factors affecting the sleep quality of college students. Physical exercise can directly predict the sleep quality of college students and can predict the sleep quality of college students through the mediating effect of smartphone use behavior.

Problematic Smartphone Use and Its Relationship With Anxiety and Suicidal Ideation Among South Korean Adolescents

OBJECTIVE

This study aimed to investigate the prevalence of problematic smartphone use (PSU) among adolescents and its association with anxiety and suicidal ideation.

METHODS

The 16th cross-sectional, population-based Korea Youth Risk Behavior Web-Based Survey was administered in 2020 and included 54,948 adolescents. We used the Korean version of the smartphone overdependence scale and the 7-item Generalized Anxiety Disorder scale to assess PSU and anxiety. Suicidal ideation was assessed through responses to the self-report question. Multiple logistic regression analyses with complex sampling were conducted to identify the association of PSU with anxiety and suicidal ideation.

RESULTS

In total, 25.1% of the adolescents reported PSU, 33.2% had anxiety symptoms, and 10.9% had seriously considered suicide during the past 12 months. Girls with PSU had a higher risk of anxiety (adjusted odds ratio [aOR], 2.81; 95% confidence interval [CI], 2.65 to 2.97) and suicidal ideation (aOR, 1.77; 95% CI, 1.64 to 1.91) than non-PSU girls. Boys with PSU reported more anxiety (aOR, 2.89; 95% CI, 2.72 to 3.07) and suicidal ideation (aOR, 1.82; 95% CI, 1.66 to 1.99) than the non-PSU group. In addition, girls with the lowest household income reported more suicidal ideation than girls with the highest household income (aOR, 3.40; 95% CI, 2.69 to 4.28).

CONCLUSION

This study demonstrated the prevalence of PSU among South Korean adolescents in 2020. The prioritization of the detection of PSU and the identification of psychological factors may help improve the diagnosis and management of mental health problems and potentially yield significant psychosocial benefits.

The reciprocal relationships between meaning in life and smartphone addiction among Chinese college students: evidence from a three-wave cross-lagged panel model

Background

Previous cross-sectional studies have shown that meaning in life (MIL) is closely associated with college students' smartphone addiction (SA), but the causal relationship between MIL and college students' SA is uncertain. Therefore, conducting a longitudinal study to explore their relationship is very necessary. Furthermore, some studies have implied possible gender differences in the relationship between MIL and SA and the relationship between SA and MIL. Therefore, it is necessary to further examine whether there are gender differences in the above relationships.

Methods

The present study constructed a three-wave cross-lag panel model to explore the relationships between MIL and college students' SA. Three waves of data were collected from 705 college students (male: 338; female: 367) in China for three consecutive years, and the interval of data collection was 1 year. These college students completed the same online questionnaire regarding MIL and SA.

Results

(1) The MIL of male college students was significantly stronger than that of female college students at time 1, time 2, and time 3, (2) Female college students' SA at time 1, time 2, and time 3 was more serious than that of male college students, (3) There were reciprocal relationships between MIL and college students' SA, (4) The influence of MIL on female college students' SA was significantly stronger than that of male college students, and (5) The influence of SA on female college students' MIL was significantly stronger than that of male college students.

Conclusion

This study showed reciprocal relationships between MIL and SA among male college students and female college students. The findings further deepen our understanding of the relationship between MIL and SA and provide a gender perspective for preventing or intervening with college students' SA.

Impact of Using Smartphone While Walking or Standing: A Study Focused on Age and Cognition

BACKGROUND

Using smartphones during a task that requires upright posture is suggested to be detrimental for the overall motor performance. The aim of this study was to determine the role of age and specific aspects of cognitive function on walking and standing tasks in the presence of smartphone use.

METHODS

51 older (36 women) and 50 young (35 women), mean age: 66.5 ± 6.3 and 22.3 ± 1.7 years, respectively, were enrolled in this study. The impact of using a smartphone was assessed during a dynamic (timed up and go, TUG) and a static balance test (performed on a force platform). Multivariate analyses of variance were applied to verify main effects of age, task, estimates of cognitive function and interactions.

RESULTS

Compared to young, older individuals exhibited a poorer performance on the dynamic and on the static test (age effect: p = 0.001 for both variables). Dual-tasking with a smartphone had a negative impact on both groups (task effect: p = 0.001 for both variables). The negative impact, however, was greater in the older group (age × task effect: p = 0.001 for both variables). Executive function and verbal fluency partially explained results of the dynamic and static tests, respectively.

CONCLUSIONS

The negative impact of using a smartphone while performing tasks similar to daily activities is higher in older compared to young people. Subclinical deficits in distinct aspects of cognitive function partially explain the decreased performance when dual-tasking.

The effect of mobile phone task and age on gait: A systematic review and meta-analysis

Objective: Mobile phone usage while performing postural-locomotor tasks is everyday activity across persons of all ages in various environmental contexts and health conditions. However, it is also an important factor contributing to accidents. To lower the risk of pedestrian accidents, this meta-analysis aimed to examine how mobile phones affect pedestrian gait and identify how mobile phone tasks and participant age affect gait differently.

Methods: Electronic database searches were performed in The Cochrane Library, PubMed, and Medline. Two examiners evaluated the eligibility and quality of included studies using the Downs and Black checklist. The mean differences (MD) or standardized mean differences (SMD) were calculated for each outcome. Subgroup analyses were used to compare the differential effects of mobile phone task and participant age on gait.

Results: Among 22 eligible studies, 592 participants in 10 countries were analyzed in this meta-analysis. The overall meta-analysis showed that using a mobile phone significantly decreased pedestrian gait velocity (SMD = −1.45; 95% CI: −1.66 to −1.24; p &lt; 0.00001; I2 = 66%), step length (SMD = −1.01; 95% CI: −1.43 to −0.59; p &lt; 0.00001; I2 = 82%), and stride length (SMD = −0.9; 95% CI: −1.19 to −0.60; p &lt; 0.00001; I2 = 79%), significantly increased pedestrian step time (SMD = 0.77; 95% CI: 0.45 to 1.08; p &lt; 0.00001; I2 = 78%), stride time (SMD = 0.87; 95% CI: 0.69 to 1.06; p &lt; 0.00001; I2 = 24%), step width (SMD = 0.79; 95% CI: 0.34 to 1.24; p = 0.0006. I2 = 75%), double support time (SMD = 1.09; 95% CI: 0.86 to 1.31; p &lt; 0.00001; I2 = 42%), and double support (%gait cycle, %GC) (MD = 2.32; 95% CI: 1.75 to 2.88; p &lt; 0.00001; I2 = 26%).

Conclusion: In summary, the effects of mobile phone tasks and participant age on gait were inconsistent. Our study found that resource-intensive tasks (texting and reading) significantly reduced gait velocity, and step time; however, small resource-intensive tasks (calling, talking, and dialing) did not affect these outcomes. In contrast to young adults, step length and step time were not affected by mobile phone use in older adults. Tips: Pedestrians should consider using a mobile phone in their daily lives according to the application scenarios (walking environment, the complexity of mobile phone tasks, pedestrians’ task processing abilities, etc.) as appropriate to avoid dangerous accidents.

Systematic Review Registration: identifier CRD42022358963.

Is distraction on the road associated with maladaptive mobile phone use? A systematic review

Maladaptive Mobile Phone Use (MMPU) (also known as Smartphone Addiction, Nomophobia, Fear of Missing Out, or Problematic Mobile Phone Use) is a growing mental health problem. However, the health and safety consequences of MMPU remain unexplored in many real-life contexts. A potential setting where MMPU may have some negative repercussions is on the road. It is well established that road users (e.g., drivers, motorcyclists, pedestrians, and cyclists) increasingly injure themselves or others due to distractions such as phone use while on the road. Emerging research suggests that MMPU is a possible determinant of this risky behaviour. Therefore, it is essential to investigate the relationship between MMPU and mobile phone use behaviour on the road, as it could help guide and improve interventions aimed at increasing road safety. This systematic review investigated the relationship between maladaptive mobile phone use and mobile phone use behaviour on the road in terms of attitudes and risk perception, intention, phone use engagement, performance changes, and safety outcomes. A total of 44 studies were identified with 47 unique samples of road users, of which 68.1% (32/47) were comprised of drivers, 19.1% (9/47) were pedestrians, 8.5% (4/47) were unspecified road users, and there was one group of motorcyclists and cyclists. Our findings confirmed that MMPU is related to risky behaviour on the roads. In the 29 studies considering observed or self-reported behaviour, 90.9% (30/33) found that road users who scored higher in MMPU are more likely to use their phones on the road as cyclists, drivers, motorcyclists, and pedestrians. Of the nine studies that analysed performance changes, 55.6% (5/9) showed evidence that MMPU changes the performance of road users engaging in mobile phone use, meaning that there is evidence suggesting that MMPU determines the level of impairment. Of the nine studies that analysed the safety-related-outcomes, 66.7% (6/9) found that the higher the MMPU score, the more likely road users are to experience safety-critical traffic events. This review contributes to the literature by showing a pathway between the negative health consequences of MMPU and road trauma. We also identified that the quality of the studies was generally low due to study design and blinding aspects. This field of research also lacks standard practices as researchers avoid using established and well-validated questionnaires, often creating new ones to measure MMPU. This hinders the generalisability of the findings and raises questions about the construct validity and external validity of MMPU. The usefulness of future research would be enhanced by a consistent methodological approach using the same scales based on standard behavioural definitions. The cross-disciplinary nature of MMPU effects means that transport and road safety professionals need to work with healthcare professionals and technology organisations to understand and address MMPU as a contributing factor to road crashes.

The problematic use of smartphones in public: the development and validation of a measure of smartphone “zombie” behaviour

Purpose

We have witnessed an evolution in the use of smartphones in recent years. We have been aware for some time of the potentially deleterious impact of smartphones on users' lives and their propensity for user addiction, as reflected in the large and growing body of work on this topic. One modern phenomenon – the distracted mobile phone user in public, or “smartphone zombie” – has received limited research attention. The purpose of the present study is to develop a robust measure of smartphone zombie behaviour.

Design/methodology/approach

The research deign comprises three studies: A round of focus groups (n = 5) and two online surveys (survey one n = 373, survey two n = 386), in order to develop and validate a three-factor, 15-item measure named the Smartphone Zombie Scale (SZS).

Findings

Following the round of focus groups conducted, Exploratory Factor Analysis and a Confirmatory Factor Analysis, the SZS measure (Cronbach's α = .932) is demonstrated to be robust and comprises three factors: Attention Deficit (Cronbach's α = .922), Jeopardy (Cronbach's α = .817) and Preoccupation (Cronbach's α = .835), that is shown to be distinct to existing closely related measures (Smartphone Addiction scale and Obsessive Compulsive Use).

Originality/value

The present study represents the first extant attempt to produce a measure of smartphone zombie behaviour, and provides us with a reliable and valid measure with which we can study this growing phenomenon.

Engaging in physical activity instead of (over)using the smartphone: An experimental investigation of lifestyle interventions to prevent problematic smartphone use and to promote mental health

Aim

Tendencies of problematic smartphone use (PSU) have risen during the past decade. As PSU is consistently linked to mental health issues, measures to prevent its appearance and to promote mental health are urgently required.

Subject and Methods

The present study investigated the impact of three interventions on health behavior, PSU, positive mental health (PMH), and depression and anxiety symptoms. Overall, 503 persons from Germany (M age = 29.19, SD age = 10.51, range: 18-79) participated in the study. Over 14 days, the three experimental groups (a) reduced their daily smartphone use time by 60 minutes, (b) increased their daily level of physical activity by 30 minutes, and (c) combined both measures. The control group continued its behavior as usual. Outcomes were assessed via online surveys at five measurement time points (baseline, intermediate, post-intervention, and 1 and 3 months after the intervention).

Results

All interventions resulted in a significant increase in weekly physical activity and in reduced symptoms of PSU, depression, and anxiety. Furthermore, the smartphone reduction and the combination of both measures contributed to a significant reduction of participants' daily smartphone use and higher levels of PMH. The effects of the reduction of smartphone use time and its combination with increased physical activity were more stable in the longer term than the increase in physical activity only.

Conclusion

Combined with an increase in physical activity, the reduction of smartphone use time could serve as an efficient and cost-effective measure for the prevention of PSU and the promotion of mental health.

Effect of Mobile Phone Addiction on Physical Exercise in University Students: Moderating Effect of Peer Relationships

OBJECTIVE

The influence of mobile phone addiction (MPA) on physical exercise in university students was explored, and peer relationships were introduced as a moderating variable.

METHODS

A cross-sectional study design was adopted, and an online survey questionnaire was conducted to investigate two universities in Nantong City, Jiangsu Province, and Chongzuo City, Guangxi Zhuang Autonomous Region. A total of 4959 university students completed the questionnaire. Measurement tools included the Mobile Phone Addiction Tendency Scale, the Physical Activity Rating Scale, and the Peer Rating Scale of university students.

RESULTS

University students scored 39.322 ± 15.139 for MPA and 44.022 ± 7.735 for peer relationships, with 87.8% of their physical exercise, in terms of exercise grade, being classified as medium or low intensity. The MPA of the university students was negatively correlated with peer relationships (r = -0.377, p < 0.001) and physical exercise behavior (r = -0.279, p < 0.001). The moderating effect of peer relationships on the MPA-physical exercise behavior relationship was significant (ΔR² = 0.03, p < 0.001).

CONCLUSIONS

The physical exercise of university students was at a medium or low intensity. The more serious the university students' addiction to mobile phones was, the lower the amount of physical exercise. The physical activity of males was higher than that of females. MPA and peer relationships were the limiting factors of the physical exercise behavior of university students. Under the lower effect of peer relationship regulation, MPA had a greater negative impact on physical exercise behavior. The data from this research can provide theoretical support to improve the participation of university students in physical activities.

Meaning in life and smartphone addiction among Chinese female college students: The mediating role of school adjustment and the moderating role of grade

Background

The fact that female college students are more addicted to smartphones than male college students has raised public concerns. However, previous studies have rarely explored the mechanism of female college students' smartphone addiction. Previous studies have shown that identity may affect the formation process of female college students' smartphone addiction, and the identity of female college students in different grades may be different. Nonetheless, few studies have explored the grade differences in the formation process of female college students' smartphone addiction.

Methods

The present study examined the relationship between meaning in life, school adjustment, and smartphone addiction among Chinese female college students using a moderated mediation model in which school adjustment played a mediating role and grade played a moderating role. A total of 1,076 Chinese female college students (Age: 19.83 ± 1.11; 369 freshmen, 379 sophomores, and 328 juniors) completed an online questionnaire regarding meaning in life, school adjustment, and smartphone addiction.

Results

(1) School adjustment mediated the relationship between meaning in life and smartphone addiction. (2) School adjustment had a partial mediating effect between meaning in life and smartphone addiction for female freshmen and sophomores, but it did not exist among female juniors. (3) The influence of school adjustment on female sophomores' smartphone addiction was significantly stronger than that of female freshmen.

Conclusion

The findings of this study advance our understanding of the potential impacts of meaning in life on smartphone addiction and provide a grade perspective for targeted prevention or intervention with female college students' smartphone addiction.

Adverse Effects of Smartphone Addiction among University Students in South Korea: A Systematic Review

BACKGROUND

Globally there has been an exponential increase in the penetration of smartphones among the youth population and smartphones have become indispensable in the daily lives of university students in South Korea. Several studies have associated the problematic use of smartphones or addiction with different adverse outcomes. The goal of this study was to collate empirical evidence and provides an overall synthesis of the literature about the adverse effects of smartphone addiction on university students in South Korea.

METHOD

We carried out a systematic review of the published literature between August and October 2022 on the adverse effects of smartphone addiction on university students in South Korea, published between 2012 and 2022 in Pubmed/Medline, PsycInfo, Embase, Biomed-Central, Web of Science, Directory of Open Access Journals, Elsevier's collection, Wiley Online Library, SpringerLink, Sage Journal's collection and Cochrane Library.

RESULTS

Thirty-four articles published between 2012 and 2022 were included in the synthesis of this review. Eight studies explored the association between smartphone addiction and the psychological and mental health of university students in Korea. Smartphone addiction was associated with physical health leading to sleep disorders and musculoskeletal and neurological problems. Academic performance, procrastination, impulsivity, self-esteem, reduced social interaction, solitude, and suicide were also negatively associated with smartphone addiction.

CONCLUSIONS

Our study adds to the literature regarding the adverse effects of smartphone addiction on university students in Korea and provides more information for addiction prevention and health promotion activities.

Prevalence of Smartphone Addiction and Its Association with Sociodemographic, Physical and Mental Well-Being: A Cross-Sectional Study among the Young Adults of Bangladesh

Smartphones have made our lives easier and have become indispensable for everyday life; however, their uncontrolled and excessive use can trigger "smartphone addiction" (SA). SA is a rising public health issue, particularly among young people around the world. There is a dearth of empirical research about SA and its impacts on young adults, particularly in developing countries such as Bangladesh. This cross-sectional study is an attempt to fill this gap. The data were collected from 440 eligible young adults in Bangladesh using an online survey between July 2021 and February 2022. Study results revealed that 61.4% of the young adults were addicted to their smartphone. Logistic regression analysis showed that being male, aged ≤25, unemployed and living with a large family size (≥8) were the significant sociodemographic predictors of SA. Smartphone-addicted participants were more likely to be less physically active, suffer from insomnia, be overweight or obese and use their phones while driving, walking and eating. In addition, the SA group were more likely to have physical and mental well-being problems. This study brings to light significant implications for policy makers and indicates a need for an SA community awareness programme which aims to reduce SA at the societal level.

Correlations between Problematic Mobile Phone Use and Depressiveness and Daytime Sleepiness, as Well as Perceived Social Support in Adolescents

(1) The aim of this study was to estimate the scale of mobile phone addiction among young adults as well as to establish whether the low level of perceived social support is related to problematic smartphone use, and whether an addictive pattern of mobile phone use is related to the prevalence of depressiveness and excessive daytime sleepiness. (2) The study was carried out using the diagnostic poll method via the questionnaire technique. Both the author's own questionnaire and the following standardized research tools were used: the Mobile Phone Problem Use Scale for Adolescents (MPPUSA), the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), and the Multidimensional Scale of Perceived Social Support (MSPSS). (3) Perceived social support was significantly lower in the group of respondents who problematically used their mobile phones in comparison with the ones who used them in a proper way. Severity of depressive symptoms and daytime sleepiness was significantly higher in respondents addicted to their mobiles compared to nonaddicted ones. (4) Conclusions: An important correlation between phone addiction and the prevalence of depressive symptoms and excessive daytime sleepiness exists. Problematic mobile phone use concerns individuals with low levels of perceived social support.

Further exploration of the psychometric properties of the revised version of the Italian smartphone addiction scale – short version (SAS-SV)

Problematic smartphone use (PSU) is an emerging public and social issue, potentially connected to the significant increase in smartphone applications. Different scales have been designed and developed to identify the risk of smartphone addiction, and the 10-item Smartphone Addiction Scale - Short Version (SAS-SV) is one of the most used instruments to assess the risk of PSU. The main objective of the present study was to provide further psychometric properties of the Italian version of the SAS-SV. The study was conducted with a convenience sample of 858 Italian university students. Parallel and confirmatory factor analyses were performed to confirm if the one-factor structure fitted the data well. In addition, because previous studies have emphasised gender and age differences in the SAS-SV, measurement invariance was also tested. Network analysis, predictive validity, and convergent validity were also explored. The parallel analysis results suggested removing Item 3 (feeling pain) because its factor loading was low, resulting in a nine-item SAS-SV. The measurement invariance showed that the SAS-SV performed similarly for gender and age. However, partial scalar invariance across gender and age was observed. Furthermore, gender differences indicated that more females than males scored higher on SAS-SV. No significant age differences were found. The receiver operating characteristic (ROC) curve results indicated a cut-off of 29 points as the best for the SAS-SV (AUC = 0.85). Moreover, among males, the cut-off was 25 (AUC = 0.84), and among females, the cut-off was 30 (AUC = 0.84). The SAS-SV showed a strong association with problematic social media use (PSMU) and other variables related to smartphone use (e.g., time spent on Facebook, Instagram, and WhatsApp). Overall, the present study results indicate that the nine-item SAS-SV appears to be a valid and reliable instrument to assess PSU risk among Italian university students.

Stress can lead to an increase in smartphone use in the context of texting while walking

Texting while walking (TWW) is a dangerous behavior that can lead to injury and even death. While several studies have examined the relationship between smartphone use and stress, to our knowledge no studies have yet investigated the relationship between stress and TWW. The objective of the present study was to investigate this relationship by examining the effects of stress on TWW, the effects of TWW on subsequent stress, and the effect of stress on multitasking performance. A total of 80 participants completed two sequential tasks in a laboratory while they walked on a treadmill and responded to a biological motion stimulus imitating the movement of another pedestrian. In the unrestricted task, participants were given the choice to use their personal phones. In the controlled task, they carried a text conversation with a research assistant while they walked and responded to the stimulus. Stress was measured via questionnaire and saliva collection for measure of cortisol (a stress hormone) before and after each task. Results show that greater psychological stress and cortisol variations were associated with a greater number of phone uses during the unrestricted task. Greater phone use during the unrestricted task was associated with lower subsequent psychological stress in women and total time of phone use was correlated with subsequent cortisol levels. Stress measured before the controlled task had no effect on multitasking performance, but participants with moderate performance were those with the highest cortisol levels. Our results suggest that stress could be a precursor to TWW and that it could affect a pedestrian’s ability to stay safe when using their smartphone.

Association between 24-Hour Movement Behaviors and Smartphone Addiction among Adolescents in Foshan City, Southern China: Compositional Data Analysis

Smartphone addiction has become a public health issue. To help reduce smartphone addiction, we assessed the combined effect of 24-Hour Movement Behaviors on smartphone addiction during Corona Virus Disease 2019 (COVID-19) home confinement in Foshan, China. Data were collected in a sample of 1323 senior middle school students ((mean age ± standard deviation): 16.4 ± 0.9 years; 43.46% males) during the COVID-19 lockdown. Their 24-Hour movement behaviors were assessed by a self-reported questionnaire, The Smartphone Addiction Scale-Short Version (SAS-SV). The compositional multiple linear regression model and compositional isotemporal substitution model were used to examine the association between the time budget composition of the day and smartphone addiction. Smartphone addiction occurred in 671 (50.72%) of the 1323 students. Compared with smartphone-addicted adolescents, non-smartphone-addicted adolescents had more moderate-to-vigorous physical activity (MVPA) and sleep duration (SLP), and less sedentary behavior (SB). The distribution of time spent in 24-Hour movement behaviors was significantly associated with smartphone addiction. The negative effect was found for the proportion of time spent in MVPA or SLP (ilr1-MVPA = −0.453, p < 0.001. ilr1-SLP = −3.641, p < 0.001, respectively) relative to the other three behaviors. Conversely, SB was positively associated with the score of smartphone addiction (ilr1-SB = 2.641, p < 0.001). Reallocating one behavior to remaining behaviors was associated with smartphone addiction. Noticeably, the effects of one behavior replacing another behavior and of one behavior being displaced by another behavior were asymmetric. The 24-Hour movement behaviors of adolescents are closely related to smartphone addiction, and future intervention studies should focus on the compositional attribute of 24-Hour movement behaviors.

Fear of missing out and fear of not being up to date: investigating different pathways towards social and process problematic smartphone use

The present study introduces a new construct potentially associated with problematic smartphone use, that is the fear of not being up to date, and tests two serial mediation models, in which it was hypothesised that: (i) metacognitions and social smartphone use would be serial mediators of the relationship between the fear of missing out (FoMO) and problematic smartphone use (PSU); and (ii) metacognitions and process smartphone use would be serial mediators of the relationship between and the fear of not being up to date and PSU. A sample of 364 participants (F = 72.8%; mean age = 36.80 ± 15.32 years; age range: 18–75 years), recruited online, were administered a battery of self-report measures assessing FoMO, the fear of not being up to date, metacognitions about smartphone use, process and social smartphone use, and PSU. The serial mediation effect of metacognitions about smartphone use and process use on the relationship between the fear of not being up to date and PSU was significant (indirect effect = 0.004; 95% CI: [0.0006, 0.009]). Conversely, the serial mediation effect of metacognitions about smartphone use and social use on the relationship between FoMO and PSU was not significant (indirect effect = 0.002; 95% CI: [-0.003, 0.009]). Smartphone social use did not predict PSU. The current study highlights a possible pathway towards process smartphone use via a relatively new phenomenon termed “fear of not being up to date” within a metacognitive framework.

Impact of Mobile Game Addiction Tendency on Chinese University Students: A Hierarchical Linear Modeling Study

This study used hierarchical linear modeling (HLM) to investigate the differences in mobile game addiction tendencies among universities (i.e., double first-class universities, ordinary colleges and universities, and higher vocational colleges), and to examine the influencing factors of mobile game addiction tendency at the individual and university levels. The participants of this study were 4,024 college students who completed the Chinese Mobile Phone Game Addiction Scale, UCLA Loneliness Scale, and Positive and Negative Affect Scale. Loneliness (β = 0.052), positive emotions (β = −0.126), negative emotions (β = 0.232), and double first-class universities (γ = 0.368) significantly predicted mobile game addiction tendencies. A significant cross-level interaction between double first-class universities and other factors (i.e., positive emotions, negative emotions, and mobile game addiction) was observed. The novelty of this study is that it distinguishes the various effects of mobile phone addiction tendency at the individual and university levels.

Smartphone addiction and victimization predicts sleep problems and depression among children

BACKGROUND

In this study we examined the phenomena of smartphone addiction, online harassment, and school bullying/victimization to predict the prospective influence these could have on the onset and persistence of sleep problems and depression among children.

METHODS

Responses from 2155 fifth-grade children recruited from 30 primary schools in Taipei were assessed, and a follow-up was performed in the 6th grade. Self-administered questionnaires were collected for each year.

FINDINGS

Children who reported smartphone addictions, online harassment, and school bullying/victimization coupled with an increase in those factors were more likely to experience the onset and persistence of sleep problems. In addition, children who reported smartphone addiction, online harassment, school bullying/victimization, and poor sleep quality were more likely to experience the onset and persistence of depression.

IMPLICATIONS

School nurses or pediatric nurses should be able to assess children's Internet use and risks to understand potential influences on sleep quality and mental status and provide recommendations for children, parents and schools.

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

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

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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.

Anxiety sensitivity mediates relations between anxiety (but not depression) and problematic smartphone use severity, adjusting for age and sex, in Chinese adolescents early in the COVID-19 pandemic

Risk factors for problematic smartphone use (PSU) have rapidly become an important area of research due to the prevalence of smartphones and functional impairment associated with PSU. Our aim was to examine relations between established predictors of PSU (depression and anxiety) and a potential mediator of PSU (anxiety sensitivity; AS). Participants (N = 4752) from junior and senior high schools in Tianjin, China completed a web‐based survey with measures of depression, anxiety, AS, and PSU. Descriptive and inferential analyses revealed significant differences between males and females on depression severity, and between junior and senior high school students on AS and PSU severity. Results of structural equation modeling indicated that anxiety was positively associated with AS when adjusting for depression; and AS was significantly associated with greater PSU severity, adjusting for age and sex. Additionally, AS mediated relations between anxiety and PSU severity. Current findings on AS are consistent with theoretical models of problematic internet use (Interaction of Person‐Affect‐Cognition‐Execution) and previous research linking AS to other kinds of behavioral addictions (e.g., smoking, alcohol use).

Health-related consequences of the type and utilization rates of electronic devices by college students

Background

College students are leading an evolution of device use both in the type of device and the frequency of use. They have transitioned from desktop stations to laptops, tablets, and especially smartphones and use them throughout the day and into the night.

Methods

Using a 35-min online survey, we sought to understand how technology daily usage patterns, device types, and postures affect pain and discomfort to understand how knowledge of that pain might help students avoid it. Data were analyzed from 515 students (69.5% male) who completed an internet-delivered survey (81.3% response rate).

Results

Participants ranked smartphones as their most frequently used technology (64.0%), followed by laptops and tablets (both 53.2%), and desktop computers (46.4%). Time spent using smartphones averaged over 4.4 h per day. When using their devices, students were more likely to adopt non-traditional workplace postures as they used these devices primarily on the couch or at a chair with no desk.

Conclusion

Recent trends in wireless academic access points along with the portability of small handheld devices, have made smartphones the most common link to educational materials despite having the least favorable control and display scenario from an ergonomic perspective. Further, the potential impact of transitions in work environments due to COVID-19 may further exacerbate ergonomic issues among millions highlighting the need for such work to be carried out.

Time flies when chatting online: a social structure and social learning model to understand excessive use of mobile instant messaging

Purpose

Widespread concerns about excessive use of mobile instant messaging (MIM) have inspired research in different disciplines. However, the focus thus far tends to be on diagnostics and cognitive predictors. There is little understanding from the socio-technical perspective to capture the drivers of excessive use of MIM. To address this research gap, the authors aim to enrich existing literature by adopting a social structure and social learning model (SSSLM) to understand the excessive use of MIM. The authors argue that excessive MIM use is developed and reinforced in highly interactive online communication, through a social learning process.

Design/methodology/approach

The authors conduct a cross-sectional online survey to validate our proposed research model on excessive use of mobile instant messaging (MIM). 368 valid responses are obtained from active MIM users in China.

Findings

The results suggest that highly interactive MIM creates a technology-based social structure that facilitates the social learning process of excessive technology use. The influence of perceived interactivity of MIM on excessive MIM use is mediated by a series of contextualized social learning factors. Furthermore, the influences of perceived interactivity on social learning factors are moderated by MIM use experience.

Originality/value

The authors contribute to literature in related fields by highlighting the crucial role of social learning in facilitating excessive technology use. The authors contribute to the social structure and social learning model by contextualizing it into the context of excessive MIM use. Design guidelines are provided with a purpose to inhibit excessive use of MIM.

Couriers' safety and health risks before and during the COVID-19 pandemic

Objectives

This study aimed to examine the safety and health hazards of motorized couriers and investigate working conditions and driving behavior possibly associated with involvement in road accidents while driving motorcycles or cars. In light of the outbreak of COVID-19, the study was aimed to explore factors that affect the couriers’ behaviors related to decreasing the risk of contracting an infectious disease.

Methods

A sample of 237 Israeli couriers, about half who drove a two-wheeled vehicles and the others who drove cars, answered an online survey questionnaire. The questionnaire examined organizational, occupational, and personal factors regarding their working conditions, behavior on the road, musculoskeletal disorders, road accidents, and perceptions of and compliance with regulations regarding COVID-19. The data were analyzed by multiple regression in SPSS 25, structural equation modeling and mediation tests in R 3.6.2.

Results

According to the couriers’ self-report, 37% reported musculoskeletal pains at least once a day, 13% of them were involved in work-related road accidents and 10% reported feeling stress at least once a week. More than 60% of the couriers reported increased stress due to the COVID-19 pandemic. Weekly working hours, shift duration and stress were related to involvement in accidents through the mediation of driving while feeling unwell. Reported stress and the weight of parcels were related to musculoskeletal pains.

Conclusions

The findings suggest that stress and attributes of work overloads experienced by couriers are associated with reduced safety and impaired health. Organizational, individual, and societal factors were correlated with the degree to which the couriers adhered to COVID-19 regulations. The increased prevalence of new modes of employment relationships in the field highlights the importance of research on employment conditions and safety and health aspects related to this occupation.

The relationship between smartphone use and dry eye disease: A systematic review with a narrative synthesis

BACKGROUND

Emerging research findings suggest a potential relationship between smartphone use (SPU) and dry eye disease (DED), which has not been systematically reviewed.

OBJECTIVES

The aim of this study was to systematically review and synthesize evidence on the relationship between SPU and DED.

METHODS

A systematic search of Medline, EMBASE, CINAHL, and PsychINFO bibliographic databases from their inception to January 15, 2021. Study screening, full-text assessment, study selection and exclusion, data extraction, and quality assessment was performed independently by at least two review authors.

RESULTS

Four studies were included in the review (3 cross-sectional studies and 1 nonrandomized clinical trial). A narrative synthesis of findings was used due to heterogeneity among study designs and measures of association summarizing the relationship between SPU and DED. All included studies were conducted in South Korea and included school children, college students, or young adults. Three of the 4 included studies showed an association between SPU and DED.

CONCLUSIONS

There is some evidence that SPU is associated with DED. However, this evidence is limited by a small number of studies of satisfactory methodological quality. There is a great need for high-quality studies to further investigate the relationship between SPU and DED and identify mechanisms underlying this potential relationship. This information is important for raising public awareness about the negative effect of SPU on eye health and development of clinical guidelines for this potentially emerging SPU-driven eye condition.

Secular trends in fall-related hospitalizations in adolescents, youth and adults: a population-based study

Background

Falls are one of the major causes of injury globally. However, there is a lack of population-based studies on falls among adolescents, young and middle-aged adults. We therefore aimed to conduct a large-scale population study on the secular trend in incidence of fall-related hospitalization.

Methods

A population-wide electronic database, Hong Kong's Clinical Data Analysis and Reporting System (CDARS), was used in this retrospective cohort study. Patients aged≥10, hospitalized with diagnosis of accidental falls (ICD-9-CM E880-E888) from 2005-2018, were included. Outcome measures included the number, age- and sex-standardized incidence rate of fall-related hospital admissions, their length of stay (LOS) and 1-year all-cause mortality. Linear regression and average annual percentage change (AAPC) using joinpoint regression were computed for trend analysis.

Findings

From 2005 to 2018, a total of 336,439 patients aged≥10 were identified with fall-related hospitalization. Among these fall patients, 33.7% occurred at age<60. The number of fall-related hospital admissions episodes increased significantly by 83.7% during the study period. The standardized incidence rate of falls per 1000 person-years increased from 3.67 (95% CI 3.62-3.72) in 2005 to 4.79 (95% CI 4.74-4.84) in 2018. Although the total hospitalized bed-days increased from 178,723 days in 2005, to 299,273 days in 2018 (+67.5%,p<.0001), the median length of stay per episode of falls decreased from 4.90 days to 3.79 days (p<.0001).

Interpretation

Continuous increase in the incidence of fall-related hospitalization in people aged≥10 was observed. This suggested that falls are a public health issue in all ages. Further studies on the differences in the underlying risk factors and comorbidities between younger and older fall patients are warranted.

Funding

None.

ROAD SAFETY AND TRAFFIC INJURIES DUE TO DISTRACTED DRIVING OF SMARTPHONE USAGE AMONG UNIVERSITY STUDENTS

This study provides the behaviour of university students using smartphone on daily basis and while driving, and exploring their perception towards the road safety of such habits. World Health Organisation states that distracted driving due to smartphone usage has been the uprising cause of road traffic injuries especially among young drivers. This study will provide knowledge in enforcing the right mitigation measures in preventing such behaviour from growing. The results from this study can also be integrated in intelligent transportation system in traffic accident prevention programme. This survey is conducted at Universiti Tun Hussein Onn Malaysia with a sample size of 371 respondents with majority of them aged 21 to 25 (86.6%) who own smartphone (100%) and private vehicle (59.1%). Results found that university student are dependent of their smartphone on daily basis for alarm (94.3%), communication and socialisation (73.9%). They tend to use their smartphone while driving, at traffic light (68.4%) and during traffic congestion (61.0%), often for maps navigations (69.8%) and to make call (57.4%) in hands-free mode. Despite knowing the danger of this behaviour (97.3%), they ignored the risks and committed such offenses. Hence, the need for education and enforcement are significant and relevant among university students to prevent such behaviours from growing.

Psychometric properties of the Metacognitions about Smartphone Use Questionnaire (MSUQ) in a sample of iranians

Research has shown that metacognitions are associated with addictive behaviors. This study aimed to evaluate the psychometric properties (i.e., factor structure, reliability, and predictive validity) of the Persian Metacognitions about Smartphone Use Questionnaire (Persian MSUQ). A community sample of 618 participants (63.6% female, mean age = 27.31 ± 8.95 years; age range: 15-67 years) was recruited in Iran. The results of exploratory factor analysis revealed that the Persian MSUQ had a three-factor structure, similar to the parent version, named positive metacognitions about emotional and cognitive regulation, negative metacognitions about uncontrollability and cognitive harm, and positive metacognitions about social advantages. The confirmatory factor analysis indicated that the three-factor structure of the Persian MSUQ had appropriate fit. Cronbach's alphas for the three factors were 0.89, 0.88, and 0.70, respectively. Test-retest coefficients over a 6-week interval showed good reliability for the Persian MSUQ total score (ICC = 0.81; 95% CI: 0.72-0.87). Regression analyses showed that metacognitions about smartphone use predicted problematic smartphone use independently of anxiety and depression. The findings suggest that the Persian MSUQ has appropriate psychometric properties in the Iranian context.

Two-dimensional taxonomy of internet addiction and assessment of smartphone addiction with diagnostic criteria and mobile apps

A recent review by Montag et al. raised a taxonomical argument about internet addiction. We propose a two-dimensional taxonomy of internet addiction by both the device and the content as the solution. For the assessment of smartphone addiction, measurements should be based on functional impairment and validated by diagnostic criteria rather than solely on self-reported questionnaires. We detail the potential of mobile applications (apps) to improve the assessment of smartphone addiction. App-generated indicators could fulfill the unmet need of assessment of smartphone addiction and facilitate future assessment and treatment planning of smartphone addiction.

Exploring the Dimensions of Smartphone Distraction: Development, Validation, Measurement Invariance, and Latent Mean Differences of the Smartphone Distraction Scale (SDS)

Background: Distraction is a functional emotion regulation strategy utilized to relieve emotional distress. Within the attention economy perspective, distraction is increasingly associated with digital technology use, performance impairments and interference with higher-order cognitive processes. Research on smartphone distraction and its association with problematic smartphone use is still scarce and there is no available psychometric assessment tool to assess this cognitive and emotive process parsimoniously. Method: The present study reports the development and evaluation of the psychometric properties of the Smartphone Distraction Scale (SDS) through exploratory and confirmatory factor analysis, construct validity, gender invariance, and latent mean differences. The study was conducted in a sample of British university students (N = 1,001; M = 21.10 years, SD = 2.77). Results: The 16-item SDS was best conceptualized in a four-factor model solution comprising attention impulsiveness, online vigilance, emotion regulation, and multitasking. Construct validity was established using relevant psychosocial and mental health measures, with SDS scores being moderately associated with deficient self-regulation and problematic social media use. Gender measurement invariance was achieved at the configural, metric, and scalar levels, and latent mean differences indicated that females had significantly higher means than males across all four SDS latent factors. Discussion: The SDS presents with several strengths, including its theoretical grounding, relatively short length, and sound psychometric properties. The SDS enables the assessment of distraction, which appears to be one of the pathways to problematic smartphone use facilitating overuse and overreliance on smartphones for emotion regulation processes. The assessment of distraction in relation to problematic use in vulnerable populations may facilitate interventions that could encourage metacognition and benefit these groups by allowing sustained productivity in an increasingly disrupted work and social environment.

Association Between Anxiety Symptoms and Problematic Smartphone Use Among Chinese University Students: The Mediating/Moderating Role of Self-Efficacy

Problematic smartphone use (PSU) is a novel manifestation of addictive behaviors. It is frequently reported to be correlated with anxiety symptoms among University students. However, the underlying mechanism has not yet been thoroughly studied. Whether the association between anxiety symptoms and PSU is mediated or moderated by self-efficacy remains unclarified. A cluster sampling cross-sectional study was thus conducted to explore the potential mediating or moderating effect of self-efficacy in Chinese University students. Participants (N = 1,113) were recruited from eight Universities in Shenyang, China. Of them, 146 did not effectively respond to the questionnaires. Thus, 967 participants were eligible for the final analysis. The mediating or moderating role of self-efficacy in the anxiety-PSU relationship was explored using hierarchical multiple regression. Then the mediation model was further verified using the SPSS macros program (PROCESS v3.0). Our results showed that anxiety symptoms was positively correlated with PSU (r = 0.302, P < 0.01), while self-efficacy was negatively correlated with anxiety symptoms and PSU (r = -0.271 and -0.181, P < 0.01). Self-efficacy partly mediated the relationship between anxiety symptoms and PSU, which accounted for ~17.5% of the total effect that anxiety symptoms have on PSU. However, the moderating effect of self-efficacy on the anxiety-PSU relationship was insignificant. In summary, our findings suggested that self-efficacy partly mediates but not moderates the link between anxiety symptoms and PSU among Chinese University students. Therefore, multicomponent interventions should be made to restrict the frequency of smartphone usage, enhance the level of self-efficacy, and thus promote the mental health status of University students.

Associations Between COVID-19 Misinformation Exposure and Belief With COVID-19 Knowledge and Preventive Behaviors: Cross-Sectional Online Study

Background

Online misinformation proliferation during the COVID-19 pandemic has become a major public health concern.

Objective

We aimed to assess the prevalence of COVID-19 misinformation exposure and beliefs, associated factors including psychological distress with misinformation exposure, and the associations between COVID-19 knowledge and number of preventive behaviors.

Methods

A cross-sectional online survey was conducted with 1049 South Korean adults in April 2020. Respondents were asked about receiving COVID-19 misinformation using 12 items identified by the World Health Organization. Logistic regression was used to compute adjusted odds ratios (aORs) for the association of receiving misinformation with sociodemographic characteristics, source of information, COVID-19 misinformation belief, and psychological distress, as well as the associations of COVID-19 misinformation belief with COVID-19 knowledge and the number of COVID-19 preventive behaviors among those who received the misinformation. All data were weighted according to the Korea census data in 2018.

Results

Overall, 67.78% (n=711) of respondents reported exposure to at least one COVID-19 misinformation item. Misinformation exposure was associated with younger age, higher education levels, and lower income. Sources of information associated with misinformation exposure were social networking services (aOR 1.67, 95% CI 1.20-2.32) and instant messaging (aOR 1.79, 1.27-2.51). Misinformation exposure was also associated with psychological distress including anxiety (aOR 1.80, 1.24-2.61), depressive (aOR 1.47, 1.09-2.00), and posttraumatic stress disorder symptoms (aOR 1.97, 1.42-2.73), as well as misinformation belief (aOR 7.33, 5.17-10.38). Misinformation belief was associated with poorer COVID-19 knowledge (high: aOR 0.62, 0.45-0.84) and fewer preventive behaviors (≥7 behaviors: aOR 0.54, 0.39-0.74).

Conclusions

COVID-19 misinformation exposure was associated with misinformation belief, while misinformation belief was associated with fewer preventive behaviors. Given the potential of misinformation to undermine global efforts in COVID-19 disease control, up-to-date public health strategies are required to counter the proliferation of misinformation.

Mobile and non-mobile Internet Use Disorder: Specific risks and possible shared Pavlovian conditioning processes. •

This commentary addresses a recent article by Montag et al. (2019) about the relevance of distinguishing between mobile and non-mobile Internet Use Disorder (IUD). In response to the review, we reflect on the clinical relevance of this distinction and, in parallel, we propose some Pavlovian conditioning processes as possible mechanisms underlying different IUDs. We believe that, from a clinical point of view, it is of fundamental importance assessing both specific "forms" of IUDs and the underlying mechanisms that would be shared across different IUDs, like multiple and parallel classes of Pavlovian responses and the influences of Internet cues on Internet-related addictive behaviors that may be influenced by the probability of obtaining Internet rewards.

The impact of smartphone use on gait in young adults: Cognitive load vs posture of texting

Many researches have reported that the use of smartphones has a negative impact on gait variability and speed of pedestrians by dispersion of cognition, but the influence of factors other than cognitive function on gait is still unclear. The purpose of this study was to investigate the impact of smartphone use on spatiotemporal gait parameters in healthy young people while walking. 42 healthy young adults were recruited and instructed to walk in four conditions (walking without using a smartphone, typing on a smartphone with both hands, typing on a smartphone with one hand, and texting posture with non-task). All spatiotemporal gait parameters were measured using the GAITRite walkway. Compared to walking without using a smartphone, the subjects walked with a slower cadence and velocity and changed stride length and gait cycle and spent more time in contact with the ground when using a smartphone (p < 0.05). In addition, even if a texting posture was taken without performing a task, a similar change was observed when using a smartphone (p < 0.05). This study found that a cautious gait pattern occurred due to smartphone use, and that a change in gait appeared just by taking a posture without using smartphone.

Internet addiction among adolescents in Macau and mainland China: prevalence, demographics and quality of life

Internet addiction (IA) is common among adolescents and significantly determined by sociocultural and economic factors. The aim of this study was to compare the prevalence of IA among adolescents between Macau and mainland China and also examine its association with quality of life. A total of 2892 secondary school students were included. Standardized instruments were used to measure IA, depressive symptoms and quality of life. The overall prevalence of IA was 23.7%, with 32.5% in Macau and 19.8% in mainland China. Students in Macau were more likely to suffer from IA than those in mainland China (OR = 2.15, p < 0.001). Correlates of IA included being in higher school grades, poor academic performance, and more severe depressive symptoms. Students with IA reported lower quality of life in physical, psychological, social, and environmental domains. IA is common among Chinese adolescents, particularly in Macau. Considering the negative impact of IA on health and quality of life, regular screening and effective interventions should be undertaken for young Internet users.

Metacognitions about problematic Smartphone use: Development of a self-report measure

BACKGROUND AND AIMS

Recent research has suggested that metacognitions may play a role across the spectrum of addictive behaviours, including problematic use of technological devices. Metacognitions associated with problematic Smartphone use (PSU) have been scarcely investigated and measures to assess these beliefs are not yet available. The goal of the present study was: (i) to develop the first self-report scale of metacognitions about Smartphone use; and (ii) to investigate its predictive validity with respect to PSU.

METHODS

Twenty-four items concerning positive and negative metacognitions about PSU were framed and administered to a community sample of 701 Smartphone users (F = 66.2%; mean age: 28.08 ± 9.81; age range: 15-70). An exploratory factor analysis was first performed in a randomly allocated subsample of 350 participants. A confirmative factor analysis was then computed on a second subsample of 351 participants to test the fit of the factor structure identified.

RESULTS

Findings revealed a 3-factor solution consisting of positive metacognitions concerning emotional and cognitive regulation, positive metacognitions concerning social advantages, and negative metacognitions about uncontrollability and cognitive harm of Smartphone use. Regression analysis showed that all the Metacognitions about Smartphone Use Questionnaire (MSUQ) factors were significantly associated to PSU independently of anxiety and depressive symptoms.

CONCLUSIONS

The MSUQ might be a promising self-report measure and further support research into the role of metacognition in technological addictions.