Is smartphone addiction really an addiction?

The relationship between internet addiction, sleep quality, and psycho-social problems among secondary school students in Erbil, 2023-2024

OBJECTIVE

This study aimed to show the association between internet addiction (IA), sleep quality, and psycho-social problems among secondary school students DESIGN: A cross-sectional, descriptive, and correlational study design was used.

SAMPLE

A total of 557 students from four secondary schools in Erbil were selected using multistage cluster sampling MEASUREMENTS: The questionnaires of this research contained socio-demographic data, Internet Addiction Test (IAT), Pittsburgh Sleep Quality Index (PSQI), and Pediatric Symptom Checklist-Y (PSC-Y) questionnaire.

RESULTS

Findings indicated that students displayed a mild IA, averaging a score of 42.9 ± 19.18. Furthermore, the average sleep quality (PSQI) score was 8.95 ± 2.75, indicating moderate sleep disturbance, and the average score for psycho-social problems was 27.78 ± 13.29. Importantly, there was a strong and positive association between IA and psycho-social issues, as shown by a correlation coefficient of 0.31 (p < .001). Sleep quality was correlated with IA and psychosocial issues (p < .001, correlation values: .23 and .27, respectively) CONCLUSIONS: The study highlights the urgent need for health policymakers and nursing managers in Erbil to develop targeted interventions, such as awareness campaigns and digital well-being programs in school curricula, to mitigate the interlinked issues of IA, sleep quality, and psycho-social problems among students.

A meta-review of screening and treatment of electronic "addictions"

Concerns surrounding electronic addictions, an umbrella term including any clinically significant technology-based addictive problem, have increased as technology has advanced. Although researchers and clinicians have observed detrimental effects associated with excessive technology use, there is no agreed-on definition or set of criteria for these problems. The lack of a consistent understanding of electronic addictions has led to a lack of consistency in both assessment and treatment studies, precluding strong recommendations for effective screening and clinical intervention. This meta-review integrates findings from 22 systematic reviews and meta-analyses of electronic addictions to determine which measures and interventions may effectively measure and treat electronic addictions. We conducted a meta-review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Findings suggest that although some measures may have good internal consistency and reliability among college students, there was a general lack of consistency in how measures were used across studies, making comparison difficult. Psychological and exercise-based interventions were shown to reduce symptoms of electronic addictions short-term, but no treatment was superior to others in overall symptom reduction. Most included reviews raise serious concerns about the lack of consensus on what constitutes an electronic addiction. Consequently, it was not possible to draw conclusions about the overall efficacy of any measurement tools or interventions. We provide suggestions for next steps to establish the phenomenology of electronic addictions before additional research on assessment and intervention is conducted.

Linking Self-Esteem to Problematic Mobile Phone Use: A Moderated Mediation Model of Fear of Missing Out and Ruminative Subtypes

Low self-esteem has been identified as a risk factor for problematic mobile phone use (PMPU). However, the magnitude of self-esteem's effect on PMPU varied across different studies. Drawing on the Interaction of Person-Affect-Cognition-Execution model and the response styles theory, this study developed a moderated mediation model to investigate the mediating role of fear of missing out (FoMO) and the moderating roles of ruminative subtypes (i.e., brooding and reflection) in the relationship between self-esteem and PMPU. We conducted a cross-sectional survey among 806 undergraduate students (Mage = 19.35 years, SD = 1.18) using the convenience sampling method. Results showed that self-esteem was negatively associated with PMPU. Mediation analysis revealed that the association between self-esteem and PMPU was mediated by FoMO. Furthermore, moderated mediation analyses revealed that the mediating effect of FoMO was moderated by both brooding and reflection, such that the indirect effect became stronger for individuals with higher levels of brooding/reflection. These findings add to previous research by shedding light on how (i.e., mediation) and under what conditions (i.e., moderation) self-esteem is associated with PMPU and have implications for early prevention and intervention of individual PMPU.

The Association Between Neuroticism and Problematic Social Networking Sites Use: The Role of Fear of Missing out and Self-Control

Problematic use of social networking sites (SNS) has a negative impact on mental health. It has been found that people who score high on neuroticism are especially vulnerable towards engaging with SNS in a problematic way but it is not clear which psychological mechanisms explain this relationship. We addressed this issue by examining the mediating role of fear of missing out and self-control in the relationship between neuroticism and problematic SNS use. For this purpose, we conducted a cross-sectional study (n = 151, 69.5% female, Mage = 26.23, SD = 7.52) and tested for parallel mediation using structural equation modelling. Neuroticism was found to be predictive of increased levels of problematic SNS use. Moreover, neuroticism was associated with both increased levels of fear of missing out and decreased levels of self-control. However, only fear of missing out was found to robustly mediate the relationship between neuroticism and problematic use of SNS. These findings suggest that fear of missing out could be an intervention target to prevent people scoring high on neuroticism from engaging in problematic SNS use.

Comparing the prevalence of nomophobia and smartphone addiction among university students pre-COVID-19 and during COVID-19

BACKGROUND

This study aimed to: (a) explore differences in the prevalence of nomophobia and smartphone addiction (SA) from pre- to during COVID-19; (b) identify students' self-reported changes in smartphone reliance and screen time during COVID-19; and (c) examine whether self-perceived changes in smartphone usage predicted nomophobia and SA scores.

METHODS

Scores on the Nomophobia Questionnaire and Smartphone Addiction Scale between two surveys administered at two timepoints were compared: Sample 1 (September 2019-January 2020; N = 878) and Sample 2 (May-June 2020; N = 258).

RESULTS

No significant differences were found between samples on nomophobia or SA. Nearly all of Sample 2 reported using some type of app more, using their smartphone a little more, and about the same perceived smartphone reliance during COVID-19. Increased screen time, smartphone reliance, and social media significantly predicted nomophobia and SA.

CONCLUSION

COVID-19 does not appear to have exacerbated the prevalence of nomophobia or SA.

Sports and exercise-related smartphone use is antagonistic to hedonic use in regular exercisers: A cross-sectional study examining the roles of exercise frequency and duration

Background

Hedonic smartphone use has been associated with dependence and addiction studied under the umbrella term Problematic Smartphone Use (PSU). Research usually explores total screen time as an index of PSU. A few studies suggest that exercise is inversely related to smartphone use time. However, it is unknown which primary characteristics of exercise behavior are related to more moderate smarthone use. Furthermore, the purpose of smartphone use, such as hedonic use associated with PSU versus utilitarian use, was not tested in the sports and exercise contexts. Hedonic use generally means playing with the smartphone for joy, distraction, and satisfaction. Utilitarian use implies practical and valuable use. There is a conjecture that sports involvement may foster utilitarian use through increased involvement in sports-related information-seeking, goal-setting, and self-monitoring.

Methods

Therefore, we examined whether weekly exercise frequency, workout duration, and perceived exercise intensity relate to total daily smarthone and hedonic use and whether this relationship is mediated by sports-related utilitarian device use. We tested regularly exercising adults (n = 360, 132 males, M age = 39.0 ± 9.8, M weekly exercise = 5.8 ± 1.9) who volunteered for this study and provided demographic information about their exercise habits and smartphone use.

Results

The results revealed that all exercise parameters mediated the total daily smartphone use, with perceived exercise intensity being a negative predictor. Further, exercise frequency and duration (but not intensity) positively predicted sports-related smartphone use, which inversely predicted hedonic use.

Conclusion

These results suggest that exercise parameters directly relate to daily smartphone use, which completely mediates hedonic use. These findings may partially account for the frequently reported inverse relationship between regular exercise and PSU by suggesting that the connection is mediated via sports-related smartphone use.

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

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

Wellbeing and Problematic Smartphone Use: Serial Mediation of Mindfulness and Self-Compassion

The relationship between wellbeing and Problematic Smartphone Use (PSU) has been explored in the past, however, the role of the potential mediators of this association is a relatively neglected area of research. Therefore, the current study examined mindfulness and self-compassion as mediators of the relationship between wellbeing and PSU in 220 university students. WHO-5 Wellbeing Index, Mindful Attention Awareness Scale- State, Self-Compassion Scale- Short form and Smartphone Addiction Scale- Short version were used for assessing wellbeing, mindfulness, self-compassion, and PSU respectively. Wellbeing had a direct and indirect effect on PSU. In addition, results supported a serial mediation model where wellbeing was found to influence PSU via mindfulness and self-compassion in a sequential manner. The results expanded the Compensatory Internet Use Theory (CIUT) to understand PSU and have implications for the management of PSU.

Phubbing and its impact on the individual's psychological well-being

Increasingly, smartphones have become a part of people's everyday lives, and are now considered by many to be an indispensable social accessory. Since attachment to a smartphone could have negative psychological consequences, a burgeoning new area of research has emerged which examines the effects of smartphones on individuals' well-being. Hence, this study focuses on phubbing - one's engagement with the smartphone during a face-to-face conversation with another person or group of people - and its association with psychological well-being. For this investigation, a quantitative descriptive approach has been adopted involving a sample of 370 women and men from Spain between 25 and 60 years old. The survey was distributed during late 2019 and the first quarter of 2020. The Phubbing Behaviors Survey was conducted, comprising five dimensions (cultural, technological, social, communicational, and psychological), and a total of 33 items requiring responses on a 5-point Likert scale. This survey was used in conjunction with the General Health Questionnaire (GHQ-28), consisting of four categories (somatic symptoms, social dysfunction, anxiety and insomnia, and severe depression), and 7 items per category. The findings reveal a positive correlation between phubbing and severe depression and, young women under 25 years old show higher levels of somatic symptoms than men in the same age group. This study demonstrates the need to raise awareness via health education and to promote healthy use of the Internet to prevent psychological distress resulting from phubbing.

Gratification and its associations with problematic internet use: A systematic review and meta-analysis using Use and Gratification theory

Problematic Internet Use (PIU) has been a growing issue for two decades, and many researchers have sought to explain its occurrence. Use and Gratification Theory (UGT) has guided empirical studies investigating the associations between gratification and PIU. However, their results appear equivocal. This study aimed to synthesize research findings applying UGT and pinpoint the associations between different gratifications and PIU. Effect sizes were pooled to obtain an overall effect size. Gratifications were then classified into four types (i.e., content, social, self-presentation, and process) according to the suggestions of previous studies and the measurement of included studies. Based on 216 effect sizes from 57 samples with 38,492 participants (mean age = 24.3; 55.1 % female), random effect model analyses yielded a medium effect size (r = 0.303, p <.001, 95 % CI [0.263, 0.343]), indicating a positive association between general gratification and PIU. Subgroup analyses revealed that all four gratifications were positively associated with PIU; self-presentation showed the largest effect size, followed by process gratification.This study enhances the conceptual relevance of UGT in understanding PIU and highlights the importance of process and self-presentation gratification as predictors for PIU in certain contexts, such as among university students and in Asian countries.

'There's more to life than staring at a small screen': a mixed methods cohort study of problematic smartphone use and the relationship to anxiety, depression and sleep in students aged 13-16 years old in the UK

BACKGROUND

Depression and anxiety are common in adolescents and have increased over the last decade. During that period, smartphone usage has become ubiquitous.

OBJECTIVES

The study aim was to assess the association between problematic smartphone usage (PSU) and anxiety.

METHODS

Using a prospective mixed methods cohort study design, students aged 13-16 year old from two schools were enrolled regarding their smartphone use, mood and sleep via a semistructured questionnaire at baseline and week 4. The primary outcome was symptoms of anxiety (Generalised Anxiety Disorder Questionnaire, GAD-7) and exposure was PSU (Smartphone Addiction Scale Short Version). A linear regression was fitted to assess the change in anxiety. Thematic analysis of free-text responses was conducted.

FINDINGS

The sample included 69 participants that were enrolled and followed up between 28 March and 3 June 2022. Of those with PSU, 44.4% exhibited symptoms of moderate to severe anxiety compared with 26.4% of those without PSU. There was a linear association between change in symptoms of anxiety and PSU β=0.18 (95% CI 0.04 to 0.32, p=0.013). Several themes were found: both positive and negative effects of smartphones on relationships; negative effects on school performance and productivity; mixed effects on mood; a desire to reduce the amount of time spent on smartphones.

CONCLUSIONS

Increased anxiety, depression and inability to sleep were seen in participants as their PSU score increased over time. Participants reported both positive and negative effects of smartphones and almost all used strategies to reduce use.

CLINICAL IMPLICATIONS

Interventions need to be developed and evaluated for those seeking support.

Clinical nurses' work procrastination and smartphone addiction: a potential profile study

Background

In the medical field, effective time management by clinical nurses is crucial for enhancing the quality of patient care. However, in recent years, with increasing work pressure for clinical nurses, procrastination has become a prevalent issue. Many nurses use smartphones as a way to alleviate stress and manage emotions, but excessive smartphone use could exacerbate procrastination, thereby jeopardizing patient safety and healthcare quality. Therefore, understanding the current state of work procrastination among clinical nurses, its heterogeneity, and exploring the impact of smartphone addiction and demographic factors on different aspects of nurse procrastination hold significant importance for improving patient care quality.

Objective

This study aims to explore the current state of work procrastination among clinical nurses and identify potential profile categories. It further analyzes the impact of mobile phone addiction and demographic factors on work procrastination among clinical nurses.

Methods

Convenience sampling was employed to recruit participants from three tertiary hospitals in central China from October to November 2023. Surveys measuring nurses' work procrastination and smartphone addiction were distributed and collected through online platforms. A total of 1,536 nurses participated in this study. Mplus 8.3 statistical software was used for latent profile analysis of clinical nurses' work procrastination, and SPSS 26.0 software was utilized for chi-square tests, rank-sum tests, and multi-classification logistic regression analyses.

Results

The median total score for clinical nurses' work procrastination was 21.00 (17.00, 28.00), and three subgroups were identified: low procrastination (66.93%), medium-low procrastination (20.66%), and medium-high procrastination (12.41%). Additionally, logistic regression analysis revealed that smartphone addiction and department atmosphere were common influencing factors for medium-low and medium-high work procrastination. Hospitals with stricter management and nurses holding the position of head nurse were more likely to belong to the low work procrastination group. Nurses with higher incomes or those holding intermediate titles were more prone to medium-low work procrastination, while those experiencing career advancement difficulties were more likely to exhibit medium-high work procrastination (p < 0.05).

Conclusion

Clinical nurses' work procrastination is generally at a medium-to-low level, with three subgroups identified: low procrastination, medium-low procrastination, and medium-high procrastination. Additionally, clinical nurses in surgical departments or those with intermediate titles exhibit higher levels of procrastination. Factors such as smartphone addiction, higher monthly income, tense departmental atmosphere, and unsuccessful career advancement are more likely to lead to work procrastination. Conversely, nurses in hospitals with strict management or those holding the position of head nurse exhibit lower levels of work procrastination. Therefore, nursing managers should pay close attention to the work procrastination behaviors of clinical nurses, actively monitor predictive factors among different groups, and provide psychological counseling and relevant training based on individual nurse circumstances. Additionally, it is also essential to focus on and improve departmental atmosphere and nurse smartphone addiction to enhance clinical nurses' work efficiency and reduce work procrastination.

Trends and Influencing Factors in Problematic Smartphone Use Prevalence (2012-2022): A Systematic Review and Meta-Analysis

Given that problematic smartphone use (PSU) has been researched for a long time, it becomes necessary to assess how the trends of PSU prevalence have evolved over time. In total, 106 articles from 2012 to 2022 with 109 studies covering 97,748 individuals were included in this systematic review and meta-analysis. The estimation of the global pooled PSU prevalence was 37.1% (95% confidence interval, 33.5 - 40.8%) and the PSU prevalence is growing over time in total. Although the PSU prevalence exhibited wide variation between regions and measurement scales, the increasing trend remained. In addition, the regression slope of the PSU prevalence trend in males was higher than that in females. Males initially had a lower prevalence of PSU than females, but this steadily changed over time until it was greater in males than in females. Moreover, the prevalence of PSU showed an increasing trend across all age groups, with a faster growth rate in the older age group. Considering the aforementioned results, it's necessary to implement proper interventions to do with this phenomenon. In addition, considering the differences in prevalence brought by regions, and measurement scales, in practice and research, we should not only take into account the disparities of PSU between countries or cultures, but also to concern about establishing unified standard and measurement tools to confirm it.

Clinical Manifestations' Spectrum of Smartphone Addiction: Moving from an Addiction toward a Clinical Syndrome

Background

Smartphone addiction is an emerging type of addiction in the digital era, characterized by smartphone dependence that negatively affects human health with a wide range of psychological and physical manifestations.

Objective

This study aimed to evaluate the detailed clinical manifestations of smartphone addiction as a delineated clinical syndrome.

Methods

A cross-sectional study design was employed to assess smartphone addiction prevalence and its health impacts among Syrian undergraduates using the Smartphone Addiction Scale-Short Version (SAS-SV 2013), the Kessler psychological distress scale (K-6), and a comprehensive assessment of the clinical manifestations frequently linked to smartphone addiction in the literature. Different statistical modeling techniques were applied; a P value of < .05 was considered statistically significant.

Results

Of 1532 invited undergraduates, 1401 (91.45%) completed the assessment adequately. Most participants were females (59.7%) and below 23 years of age (73.2%). The prevalence of smartphone addiction was 67.80%; statistically significant smartphone addiction associations were revealed with psychological distress (P < .0001) with odds ratios of 3.308. Most screened physical manifestations also showed a significant association with smartphone addiction.

Conclusion

A high prevalence of smartphone addiction was observed with a broad spectrum of associated mental and physical manifestations. As smart device addiction becomes a global health concern, combining the clinical findings reported in the related literature into one clinical identity is necessary to develop a holistic management approach for the delineated clinical syndrome.

On-device query intent prediction with lightweight LLMs to support ubiquitous conversations

Conversational Agents (CAs) have made their way to providing interactive assistance to users. However, the current dialogue modelling techniques for CAs are predominantly based on hard-coded rules and rigid interaction flows, which negatively affects their flexibility and scalability. Large Language Models (LLMs) can be used as an alternative, but unfortunately they do not always provide good levels of privacy protection for end-users since most of them are running on cloud services. To address these problems, we leverage the potential of transfer learning and study how to best fine-tune lightweight pre-trained LLMs to predict the intent of user queries. Importantly, our LLMs allow for on-device deployment, making them suitable for personalised, ubiquitous, and privacy-preserving scenarios. Our experiments suggest that RoBERTa and XLNet offer the best trade-off considering these constraints. We also show that, after fine-tuning, these models perform on par with ChatGPT. We also discuss the implications of this research for relevant stakeholders, including researchers and practitioners. Taken together, this paper provides insights into LLM suitability for on-device CAs and highlights the middle ground between LLM performance and memory footprint while also considering privacy implications.

Is problematic use of the Internet and smartphone predictor of unhealthy eating behaviors and abnormal body weight in Turkish young adults?

With technological progress, the use of the internet and smartphones has become an inseparable part of our lives and their use is increasing. The uncontrolled use of both the internet and smartphones is defined as problematic use. This study examined the effects of problematic internet and smartphone use on dietary behaviors and abnormal body weight status in young adults. Participants were 560 university students. Participants completed measures of demographics, dietary behaviors, internet and smartphone usage habits, Young's Internet Addiction Test and Smartphone Addiction Scale. Negative associations were found between dietary behaviors and problematic internet and smartphone use. Significant inverse associations were also found between these uses and recommended consumption levels of several food groups. For a healthy future generation, it is recommended that policies be developed to prevent or manage these problematic uses, especially in young adults with negative dietary behaviors and abnormal body weight.

The Impact of Family Functioning Factors on Smartphone Addiction and Phubbing among Muslim Adolescents in Thailand

BACKGROUND

While there is research on protective factors against smartphone addiction (SA) and phubbing, which impact adolescents' physical, psychological, interpersonal, and academic well-being, focused studies on these issues among Thai Muslim students in Southern Thailand remain scarce.

OBJECTIVES

To bridge this gap, this research aimed to explore the influence of five family functioning factors-discipline, communication and problem-solving (CPS), relationship, emotional status, and family support-guided by family systems theory and the McMaster Model, on SA and phubbing.

METHODS

Data from 825 Thai Muslim adolescent secondary school students (Female N = 459 (55.7%), Mage = 15.11 ± 1.78) across three southern Thai provinces were analyzed utilizing structural equation modeling (SEM).

RESULTS

Significant connections were identified between family functioning factors, particularly emotional status and discipline, and SA, and their impact on phubbing behavior. SA was found to mediate the relationship between these two family factors and phubbing. Interestingly, a higher quality of family relationships was found to be associated with an increased risk of SA, while the other two family functions-CPS and family support-demonstrated no significant association with these digital behaviors.

CONCLUSIONS

Despite its limitations, including a cross-sectional design and reliance on self-reports, the study underscores the importance of specific family functions in preventing and addressing adolescent SA and phubbing.

Factors influencing smartphone overdependence among adolescents

Adolescents are particularly vulnerable to smartphone overdependence. Therefore, we identified the factors influencing smartphone overdependence and risk subgroups among adolescents. The current study is a secondary analysis of nationally representative data from the 2020 Korea Youth Risk Behavior Survey. The survey targeted middle- and high-school students in South Korea aged 12-18 using stratified, clustered, multistage probability sampling, and 53,457 students from 793 schools participated in this study. Complex sample data were analyzed considering the strata, clusters, and weights. Multiple logistic regression analysis revealed age, gender, household economic status, anxiety, loneliness, depressive symptoms, and experience of violent treatment as significant predictors of smartphone overdependence. Adolescents with severe anxiety were at a 3.326 times higher risk of smartphone overdependence than adolescents with minimal anxiety. Decision tree analysis showed that anxiety, gender, loneliness, and depressive symptoms were important in differentiating risk subgroups, with anxiety being the most significant factor. Group 13, comprising girls with severe anxiety, had the highest risk at 52.9%. Thus, early detection and prevention of issues such as anxiety, loneliness, and depressive symptoms, as well as treatment for violence, can prevent smartphone overdependence among adolescents. Additionally, more thorough interventions for anxiety are warranted to prevent smartphone overdependence.

Childhood Adversity and Adolescent Smartphone Use Across Sexual Orientation and Gender Expression

Importance

Nonheterosexual and gender-nonconforming (GNC) individuals tend to report adverse childhood experiences (ACEs) more frequently compared with heterosexual and gender-conforming individuals, and individuals who have experienced ACEs, identify as nonheterosexual, or exhibit moderate to high levels of GNC are more prone to engaging in problematic smartphone use (PSU). However, there is limited school-based data among adolescents regarding this matter.

Objectives

To explore the associations between ACEs and PSU among adolescents across different sexual orientation and gender expression groups.

Design, setting, and participants

Using data from the 2021 School-Based Chinese Adolescents Health Survey, this cross-sectional study includes participants from 288 public high schools across 8 provinces in China. Statistical analysis was performed from October 2023 to February 2024.

Exposures

Data on ACEs, sexual orientations, and gender expressions (high, moderate, and low GNC) were collected.

Main outcomes and measures

PSU was assessed using the 10-item Smartphone Addiction Scale-Short Version (SAS-SV). Weighted linear, logistic, or Poisson regression models were used.

Results

Among the 85 064 adolescents included (mean [SD] age, 14.92 [1.77] years), 42 632 (50.1%) were female, 70 157 (83.2%) identified as Han Chinese, and 14 208 (16.8) identified as other ethnicities (Miao, Hui, Yi, Dai, and other ethnic groups). The prevalence of PSU among participants was 35.4%. Weighted Poisson regression models indicated that the interaction between GNC and ACE was significant (adjusted prevalence ratio [APR], 0.98; 95% CI, 0.97-0.99). Further stratified analysis demonstrated homosexual adolescents who experienced 4 or more ACEs showed a significantly increased prevalence of PSU (APR, 1.79; 95% CI, 1.64-1.96). Similarly, a markedly higher prevalence of PSU was observed among bisexual individuals with 4 or more ACEs (APR, 1.60; 95% CI, 1.41-1.80). Regarding gender expression categories, a significantly higher prevalence of PSU was noted among high GNC adolescents with 4 or more ACEs (APR, 1.78; 95% CI, 1.60-1.98) compared with low GNC adolescents without ACEs. Furthermore, experiencing any 3 ACE categories (abuse, neglect, and household dysfunction) was associated with an increased prevalence of PSU across different sexual orientation and gender expression subgroups.

Conclusions and relevance

In this cross-sectional study, the amalgamation of elevated ACE scores with nonheterosexual orientations or GNC identities was significantly associated with increased PSU prevalence. These findings underscore that preventing ACEs may be beneficial in mitigating PSU among adolescents, particularly for nonheterosexual adolescents and those with high levels of GNC.

Predictors of Procrastination in a Moderated Mediation Analysis: The Roles of Problematic Smartphone Use, Psychological Flexibility, and Gender

Research has revealed that problematic smartphone use is a cause of procrastination. This study investigated the predictive role of problematic smartphone use on procrastination with consideration of the mediating effect of psychological flexibility. The moderating role of gender in the frequency of checking smartphones was also tested in this mediational model. Of total, 471 undergraduate students (369 female, 102 male) with a mean age of 20.65 participated in the study. The study was conducted face to face in classroom settings, and the results of the analysis revealed that psychological flexibility indeed affected the relationship between problematic smart phone use and procrastination. In addition, moderated mediation analysis suggested that female university students were significantly impacted. Finally, it was observed that psychological flexibility played a significant role amongst the female university students surveyed in the relationship between problematic smart phone use and procrastination.

Annual Research Review: Sex, gender, and internalizing conditions among adolescents in the 21st century - trends, causes, consequences

Internalizing conditions of psychopathology include depressive and anxiety disorders; they most often onset in adolescence, are relatively common, and contribute to significant population morbidity and mortality. In this research review, we present the evidence that internalizing conditions, including depression and anxiety, as well as psychological distress, suicidal thoughts and self-harm, and fatal suicide, are considerably increasing in adolescent populations across many countries. Evidence indicates that increases are currently greatest in female adolescents. We present an epidemiological framework for evaluating the causes of these increases, and synthesize research on whether several established risk factors (e.g., age of pubertal transition and stressful life events) and novel risk factors (e.g., digital technology and social media) meet conditions necessary to be plausible causes of increases in adolescent internalizing conditions. We conclude that there are a multitude of potential causes of increases in adolescent internalizing conditions, outline evidence gaps including the lack of research on nonbinary and gender nonconforming populations, and recommend necessary prevention and intervention foci from a clinical and public health perspective.

Mobile phone addiction and suicide behaviors among Chinese adolescents: The mediation of poor sleep quality

Background and aims

Mobile phone addiction (MPA) is emerging among adolescents, especially during the COVID-19 pandemic. Nevertheless, there is a dearth of knowledge regarding the correlation between MPA and suicide behaviors and its mechanism. The objective of the current study is exploring the direct effect of MPA on suicide behaviors and the indirect effect through poor sleep quality.

Methods

A total of 18,900 Chinese adolescents aged 12 to 18 were recruited via a multi-stage cluster sampling method.

Results

The prevalence of MPA and poor sleep quality was 26.2 and 23.1%, respectively. During the past year, 24.4% participants were involved in suicide behaviors. Specifically, suicide ideators, suicide planners, and suicide attempters were 10.7, 8.4, and 5.3%, respectively. Particularly, rural females had the highest prevalence of suicide behaviors, MPA, and poor sleep quality. Logistic regression analysis showed that MPA was significantly associated with suicide ideators (OR = 1.22, 95% CI: 1.09-1.37, p < 0.001) and planners (OR = 1.18, 95% CI: 1.04-1.34, p < 0.05), but not for suicide attempters (p > 0.05). Structural equation modelling demonstrated that MPA had direct effect on suicide behaviors (β = 0.145, 95% CI = 0.127-0.160), and poor sleep quality partially mediated the relationship (the mediating ratio was 46.7%). The mediating ratio of poor sleep quality was the highest in urban males.

Conclusions

MPA has both direct and indirect effects on suicide behaviors. For suicide prevention, limited mobile phone use and improvement sleep quality may be practical for adolescents. Additionally, more efforts of intervention could give priority to rural girls.

What makes children aged 10 to 13 engage in problematic smartphone use? A longitudinal study of changing patterns considering individual, parental, and school factors

Background and aims

The current research aimed to discover classification concerning problematic smartphone use in children. Furthermore, to investigate their longitudinal trajectories, as well as to discover the connection concerning problematic smartphone usage by individual, parental, and school factors.

Methods

A total of 2,399 South Korean children who were in the 4th grade (female 1,206 (50.3%), age 10-13 years) at baseline. Latent class growth analysis was utilized to discover typologies in problematic smartphone use and their longitudinal trajectories. Multinomial logistic regression analysis was used to find various associations among problematic smartphone use and individual, parental, as well as school factors.

Results

The results identified three distinct trajectories of problematic smartphone use: (1) a high-level group (7.7%), (2) a mid-increasing group (62.5%), and (3) a low-increasing group (29.8%). The increasing group showed the highest level of problematic smartphone use. Gender, self-esteem, social withdrawal, exercise, parental inconsistency, monthly income, and teacher support were significant predictors.

Discussion and Conclusions

The findings suggest that there are distinct developmental trajectories concerning problematic smartphone usage of childhood. The results show that the early discovery of children in danger of problematic smartphone use and targeted interventions aimed at reducing parental inconsistency and social withdrawal, improving self-esteem, exercise, and teacher support may be effective strategies for preventing problematic smartphone usage during childhood.

Addicted to socialising and still lonely: A comparative, corpus-driven analysis of problematic social networking site use

Background and Aims

Problematic Social Networking Site Use (PSNSU) is not a formally recognised addiction, but it is increasingly discussed as such in academic research and online. Taking a quantitative, exploratory approach, this study aims to (1) determine whether PSNSU is presented like clinically defined addictions by the affected community and (2) address how well measurements of PSNSU fit with the thematic content found within the associated discourse.

Methods

Four corpora were created for this study: a corpus concerning PSNSU and three control corpora concerning established addictions, including Alcohol Use Disorder, Tobacco Use Disorder and Gaming Disorder. Keywords were identified, collocates and concordances were explored, and shared themes were compared.

Results

Findings show broad thematic similarities between PSNSU and the three control addictions as well as prominent interdiscursive references, which indicate possible confirmation bias among speakers.

Conclusions

Scales based upon the components model of addiction are suggested as the most appropriate measure of this emerging disorder.

The impact of long-term online learning on social anxiety and problematic smartphone use symptoms among secondary school students with different levels of fear of missing out: Evidence from a symptom network and longitudinal panel network analysis

Background

The advancement of communication technology and the impact of the COVID-19 pandemic have led to an increased reliance on online education. However, the effects of the long-term use of smart devices for online learning on students' social anxiety and problematic smartphone use (PSU) and the role of fear of missing out (FoMO) in this process have yet to be fully explored.

Methods

This study analysed longitudinal data from 2,356 high school students (female = 1,137 (48.26%), mean age = 13.84, SD age = 1.37) in China, divided into high- and low-FoMO groups based on their scores on the FoMO scale, to examine the impact of four months of online learning on social anxiety and PSU. The Social Anxiety Scale (SAS) and Mobile Phone Addiction Index (MPAI) were used to assess social anxiety and PSU symptoms.

Results

The undirected symptom networks revealed more bridge symptoms among the students in the high-FoMO group, although their overall symptom scores decreased. The results of the directed cross-lagged panel networks showed that "productivity loss" predicted other symptoms in the low-FoMO group but that "afraid of negative evaluation" was the predictor in the high-FoMO group. Meanwhile, "withdrawal/escape" and "productivity loss" were the symptoms that were most affected by other symptoms in the high-FoMO and low-FoMO groups, respectively.

Conclusions

The current study therefore sheds light on the changes in social anxiety and PSU symptoms among secondary school students during long-term online learning, as well as the moderating role of FoMO.

Do Smartphone Addiction and Self-Regulation Failures Affect Students' Academic Life Satisfaction? The Role of Students' Mind Wandering and Cognitive Failures

Purpose

The purpose of this study is to investigate how smartphone addiction and self-regulation failure influence students' academic life satisfaction considering the impacts of students' mind wandering and cognitive failures. It also sought to look at how students' minds wander, and cognitive failures are affected by smartphone addiction and self-regulation failure among university students.

Methods

The WarpPLS-SEM software was used to analyze the research data retrieved from a sample of 950 undergraduate students from universities in Egypt and the Kingdom of Saudi Arabia (KSA).

Results

In both countries, the findings revealed that students' smartphone addiction and self-regulation failures negatively affect students' academic life satisfaction and positively affect students' mind wandering and cognitive failures. Additionally, smartphone addiction is positively related to failures of students' self-regulation. Besides the negative influences of students' cognitive failures on their academic life satisfaction, cognitive failures mediated negatively the relationship between mind wandering and students' academic life satisfaction. Finally, students' mind wandering mediated the relationship between smartphone addiction, self-regulation failure, and academic life satisfaction.

Discussion

The study introduces fresh insights into the study variables that can be used to expand the literature on academic life satisfaction. The study provides theoretical and practical contributions to students, educators, and policymakers of education.

The relationship between mobile phone addiction and non-suicidal self-injury: Findings from six universities in Shaanxi province, China

BACKGROUND

Although the development and application of mobile phones have changed various aspects of people's lives, excessive use of mobile phones has also raised physical and mental health concerns. However, the relationship between mobile phone addiction (MPA) and non-suicidal self-injury (NSSI) is unclear.

METHODS

A cross-sectional study was conducted (2022) among students from six universities to assess the relationship between MPA and NSSI. A Mobile Phone Addiction Tendency Scale (MPATS) was used to assess MPA, while NSSI was assessed via The Ottawa Self-Injury Inventory. Binary logistic regression models were used to assess the relationship between MPA and NSSI.

RESULTS

A total of 18,723 college students (6531 males [34.9 %] and 12,192 females [65.1 %]) were included in the final analyses. The prevalence of NSSI during the past 12 months was 6.5 %. Furthermore, 5553 participants (29.7 %) met the MPA criteria (MPATS score ≥ 48), and the average MPATS score was 39.5 ± 13.0. MPA was associated with increased odds of NSSI after adjusting for socio-demographic characteristics, health-related characteristics, and relevant psychosocial variables (OR, 1.29; 95 % CI, 1.13-1.46). Moreover, gender did not affect the association of MPA and MPATS score with NSSI (P for interaction>0.05). The restricted cubic splines regression showed that a monotonically increasing risk of NSSI was associated with increasing MPATS score (P for non-linearity = 0.474).

CONCLUSIONS

MPA is associated with increased odds of NSSI among college students, indicating that early examination, prevention, and intervention for MPA may prevent and control NSSI.

Vitality structures in 'addictive' game design

For decades, research on technology use and mental health has been based on the assumption that identifiable structures of 'design' are psychologically relevant for their users. This has been central especially for the nosological emergence of 'behavioural addictions', which currently involve two formal diagnoses involving technology: problems related to playing gambling games (gambling disorder) and videogames (gaming disorder). Alas, the research on identifying 'addictive' design structures has suffered from major construct validity issues. To make progress across those issues, I draw from the history of 'vitality affects' in psychiatry and introduce vitality structures as a design-phenomenological framework that can help researchers conceptualise clinically (and non-clinically) relevant 'bonds' between entities of game design and corresponding player phenomenology. Vitality structures are not natural kinds to be discovered but pragmatic constructs to be created and used: they are useful as long as they communicate what is both identifiable and empirically prevalent. As a demonstration of practice, I propose working conceptualizations of three vitality structures, which surface in videogames that have been prevalent sources of self-identified problems among gaming treatment-seekers. Systematic programs of research for identifying relevant vitality structures across technological, psychological, and psychiatric contexts can lead to construct-valid and replicable design effects.

Treatment readiness and prognosis for problematic smartphone use: Evaluation of the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES) and log data

Aim

While moderate smartphone use contributes to information gathering and relationship building, excessive smartphone use, also referred to as problematic smartphone use (PSU), has raised concerns because of its addictive nature and associated health consequences. This study aimed to investigate the relationship between treatment readiness and prognosis in individuals with PSU and to assess the predictive ability of smartphone log data in evaluating treatment readiness.

Methods

A sample of 47 patients with PSU participated in this study. Treatment readiness was assessed using the Stages of Change, Readiness, and Treatment Eagerness Scale (SOCRATES), and log data were collected using a smartphone log application.

Results

The results showed a significant correlation between baseline SOCRATES scores and the difference in Global Assessment of Functioning scores between baseline and 6 months (Spearman's ρ = 0.640, P-value = .001), suggesting that treatment readiness may explain part of the treatment outcomes (Pearson's r 2 = 0.379, P-value = 0.032). In addition, baseline log data, including the log acquisition rate, showed a positive correlation with treatment readiness (Spearman's ρ = 0.328, P-value = 0.045).

Conclusion

These findings provide valuable insights into the relationship between treatment readiness and clinical outcomes in patients with PSU, and suggest the potential of log data as objective indicators of treatment motivation.

The relationship between nighttime exercise and problematic smartphone use before sleep and associated health issues: a cross-sectional study

OBJECTIVE

Physical exercise has the potential to mitigate addictive behaviors and relevant health issues. However, the nighttime exercise has not been studied regarding this research topic. This study aims to explore the association between nocturnal physical exercise and problematic smartphone use before sleep, as well as related health issues.

METHODS

To explore the association between nighttime physical exercise and problematic smartphone use before sleep as well as related health issues, we conducted a cross-sectional survey among 1,334 college students. Their daily exercise behaviors (including timeframe, rationale, frequency, and duration), smartphone use before sleep, sleep quality, smartphone addiction, anxiety, and depression were measured by questionnaires. The associations were assessed using generalized linear models.

RESULTS

Our findings indicate that nearly 70% of participants chose to perform exercise at nighttime. Among these individuals who exercised at nighttime, the frequency and duration of nighttime exercise were significantly associated with decreased probabilities of smartphone use before sleep. Additionally, the frequency and duration of nighttime exercise were associated with lower levels of smartphone addiction and anxiety disorders.

CONCLUSION

Nighttime Exercise behaviors can effectively reduce sleep delays caused by problematic smartphone use before bedtime. These findings contribute to understanding the potential effects of nighttime exercise on problematic smartphone use and relevant health issues. Future research should employ more precise methodologies to examine these associations.

The Links Among Cumulative Ecological Risk and Smartphone Addiction, Sleep Quality in Chinese University Freshmen: A Two-Wave Study

Purpose

While previous research has highlighted the influence of family, school, and peer factors on smartphone addiction and sleep quality, the cumulative effects of these risk factors and their underlying causal relationships remain poorly understood. Therefore, based on the cumulative risk model and the bioecological model of human development, this study examined the longitudinal associations between cumulative ecological risk and smartphone addiction and sleep quality.

Methods

A survey was conducted among 653 Chinese university freshmen (mean age 18.56) at two distinct time points, with a 6-month interval. The initial assessment focused on family, school, and peer risk factors, while the subsequent assessment focused on smartphone addiction and sleep quality.

Results

Approximately 63.71% of university freshmen were found to be at risk of exposure. Compared to other risk-exposure groups, the group with no-risk exposure exhibited the lowest scores for smartphone addiction and sleep quality. The relationships between cumulative ecological risk and smartphone addiction and sleep quality displayed a linear pattern and a discernible "gradient effect". Smartphone addiction was identified as a fully mediating factor in the link between cumulative ecological risk and sleep quality, with a mediating effect value of 0.08 (representing 44.44% of the total effect).

Conclusion

University freshmen face various risks associated with their families, schools, and peers. The cumulative ecological risk can, directly and indirectly, impact sleep quality by influencing smartphone addiction. Given the observed "gradient effect" of cumulative ecological risk on smartphone addiction and sleep quality, it is imperative to adopt comprehensive risk prevention strategies to mitigate the impact of each risk factor.

Validation of a modified problematic use of mobile phones scale to examine problematic smartphone use and dependence

Over the past decade, the world population has experienced rapid and widespread adoption of smartphones due to their usefulness and convenience. However, researchers have identified a range of adverse behaviours associated with the adoption of smartphones and their higher use. These behaviours are collectively described as Problematic Smartphone Use and Dependence (PSUD). Despite growing research, the underlying processes and drivers leading to these behaviours are inadequately understood. This can partly be attributed to the absence of developed statistical tools and measures that allow researchers to build a comprehensive conceptual understanding of PSUD. To address this issue, this study proposes and evaluates a validated extension to the Problematic Use of Mobile Phones (PUMP) scale. The extension of this tool incorporates factors associated with substance dependence outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), including additional items to measure PSUD accurately, referred to as the modified problematic use of mobile phones (MPUMP) scale. The newly developed tool was used in a cross-sectional online survey during September and October 2022, drawing on 1018 adult Australian participants. Principal Component Analysis (PCA) and Exploratory Factor Analysis (EFA) were conducted to derive the underlying factors. The EFA revealed two distinct factors: Distraction and Dysregulation. Both factors exhibited high internal consistency, with Cronbach's Alpha coefficients of 0.92 and 0.86, respectively. A one-way analysis of variance (ANOVA) revealed significant variations inthe identified factors' mean scores across different socio-demographic characteristics. The study provides evidence that the MPUMP scale is a validated and reliable measure for accurately assessing PSUD. The study findings offer novel insights into the psychosocial and physical aspects of PSUD, providing a foundation for exploring the causes and potential interventions for PSUD.

Fun in a Box? Loneliness and Adolescents' Problematic Smartphone Use: A Moderated Mediation Analysis of the Underlying Mechanisms

Addictive smartphone use is one of the most concerning behaviors among adolescents. The present study investigated the indirect effects of self-esteem and boredom proneness and the moderating role of the need to belong on the link between loneliness and addictive smartphone use (ASU). Our sample included 357 adolescents aged 12 to 19 (Mage = 15.56, SD = 1.01, 57.42% males) from ten public schools in Romania. We used a moderated mediation approach, with moderation of the both second mediation paths and the direct effect path. Results suggested that the influence of loneliness on ASU was statistically significant and partially mediated both by self-esteem and boredom proneness. Adolescents' need to belong significantly moderated the positive association between boredom proneness and ASU, and the direct negative association between loneliness and ASU; however, it did not moderate the negative association between self-esteem and ASU. Thus, high levels of the need to belong also increased the influence of boredom proneness on AUS and had a marginally significant effect on the relation between loneliness and ASU. These results suggested that adolescents' need to belong, self-esteem, and boredom proneness might contribute to developing ASU. Interventions centered around countering the adverse effects of excessive technology use ought to consider group activities that facilitate social bonding to satisfy the participants' need to belong, reduce their levels of boredom, and, thus, reduce the risk of developing ASU symptoms.

Peer victimization and non-suicidal self-injury among high school students: the mediating role of social anxiety, mobile phone addiction, and sex differences

BACKGROUND

Peer victimization (PV) is one of the major causes of non-suicidal self-injury. Non-suicidal self-injury (NSSI), peer victimization, social anxiety, and mobile phone addiction are significantly related; however, the interaction mechanism and effect of sex differences remain to be determined.

OBJECTIVE

Herein, we investigated the relationship between peer victimization and NSSI among Chinese high school students. We also explored the chain mediating roles of social anxiety and mobile phone addiction and the regulatory role of sex. The findings of this study provide insights for theoretical interventions based on internal mechanisms.

METHOD

A self-reported survey of 14,666 high school students from Sichuan County was conducted using a peer victimization scale, NSSI scale, social anxiety scale, and mobile phone addiction scale. A self-administered questionnaire was used to capture sociodemographic information.

RESULTS

Peer victimization, social anxiety, and mobile phone addiction were positively correlated with NSSI. Peer victimization had significant direct predictive effects on NSSI (95% CI: 0.341, 0.385) and significant indirect predictive effects on NSSI through social anxiety (95% CI: 0.008, 0.019) or mobile phone addiction (95% CI: 0.036, 0.053). Peer victimization had significant indirect predictive effects on NSSI through social anxiety as well as mobile phone addiction (95% CI: 0.009, 0.014). The first stage (predicting the effect of peer victimization on NSSI) and the third stage (predicting the effect of mobile phone addiction on NSSI) were both moderated by sex.

CONCLUSIONS

Peer victimization could directly predict NSSI and indirectly predict NSSI through social anxiety and mobile phone addiction. Thus, social anxiety and mobile phone addiction exhibited chain mediating effects between peer victimization and NSSI in high school students; moreover, sex might be involved in the regulation of the mediation process.

A motivational approach to understanding problematic smartphone use and negative outcomes in university students

Considering the rising integration of smartphones into classrooms, the purpose of this research was to explore the relationship between problematic smartphone use (PSU) and negative outcomes through the lens of self-determination theory. This study examined 1,039 students' reported academic motivation, PSU, anxiety, insomnia, and perceived stress. The first objective of this study was to examine how motivational orientations could predict PSU. Then, we examined how motivational orientations and PSU, when used as a mediating variable, could be modeled to predict negative student mental health outcomes (anxiety, insomnia, and perceived stress). As predicted, statistically significant results suggested that autonomous academic motivation was associated with less PSU (β = -0.16), as well as less anxiety (β = -0.12), insomnia (β = -0.16), and stress (β = -0.10). In contrast, higher levels of controlled academic motivation were associated with more PSU (β = 0.37), as well as higher levels of anxiety (β = 0.49) and insomnia (β = 0.41). Amotivation was also positively related to PSU (β = 0.17), anxiety (β = 0.36), insomnia (β = 0.62), and stress (β = 0.22). All indirect effects (mediation effects) were statistically significant and in the predicted direction: the impact of autonomous motivation on negative outcomes was mediated by lower levels of PSU while controlled motivation and amotivation were mediated by higher levels of PSU. Overall, this study advanced the understanding of PSU in university classrooms by demonstrating a link with academic motivation and mental health outcomes.

Prevalence of Thumb and Wrist Pain Among Smartphone Users in the Saudi Arabian General Population: A Cross-Sectional Study

Background This study aims to investigate the prevalence of thumb and wrist pain among smartphone users in the general population of Saudi Arabia, examining the potential links between the duration and frequency of smartphone usage, specific smartphone activities, and the occurrence of discomfort in the thumb and wrist. Methodology This descriptive cross-sectional study was conducted at Jazan University, Saudi Arabia, between July 2022 and June 2023. The questionnaire developed following an extensive literature review, covered demographic information, smartphone usage patterns, assessment of thumb or wrist pain, and evaluation of the impact of this discomfort. Descriptive statistical methods were employed, and relationships between thumb or wrist pain and demographic variables were analyzed using chi-square and Wilcoxon rank-sum tests. Results In total, 811 participants were included in this study. Approximately 322 (39.7%) study participants reported wrist or thumb pain. Notably, female sex (P = 0.001) and prolonged daily smartphone usage exceeding five hours (P = 0.045) were linked to thumb or wrist pain. Additionally, emailing on smartphones was linked to thumb or wrist pain (P = 0.04). Concerning smartphone ergonomics, the majority of respondents reported holding their phones with one hand (215, 66.77%), in a downward position (290, 90.06%), and with their wrists bent downward (136, 42.24%). Conclusions Our study highlights a relatively high prevalence of wrist and thumb pain among smartphone users in the general Saudi Arabian population. Furthermore, we identified a connection between prolonged smartphone use and wrist and thumb pain, with a more pronounced prevalence observed among females.

The working memory approach of persuasion: Induced eye movements lead to more social media self-control behaviours

In the framework of prevention of social media addiction, persuasive messages can be used to stimulate people to engage in social media self-control behaviours. However, the effects of these messages may be weakened by defensive reactions. In the Working Memory account of Persuasion, these defensive self-regulatory actions in the Working Memory (WM) are activated to lower a given threat. Because the WM has limited capacity, and these defensive processes take WM capacity, they can be inhibited by inducing eye movements (EMi). Adults (N = 117) from the general population listened in an online experiment to an auditory message on the negative consequences of social media use (SMU). Half of the participants were randomly assigned to the EMi condition; they were asked to keep watching a moving red square on their screen during the exposure to the auditory message. SMU self-control behaviour was the outcome measure, assessed by self-report 2 weeks later. The effects of EMi on SMU self-control behaviour were moderated by individual differences, indicating defensive self-regulatory actions: EMi significantly increased behaviour in participants who scored low on Cognitive Self-affirmation Inclination, high on SMU-control-failure, and, unexpectedly, low in SMU. This study detected defensive reactions towards persuasive information concerning SMU, using the EMi research paradigm.

Smartphone addiction, musculoskeletal pain and functionality in university students - a observational study

Smartphone addiction and its excessive use could cause musculoskeletal symptoms such neck and upper limb pain. The purpose of this study was to investigate the association between smartphone use and musculoskeletal pain in the upper limbs and neck, as well as to observe the relationship in between smartphone addiction and musculoskeletal pain and upper limb function in university students. It is a cross-sectional, analytical study. A total of 165 university students participated in the research. Each student had their own smartphone. The students answered a structured questionnaire about pain in the upper limbs and neck; the Smartphone Addiction Inventory (SPAI) and the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH). Prevalence of neck and upper limb pain was 34.0%. Smartphone addiction and its use to play games and listen to music were risk factors to upper limb pain. Moreover, the smartphone addiction and age proved to be risk factors to neck pain. There was correlation between DASH and SPAI scores, and there was association between DASH score and neck and upper limb pain. Being of the female sex and smartphone addiction predicted the risk of incapacity development. We found association between neck and upper limb pain with smartphone addiction. Functional incapacity was associated to neck and upper limb pain. It was predicted by smartphone addiction and being of the female sex.

Leisure time activities in adolescents predict problematic technology use

The problematic use of technology of children and adolescents is becoming a growing problem. Research has shown that excessive technology use predicts a variety of psychological and physical health problems. The aim of this study was to analyze the role of leisure time activities (structured and unstructured) in adolescents as a predictor of problematic technology use. Participants were 7723 adolescents, of which 55% were girls, from four Spanish-speaking countries (Chile, Spain, Mexico, and Peru) between the ages of 13 and 18 years. The evaluation instrument applied was the YOURLIFE project self-report questionnaire. Two executive functions were measured: goal setting and inhibitory control. Using structural equation modeling, findings indicated that structured leisure time activities predicted less PTU, whereas unstructured activities predicted more PTU, MLχ2 (69, N = 7723) = 806.60; CFI = 0.929, RMSEA = 0.042, and the model had good predictive capacity for PTU (R2 = 0.46). Structured and unstructured activities also showed indirect effects on PTU through executive functions. As adolescents spent more time in unstructured leisure activities, poorer goal setting, inhibitory control skills, and more PTU were found. The opposite was true for structured leisure time activities. Implications of structured leisure activities to develop executive functioning and to prevent PTU for adolescents are discussed.

Association Between Electronic Device Use at Bedtime and COVID-19 Vaccine-Related Adverse Events During the COVID-19 Pandemic in Korean Adults: A Nationwide Cross-Sectional Population-Based Study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has led to heightened mood disturbances linked to increased electronic device use at bedtime (EUB). General anxiety may contribute to an increased likelihood of experiencing nocebo responses, which have been reported to be associated with COVID-19 vaccine-related adverse events (CAEs). However, no related studies have been conducted to examine this association to date.

METHODS

We executed a nationwide cross-sectional study to explore these correlations during the pandemic. Using data from the 2022 National Sleep Survey of South Korea, we analyzed the sleep health of 4,000 adults aged 20-69 years between January and February 2022. Shift workers and those with severe sleep disorders were excluded. Participants with EUB more than four days a week were labeled as high frequency EUB, and those reporting CAEs after both vaccine doses were marked as having a presence of CAEs. The survey also included details about anthropometric data, socioeconomic status, and sleep status.

RESULTS

Of the 3,702 participants, 92.6% had received two or more vaccine doses, with 41.2% experiencing CAEs. Furthermore, 73.7% had a high EUB frequency. Factors associated with CAE reporting included younger age, female sex, and high EUB frequency, while heavy alcohol use was found to be less likely to be associated with CAE reporting. Notably, a high EUB frequency was significantly associated with reported CAEs (odds ratio, 1.223; 95% confidence interval, 1.028-1.455; P = 0.023).

CONCLUSION

A nationwide online survey conducted in South Korea during the pandemic found that individuals who engaged in the relatively frequent use of electronic devices during bedtime had worse sleep quality and increased COVID-19-related adverse events compared with those using these devices less frequently. These findings have the potential to enhance our understanding of the impact of the use of electronic devices at bedtime on health.

Taking a Break: The Effects of Partaking in a Two-Week Social Media Digital Detox on Problematic Smartphone and Social Media Use, and Other Health-Related Outcomes among Young Adults

Despite their increasing popularity, especially among young adults, there is a dearth of research examining the effectiveness of digital detoxes focused on restricting or limiting social media use. As such, the purpose of this exploratory study was to create and carry out a social media digital detox among young adults and evaluate its effectiveness with regards to smartphone and social media addiction, as well as several health-related outcomes. Additionally, the study also sought to obtain an understanding of participants' experiences and perceptions regarding the digital detox via semi-structured exit interviews in order to improve and maximize the effectiveness of future social media digital detox interventions. Thirty-one young adults completed a two-week social media digital detox (preceded by a two-week baseline period and followed up by a two-week follow-up period), whereby their social media use was limited to 30 min per day. A series of one-way repeated measures analyses of variance revealed that a two-week social media detox improved smartphone and social media addiction, as well as sleep, satisfaction with life, stress, perceived wellness, and supportive relationships. Thematic analysis of exit interviews also revealed eight themes: feelings, effort to detox, adjustment period, the Goldilocks effect, screen to screen, post-detox binge, progress not perfection, and words of wisdom, all of which provide contextualization of the quantitative findings and valuable insights for future detoxes. In conclusion, the findings of this exploratory study provide initial support for the use of social media digital detoxes, suggesting that limiting usage can have beneficial effects with regards to smartphone and social media addiction, as well as many other health-related outcomes.

Standalone effects of focus mode and social comparison functions on problematic smartphone use among adolescents

Problematic smartphone use (PSU) has been reported, particularly among adolescents. Digital interventions may be offered for preventing and reducing PSU. This study evaluated the effects of two smartphone-based interventions among adolescents. Grounded in nudge theory, the focus function allowed users to hide smartphone applications (apps) for a selected length of time, while the feedback function provided a social comparison of the smartphone use of the user and other users. In total, 305 adolescents with Android smartphones were randomly allocated to the focus-function group, feedback-function group or control group. Participants used their smartphones as usual during the two-week baseline period, followed by the one-week period of intervention app instillation and four-week period of intervention use. The primary outcome was self-reported PSU after the intervention period. The secondary outcomes were self-reported smartphone use time during weekdays and app-recorded smartphone use time and frequency. The Group × Time interaction effects showed reduced self-reported PSU in the focus-function and feedback-function groups, Cohen's d = -0.32, 95% CI [-0.63, -0.008], Cohen's d = -0.36, 95% CI [-0.66, -0.06], respectively. The app-recorded smartphone use frequency was also reduced in the focus-function and feedback-function groups, Cohen's d = -0.16, 95% CI [-0.07, -0.25], Cohen's d = -0.32, 95% CI [-0.23, -0.41], respectively. The findings suggest that both utilizing time-outs from nonessential apps and engaging in social comparison lower PSU and smartphone use frequency with small effect sizes. These functions may be noncoercive interventions for preventing and reducing PSU.

The Smartphone Addiction Measure (SAM): Subscales, Validity, and Reliability

Dependence on smartphones continues to grow, with young adults showing the highest usage. In fact, reliance on smartphones may indicate a behavioral addiction, a concept gaining interest in both research and clinical practice. However, valid and reliable assessments of smartphone addiction are needed. To this end, we developed the Smartphone Addiction Measure (SAM) with an initial sample (113 participants; 32 males, 81 females) and assessed the validity and reliability of this new measure. Principle components analysis with an additional sample (286 participants; 78 males, 207 females, 1 other) revealed four factors generally associated with addiction, including salience, mood modification, withdrawal, and conflict, thus providing support for the SAM as a valid measure of addictive behavior related to smartphone use. Analyses also revealed good validity and reliability (221 participants; 38 males, 179 females, 4 other) that sufficiently support the SAM as a psychometrically sound assessment for smartphone addiction.

Effect of online game policy on smartphone game play time, addiction, and emotion in rural adolescents of China

BACKGROUND

Smartphone game addiction has emerged as a major public health problem in China and worldwide. In November 2019 and August 2021, the National Press and Publication Administration of China implemented two increasingly strict policies, as a means of preventing smartphone game addiction in adolescents aged 18 or below. This study aimed to analyze the effect of the policies on smartphone game play time, addiction, and emotion among rural adolescents in China.

METHODS

We sent the questionnaire to rural adolescents through the online survey tool Questionnaire Star, a professional online survey evaluation platform. The questionnaire included demographic data, smartphone use survey, smartphone game addiction and emotion evaluation scales. The Smartphone Addiction Scale-Short Version (SAS-SV) measured adolescents' smartphone game addiction. The Short Version of UPPS-P Impulsive Behavior Scale (SUPPS-P) and Social Anxiety Scale for Children (SASC) measured emotion. According to SAS-SV score, the enrolled rural adolescents were divided into addiction group and non-addiction group. The t-test, Chi-square test, and repeated measure ANOVA assessed the effect of the policies on adolescents' smartphone game addiction and emotion.

RESULTS

Among enrolled 459 rural adolescents with a mean age of 14.36 ± 1.37years, 151 (32.90%) were in the addiction group and 308 (67.10%) were in the non-addiction group. Adolescents in the addiction group were older, more male, and higher grade. There were time and group effects between the two groups in playtime. After a year of policies implementation, the weekly game time dropped from 3.52 ± 1.89 h to 2.63 ± 1.93 h in the addiction group and from 2.71 ± 1.75 h to 2.36 ± 1.73 h in the non-addiction group. There were also time and group effects in SAS-SV and SASC scores, but not for SUPPS-P score. In the addiction group, the SAS-SV score dropped from 41.44 ± 7.45 to 29.58 ± 12.43, which was below the cut-off value for addiction, and the level of social anxiety was consistently higher than non-addiction group.

CONCLUSIONS

The playtime of rural adolescents spent on smartphone games has decreased significantly due to the restriction of the policies rather than the lack of addiction or social anxiety. The policies had practically significant effects in reducing smartphone game play time for rural adolescents in China.

Smart phone addiction and its mental health risks among university students in Jordan: a cross-sectional study

BACKGROUND

Addiction to smart phones is classified clinically as behavioral addiction resulted from an excessive problematic usage of smart phones that effect the daily life of the users. Therefore, this study aims to explore the prevalence of smart phone addiction, its associated psychological distress risk, and its associated predictors among university students in Jordan.

METHODS

Between November 2022 and January 2023, a cross-sectional online survey study was conducted in Jordan. In this study, we used previously developed questionnaire instruments, the psychological Distress scale of Kessler and the Smartphone Addiction Scale. A score of 30 was used to identify the dummy variable in the binary logistic regression analysis to identify predictors of severe psychological distress, and smartphone addiction score of 38.7 was used to to identify predictors of smartphone addiction.

RESULTS

A total of 2337 university students participated in this study. The mean psychological distress score for the study participants was 30.0 (SD: 8.9). More than half of the study participants (59.1%) had a psychological distress score of 30 and above, which indicates a severe mental disorder state. More than half of the study participants (56.7%) had a smartphone addiction score of 30 and above, which reflects a smartphone addiction state. Females, divorced, those who feel that their mental abilities have been negatively affected by the use of smart phones, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to have severe psychological distress compared to others (p < 0.05). Females, those who feel that using smartphones has affected their sleep and made it harder to fall asleep, and those feel that everything requires effort and fatigue, and they do not want to do any activity that requires effort were more likely to be smartphone addicted compared to others (p < 0.05).

CONCLUSION

Mental diseases are a major public health concern in Jordan, especially among university students. Females, those who thought smartphone usage hurt their mental capacities, and those who had trouble sleeping and fatigue were more likely to develop serious psychological discomfort and smartphone addiction. Smartphones are indispensable, but excessive use can lead to addiction and harm university students' mental health.

Relationship between Problematic Smartphone Use, Sleep Quality and Bedtime Procrastination: A Mediation Analysis

The purpose of this investigation was to study the relationship between sleep quality, problematic smartphone use (PSU) and bedtime procrastination, as well as to assess gender and age differences. A total of 313 participants, aged 18-60 (M = 30 ± 10.1; 53.2% males), completed an online survey between February and May 2023 in Spain. The Pittsburgh Sleep Quality Index, Smartphone Addiction Scale-Short Version and Bedtime Procrastination Scale were used to measure sleep quality, PSU and bedtime procrastination, respectively. Additionally, smartphone use habits were evaluated through self-report questions. Pearson correlations, independent samples t-tests, one-way ANOVA, Bonferroni's post hoc tests and mediation analysis were conducted. Correlation analysis showed positive associations between the three main variables. Independent sample t-tests indicated females were more prone to PSU along with higher overall smartphone use. Post hoc analysis of one-way ANOVA exposed age differences between young adults (18-25 years old), adults (26-44 years old) and middle-aged adults (45-60 years old) in PSU and bedtime procrastination. Finally, mediation analysis revealed that PSU had indirect effects on sleep quality through bedtime procrastination, but no direct effects on sleep quality. Therefore, PSU, and especially bedtime procrastination, should be considered as targets in future campaigns or intervention programs to improve sleep quality among the young Spanish population.

Smartphone addiction and its association with hypertension and quality of sleep among medical students of Northern Border University, Arar, Saudi Arabia

OBJECTIVES

To observe the smartphone addiction's prevalence and its relation to hypertension and sleep quality.

METHODS

This study was carried out at the College of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia from October 2022 to March 2023. A total of 200 medical students were selected using convenience sampling. Standard procedures were used to estimate the student's height, weight, body mass, and blood pressure. Smartphone addiction was assessed using the Smartphone Addiction Scale-Short Version and sleep quality was assessed using Pittsburgh Sleep Quality Index. Relationships between smartphone addiction, sleep quality, hypertension, and obesity were estimated using multivariate logistic regression. A p<0.05 was viewed as statistically significant.

RESULTS

Prevalence rate of smartphone addiction was 36% (39.8% in men and 30.5% in women) and prevalence rate of hypertension was 35.5% (42.4% in men and 25.6% in women). Hypertension showed a significant positive relationship with smartphone addiction (odds ratio [OR]=2.12, 95% confidence interval [CI] =1.034-4.36), poor sleep quality (OR=3.54, 95% CI=1.73-7.22), and obesity (OR=3.03, 95% CI=1.09-8.42).

CONCLUSION

Smartphone addiction has been demonstrated to have a high prevalence among medical undergraduates and has been associated significantly with elevated blood pressure.

Impacts of problematic smartphone use on children: Perspectives from main caregivers

PURPOSE

This study examines the impact of problematic smartphone use (PSU) on children aged six years and younger, as perceived by their main caregivers.

METHOD

Overall, 15 mothers who identified that their children used smartphones excessively were recruited and interviewed. Data were analyzed using summative content analysis.

FINDINGS

Participants reported various impacts of PSU that were categorized into developmental, behavioral, health, quality of life, and parent-child relational perspectives.

PRACTICAL IMPLICATIONS

Efforts to prevent PSU in children are needed. Nurses' roles in the early assessment of PSU are essential.

The relationship between loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic: The mediating role of negative emotions and maladaptive coping

INTRODUCTION

Given the observed increased feelings of loneliness and problematic smartphone use among adolescents during the COVID-19 pandemic, further research was needed to determine whether and how the increased loneliness of adolescents during such major public health crisis events affects the risk of problematic smartphone use among adolescents. This study aimed to examine the relationship between loneliness and problematic smartphone use among Chinese adolescents (aged 10-16 years) during the COVID-19 pandemic and to investigate the possible mediating role of negative emotions and maladaptive coping.

METHODS

A total of 672 Chinese adolescents (Mage  = 13.05, SD = 1.51, 50.4% boys, 93.8% from rural areas, 22.5% of whom were only children) took part in this cross-sectional study in April 2022 by completing the Chinese adolescent version of the Loneliness Scale, the Positive and Negative Affect Scale (subscale), the Ways of Coping Questionnaire, and the Mobile Phone Addiction Index Scale.

RESULTS

The serial mediation model revealed that negative emotions and maladaptive coping independently mediated the relationship between adolescents' loneliness and problematic smartphone use. In addition, the mediation effects of "negative emotions-maladaptive coping" could also mediate the relationship between loneliness and problematic smartphone use.

CONCLUSIONS

Loneliness may be positively related to problematic smartphone use through negative emotions and maladaptive coping among adolescents during major public health crisis events, such as the COVID-19 pandemic.

The habitual characteristic of smart phone use under relevant cues among Chinese college students

Excessive smartphone use may be habitual behavior induced by cues associated with the phone. Habitual behavior occurs outside of awareness and is characterized by lack of control. It is not like problematic smartphone use (PSU) (Brand et al., 2016), which is used to either limit behavior or produce pleasure and relieve feelings of pain, stress, and failure despite significant harmful consequences. 62 college students participated in experiments to test the effects of visual cues and self-control, which are the important characteristic of habitual behavior in smartphone-related behavior. The results showed that a significantly larger amount of cue-related phone use behavior occurred in the setting where participants (a) had their smartphones in sight and (b) were given no instructions to exert self-control, compared to when neither of the two conditions was imposed. The habitual model is a useful framework for understanding PSU and can help people avoid it with less stress. The results provide substantial implications for reducing the frequency and duration of smartphone use among college populations.