Smartphone Use and Sleep Quality in Chinese College Students: A Preliminary Study

Exploring the Associations between Autistic Traits, Sleep Quality and Well-Being in University Students: A Narrative Review

While research on autism spectrum disorder (ASD) has been growing, not enough research has been conducted to understand the impact of autistic traits and the broader autism phenotype (BAP), especially on the sleep quality and well-being of university students. The focus of this paper is to review the existing research on this topic and identify the key areas of interest for future research, presented in the form of a narrative review. While the review identifies the need for research on the topic, it also identifies other factors such as gender, age, culture, and internet and smartphone use that may have an impact on the relationship between autistic traits, sleep quality and well-being in university students. The review also identified the importance of using a larger sample size, appropriate measures, especially for quantifying autistic traits, and an appropriate analysis strategy involving a multivariate analysis.

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.

The Role of Smartphone Addiction as a Mediator between Psychological Resilience and Insomnia in Medical Students at a University

Background

To explore the mediating effect of smartphone addiction between psychological resilience and insomnia among university students.

Methods

This study included 581 clinical medical students from the Dalian Medical University, enrolled between September 2020 and May 2023. The Smartphone Addiction Scale (SAS-SV), Insomnia Severity Index (ISI), and Connor-Davidson Resilience Scale (CD-RISC) were used to assess smartphone addiction, insomnia, and psychological resilience among the students. The Process macro and Bootstrap methods were employed to analyze the mediating effect of smartphone addiction between psychological resilience and insomnia.

Results

The detection rate of smartphone addiction was 28.06% (163/581), and the detection rate of insomnia was 26.17% (152/581). The total SAS-SV score was 27.60 ± 14.27, the total ISI score was 6.60 ± 5.33, and the total CD-RISC score was 72.86 ± 6.88. There was a significant negative correlation between the total CD-RISC score and the total SAS-SV score (r = -0.4129, P < .0001), and a significant negative correlation between the total CD-RISC score and the total ISI score (r = -2.942, P < .0001). The total SAS-SV score and the total ISI score were significantly positively correlated (r = 0.5687, P < .0001). Psychological resilience was used as the independent variable, insomnia as the dependent variable, and smartphone addiction as the mediating variable in the mediation effect analysis. Psychological resilience negatively predicted insomnia (β = -0.0940, P < .0001), smartphone addiction positively predicted insomnia (β = 0.1564, P < .0001), and smartphone addiction mediated the relationship between psychological resilience and insomnia (effect value = -0.1339, 95% CI: -0.1680 to -0.1034), with an effect size of 58.75%.

Conclusion

Psychological resilience directly affects insomnia and also indirectly affects insomnia through the mediating effect of smartphone addiction.

Associations of smart device apps with and without a perceived self-efficacy component in a physical activity context with BMI

Smart device apps can be used to promote physical activity, decrease sedentariness, or increase self-efficacy to get active in college students, possibly reducing their obesity risk. This study assessed associations of college students' smart device use with body mass index (BMI), expecting associations between physical activity parameters and self-efficacy with BMI, moderated by app type. In an online survey, app data of a week from student's devices, weight, height, physical activity, and self-efficacy to get active were collected from 120 students. Apps were categorized "physical activity," "physical activity with a self-efficacy component," or "unrelated." Use time of physical activity apps is not associated with BMI, while self-efficacy app time show negative and unrelated app time positive associations. Self-efficacy may be an important component in app design for obesity risk reduction of college students. Test economy was low, which is why future studies need to concentrate on better data extraction methods.

Validation of the Chinese version of the Smartphone Distraction Scale

The Smartphone Distraction Scale (SDS) is a novel assessment scale for smartphone distraction; it comprises 16 items that cover attention impulsiveness, online vigilance, multitasking, and emotion regulation. This study aimed to investigate the validity and reliability of the SDS in college students in China. After translating and culturally adapting the original version of the SDS into Chinese, the scale was tested on a sample of 1302 college students.The validity and reliability were assessed utilizing SPSS 25.0, AMOS 25.0 and Mplus 8.3. Parallel analysis, Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed for the validity analysis. Criterion-related validity for the SDS was tested by correlation analysis with the mobile phone addiction scale (MPAI). The reliability analysis was tested by Cronbach's alpha coefficients and intraclass correlation coefficients (ICC). EFA and parallel analysis revealed a three-factor structure. The EFA identified factor loadings on three factors (14 items), explaining a total variance of 60.73 %. The CFA model fit was good (χ2/df = 4.644, RMSEA = 0.047, GFI = 0.930, CFI = 0.955, SRMR = 0.047), and the multigroup confirmatory factor analysis indicated measurement invariance for gender. Both convergent and discriminant validity were established. The criterion-related validity was established based on a significant correlation (r = 0.758) with the MPAI. The Cronbach's alpha coefficient was 0.916, and the split-half reliability was 0.769, demonstrating a satisfactory internal consistency. The score of ICC was 0.907, demonstrating the stability of the SDS. Based on these data, the Chinese version of the SDS demonstrated satisfactory validity and reliability in a sample of college students.

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.

The Impact of Problematic Smartphone Use on Sleep Quality Among Chinese Young Adults: Investigating Anxiety and Depression as Mediators in a Three-Wave Longitudinal Study

Background

Sleep disorders are a significant health issue that urgently needs to be addressed among undergraduate students, and one of the potential underlying problems could be problematic smartphone use (PSU). This study aimed to clarify the relationship between PSU and poor sleep quality by investigating the independent and serial mediating roles of anxiety and depressive symptoms in a population of university students in Tibet, China.

Methods

A total of 2993 Tibetan college students completed three waves of data surveys, with all participants completing questionnaires on PSU, anxiety, depressive symptoms, and sleep quality (Time 1 (T1) -Time 3 (T3)). Bootstrapped mediation analysis was used to explore the mediating role of anxiety and depressive symptoms in the longitudinal relationship between PSU and sleep quality.

Results

Both direct and indirect effects of PSU on poor sleep quality were found. PSU (T1) can had not only a direct negative influence on poor sleep quality (T3) among young adults (direct effect = 0.021, 95% CI = 0.010-0.033) but also an indirect negative impact via three pathways: the independent mediating effect of anxiety symptoms (T2) (indirect effect 1 = 0.003, 95% CI = 0.001-0.006), the independent mediating effect of depressive symptoms (T2) (indirect effect 2 = 0.004, 95% CI = 0.002-0.006), and the serial mediating effects of anxiety (T2) and depressive symptoms (T2) (indirect effect 3 = 0.008, 95% CI=0.005-0.011).

Conclusion

These findings highlight the role of anxiety and depression symptoms as joint mediating factors in the relationship between PSU and sleep disturbances. Interventions focused on improving sleep that incorporate behavioural measures could benefit from treatment approaches targeting mental disorders.

Electronic Media Use and Sleep Quality: Updated Systematic Review and Meta-Analysis

BACKGROUND

This paper explores the widely discussed relationship between electronic media use and sleep quality, indicating negative effects due to various factors. However, existing meta-analyses on the topic have some limitations.

OBJECTIVE

The study aims to analyze and compare the impacts of different digital media types, such as smartphones, online games, and social media, on sleep quality.

METHODS

Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the study performed a systematic meta-analysis of literature across multiple databases, including Web of Science, MEDLINE, PsycINFO, PubMed, Science Direct, Scopus, and Google Scholar, from January 2018 to October 2023. Two trained coders coded the study characteristics independently. The effect sizes were calculated using the correlation coefficient as a standardized measure of the relationship between electronic media use and sleep quality across studies. The Comprehensive Meta-Analysis software (version 3.0) was used to perform the meta-analysis. Statistical methods such as funnel plots were used to assess the presence of asymmetry and a p-curve test to test the p-hacking problem, which can indicate publication bias.

RESULTS

Following a thorough screening process, the study involved 55 papers (56 items) with 41,716 participants from over 20 countries, classifying electronic media use into "general use" and "problematic use." The meta-analysis revealed that electronic media use was significantly linked with decreased sleep quality and increased sleep problems with varying effect sizes across subgroups. A significant cultural difference was also observed in these effects. General use was associated with a significant decrease in sleep quality (P<.001). The pooled effect size was 0.28 (95% CI 0.21-0.35; k=20). Problematic use was associated with a significant increase in sleep problems (P≤.001). The pooled effect size was 0.33 (95% CI 0.28-0.38; k=36). The subgroup analysis indicated that the effect of general smartphone use and sleep problems was r=0.33 (95% CI 0.27-0.40), which was the highest among the general group. The effect of problematic internet use and sleep problems was r=0.51 (95% CI 0.43-0.59), which was the highest among the problematic groups. There were significant differences among these subgroups (general: Qbetween=14.46, P=.001; problematic: Qbetween=27.37, P<.001). The results of the meta-regression analysis using age, gender, and culture as moderators indicated that only cultural difference in the relationship between Eastern and Western culture was significant (Qbetween=6.69; P=.01). All funnel plots and p-curve analyses showed no evidence of publication and selection bias.

CONCLUSIONS

Despite some variability, the study overall confirms the correlation between increased electronic media use and poorer sleep outcomes, which is notably more significant in Eastern cultures.

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.

Depression and Smartphone Addiction Among College Students: The Mediating Effect of Emotional Exhaustion

Objective

Multiple studies claim that depression was a triggering factor for smartphone addiction among college students. But we still know very little about the underlying mechanisms of smartphone addiction. The aim was to shed light on the underlying mechanisms of smartphone addiction from the perspective of depression and emotional exhaustion, to provide alternative paths for university administrators to address smartphone addiction among college students.

Methods

A total of 2764 Chinese college students participated in the survey. They independently filled out self-assessment questionnaires including the Cell Phone Addiction Scale, Beck Depression Inventory II, and Emotional Exhaustion Scale. Subsequently, mediation analysis was conducted using the PROCESS macro developed by Hayes (v 4.0; Model 4).

Results

Statistical analysis showed that depression was positively correlated with emotional exhaustion and smartphone addiction, emotional exhaustion was positively correlated with smartphone addiction, all of which were statistically significant. In addition, the effect of depression on smartphone addiction among college students was partially mediated by emotional exhaustion.

Conclusion

The impact of depression and emotional exhaustion on smartphone addiction had been preliminarily explored, which had certain value for further understanding of smartphone addiction among college students. This study could provide references for universities to develop intervention measures for smartphone addiction.

Factors associated with sleep disorders among university students in Jiangsu Province: a cross-sectional study

Objective

This study aims to establish the precise prevalence of sleep disorders among university students in Jiangsu Province. Utilizing a representative sample of students, we measured their sleep quality based on the Pittsburgh Sleep Quality Index (PSQI). Our objective is to quantitatively assess the magnitude of sleep quality and identify key factors. By detailed analysis of these relationships, our study seeks to provide actionable insights for the development of targeted interventions to enhance sleep quality within this population.

Methods

From October to November 2022, we conducted a cross-sectional web-based survey in Jiangsu Province, China. Using convenient cluster sampling in each college, a total of 8457 participants were selected. The PSQI was applied to assess sleep quality among university students. Data collected included sociodemographic details, scores from the Mobile Phone Dependence Index (MPAI) and psychological resilience measured by the Connor-Davidson Resilience Scale (CD-RISC).

Results

The overall prevalence of poor sleep quality among the participants was 39.30%. Binary logistic regression analysis revealed that higher physical activity (OR = 0.921; 95% CI: 0.779-1.090), earlier roommate bedtimes (OR = 0.799; 95% CI: 0.718-0.888), quieter dormitories (OR = 0.732; 95% CI: 0.647-0.828) and higher psychological resilience (OR = 0.982; 95% CI, 0.979-0.984) were protective factors linked to lower risk of poor sleep quality. Conversely, being a female student (OR = 1.238; 95% CI: 1.109-1.382), being a senior (OR = 1.582; 95% CI: 1.344-1.863), single-child status (OR = 1.195; 95% CI: 1.077-1.326), regular smoking (OR = 1.833; 95% CI: 1.181-2.847), regular alcohol consumption (OR = 1.737; 95% CI: 1.065-2.833), high academic stress (OR = 1.326; 95% CI: 1.012-1.736), high employment stress (OR = 1.352; 95% CI: 1.156-1.582), dissatisfaction with dormitory hygiene (OR = 1.140; 95% CI: 1.028-1.265), poor self-rated physical health (OR = 1.969; 95% CI: 1.533-2.529), poor self-rated mental health (OR = 2.924; 95% CI: 2.309-3.702) and higher mobile phone dependency were risk factors associated with an increased likelihood of poor sleep quality.

Conclusion

The sleep quality among university students should attract immediate attention. The development of public services and mental health education initiatives is crucial in enhancing the sleep health of this population.

Life Events, Boredom Proneness and Mobile Phone Addiction Tendency: A Longitudinal Mediation Analysis Based on Latent Growth Modeling (LGM)

Purpose

Mobile phone addiction has motivated a widespread concern in recent years. From a developmental perspective, this study explored the predictive relations between life events, boredom proneness (BP), and mobile phone addiction tendency (MPAT) among undergraduate students. It also tested the longitudinal mediation of BP between life events and MPAT.

Methods

Five hundred and eighty-four undergraduate students completed the Mobile Phone Addiction Tendency Scale, the Adolescent Self-Rating Life Events Checklist, and the Boredom Proneness Scale-Short Form. A longitudinal mediation analysis based on latent growth modeling was conducted to test the hypothesized relationships among life events, BP and MPAT.

Results

Latent growth modeling (LGM) showed that the BP and MPAT of undergraduate students both increased linearly. A longitudinal model based on LGM showed that negative life events both directly and indirectly affected the initial level and the growth rate of the MPAT through the mediating effect of the initial level of BP.

Conclusion

These results reveal that negative life events are an indicator of the development of MPAT. It has practical implications for calling for adopting health coping styles when facing negative life events. Supported for reducing college students' boredom proneness in order to lessen the tendency towards mobile phone addiction to improve their mental health.

Associations between sleep characteristics, chronotype and body mass index among Chinese college freshmen

Research indicates that sleep problem is a behavioral risk factor of obesity. However, few research have applied a multi-dimensional approach to investigate the relationship between sleep health and adiposity. Therefore, the current study aimed to examine the associations of sleep characteristics (duration, quality) and chronotype with overweight/obesity as measured by body mass index. Data were obtained from 2014 college students from the Dali University in the Yunnan province of China in the year 2021. Sleep characteristics and chronotype were measured using self-reported questionnaires. The presence of overweight/obesity was assessed by anthropometric measurements. Multiple logistic regression models and restricted cubic spline hazard models were established to examine associations between sleep characteristics, chronotype and adiposity. After adjusting for demographic characteristics and other obesity-related behavioral risk factors, evening type was positively associated with overweight/obesity, and an L-shaped dose-effect relationship was observed between chronotype scores and the presence of overweight/obesity. However, sleep duration and quality were not associated with the presence of overweight/obesity in the logistic regression models and restrictive cubic splines models. This study indicated that Chinese college students who had the evening chronotype were more likely to be affected by overweight/obesity. Chronotype as an important dimension of sleep health should be incorporated in obesity intervention programs.

Exploring associations between eHealth literacy, cyberchondria, online health information seeking and sleep quality among university students: A cross-section study

Background

University students are increasingly inclined to use the Internet for health-related purposes, and their sleep problems are becoming increasingly prominent. Currently, the relationship between sleep quality and online health-related searches is poorly understood. The aim of this study was to exam the associations of sleep quality, Internet use, eHealth literacy, online health information seeking and cyberchondria in the sample of Chinese university students.

Methods

A total of 2744 students completed self-reported questionnaires online containing the Pittsburgh Sleep Quality Index (PSQI), eHealth Literacy Scale, Online Health Information Seeking, Cyberchondria Severity Scale (CSS) and questions regarding sleep duration, Internet use, health status, and demographic information.

Results

The prevalence of poor sleep quality (PSQI >7) among the university students was 19.9% and 15.6% students slept less than 7 h per day. As time spent on online daily and playing phone before bed increased, the prevalence of sleep disturbance gained. Sleep disturbance was significantly associated with cyberchondria (OR = 1.545, p = 0.001), health status [good (OR = 0.625, p = 0.039), poor (OR = 3.128, p = 0.010), and fair (OR = 1.932, p = 0.001)]. Sleep quality, online health information seeking and eHealth literacy positively influenced with cyberchondria. Compared to 7-8 h sleep duration, online health information seeking (OR = 0.750, p = 0.012) was significantly associated with ≥8 h sleep duration.

Conclusion

Our findings highlighted poor health status, too much time spent on online daily and high cyberchondria level might decrease sleep quality in the sample of Chinese university students, further suggesting the need for developing interventions based on online health-related searches for improving sleep quality among university students.

The Relationship between Nomophobia, Insomnia, Chronotype, Phone in Proximity, Screen Time, and Sleep Duration in Adults: A Mobile Phone App-Assisted Cross-Sectional Study

Earlier studies that have investigated the association between nomophobia and insomnia revealed that a strong relationship exists between both variables. This study aimed to explore possible associations between these variables and their impact on physical and mental health outcomes using a cross-sectional study design and mobile phone apps to collect data. Using a survey approach, data were collected from 444 participants (52% female, mean age 34 ± 12) using the Nomophobia Questionnaire (NMP-Q), the Insomnia Severity Index (ISI), the Morningness-Eveningness Questionnaire (MEQ) and three Android mobile phone apps. The Plees Tracker, screen time, and pedometer apps aided in collecting data on sleep duration, time spent on screen per day, and how close the phone was to the person. A statistically significant association was noted between nomophobia and insomnia, nomophobia and the eveningness chronotype, and nomophobia and screen time. The eveningness chronotype was also associated with an increased screen time use. The results show that NMP-Q, ISI, and screen time increase according to the chronotype. No statistically significant differences were noted in daily steps or sleep duration according to chronotype. The findings suggest that interventions targeting nomophobia may be beneficial in addressing insomnia among adults, particularly those with an evening chronotype. Future studies should consider exploring the causal relationship between them.

Nomophobia among university students: Prevalence, correlates, and the mediating role of smartphone use between Facebook addiction and nomophobia

Nomophobia ('no mobile phone phobia') has been growing issue worldwide in recent years and has been associated with a number of psychological and behavioral health-related problems. However, few studies have examined nomophobia in Bangladesh. Therefore, the severity and correlates of nomophobia, and the mediating role of smartphone use between Facebook addiction and nomophobia was investigated. A cross-sectional study utilizing 585 university students was conducted employing a convenience sampling method. Data were collected using a survey in March 2022. The survey comprised questions related to socio-demographics, behavioral health, academic performance, nomophobia, smartphone addiction, Facebook addiction, insomnia, and depression. The mean score of nomophobia was 88.55 out of 140 (±21.71). The prevalence was 9.4% for mild nomophobia, 56.1% for moderate nomophobia, and 34.5% for severe nomophobia. First-year students had higher levels of nomophobia than other years. Significant predictors for nomophobia included daily duration of smartphone time, psychoactive substance use, and being in a relationship. Nomophobia was significantly associated with smartphone addiction, Facebook addiction, insomnia, and depression. Moreover, smartphone addiction significantly mediated the relationship between Facebook addiction and nomophobia. Strategies that help reduce daily smartphone time, and reduce psychoactive substance use might help reduce nomophobia prevalence among university students.

Dose-response analysis of smartphone usage and self-reported sleep quality: a systematic review and meta-analysis of observational studies

STUDY OBJECTIVES

Several studies have recently reported on the association between smartphone usage and self-reported sleep quality. However, no systematic review or meta-analysis has yet been performed. We aimed to analyze the association between smartphone usage time and self-reported sleep quality.

METHODS

We searched for articles published up to January 13, 2022, using the Embase and Medline databases. All observational studies were eligible for inclusion. The Newcastle-Ottawa scale was used to evaluate the risk of bias within studies. We used restricted cubic spline analysis to perform a dose-response analysis.

RESULTS

Seventeen studies with a total of 36,485 participants were included. The pooled odds ratio was 2.28 (confidence interval [CI]: 1.81-2.89; P < .001) and heterogeneity was 80%. In the dose-response analysis conducted on 5 studies, the regression coefficient between daily smartphone usage time (hours/day) and poor sleep quality was 1.042 (1.027-1.058), which confirmed a significantly positive association.

CONCLUSIONS

Smartphone overuse was closely associated with poor self-reported sleep quality, sleep deprivation, and sleep latency prolongation. Further studies using a more structured method and high-quality evidence (cohort or case-control) should be conducted.

SYSTEMATIC REVIEW REGISTRATION

CRD42022303371.

CITATION

Chu Y, Oh Y, Gwon M, et al. Dose-response analysis of smartphone usage and self-reported sleep quality: a systematic review and meta-analysis of observational studies. J Clin Sleep Med. 2023;19(3):621-630.

Association between Problematic Use of Smartphones and Mental Health in the Middle East and North Africa (MENA) Region: A Systematic Review

Smartphones have become essential components of daily life, and research into the harmful effects of problematic smartphone use (PSU) on mental health is expanding in the Middle East and North Africa (MENA) region. This issue has yet to be synthesized and critically evaluated. To find quantitative observational studies on the relationship between PSU and mental health in the MENA region, we developed a search equation and adapted it for four databases. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed during the selection process. This review included 32 cross-sectional studies and one cohort study. The available language was English. All identified studies published until 8 October 2021, were considered. A modified Newcastle-Ottawa scale was used to assess the quality of the included studies. The studies enrolled 21,487 people and had low-to-moderate methodological quality. The prevalence of PSU ranged from 4.3 to 97.8 percent. The time factor, type of application used on the smartphone, and sociodemographic characteristics were the determinants of PSU. Depression, anxiety, and stress were strongly correlated with PSU. Epidemiological longitudinal studies that respect the quality of evidence are needed in all MENA countries to better plan and implement preventive measures against PSU.

Role of Gaming Devices Associated With Internet Gaming Disorder in China: Cross-sectional Study

BACKGROUND

Chinese gamers use computer and mobile phone games widely. Consequently, concerns regarding the development of internet gaming disorder (IGD) in adolescents have been raised. However, only a few studies have focused on the influence of gaming devices on IGD.

OBJECTIVE

This study aims to compare sociodemographic information, gaming use characteristics, personality traits, and gaming motivations between computer game users (CGUs) and mobile phone game users (MGUs), as well as identifying IGD predictors.

METHODS

This was a cross-sectional study. A total of 3593 internet game players took part in an online survey, which included sociodemographic information, gaming patterns, gaming motivations, the Chinese version of the Video Game Dependency Scale, and the Chinese Big Five Personality Inventory brief version. The population was divided into 2 groups for comparison by mobile phone or computer use, and the IGD population was also compared within the 2 groups.

RESULTS

There were significant differences between the 2 gaming device groups in the time (t₂₉₉₄=7.75, P<.001) and money (t₂₉₉₄=5.11, P<.001) spent on gaming and in internet game addiction scores (t₂₉₉₄=3.68, P<.001). Individuals using different gaming devices had different game motivations and personality traits and preferred different genres of games. Results showed that IGD predictors were different for the 2 groups, for example, strategy (odds ratio [OR] 4.452, 95% CI 1.938-10.227; P<.001) and action shooter (OR 3.725, 95% CI 1.465-9.474; P=.01) games increased the risk for MGUs.

CONCLUSIONS

Gaming devices should be considered during early identification, such as long daily gaming time, much money spent on gaming, neuroticism, and conscientiousness. In addition, more research should be conducted on new gaming devices and IGD treatment.

The association between autistic traits and excessive smartphone use in Chinese college students: The chain mediating roles of social interaction anxiety and loneliness

This study draws upon a large sample of Chinese college students to examine the chain mediating roles of social interaction anxiety and loneliness in the relation between autistic traits and excessive smartphone use. To test our hypothesis that social interaction anxiety and loneliness mediate the relation between autistic traits and excessive smartphone use, we recruited a sample of 1103 college students and asked them to complete an assessment that measured the degrees of autistic traits, social interaction anxiety, loneliness, and excessive smartphone use. The results showed significant correlations among these variables. More autistic traits, which are correlated with higher levels of social interaction anxiety and higher levels of loneliness, were found to be associated with excessive smartphone use. In conclusion, this study highlights the need for screening for excessive smartphone use among college students who demonstrate autistic traits. Social interaction anxiety and loneliness show great potential in screening for excessive smartphone use among college students with high levels of autistic traits. We discuss the practical implications of the findings and directions for future study.

Problematic smartphone use is associated with differences in static and dynamic brain functional connectivity in young adults

Introduction

This study aimed to investigate the possible associations between problematic smartphone use and brain functions in terms of both static and dynamic functional connectivity patterns.

Materials and methods

Resting-state functional magnetic resonance imaging data were scanned from 53 young healthy adults, all of whom completed the Short Version of the Smartphone Addiction Scale (SAS-SV) to assess their problematic smartphone use severity. Both static and dynamic functional brain network measures were evaluated for each participant. The brain network measures were correlated the SAS-SV scores, and compared between participants with and without a problematic smartphone use after adjusting for sex, age, education, and head motion.

Results

Two participants were excluded because of excessive head motion, and 56.9% (29/51) of the final analyzed participants were found to have a problematic smartphone use (SAS-SV scores ≥ 31 for males and ≥ 33 for females, as proposed in prior research). At the global network level, the SAS-SV score was found to be significantly positively correlated with the global efficiency and local efficiency of static brain networks, and negatively correlated with the temporal variability using the dynamic brain network model. Large-scale subnetwork analyses indicated that a higher SAS-SV score was significantly associated with higher strengths of static functional connectivity within the frontoparietal and cinguloopercular subnetworks, as well as a lower temporal variability of dynamic functional connectivity patterns within the attention subnetwork. However, no significant differences were found when directly comparing between the groups of participants with and without a problematic smartphone use.

Conclusion

Our results suggested that problematic smartphone use is associated with differences in both the static and dynamic brain network organizations in young adults. These findings may help to identify at-risk population for smartphone addiction and guide targeted interventions for further research. Nevertheless, it might be necessary to confirm our findings in a larger sample, and to investigate if a more applicable SAS-SV cutoff point is required for defining problematic smartphone use in young Chinese adults nowadays.

Association of Smartphone Use Duration with Physical Fitness among University Students: Focus on Strength and Flexibility

High-frequency smartphone use leads to physical inactivity and may consequently cause the loss of physical fitness. Although the relationship between smartphone usage and physical fitness has been investigated, most of these studies focused on partial physical fitness, and the evaluation of the duration of smartphone use was insufficient. Therefore, this study aimed to investigate the relationship between the time period of using smart phones and physical fitness in Chinese university students. In this cross-sectional study, 8977 college students (5189 men and 3788 women) were enrolled. The assessment of smartphone usage was performed using a self-reported questionnaire. Physical fitness was measured in a sports facility, consisting of grip strength, standing long jump, and sit-and-reach test. The post adjustment relationship between smartphone use duration and physical fitness was examined by using the ANCOVA test. In the final adjusted model, an inverse association was observed between the smartphone use duration and grip strength in male and female participants (p = 0.003 and <0.001, respectively). The smartphone use duration was also negatively associated with standing long jump in both sexes (p = 0.003 for male and = 0.026 for female). In male participants, the longer the period of using smartphones, the lower their flexibility (p = 0.026). In conclusion, this study investigated the association between the duration of smartphone use and physical fitness. The results showed that longer durations of smartphone use were associated with weaker grip strength, a shorter standing long jump, and lower flexibility. Controlling smartphone-use duration might be beneficial for physical fitness among university students.

Relation between internet gaming addiction and comorbid psychiatric disorders and emotion avoidance among adolescents: A cross-sectional study

INTRODUCTION

Internet Gaming Disorder has been a controversial subject. Even though internet addiction has been studied among adolescents, there is a lack of evidence regarding Internet Gaming Disorder. The purpose of this study was to assess the prevalence rate of Internet Gaming Disorder and the relationship between Internet Gaming Disorder, comorbid psychiatric disorders, and emotion avoidance among adolescents.

METHODS

Four hundred seven adolescents aged 11 to 18 years old were recruited. Participants were divided into two groups based on the internet gaming addiction scale-Adolescents with IGA (N = 40) and adolescents without IGA (N = 367). All participants were evaluated for demographic data, the Strengths and Difficulties Questionnaire (SDQ), socioeconomic scale, and the Emotional Avoidance Strategy Inventory for Adolescents (EASI-A).

RESULTS

The adolescent with IGA had a higher mean of the number of hours and devices using Internet gaming apps than an adolescent without IGA. Regarding SDQ, adolescents with IGA had a significantly higher mean value for all subscales of SDQ except the prosocial scale and all subscales of EASI-A compared with adolescents without IGA.

CONCLUSIONS

Adolescents with IGA had more hours and devices using Internet gaming apps; more comorbid psychiatric disorders and problems in emotional expression inform of using avoidance techniques than adolescents without IGA.

A longitudinal study of the effects of problematic smartphone use on social functioning among people with schizophrenia: Mediating roles for sleep quality and self-stigma

Background and aims

Individuals with schizophrenia may often experience poor sleep, self-stigma, impaired social functions, and problematic smartphone use. However, the temporal relationships between these factors have not been investigated. The present study used a longitudinal design to examine potential mediating roles of poor sleep and self-stigma in associations between problematic smartphone use and impaired social functions among individuals with schizophrenia.

Methods

From April 2019 to August 2021, 193 individuals with schizophrenia (mean [SD] age = 41.34 [9.01] years; 88 [45.6%] males) were recruited and asked to complete three psychometric scales: the Smartphone Application-Based Addiction Scale to assess problematic smartphone use; the Pittsburgh Sleep Quality Index to assess sleep quality; and the Self-Stigma Scale-Short Scale to assess self-stigma. Social functioning was evaluated by a psychiatrist using the Personal and Social Performance Scale. All measures were assessed five times (one baseline and four follow-ups) at three-month intervals between assessments.

Results

General estimating equations found that problematic smartphone use (coefficient = -0.096, SE = 0.021; P < 0.001), sleep quality (coefficient = -0.134, SE = 0.038; P < 0.001), and self-stigma (coefficient = -0.612, SE = 0.192; P = 0.001) were significant statistical predictors for social functioning. Moreover, sleep quality and self-stigma mediated associations between problematic smartphone use and social functioning.

Conclusion

Problematic smartphone use appears to impact social functioning longitudinally among individuals with schizophrenia via poor sleep and self-stigma concerns. Interventions aimed at reducing problematic smartphone use, improving sleep, and addressing self-stigma may help improve social functioning among individuals with schizophrenia.

Resting-state functional connectivity of the sensory/somatomotor network associated with sleep quality: evidence from 202 young male samples

Previous neuroimaging studies have demonstrated that sleep is associated with brain functional changes in some specific brain regions. However, few studies have examined the relationship between all possible functional connectivities (FCs) within the sensory/somatomotor network (SSN) and the sleep quality of young male samples. The SSN consists of two motor cortices and is known to play a critical role in sleep. Poor sleep quality may be associated with increased sensory/somatomotor functional connectivity during rest. Hence, 202 young male participants underwent a resting-state functional magnetic resonance imaging (fMRI) scan and completed the Pittsburgh Sleep Quality Index (PSQI). Results indicated that increased functional connectivity within the SSN was associated with poor sleep quality. Specifically, the total PSQI score was positively correlated with the increased functional connectivity of the left paracentral lobule (PCL), bilateral precentral gyrus (PreCG), supplementary motor area (SMA) and bilateral postcentral gyrus (PoCG). Additionally, our findings also exhibited that (a) the subjective sleep quality factor of PSQI was positively correlated with FC between the bilateral PoCG and the bilateral PCL as well as between the left PreCG and the right SMA; (b) the sleep latency factor of PSQI was positively correlated with FC between the left PoCG and the right precuneus (PCUN); (c) the sleep disturbances factor of PSQI was positively correlated with FC between the left PCL and the right PoCG, and (d) the daytime dysfunction factor of PSQI was positively correlated with FC between the bilateral PoCG and the left PCL as well as between the bilateral PreCG and the SMA. In short, our findings can be comprehensively understood as neural mechanisms of intrinsic SSN connectivity are associated with sleep quality of man. Meanwhile, it may expand our knowledge and provide new insight into a deeper understanding of the neurobiological mechanisms of sleep or sleep problems.

Mediating Effect of Sleep Quality on the Relationship Between Electronic Screen Media Use and Academic Performance Among College Students

OBJECTIVE

We aimed to examine the effects of sleep quality on the association between pre-bedtime electronic screen media use for entertainment and academic performance among college students. We hypothesized that sleep quality mediates the association between pre-bedtime electronic screen media entertainment use and academic performance among college students.

METHODS

This was a cross-sectional survey with 1385 participants (age 19.99 ± 1.4 years [range, 17-24 years] and 36.82% males) conducted at Shantou University. The levels of academic performance were based on self-reported academic class ranking from average grades of their last final major examinations. Poor sleep quality was defined as a total score of the Pittsburgh Sleep Quality Index >7. The pre-bedtime prolonged electronic screen media use for entertainment (PESM-E) was defined as the use of electronic screen media for entertainment longer than 60 minutes/night after 10:00 p.m. during the past 6 months.

RESULTS

College students with pre-bedtime PESM-E were 1.28-fold more likely to have a poor academic performance than those who used electronic screen media less than 60 minutes (95% confidence interval [CI]: 1.04-1.57, P=0.020). Furthermore, pre-bedtime PESM-E was significantly associated with poor sleep quality (adjusted odds ratio [AOR]=1.87, 95% CI: 1.27-2.74, P=0.001) after controlling for confounders. Mediation model showed that poor sleep quality accounted for 53.08% of the effect of pre-bedtime PESM-E on lower levels of academic performance (Sobel Z=2.04, P=0.041).

CONCLUSION

Pre-bedtime PESM-E is associated with poor academic performance in college students, and this association is mediated by poor sleep quality. Our findings highlight the importance of limiting the use of electronic screen media before bedtime in college students.

Relationship of Sleep Quality and Oxidative Stress Level in Smartphone Users; Study in Faculty of Medicine Student, Universitas Baiturrahmah

BACKGROUND: Excessive smartphones can affect sleep quality, reducing sleep duration. This lack of sleep will impact various health and increase levels of free radicals in the body, affecting various cell functions. AIM: The aim of the study was to measure the relationship between sleep quality due to smartphone use and serum malondialdehyde (MDA) levels. MATERIALS AND METHODS: This was a quasi-experimental with pre- and post-test group study. Sleep quality was assessed with Pittsburgh Sleep Quality Index (PSQI), and the smartphone addiction was assessed based on Smartphone Addiction Scale (SAS) score. The subjects were divided into four groups (n = 6) based on their PSQI and SAS score. The first group was the subjects with normal sleep and non-smartphone addict. The second group was the subjects with normal sleep but smartphone addict. The third group was the subjects with abnormal sleep and non-smartphone addict. Furthermore, fourth was the subjects with abnormal sleep and smartphone addiction. All the subjects were asked to sleep usually and used the smartphone as necessary a day before the study started. Blood plasma was collected from the subject before and after the study for MDA measurement. Plasma MDA was determined using the thiobarbituric acid test. RESULTS: Smartphone use can reduce sleep quality and duration, resulting in sleep deprivation. There was no increase in MDA concentration (p > 0.05) in the ordinary and non-addictive or smartphone-addicted sleep group. Meanwhile, the group that stayed up late and was neither addictive nor addictive showed an increase in MDA levels and was statistically significant (p < 0.05). CONCLUSION: Adequate sleep can reduce blood serum MDA levels and smartphone use does not affect MDA levels.

Problematic Mobile Phone Use and Life Satisfaction Among University Students During the COVID-19 Pandemic in Shanghai, China

Objective

This study examined problematic mobile phone use (PMPU) and its relationship with life satisfaction in Chinese university students during the pandemic.

Methods

An anonymous online survey was conducted in a university in China. The Mobile Phone Addiction Index (MPAI) and the Satisfaction with Life Scale (SWLS) were used to assess the severity of problematic mobile phone use and life satisfaction, respectively. Data on demographic and health-related factors were also collected.

Results

A total of 1,491 undergraduate students (73.3% were male) completed the survey. On average, students in the survey reported spending 7.4 ± 4.3 h/day on phone use. Their MPAI score was 38.1 ± 13.3 and SWLS score was 24.9 ± 6.8, respectively. After controlling for confounding factors, the MPAI score was significantly associated with lower life satisfaction. Multiple linear regression revealed that higher monthly allowances, frequent insomnia, longer phone use duration were significantly associated with PMPU.

Conclusion

University students in China spend nearly half of their waking hours on mobile phone use, significantly longer than before the COVID-19 pandemic. PMPU is associated with insomnia, lower life satisfaction and higher allowances. If the trend continues after the pandemic, interventions may be needed. Increase in-person interactions, limiting online social and gaming time, awareness campaign may be effective in reducing the impact of PMPU and improve life satisfaction.

The effect of internet addiction and smartphone addiction on sleep quality among Turkish adolescents

Background: Sleep quality plays a principal role in the protection of health. There is an increasing number of studies in the literature demonstrating that internet addiction and smartphone addiction impair sleep quality. However, the number of studies on Turkish adolescents is very limited. Therefore, this study examined the effects of internet addiction and smartphone addiction on sleep quality among Turkish adolescents. Methods: Participants in this cross-sectional study were 910 adolescents aged 13-18 years. Data were collected with the Short Internet Addiction Test, Smartphone Addiction Scale, and Pittsburgh Sleep Quality Index. In addition, a questionnaire was used to gather information about the demographic, socioeconomic, and health-related characteristics. Pearson's Chi-square test, Chi-square test for trend, Mann-Whitney U test, logistic regression analysis, and Spearman's correlation analysis were used in the analysis. Results: The sleep quality of 58.7% of the adolescents was poor. Additionally, girls and adolescents ≥16 years old had poor sleep quality. Sleep quality deteriorated as perceived health status and perceived economic status of family deteriorated. Compared to participants with normal internet addiction scores, poor sleep quality was 1.83 (95% CI [1.22-2.74]) times higher in those with problematic internet addiction and 1.99 (95% CI [1.23-3.87]) times higher in those with pathological internet addiction. One point increase in Smartphone Addiction Scale total score increased poor sleep quality 1.01 (95% CI [1.00-1.02]) times. Sleep quality scale were positively correlated with the smartphone addiction and internet addiction. However, there was no positive correlation between habitual sleep efficiency subcomponent of sleep quality and smartphone addiction and internet addiction. Conclusions: Internet addiction and smartphone addiction were associated with poor sleep quality in adolescents. Older adolescents (≥16 years), gender (female), poor health perception, and perception of moderate economic status of the family were other factors associated with poor sleep quality.

Suicidal Ideation Is Associated With Excessive Smartphone Use Among Chinese College Students

BACKGROUND

Suicidal ideation is the first step and a strong predictor of suicide. College students are at a considerably high risk of suicidal ideation, and smartphones are commonly used in this group. However, the relationship between suicidal ideation and smartphone use among Chinese college students is unclear. The current study aimed to investigate the prevalence of suicidal ideation among Chinese college students and its association with smartphone use and addiction factors.

METHODS

A total of 439 college students participated the survey. We collected the demographic information, physical health, psychosocial factors (depressive symptoms, social support, sleep quality), characteristics of smartphone use, and mobile phone addiction (MPA). Suicidal ideation was measured with a single question, "did you feel that life was not worth living in the past 1 year?"

RESULTS

The prevalence of suicidal ideation ("Yes" response) in the past year among Chinese college students was 7.5%. In binary logistic regression analysis, suicidal ideation was significantly correlated with less subjective social support (OR: 2.49, p = 0.049), lower utilization of social support (OR: 13.28, p = 0.012), more depressive symptoms (OR:4.96, p = 0.005), and more than 5 h of daily smartphone use (OR: 2.60, p = 0.025).

CONCLUSION

Considering the widely use of smartphones in Chinese colleges and the correlation with suicidal ideation, excessive phone use among college students should be given more attention by administrators and health workers. It is necessary to obtain more information about the intention of smartphone use, make full use of smartphones for health education, and monitor excessive use of smartphones, while improving social support and coping mechanisms for depression, to identify suicidal ideation and prevent suicidal behavior among Chinese college students.

Diathesis stress or differential susceptibility? testing the relationship between stressful life events, neuroticism, and internet gaming disorder among Chinese adolescents

A previous study has documented that stressful life events is positively related to Internet gaming disorder (IGD) among adolescents. However, the mechanism underlying this relationship remains unclear. The current study examined whether the link between stressful life events and adolescent IGD was moderated by neuroticism and whether the interaction of stressful life events and neuroticism supported the diathesis stress model or differential susceptibility model. To this end, self-report questionnaires were distributed. Participants were 927 Chinese adolescents (meanage = 14.53 years, 51.02% male). After controlling for adolescent gender, age, family economic situation, and family socioeconomic status, the results revealed that stressful life events could be positively associated with adolescent IGD and that this link is moderated by neuroticism. Moreover, the results of interaction effects supported the "diathesis stress" model. The above findings contributed to a better understanding of how and when stressful life events increase the risk of IGD and provided new evidence for the diathesis stress hypothesis.

Fear of COVID-19, prolonged smartphone use, sleep disturbances, and depression in the time of COVID-19: A nation-wide survey

BACKGROUND

The COVID-19 pandemic has had a wide range of behavioral and psychological effects on the general population. This study examined the relationship between fear of COVID-19, daily smartphone use, sleep disturbance, and depression in the general population during the early stage of COVID-19.

METHODS

An online nation-wide survey was conducted from March 20 to April 10, 2020. Sociodemographic information, including age, gender, educational attainment, vocation, and duration of self-isolation, was collected; fear of COVID-19 and other objective exposures, daily hours of smartphone use, night sleep duration, sleep disturbance, and depressive symptoms were measured with structured questions and PHQ-9. There were 1,280 questionnaires in total, and 1,250 valid questionnaires remained.

RESULTS

The prevalence of sleep disturbance and depression were found to be 13.1 and 10.7%, respectively. Feelings of extreme fear, longer smartphone use, difficulty initiating sleep, and early morning awakening were significant risk factors for depression. Daily hours of smartphone use, difficulty initiating sleep, and early morning awakening partially mediated the association between feeling extremely scared of the pandemic and depression.

CONCLUSION

Psychological interventions in a major public health crisis should focus more on the subjective perception of pandemic fear. At the same time, daily smartphone use and sleep disturbances could serve as targets for monitoring and intervention for depression during a pandemic.

Substance and Internet use during the COVID-19 pandemic in China

The coronavirus disease 2019 (COVID-19) has adversely influenced human physical and mental health, including emotional disorders and addictions. This study examined substance and Internet use behavior and their associations with anxiety and depression during the COVID-19 pandemic. An online self-report questionnaire was administered to 2196 Chinese adults between February 17 and 29, 2020. The questionnaire contained the seven-item Generalized Anxiety Disorder Scale (GAD-7) and Patient Health Questionnaire (PHQ-9), questions on demographic information, and items about substance and Internet use characteristics. Our results revealed that males consumed less alcohol (p < 0.001) and areca-nut (p = 0.012) during the pandemic than before the pandemic. Age, gender, education status, and occupation significantly differed among increased substance users, regular substance users, and nonsubstance users. Time spent on the Internet was significantly longer during the pandemic (p < 0.001) and 72% of participants reported increased dependence on the Internet. Compared to regular Internet users, increased users were more likely to be younger and female. Multiple logistic regression analysis revealed that age <33 years (OR = 2.034, p < 0.001), increased substance use (OR = 3.439, p < 0.001), and increased Internet use (OR = 1.914, p < 0.001) were significantly associated with depression. Moreover, anxiety was significantly related to female gender (OR = 2.065, p < 0.001), "unmarried" status (OR = 1.480, p = 0.017), nonstudents (OR = 1.946-3.030, p = 0.001), and increased substance use (OR = 4.291, p < 0.001). Although there was a significant decrease in social substance use during the pandemic, more attention should be paid to increased Internet use. Increased Internet use was significantly associated with both anxiety and depression, and increased substance use was related to depression. Professional support should be provided to vulnerable individuals to prevent addiction.

Design, Validity and Effect of an Intra-Curricular Program for Facilitating Self-Regulation of Learning Competences in University Students with the Support of the 4Planning App

Background: Smartphone applications have the potential to support university students for the benefit of learning in higher education. Objective: To design and evaluate the effect of an intra-curricular program using a mobile application on self-regulated learning strategies in university students. Method: The 4Planning mobile application was designed following a systematic literature review, expert judgement and application. The instrument to assess the effect of the intervention was the SRL Readiness Practices Scale, with a one-factor structure (CFI = 0.98; TLI = 0.97; RMSEA = 0.05) with reliability of α = 0.89. The design was quasi-experimental with pre- and post-test measures and experimental and control groups. The sample consisted of 473 first-year university students (37.02% male) from seven Chilean universities with a mean age of 19.35 (SD = 2.49). Statistical analysis was an ANOVA performed in R software version 4.0.3. Results: Statistically significant differences were identified in the levels of self-regulated learning between the experimental group compared to the control group. Conclusion: The development of the 4Planning app proved to be effective in promoting the development of self-regulated learning strategies in university students.

Smartphone Use among Undergraduate STEM Students during COVID-19: An Opportunity for Higher Education?

Due to the COVID-19 pandemic, students worldwide have continued their education remotely. One of the challenges of this modality is that students need access to devices such as laptops and smartphones. Among these options, smartphones are the most accessible because of their lower price. This study analyzes the usage patterns of smartphone users of undergraduate Science, Technology, Engineering, and Math (STEM) students during the COVID-19 pandemic. This cross-sectional descriptive study included 365 students: 162 (44.4%) women and 203 (55.6%) men from a Chilean university. The results revealed that students often accessed the learning management system (LMS) with their computers rather than with their smartphones. Students were connected to the LMS for more hours on their computers than on their smartphones. However, they spent more hours simultaneously connected on their computers and smartphones than just on their computers. During the day, students accessed the LMS mainly from 13:00 to 1:00. The number of connections decreased from 1:00 to 8:00 and increased from 8:00 to 13:00. The LMS resource that students accessed the most using smartphones was discussion forums, while the one they accessed the least was wiki pages. We expect these results to motivate faculties to schedule their activities during the hours students tend to be online and promote discussion forums.

Excessive Smartphone Use Is Associated With Health Problems in Adolescents and Young Adults

Background and Aims: This present paper will review the existing evidence on the effects of excessive smartphone use on physical and mental health. Results: Comorbidity with depression, anxiety, OCD, ADHD and alcohol use disorder. Excessive smartphone use is associated with difficulties in cognitive-emotion regulation, impulsivity, impaired cognitive function, addiction to social networking, shyness and low self-esteem. Medical problems include sleep problems, reduced physical fitness, unhealthy eating habits, pain and migraines, reduced cognitive control and changes in the brain's gray matter volume. In Conclusion: Excessive smartphone use is associated with psychiatric, cognitive, emotional, medical and brain changes that should be considered by health and education professionals.

A longitudinal study of changes in smart phone addiction and depressive symptoms and potential risk factors among Chinese college students

BACKGROUND

The current study aims to track the changes in the levels of smart phone addiction (SPA) and depressive symptoms between pre and during COVID-19 and potential risk factors of among Chinese college students in a four-wave longitudinal study.

METHODS

The participants were recruited from a Chinese university (n = 195; 58.5% females). The first three-wave surveys were conducted before COVID-19 (during December of Year 1, June of Year 1, and December of Year 2 of their college study; Time 1, Time 2, Time 3), while the fourth survey (Time 4; during June of Year 2 of their college study) was conducted in June 2020 during COVID-19. COVID-19-related factors, including quarantine, lockdown, boredom, emotional loneliness, and social loneliness, were investigated.

RESULTS

The results showed a significant increase in the levels of depressive symptoms and prevalence of probable depression during COVID-19 (69.2%) compared to those 18 months, 12 months and 6 months before COVID-19 (41.5, 45.6, 48.2%) but non-significant changes in SPA. Boredom and emotional loneliness were positively associated with both SPA and depressive symptoms during COVID-19. Social loneliness was also positively associated with depressive symptoms during COVID-19. Quarantine and lockdown were not significantly associated with SPA or depressive symptoms.

DISCUSSION AND CONCLUSIONS

The results highlight that the study population may be a high risk group of probable depression. Future studies should continue to track these mental and behavioral status with the progression of the epidemic. The identified emotional factors could be used to reduce depressive symptoms during COVID-19 and prevent the potential risk of SPA.

Effects of Online Social Support and Perceived Social Support on the Relationship Between Perceived Stress and Problematic Smartphone Usage Among Chinese Undergraduates

PURPOSE

Recent research has identified a relationship between perceived stress and problematic smartphone usage. However, little is known about the underlying mediating and moderating mechanisms. The present study aimed to test the relationship between perceived stress and problematic smartphone usage as well as the mediating role of online social support and the moderating role of perceived social support among Chinese undergraduates.

PATIENTS AND METHODS

A sample of 1123 college students participated in the study. The Perceived Stress Scale, Mobile Phone Addiction Index Scale, Online Social Support Questionnaire, and Perceived Social Support Scale were used.

RESULTS

Perceived stress was significantly and positively associated with problematic smartphone usage, and online social support partially mediated the relationship between perceived stress and problematic smartphone usage. Moderated mediation analysis suggested that perceived social support moderated the association between perceived stress and online social support. This relationship became stronger for college students with lower levels of perceived social support.

CONCLUSION

The results of this study can contribute to a better understanding of how perceived stress increases the risk of problematic smartphone usage. The importance of reducing online social support and enhancing perceived social support in preventing undergraduates' problematic smartphone usage is highlighted. The findings should be taken with caution given the convenience sampling and cross-sectional study design.

Relationships between College Students' Sedentary Behavior, Sleep Quality, and Body Mass Index

PURPOSE

Sedentary behavior (SB), sleep efficiency (SE), sleep duration (SD), and body mass index (BMI) are crucial determinants of an individual's health. However, empirical evidence regarding associations between these factors in young adults living in China remains unknown. Therefore, the purpose of this study was to examine the relationships between accelerometer-measured SB, SE, SD, and BMI in Chinese college students.

METHODS

Two-hundred and twenty college students (115 females, Meanage = 20.29 years, SD = 2.37) were recruited from a south-central Chinese university. Participants' SB (daily % time spent in SB), SE (number of minutes of sleep duration/number of minutes in bed), and SD were assessed via wrist-worn ActiGraph GT9X Link accelerometers for one week. Body weight was measured using a digital weight scale, height was measured using a stadiometer, and BMI was calculated as weight (kg)/height (m2).

RESULTS

Participants' average time spent in SB was 76.52% (SD = 10.03), SE was 84.12% (SD = 4.79), and BMI was 20.67 kg/m2 (SD = 3.12), respectively. Regression analyses indicated that SB (β = -0.17, p = 0.01) and BMI (β = -0.20, p < 0.01) negatively predicted SE. In addition, BMI negatively predicted SD (β = -0.22, p < 0.01).

CONCLUSION

Prolonged SB (e.g., screen viewing, smartphone use, and computer playing) and higher BMI may link to shorter sleep duration and lower sleep efficiency in Chinese young adults. Future randomized controlled trials are needed to further confirm these findings. Given that increased BMI status and SB may relate to adverse health outcomes, more population-based intervention strategies seeking to lower BMI and reduce SB (e.g., nutrition education and physical activity promotion) are needed in this population.

Nomophobia is Associated with Insomnia but Not with Age, Sex, BMI, or Mobile Phone Screen Size in Young Adults

PURPOSE

NOMOPHOBIA (NO MObile PHone PhoBIA) or problematic smartphone use is a psychological disorder in which people are afraid of being cut off from their mobile phones. Currently, there has been no direct assessment of mobile phone screen size in the home setting and its effect on nomophobia and related symptoms, such as insomnia. Thus, we investigated the association between nomophobia, insomnia, and mobile phone screen size in a young adult population in Bahrain.

PATIENTS AND METHODS

Using a descriptive, cross-sectional design, we surveyed participants aged 18 to 35 between August and September 2020 using an online questionnaire. Participants completed demographic questions and questions about personal mobile phones, the Nomophobia Questionnaire (NMP-Q), and the Insomnia Severity Index (ISI). The mobile phone screen size was determined using an open-source online database. Crude and adjusted regression analyses were fitted to examine the associations between the study variables.

RESULTS

A total of 549 individuals, 54% females, were included in the final analyses. One hundred and fourteen participants (21%) had severe nomophobia, and 81 (14%) had clinical insomnia. A strong positive pair-wise linear association was observed between NMP-Q and ISI β 0.15, P = 0.001. Age, sex, BMI, and mobile phone screen size showed no association with the NMP-Q.

CONCLUSION

Nomophobia is very prevalent in young adult men and women, and it is closely associated with insomnia, regardless of mobile phone screen size, suggesting that mobile phone screen size should not be used as a proxy for hazardous usage.

Prevalence of Internet Gaming Disorder and Its Association With Personality Traits and Gaming Characteristics Among Chinese Adolescent Gamers

Background: Internet gaming is extremely popular in China. However, some players overuse it, with negative outcomes. Knowing the prevalence rate and specific risk factors can provide a better understanding of the etiology of Internet Gaming Disorder (IGD). This study aimed to estimate the prevalence of IGD among Chinese adolescents and its association with their personality traits and Internet gaming characteristics. Methods: A cross-sectional study design was utilized in this study. Participants were recruited from 34 provincial administrative districts in China and consisted of 6,379 adolescent game players aged 15-25 (males/females = 3,701/2,678, mean age: 19.35 ± 1.61). A self-report structured questionnaire containing questions regarding demographic information and Internet gaming use characteristics, the Video Gaming Dependency Scale, and the Chinese Big Five Inventory-brief version, was used in the study. Results: The prevalence of IGD among Chinese adolescent game players was 17.0%. All participants were divided into the IGD group (males/females = 751/333, mean age: 19.74 ± 1.85) or the non-IGD group (males/females = 2,950/2,345, mean age: 19.27 ± 1.54). Specifically, twelve factors were significantly associated with IGD (p < 0.001), including neuroticism (β = 0.17), conscientiousness (β = -0.14), Internet gaming time per day (Hour) (β = 0.21), Internet gaming charge per month (Yuan) (β = 0.21), motive: escaping (β = 0.15), motive: sensation seeking (β = 0.13), motive: maintaining (β = 0.08), motive: coping (β = 0.06), having one or two long-term game partners (β = 0.06), male (β = 0.12), undergraduate and above (β = 0.04), and relationship status of couple (β = 0.04). Conclusion: Our findings offer evidence with respect to the prevalence of IGD and its relationships with specific personality traits and Internet gaming characteristics in China. It is necessary for Chinese parents, teachers, and social workers to pay more attention to adolescents' personality traits of high neuroticism and low conscientiousness, long time and high expense they spend on game, as well as their motives.