Smartphone Addiction and Associated Health Outcomes in Adult Populations: A Systematic Review

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.

Attention-Deficit Hyperactivity Disorder Symptoms in Adults Diagnosed with Multiple Sclerosis: Prevalence and Correlates

Background: The relationship between adult ADHD symptoms in People with Multiple Sclerosis (PwMS) is understudied. This study aimed to answer two questions: are PwMS more likely to experience higher ADHD symptoms versus healthy subjects? And what are the correlates of severe ADHD symptoms in PwMS? Methods: This study followed a cross-sectional design with predefined inclusion criteria. The Adult ADHD Self-Report Scale-V1.1 (ASRS) was used to assess the ADHD symptoms severity. Results: Data were analyzed from 171 PwMS and 200 controls. Regression analysis revealed that PwMS were at a significantly (B = 3.05, t = 2.24, 95% CI = 0.37-5.73, p = 0.02) higher risk to report higher ADHD scores versus controls. In addition, PwMS with relapses in the last 6 months and PwMS reporting smartphone addiction were at a significantly higher risk for severe ADHD (B = 7.19, t = 269, 95% CI = 1.91-12.48, p = 0.008) and (B = 9.18, t = 3.47, 95% CI = 3.97-14.41, p = 0.001), respectively. In conclusion, diagnosis with MS in our study was identified as a risk for higher ADHD symptoms. Conclusions: Further research is required to establish this relationship, and holistic medical and psychological interventions are required to improve the cognitive status of PwMS.

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.

Associations of problematic smartphone use with depressive symptoms and suicidal ideation in university students before and after the COVID-19 outbreak: A meta-analysis

BACKGROUND AND AIM

Problematic smartphone use (PSU) has been suggested to present with depressive symptoms and suicidal ideation (SI) as well as sleep disturbance, lack of social support, and emotional isolation. The aim of this systematic review and meta-analysis was to evaluate the association between PSU with depressive symptoms and SI in university students, and to determine the potential influence of the coronavirus disease 2019 (COVID-19) outbreak.

METHODS

Observational studies pertinent to our research were identified through comprehensive searches of the PubMed, Embase, Cochrane Library, and Web of Science databases. To account for potential heterogeneity, the random-effects models were employed to aggregate the findings.

RESULTS

Eighteen datasets from 17 case-control studies, including 24,019 university students, were included. Among them, 8,775 (36.5 %) had PSU. A higher prevalence of depressive symptoms (odds ratio [OR]: 2.40, 95 % confidence interval [CI]: 2.19 to 2.63, p < 0.001; prediction interval: 1.95 to 2.96) was observed in university students with higher scores for PSU measures. A subgroup analysis showed a stronger association between PSU and depressive symptoms after the COVID-19 outbreak as compared to that before the outbreak (OR: 2.76 versus 2.16, p for subgroup difference = 0.002), which explained the heterogeneity. The association between PSU and depressive symptoms in university students was similar to those reported in studies from China and other countries, and in studies with different quality scores. Finally, a meta-analysis of three studies suggested that PSU was also associated with the prevalence of SI (OR: 2.18, 95 % CI: 1.77 to 2.68, p < 0.001; I2 = 0 %).

CONCLUSION

In university students, PSU may be a risk factor for depressive symptoms and SI, and the association between PSU and depressive symptoms became stronger after the COVID-19 outbreak.

The mediating effect of attentional impulsivity between mindfulness and problematic smartphone use

OBJECTIVE

Problematic smartphone use has been linked to lower levels of mindfulness, impaired attentional function, and higher impulsivity. This study aimed to identify the psychological mechanisms of problematic smartphone use by exploring the relationship between addictive smartphone use, mindfulness, attentional function and impulsivity.

METHODS

Ninety participants were evaluated with the smartphone addiction proneness scale and classified into the problematic smartphone use group (n = 42; 24 women; mean age: 27.6 ± 7.2 years) or normal use group (n = 48; 22 women; mean age: 30.1 ± 5.7 years). All participants completed self-report questionnaires evaluating their trait impulsivity and mindfulness and attention tests that assessed selective, sustained and divided attention. We compared the variables between the groups and explored the relationship between mindfulness, attentional function, impulsivity and addictive smartphone use through mediation analysis.

RESULTS

The problematic smartphone use group showed higher trait impulsivity and lower mindfulness than the normal use group. There were no significant group differences in performance on attention tests. Levels of addictive smartphone use were significantly correlated with higher levels of trait impulsivity and lower levels of mindfulness, but not with performance on attention tests. Mediation analysis showed that acting with awareness, an aspect of mindfulness, reduces the degree of addictive smartphone use through attentional impulsivity, one of the trait impulsivity.

CONCLUSION

Acting without sufficient awareness could influence addictive smartphone use by mediating attentional impulsivity. This supports that executive control deficits, reflected in high attentional impulsivity, contribute to problematic smartphone use. Our findings imply that mindfulness-based interventions can enhance executive control over smartphone use by promoting awareness.

Association between smartphone addiction and myofascial trigger points

BACKGROUND

The purpose of this study was to clarify the relationship between smartphone addiction and miyafascial trigger points in university students.

METHODS

A cross-sectional study of university students was conducted for the purpose of this study. The participants were assessed based on age, gender, dominant side, the amount of time they spent on their smartphones, the purpose of their use, and their posture. The Smartphone Addiction Scale Short Form (SAS-SF) was used to determine addictes and non-addicts. The cut-off value of SAS-SF is 31 and above for male and 33 and above for female.

RESULTS

There were 136 participants in the study. The posture score for addicts and non-addicts ones was not significantly different (p > 0,05), but the number of trigger points, maximal bending posture and trigger points in the right levator scapula and right cervical erector muscles were significantly higher in the smartphone addict participants (p < 0,05).

CONCLUSIONS

Smartphone addiction in university students is associated with postural changes and trigger points in the bilateral levator scapula and right cervical erector muscles. Public health programs should be developed to raise awareness about smartphone addiction, encourage screen breaks, and emphasize physical activity and exercise regularly.

The effect of smartphone addiction on vessel wall thickness, which is a predictor of atherosclerosis

AIM

The increasing global popularity of smartphone usage has increased concerns about the negative effects of smartphone addiction, such as lack of sleep, sedentary life, bad eating habits, anxiety, stress, and depression, especially among the young population. These problems caused by smartphone addiction are also well-known risk factors for atherosclerosis. However, according to our observation, there is no research in the literature that directly shows the relationship between smartphone addiction and subclinical atherosclerosis. In this study, carotid intima-media thickness, an important surrogate marker in demonstrating subclinical atherosclerosis, was used to examine the relationship between smartphone addiction and subclinical atherosclerosis.

MATERIALS AND METHOD

This cross-sectional study was conducted on 96 high school students aged between 13 and 22 years. A smartphone addiction questionnaire consisting of 33 questions was applied to measure smartphone addiction. Along with the socio-demographic characteristics of the patients, factors such as eating habits, sleep patterns, and activity levels were also questioned. The mean carotid intima-media thickness was measured by an experienced sonographer according to the published and accepted methods.

RESULTS

When we set the threshold for smartphone addiction at over 66 points, we discovered that the group with smartphone addiction had considerably thicker carotid intima-media (0.68 ± 0.2 versus 0.45 ± 0.1; p < 0.001). In addition, logistics regression analysis had shown that smartphone addiction level independently affects the carotid intima-media thickness (odds ratio:1.111; %95 GA:1.057-1.168, p < 0.001).

CONCLUSION

Smartphone addiction may help prediction of subclinical atherosclerosis via carotid intima-media thickness among teenagers.

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.

Internet, App-Based, and Casino Gambling: Associations Between Modality, Problem Gambling, and Substance Use

Technology-based gambling prevalence is not well understood since relevant questions are not included in health and disease surveillance studies. The current study sought to estimate the prevalence of internet-based and smartphone app-based gambling, along with casino gambling, in a sample of U.S. young adults and determine if gambling modality was associated with problem gambling symptoms or substance use. The 2022 Rhode Island Young Adult Survey included N = 1,022 students between the ages of 18 to 25 years old who had lived in Rhode Island, with n = 414 lifetime gamblers (40.5%) included in this study. Odds of gambling via a smartphone app and on the internet, respectively, were greater in heterosexual cis-males compared to heterosexual cis-females (OR[95%CI] = 3.14 [1.25,7.91]; OR[95%CI] = 6.30 [2.05,19.3]). Internet gambling amongst employed students was less common than among those who were not a student and not employed (OR[95%CI] = 0.25 [0.06,1.00]). Odds of problem gambling symptoms were higher among those who gambled via a smartphone app (OR[95%CI] = 3.23 [1.21,8.60]). All forms of gambling were associated with alcohol consumption, although the strength of the association was stronger in app and internet gamblers. Casino gamblers were more likely to be high risk marijuana and illicit drug users. The rising availability of app gambling coupled with its social, psychological, and cultural context may presents an alternative pathway to problem gambling. Bans on internet gambling and/or strict guidelines on the frequency of wagers and cash placed per wager, should be considered as viable methods to mitigate associated consequences.

Relationship Between Alexithymia, Smartphone Addiction, and Psychological Distress Among University Students: A Multi-country Study

Objectives

Increasing dependence on smartphones results in the appearance of psychological problems, especially among young people. This study aims to determine the rates of alexithymia and its relationship with smartphone addiction and psychological distress in university students.

Methods

A total of 2616 students (mean age = 22.5±3.5 years; 73.1% female) from universities in Egypt, Oman, and Pakistan were included in a cross-sectional and comparative study conducted through a web survey during the COVID-19 pandemic from October to December 2021. The following scales were used: Toronto Alexithymia Scale (TAS-20), Depression Anxiety Stress Scale (DASS-21), and Smartphone Addiction Scale-Short Version (SAS-SV). The survey also included questions related to sociodemographic and smartphone usage patterns.

Predictors of problematic smartphone use among young adult lesbian, gay and bisexual individuals during the COVID-19 pandemic: a four-year follow-up study

BACKGROUND

This 4-year follow-up study was conducted to evaluate the predictive effects of prepandemic individual and environmental factors on problematic smartphone use (PSU) among young adult lesbian, gay, and bisexual (LGB) individuals during the COVID-19 pandemic.

METHODS

Data on prepandemic PSU, demographics, sexual stigma (e.g., perceived sexual stigma from family members, internalized sexual stigma, and sexual microaggression), self-identity confusion (e.g., disturbed identity, unconsolidated identity, and lack of identity), anxiety, depression, and family support were collected from 1,000 LGB individuals between August 2018 and June 2019. The participants' PSU was surveyed again after 4 years (between August 2022 and June 2023). The associations of prepandemic individual and environmental factors with PSU at follow-up were analyzed through linear regression.

RESULTS

In total, 673 (67.3%) participants completed the follow-up assessment. The severity of PSU significantly decreased after 4 years (p = .001). Before the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels depressive symptoms (p < .001), disturbed identity (p < .001), and perceived sexual stigma from family members (p = .025) at baseline were significantly associated with PSU at follow-up. After the incorporation of PSU at baseline into the analysis model, the results of the model revealed that high levels PSU (p < .001) and depressive symptoms (p = .002) at baseline were significantly associated with PSU at follow-up.

CONCLUSION

Interventions aimed at reducing the severity of PSU among LGB individuals should be designed considering the predictors identified in our study.

Impact of smart phone use on adolescence health in India

Smart phone use is on the rise globally, which may have an impact on people's health. The second-largest country in terms of mobile phone usage is India. However, there aren't many studies that have been done in India to evaluate its health impacts. Therefore, it is of interest to assess the effectiveness of codex on the impact of smart phone use on various dimensions of health status among adolescence. The pre-test mean score for knowledge regarding the impact of smart phones on physical health was 1.92, while the post-test mean score was 3.75. The pre-test and post-test standard deviations were 0.91 and 0.93, respectively, and the mean deviation score was the 't'-value that was 11.000 and Significant at the p<0.001*** level. The research was conducted in higher secondary school, and 60 students participated. The research design was a pre-experimental design; a self-administered questionnaire was used to assess the knowledge of Students on the Impact of mobile phone use on various dimensions of health. Most people, on average, spend 3 hours and 15 minutes on their phones each day. As adolescents are engaged in smartphone use, it disturbs their sleep patterns, adversely impacting their short-term memory.

Smartphone obsession linked behavioural changes among Indian adolescents

The best technological gifts of the 21st century are mobile phones, which are especially well-liked to adolescents. Infinite resources with numerous uses and applications are available on modern mobile devices. Adolescents have behavioral changes as a result of its excessive use. Therefore, it is of interest to explore the connection between smartphone obsession and potential behavioral changes. A School based, co relational study was conducted among 100 adolescents at selected schools at Tamil Nadu. Samples were selected by simple random sampling technique. Data were collected to assess the mobile addiction by using Smartphone Addiction Scale - Short Version (SVSAC) and Pediatric symptom checklist - 17was used to evaluate the behavioral changes. Collected data were analyzed by using descriptive and inferential statistics. The Study shows that 52 adolescents had a high smartphone Obsession, in that 37 had negative behavioral changes due to overuse of the smart phone and also had slight positive correlation between smartphone obsession and behavioral changes. A significant relationship was seen between smart phone obsession with behavioral changes (p<0.001) among adolescents. The study concluded that smart phone obsession and behavioral changes having strong connection in adolescents was significantly associated with their behaviors.

Phone addiction, cyberbullying, and mental health amongst young adults in the United Arab Emirates: a cross-sectional study

BACKGROUND

Smartphone addiction is a common phenomenon worldwide and within the UAE. It is related to many factors, including gender and ethnicity, and can lead to mental health disorders, such as anxiety and depression. This study investigates these factors concerning smartphone addiction among young adults in the UAE.

METHODS

421 participants answered a questionnaire of validated and reliable scales measuring smartphone addiction, cyberbullying experiences, mental health, and demographic information. The average age of the participants was 21 years, and the age groups were divided into two groups. Group 1 consists of participants who are 20 years or younger, and group 2 consists of participants aged 21 or older.

RESULTS

There was a positive correlation between smartphone addiction with both anxiety and depression. A positive correlation was also found between cyberbullying victims, anxiety, and depression. Females were found to have higher levels of anxiety and smartphone addiction in comparison to males.

CONCLUSION

Smartphone addiction is a problem that connects to disorders like anxiety and depression. Conversely, cyberbullying is not directly related to smartphone addiction but is also strongly related to anxiety and depression.

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.

Do young people perceive their smartphone addiction as problematic? A study in Danish university college students

As smartphone addiction has been linked to poor mental health and lower levels of physical activity, it is of public health interest to explore the behavior behind problematic smartphone use and develop interventions to reduce smartphone use. This study aimed to investigate the risk of smartphone addiction and examine perceived problematic smartphone behavior among university college students. This online survey conducted amongst 1251 Danish University College students studied smartphone addiction in conjunction with physical- and mental health dimensions. The risk of smartphone addiction was estimated using the Smartphone Addiction Scale-Short Version (SAS-SV). The main results are presented as odds ratios from multivariate logistic regressions. One in four (23%) were at high risk of smartphone addiction. Of this high-risk group, 74% identified their smartphone behavior as problematic, with 91% having considered reducing their smartphone use. Students with a high risk of smartphone addiction perceiving their behavior as problematic were more likely to report low mental health and well-being. In conclusion, students at high risk of smartphone addiction acknowledge their problematic behavior and have actively considered behavior modifications. This knowledge can enable teachers, parents, and social and health workers to understand that a majority of heavy smartphone users are open to reducing their smartphone usage, albeit with the appropriate support.

Does the Effect of Stress on Smartphone Addiction Vary Depending on the Gender and Type of Addiction?

Stress is closely associated with smartphone addiction. Nevertheless, there is a dearth of studies investigating the potential variation in the effect of stress on smartphone addiction based on the specific addiction type and gender. We conducted a cross-sectional questionnaire survey among 596 high school students. The results revealed that the effect size of stress on smartphone addiction varied across different types of addiction. The strongest relationship was observed between stress and social media addiction, followed by the relationship between stress and information acquisition addiction. Furthermore, gender played a significant moderating role in stress and three types of smartphone addiction. Specifically, stress was strongly associated with information acquisition addiction overall, with no significant gender differences observed. In contrast, stress exhibited a strong correlation with social media addiction, which was significantly more prevalent among females. On the other hand, game addiction and short-form video addiction were both strongly associated with stress, but showed significantly higher prevalence among males. This study enhances current research by offering supplementary insights into the correlation between stress and smartphone addiction, as well as exploring the potential implications of intervening in smartphone addiction.

The relationship between smartphone addiction and sleep among medical students: A systematic review and meta-analysis

OBJECTIVES

This systematic review aimed to evaluate the association between smartphone addiction and sleep in medical students. The secondary outcomes included the prevalence of smartphone addiction, duration and purpose of its use, prevalence of poor sleep, duration and quality of sleep.

METHODS

The authors searched PubMed, Cochrane Library, Embase, PsycINFO and CINAHL databases, from inception of each database to October 2022. Quantitative studies in the English language on smartphone addiction and sleep in students studying Western Medicine were included. The Rayyan application was used for title-abstract screening, and Joanna Briggs Institute (JBI) critical appraisal checklist to assess the risk of bias. Heterogeneity tests and meta-synthesis of data were performed using the meta-package in R software. Data on the activities used on the smartphone was synthesized qualitatively.

RESULTS

A total of 298 abstracts were initially assessed for inclusion eligibility: 16 of them were eventually appraised, covering 9466 medical students comprising 3781 (39.9%) males and 5161 (54.5%) females. Meta-correlation between the Smartphone Addiction Scale Short Version (SAS-SV) and Pittsburgh Sleep Quality Index (PSQI) was 0.30 (95%CI = 0.24-0.36), and 0.27 (95% CI = 0.18-0.36) for SAS-SV and sleep duration. The meta-analytic estimation of smartphone addiction prevalence was 39% (95%CI = 0.30-0.50), and score using SAS-SV was 31.11 (95%CI = 29.50-32.72). The mean duration of smartphone daily used was 4.90 hours (95%CI = 3.72-6.08). The meta-analytic estimation on prevalence of poor sleep was 57% (95%CI = 0.48-0.66), and the meta-mean of PSQI and duration of sleep was 5.95 (95%CI = 4.90-7.00) and 5.62h (95%CI = 4.87-6.36) respectively. Medical students used their smartphones mostly for text messaging, followed by photo-sharing or social networking. Its usage for medical education remains unclear.

CONCLUSION

The prevalence of poor sleep and smartphone addiction in medical students was 57% and 39% respectively, with a correlation index of 0.30. Medical students commonly used the smartphone for text-messaging, photo-sharing or social networking, averaging 4.9 hours daily.

Nomophobia (No Mobile Phone Phobia) and Psychological Health Issues among Young Adult Students

BACKGROUND

Smart phone use has become a part of people's everyday life. However, when the lack of using the smart phone to establish and maintain electronic communication is related to psychological distress, such a behavior may be considered a modern-age phobia, or nomophobia (no mobile phone phobia). The aims of the present study were to investigate among a sample of young adults the associations between scores for nomophobia and symptoms of depression, anxiety, stress, insomnia, and obsessive-compulsive disorders.

METHODS

A total of 537 students (mean age: 25.52 years; 42.3% females) participated in the study. They completed a booklet of self-rating questionnaires covering sociodemographic information and symptoms of nomophobia, depression, anxiety, stress, insomnia, and obsessive-compulsive disorders.

RESULTS

Higher scores for nomophobia were associated with higher scores for depression, anxiety, and stress, but not with scores for insomnia and obsessive-compulsive disorders. The regression model confirmed that symptoms of anxiety predicted nomophobia.

CONCLUSIONS

The present results support the assumption that nomophobia appears to be a mood disturbance related to stronger associations with symptoms of anxiety and, to a lesser extent, with symptoms of depression and stress. By contrast, nomophobia appeared to be unrelated to insomnia and symptoms of obsessive-compulsive disorders.

Smartphone Distraction: Italian Validation of the Smartphone Distraction Scale (SDS)

This work aimed to validate the use of the Smartphone Distraction Scale (SDS) in Italy. The SDS was devised to assess distraction related to smartphone use in adult populations. A cross-sectional study was conducted among n = 609 adults (females = 76.4%; mean age = 30.26; SD age = 9.90). An assessment of the factorial structure of the Italian version was carried out using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The four factors identified by Throuvala and colleagues were confirmed (i.e., attention impulsiveness, online vigilance, multitasking and emotion regulation). Reliability was assessed using Cronbach's alpha coefficient (0.703-0.889). The scale's scores showed significant linear correlations with validated instruments, including the Mobile Phone Problematic Use Scale (MPPUS)and the Cognitive Failures Questionnaire (CFQ). A multivariate analysis of variance showed significant differences in the means among participants belonging to different age groups (born before 1995 vs. born after 1996). In summary, the good psychometric properties observed led us to assume that this instrument can be applied and used in Italian studies to assess the cognitive dimension of distraction related to the use of smartphones.

Smartphone use affects gait performance, spinal kinematics and causes spinal musculoskeletal discomfort in young adults

BACKGROUND

Smartphone use may lead to alterations in spinal kinematics and musculoskeletal discomfort.

OBJECTIVES

The aim of this study was to evaluate the effect of smartphone use on spinal kinematics, and to examine the relationship between smartphone addiction, spinal discomfort, and gait parameters.

DESIGN

Cross-Sectional Study.

METHODS

The study included 42 healthy adults aged 18-30 years. A photographic method was used for spinal kinematic evaluation in sitting, standing and at the end of a 3-min walk. GAITRite electronic walkway was used for spatiotemporal gait parameters. Smartphone addiction was evaluated with the Smartphone Addiction Scale - Short Version (SAS-SV). The Cornell Musculoskeletal System Discomfort Questionnaire (CMDQ) was used to evaluate feelings of discomfort and pain.

RESULTS

There was an increase in head, cervical, and thoracic flexion angles while sitting, standing, and at the end of a 3-min walk. Similarly, an increase in thoracolumbar and lumbar flexion angles was observed only in the sitting position (p < 0.05). While using a smartphone during walking, cadence, walking speed, step length decreased, while step duration and double support duration increased (p < 0.05). A statistically significant correlation was determined between the SAS-SV and CMDQ scores (p < 0.05).

CONCLUSION

The study showed that smartphone use has an impact on spinal kinematics during sitting, standing and at the end of a 3 min-walk, as well as on the spatiotemporal parameters of gait. This study suggest that smartphone addiction should be taken into consideration due to its potential to cause musculoskeletal discomfort and there may be a need to raise public awareness on this matter.

Relationship between depression, smartphone addiction, and sleep among Chinese engineering students during the COVID-19 pandemic

BACKGROUND

Existing research has demonstrated that depression is positively related to smartphone addiction, but the role of sleep has not been discussed thoroughly, especially among engineering undergraduates affected by the coronavirus disease 2019 pandemic.

AIM

To evaluate sleep as a mediator of the association between smartphone addiction and depression among engineering undergraduates.

METHODS

Using a multistage stratified random sampling method, a cross-sectional survey was conducted among 692 engineering undergraduates from a top engineering university in China, and data were collected by self-reported electronic questionnaires. The data included demographic characteristics, such as age, gender, the Smartphone Addiction Scale-Short Version (SAS-SV), the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index. Pearson correlation and multiple linear regression analyses were used to examine the association between smartphone addiction and depression, while structural equation models were established to evaluate the possible mediating role of sleep.

RESULTS

Based on the cutoffs of the SAS-SV, the rate of smartphone addiction was 63.58 percent, with 56.21 percent for women and 65.68 percent for men, among 692 engineering students. The prevalence of depression among students was 14.16 percent, with 17.65 percent for women, and 13.18 percent for men. Smartphone addiction was positively correlated with depression, and sleep played a significant mediating effect between the two, accounting for 42.22 percent of the total effect. In addition, sleep latency, sleep disturbances, and daytime dysfunction significantly mediated the relationship between depression and smartphone addiction. The mediating effect of sleep latency was 0.014 [P < 0.01; 95% confidence interval (CI): 0.006-0.027], the mediating effect of sleep disturbances was 0.022 (P < 0.01; 95%CI: 0.011-0.040), and the mediating effect of daytime dysfunction was 0.040 (P < 0.01; 95%CI: 0.024-0.059). The influence of sleep latency, sleep disturbances, and daytime dysfunction accounted for 18.42%, 28.95%, and 52.63% of the total mediating effect, respectively.

CONCLUSION

The results of the study suggest that reducing excessive smartphone use and improving sleep quality can help alleviate depression.

Neurobiological risk factors for problematic social media use as a specific form of Internet addiction: A narrative review

Problematic social media use (PSMU) is a behavioral addiction, a specific form of problematic Internet use associated with the uncontrolled use of social networks. It is typical mostly for modern adolescents and young adults, which are the first generations fully grown up in the era of total digitalization of society. The modern biopsychosocial model of the formation of behavioral addictions, postulating the impact of a large number of biological, psychological, and social factors on addictive behavior formation, may be quite applicable to PSMU. In this narrative review, we discussed neurobiological risk factors for Internet addiction with a focus on current evidence on the association between PSMU and structural/ functional characteristics of the brain and autonomic nervous system, neurochemical correlations, and genetic features. A review of the literature shows that the vast majority of the mentioned neurobiological studies were focused on computer games addiction and generalized Internet addiction (without taking into account the consumed content). Even though a certain number of neuroimaging studies have been conducted for PSMU, there is practically no research on neuropeptide and genetic associations for PSMU to date. This fact points to the extremely high relevance of such studies.

Relationship between smartphone addiction and eating disorders and lifestyle among Chinese college students

Purpose

Smartphone addiction has been a matter of serious concern among society and parents because of its high incidence and serious negative effects. This study aimed to determine the association between smartphone addiction and eating disorders and lifestyle changes among college students.

Methods

The present article is a descriptive, cross-sectional study involving 1,112 college students from several universities in Chengdu, China. The data were collected by using the Chinese version of the Mobile Phone Addiction Index (MPAI) and the Eating Attitudes Test-26 (EAT-26). In addition, the information on sociodemographic, lifestyle, and smartphone use were obtained through a self-administered questionnaire.

Results

The prevalence of smartphone addiction among the students involved in the study was 22.6%, of which 10.4% were at risk for eating disorders. Female students had higher MPAI scores and EAT-26 scores than male students (p < 0.001). The proportion of male students with a risk of eating disorders was significantly higher than that of female students (p < 0.05). The total EAT-26 scores of students with smartphone addiction were higher than that of others (p < 0.001). The correlation analysis indicated that the MPAI scores were significantly positively correlated with the EAT-26 scores, depression and anxiety, difficulty in falling asleep at night, the frequency of eating fast food and drinking carbonated soft drink (p < 0.01). In addition, the MPAI scores were significantly negatively correlated with skipping breakfast and the frequency of physical activity (p < 0.05).

Conclusion

Smartphone addiction is significantly associated with eating disorders, eating habits, and lifestyle. The influence of dietary habits and lifestyle needs to be considered for the prevention and development of an intervention for smartphone addiction among college students.

Smartphone addiction and psychological distress among Vietnamese college students: cyber-victimization as a mediator and academic stress as a moderator

Purpose

The purpose of this paper is to examine the mediating effect of cyber-victimization (CV) and the moderating effect of academic stress (AS) in the link between smartphone addiction (SPA) and psychological distress (PD) among a sample of Vietnamese college students.

Design/methodology/approach

A total of 423 college students participated in this study. Measures of SPA, CV, AS and PD were used for data collection. Using PROCESS macro software (Model 4 and Model 1) and the bootstrapping method, the author performed a mediation analysis and a moderation analysis.

Findings

Results indicated a significant mediating effect of CV in the link between SPA and PD. Moreover, this relationship was moderated by AS.

Originality/value

The findings could serve as a guide for future research and mental health professionals.

Relationships Among Smartphone Use, Physical Activity, and Quality of Life in Chinese College Students

This study aimed to investigate the correlations between smartphone use, physical activity, and quality of life (QOL) among Chinese college students. We enrolled 6323 students who were chosen from three Chinese universities. All participants completed the World Health Organization QOL Scale-Brief, Smartphone Addiction Index, and Physical Activity Questionnaire-Short Form. Smartphone addiction was negatively related to QOL (β = -1.375, 95% CI [-1.442, -1.306]), whereas physical activity was positively related to QOL (β = .059, 95% CI [0.047, 0.071]). The presence of both smartphone addiction and insufficient physical activity decreased QOL scores when compared with the group with sufficient physical activity and non-smartphone addiction (β = -36.505, 95% CI [-39.046, -33.964]). Physical activity and smartphone use are potentially modifiable risk factors for poor QOL in college students. Thus, interventions to decrease smartphone use and promote physical activity could be beneficial for improving QOL in this population.

Problematic Smartphone Use Mediates the Pathway from Suicidal Ideation to Positive Psychotic Experiences: a Large Cross-Sectional, Population-Based Study

The present study followed the newly hypothesized "suicidal drive for psychosis" suggesting that psychosis may be consequential to suicidal ideation (SI) and behavior and attempted to explain parts of the pathway between these variables. To this end, we aimed to test whether problematic smartphone use (PSU) has an indirect mediating effect in the cross-sectional relationship between SI and positive psychotic experiences (PEs). Lebanese community young adults (N=4158; 64.4% females; mean age 21.91±3.79) have been invited to participate to a cross-sectional, web-based study in the period from June to September 2022. After adjusting for potential confounders (i.e., the living situation, marital status, household crowding index, economic pressure, cannabis use, other drugs use, and past history of mental illness other than psychosis), we found that higher levels of suicidal ideation was significantly associated with greater PSU, which was also positively and significantly associated with more positive PEs. Finally, greater suicidal ideation was significantly and directly associated with more positive PEs. Our findings suggest that SPU may be regarded as a potential target for prevention and intervention in psychosis. Clinicians, educators, and school administrators ought to give greater attention to PSU among vulnerable young people who present with SI.

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

Aim

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

Subject and Methods

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

Results

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

Conclusion

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

A bidirectional association between smartphone addiction and depression among college students: A cross-lagged panel model

Background

Smartphone addiction (SA) is associated with adverse consequences, especially for freshmen. Evidence indicates that SA is associated with depression, and it is necessary to conduct a longitudinal study to explore the association further.

Methods

SA (measured by the Smartphone Addiction Scale-Short Version) and depression (measured by the Zung's Self-Rating Depression Scale) among 1,186 freshmen were surveyed at baseline and a respective 12-month follow-up for each participant. The application of a cross-lagged panel model approach (CLPM) revealed an association between SA and depression after adjusting for demographic variables.

Results

The CLPM results showed a significant path from baseline SA to follow-up depression (β = 0.08, P < 0.001) and a significant path from baseline depression to follow-up SA (β = 0.08, P < 0.001). Compared with the overall cross-lagged model, the cross-lagged coefficient of the path from baseline SA to follow-up depression increased in the female group (β = 0.10, P = 0.015), and the cross-lagged coefficient of the path from baseline depression to follow-up SA also increased significantly (β = 0.15, P < 0.001). In contrast, the cross-lagged model in the male group showed no predictive effect between SA and depression (P > 0.05).

Conclusions

The current study showed a significant bidirectional association between smartphone addiction and depression among freshmen, but only in the female population.

Effects of chronic stress on smartphone addiction: A moderated mediation model

Introduction

Based on the compensatory Internet use theory and diathesis-stress model, the present study explores the effects of chronic stress on smartphone addiction (SPA). As intolerance of uncertainty and emotion-related variables are important factors that affect addictive behavior, we explore the mediating role of intolerance of uncertainty and the moderating role of emotion differentiation.

Methods

We conducted a questionnaire survey of 286 participants (13.64% female; M _age = 22.88; SD = 3.77; range = 17-39) on chronic stress, SPA, intolerance of uncertainty, and emotion differentiation. SPSS 28.0 was used to analyze the descriptive statistics and correlations and test the moderated mediation model.

Results

We find that (1) intolerance of uncertainty, SPA, and chronic stress are positively correlated with each other. Positive emotion differentiation is positively correlated with intolerance of uncertainty and negative emotion differentiation. (2) Intolerance of uncertainty plays a mediating role in chronic stress and SPA. (3) Positive emotion differentiation significantly moderates the relationship between chronic stress and SPA. Under the condition of low positive emotion differentiation, chronic stress is more effective in predicting SPA.

Discussion

These findings may contribute to intervention and prevention programs for SPA. Thus, the intervention and prevention of SPA can start from two directions-reduce the intolerance of uncertainty and enhance the ability to experience positive emotion differentiation.

Psychological needs satisfaction and smartphone addiction among Chinese adolescents: The mediating roles of social anxiety and loneliness

Objectives

Although previous studies have initially noted that psychological needs satisfaction (PNS) might be a significant risk factor for technology addiction (e.g. online gaming addiction and Internet addiction), specific mechanisms involved in the association between PNS and adolescent smartphone addiction are largely unknown. Based on self-determination theory, this cross-sectional study constructed a multiple mediation model to examine whether PNS will influence adolescent smartphone addiction through the mediating roles of social anxiety and loneliness.

Methods

Eight hundred and ninety-nine Chinese adolescents answered the questionnaire including measures of PNS, social anxiety, loneliness, and smartphone addiction. SPSS 24.0 was used for common method bias test, reliability test, and correlation analysis, and Mplus 7.4 was used to examine the mediating roles of social anxiety and loneliness in the multiple mediation model.

Results

This study found that (1) PNS was negatively associated with adolescent smartphone addiction; (2) loneliness significantly mediated the association between PNS and smartphone addiction while the mediating role of social anxiety in this association was nonsignificant; and (3) social anxiety and loneliness also sequentially mediated this association.

Conclusion

This study further enriched potential mechanisms linking PNS and smartphone addiction among adolescents, which may contribute to intervention and prevention programs for adolescent smartphone addiction from the perspective of improving both PNS and negative emotions including social anxiety and loneliness.

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

The effect of mobile phone addiction on perceived stress and mediating role of ruminations: Evidence from Chinese and Czech university students

Introduction

The rise in the capabilities of mobile devices and the associated increase in the proportion of time we spend on them has not only positive benefits but also several risks, including mobile phone addiction and its consequences. The complex mechanisms of the impact of this addiction on mental health, especially in a cross-cultural context, however, remain relatively unknown. The aim of this cross-cultural study was to investigate the mediating role of rumination on the association between mobile phone addiction and perceived stress.

Methods

A population of 358 Chinese and 282 Czech university students was tested using a battery of validated psychological tests that included a short version of the Smartphone Addiction Scale, the Ruminative Response Scale, and the Perceived Stress Scale.

Results

The results showed significant cross-cultural differences with Czech students manifesting greater rumination (d = 0.79) and perceived stress (d = 0.42) and Chinese students showing greater mobile phone addiction (d = 1.01). Mediation analyses showed that the effect of mobile phone addiction on stress levels was mediated through the rumination in both populations (45.6% and 80.9% of the explained variance for Chinese and Czech students, respectively) and did not differ between the two countries (estimate of difference [95%CI] = -0.052[-0.166, 0.037], p = 0.27). In contrast, the significant direct effect of mobile phone addiction on perceived stress was only present in Chinese students, where it was marginally larger than the indirect effect. In Czech students, the direct effect was not manifested and the difference between countries was significant (estimate of difference [95%CI] = 0.242 [0.035, 0.413], p < 0.001). In all of the cases, the association between the variables was positive, i.e., as one grew, so did the other. Finally, a moderated-mediation analysis confirmed that country of origin significantly moderated only the direct relationship between mobile phone dependence and perceived stress (p = 0.002).

Discussion

These results suggest that the mechanism of interaction between excessive mobile phone use and perceived stress is culturally conditioned, which may limit the transferability of research findings in a global context and requires further cross-cultural studies.

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

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

Structural and Functional Neural Correlates in Individuals with Excessive Smartphone Use: A Systematic Review and Meta-Analysis

Background: Despite known association of internet addiction with a reduced brain volume and abnormal connectivity, the impact of excessive smartphone use remains unclear. Methods: PubMed, Embase, ClinicalTrial.gov, and Web of Science databases were systematically searched from inception to July 2022 using appropriate keywords for observational studies comparing differences in brain volumes and activations between excessive smartphone users and individuals with regular use by magnetic resonance imaging. Results: Of the 11 eligible studies retrieved from 6993 articles initially screened, seven and six evaluated brain volumes and activations, respectively. The former enrolled 421 participants (165 excessive smartphone users vs. 256 controls), while the latter recruited 276 subjects with 139 excessive smartphone users. The results demonstrated a smaller brain volume in excessive smartphone users compared to the controls (g = −0.55, p < 0.001), especially in subcortical regions (p < 0.001). Besides, the impact was more pronounced in adolescents than in adults (p < 0.001). Regression analysis revealed a significant positive association between impulsivity and volume reduction. Regarding altered activations, the convergences of foci in the declive of the posterior lobe of cerebellum, the lingual gyrus, and the middle frontal gyrus were noted. Conclusions: Our findings demonstrated a potential association of excessive smartphone use with a reduced brain volume and altered activations.

Indulging in Smartphones in Times of Stress: A Moderated Mediation Model of Experiential Avoidance and Trait Mindfulness

Although previous studies have shown that perceived stress is positively related to problematic smartphone use, knowledge of mediating and moderating mechanisms underpinning this relationship is quite limited. In this study, we explored whether experiential avoidance mediated the relationship between perceived stress and problematic smartphone use and whether trait mindfulness moderated this mediating process. A total of 763 Chinese college students completed the measures of perceived stress, experiential avoidance, problematic smartphone use, and trait mindfulness. The results indicate that perceived stress was positively related to problematic smartphone use and this relation was partially mediated by experiential avoidance. Furthermore, moderated mediation analysis showed that trait mindfulness moderated the linkage between perceived stress and problematic smartphone use via experiential avoidance. This link became weaker for college students with higher levels of trait mindfulness. The results highlight the value of identifying the underlying mechanisms between perceived stress and college students' problematic smartphone use.

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.

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

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

Problematic Smartphone Use: Prevalence and Associated Factors Among Health Sciences Students in Saudi Arabia

Excessive smartphone use leads to several physical and psychological disorders, particularly among young adults. This study aimed to investigate the prevalence and the associated factors of problematic smartphone use (PSU) among health sciences students in Jeddah, Saudi Arabia. During the 2019 academic year, a cross-sectional analytic study randomly recruited 408 health sciences students (67.5% were females), with a mean age of 20.5 ± 1.42. Data on sociodemographic and health profiles, smartphone usage patterns, and overuse symptoms were collected for each participant. The Smartphone Addiction Scale-Short Version (SAS-SV) and Generalized Anxiety Disorder 7-item (GAD-7) scale were used to assess PSU and anxiety levels. PSU was detected in 66.9% of the study participants. The prevalence is high among both females and males (69.5 and 61.7%, respectively). PSU was found to be associated with more years of use and frequent smartphone upgrading (aOR = 2.11, 95% CI: 1.12, 3.97) and (aOR = 1.69, 95% CI: 1.08, 2.65), respectively (p = 0.021 and 0.021, respectively). Participants with moderate and severe anxiety levels were found to be more likely to have PSU (aOR = 2.22, 95% CI: 1.21, 4.05) and (aOR = 5.97, 95% CI: 2.41, 14.78), respectively. (p = 0.010 and < 0.001, respectively). PSU is an emerging problem among health sciences students in Saudi Arabia with a high prevalence in both genders. Longer years of use, more frequent smartphone upgrades, and higher anxiety levels are associated with PSU among health sciences students. Special health education and psychological support programs are recommended to guide and support future healthcare providers against the consequences of PSU.

Psychological Morbidities Associated With Excessive Usage of Smartphones Among Adolescents and Young Adults: A Review

Adolescents and young adults have progressively become smartphone and internet-dependent. Its addiction is affecting them mentally and physically. Due to its overutilization, it is causing a detrimental effect on them. These dilemmas need to be acknowledged. Furthermore, the goal is to reduce overutilization and overreliance, and the task is to reduce the heavy toll on their mental and psychological condition. We need to review the evidence linking smartphone and social media use with psychological morbidities among adolescents and young adults. The aim of this study is to summarize the present situation and the correlation between smartphones and mental health. Cognitive, emotional difficulties, poor cognitive function, impulsivity, shyness, social networking addiction, low self-esteem, and some medical issues like insomnia, anxiety, depression, and a lack of cognitive control have been linked to excessive smartphone use.

Prevalence of smartphone addiction among Asian medical students: A meta-analysis of multinational observational studies

BACKGROUND

High prevalence of smartphone addiction among medical students may contribute to adverse physical and mental health outcomes.

AIM

To estimate the prevalence of smartphone addiction, and explore the influencing factors and related mental health symptoms of smartphone addiction among Asian medical students.

DESIGN

Systematic review and meta-analysis.

METHODS

PubMed (MEDLINE), the Cochrane Central Register of Controlled Trials, and EMBASE were searched for relevant literature from the inception to September 10, 2021. Using Stata software 11.0, the meta-analysis of prevalence and the influencing factors of smartphone addiction were determined with 95% confidence intervals.

RESULTS

Nineteen articles, published between 2014 and 2019, were included, producing medical student studies from seven different Asian countries. The included studies were conducted in India (n = 11) and Malaysia (n = 3), with China, Saudi Arabia, Turkey, Nepal, and Iran each contributing one study. Among a total of 5,497 medical students, the participants included 3,214 females, of whom 2,181 were medical students with smartphone addiction. The prevalence of smartphone addiction among Asian medical students was 41.93% (95% CI [36.24%, 47.72%]). The influencing factors of smartphone addiction among medical students included gender, duration of smartphone use, smartphone function, and marital status. Ten studies (52.63%) explored related mental health symptoms of smartphone addiction among Asian medical students. Smartphone addiction was positively correlated with poor sleep quality (r = .17-.31), stress (r = .30-.40), anxiety, depression, neuroticism, and general health among Asian medical students.

CONCLUSION

Smartphone addiction is highly prevalent among Asian medical students. Smartphone addiction may adversely affect mental health, resulting in sleep disturbance, stress, anxiety, depression, and neuroticism. It is necessary to take appropriate precautionary actions and interventions to prevent smartphone overuse among medical students.

Mobile phone addiction and depression among Chinese medical students: the mediating role of sleep quality and the moderating role of peer relationships

The literature has shown that mobile phone addiction is an important risk factor for depression. However, the internal mechanisms of mobile phone addiction leading to depression are still not clear. This study examined the mediating role of sleep quality and moderating role of peer relationships in the association between mobile phone addiction and depression. A sample of 450 Chinese medical students were recruited to complete measures of mobile phone addiction, depression, sleep quality and peer relationships. In this study, SPSS 25.0 and macro PROCESS were used to conduct statistical analysis on the collected data. The results showed that sleep quality partially mediated the association between mobile phone addiction and depression. Moreover, the effect of sleep quality on depression was moderated by peer relationships. The present study can advance our understanding of how and when mobile phone addiction leads to depression. Limitations and implications of this study are discussed.

Ultrasound biomicroscopy study of accommodative state in Smartphone abusers

Background

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

Methods

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

Results

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

Conclusions

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

Supplementary Information

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

Mobile Device Usage before and during the COVID-19 Pandemic among Rural and Urban Adults

Technology has played a critical role during the COVID-19 pandemic. Despite affording a safe way for people to connect with others, the potential for problematic device usage (e.g., overuse, addiction) should be considered. The goal of this study was to examine mobile device use during the COVID-19 pandemic among rural and urban people in Canada. Based on an online survey conducted in the summer of 2021 in British Columbia (n = 465), participants self-reported spending more hours per day (M = 8.35 h) using technology during the pandemic compared to prior (M = 6.02 h), with higher increases among urban participants (p < 0.001). Mobile device usage scores were highest for reasons of social connectedness and productivity, with no rural/urban differences; however, urban participants reported higher use of mobile devices for their mental well-being (p = 0.001), but also reported higher, continuous use (p < 0.001), addiction (p < 0.001), and detrimental impacts on their physical health (p < 0.001) compared to rural participants. Because urban participants were more vulnerable to mobile device overuse and addiction during the pandemic, researchers and policy makers should consider the ongoing role and positive/negative impacts of mobile device use, paying particular attention to urban populations.

Anxiety, Addiction to Social Networks, Internet and Smartphones in Paraguayan Adolescents: A Brief Report

Background

Several authors have pointed out that the use of smartphones might have an impact on mental health in general. Most of the evidences are focused on the incorrect or overblown use of smartphones, videogame or Internet, particularly focusing on related addiction problems among adolescents.

Objective

The present study, although preliminary, aims to report the first evidence in Paraguay regarding the association between anxiety and addiction to social networks/internet as well as the use of smartphones among adolescents.

Method

Participants (100 adolescents, aged 12- 17 years old) were assessed in a school setting with the Beck Anxiety Inventory (BAI) and the Scale of risk of Addiction to Social Networks and Internet for adolescents (ERA-RSI). Categorical variables and associations were statistically assessed.

Results

The average smartphone use in boys rated 8.06 ±3.81 hours and in girls 9.46 ±4.4 hours. The BAI mean score was 20.71 ± 13.2. Of the participants, 27% reported moderate anxiety, and 36% severe anxiety and scores on this scale were not associated with hours of smartphone use. The ERA-RSI mean score was 1.94 ± 0.46 and anxiety was related to the symptoms-addiction, social-use, and nomophobia dimensions of the scale.

Conclusion

The misuse of smartphones in the Paraguayan pediatric population has been reported to be closely related to anxious symptoms. Our results suggest further research with an impact on possible public health policies aimed at preserving the mental health of children and adolescents exposed to internet and electronic devices.