Problematic mobile phone use in adolescence: a cross-sectional study

Association between mobile phone addiction, sleep disorder and the gut microbiota: a short-term prospective observational study

Bidirectional communication between the gut microbiota and the brain has sparked interest in exploring the link between mobile phone addiction (MPA) and sleep disorders (SD) in microbiome research. However, investigating the role of gut microbiota in this relationship using animal models presents challenges due to the unique nature of MPA, and human research in this area is scarce. We recruited 99 healthy college students to evaluate the gut microbiome using 16S rRNA gene amplicon sequencing and assess MPA and SD at baseline and after a two-month follow-up. Multiple covariate-adjusted statistical models, including linear regression, permutational multivariate analysis of variance and so on, were employed to determine microbiome associations with MPA at baseline and changes in SD at follow-up. Our findings revealed negative associations between MPA and three alpha diversity metrics, along with alterations in bacterial composition. MPA showed negative associations with the relative abundance of Bacteroidetes, while displaying positive associations with Actinobacteria and Bifidobacteriales. Conversely, Actinobacteria exhibited a negative association with increased SD. This study has established a significant link between MPA and a decrease in the alpha diversity of the gut microbiota. Actinobacteria was associated with MPA and SD, respectively. Additional investigation is needed to fully comprehend the relationship between comorbid behavioral disorders and the gut microbiota.

Network structure of mobile phone addiction and anxiety symptoms among rural Chinese adolescents

BACKGROUND

The incidence of mobile phone addiction among adolescents in rural areas of China is increasing year by year, and has already exceeded that of some cities. And phone addiction increases the risk of anxiety and poor sleep. Therefore, this study used network analysis to investigate the relationship between mobile phone addiction and anxiety symptoms, and the predictability to sleep quality.

METHODS

From September 2021 to March 2022, a total of 1920 rural adolescents in Xuzhou, China were included. The survey included information on phone addiction, anxiety symptoms, and sleep quality. Network analysis was used to estimate the network structure of adolescents' mobile phone addiction and anxiety symptoms. LOWESS curve and linear regression were used to test the predictive ability of node-centrality on sleep quality.

RESULTS

In the network of mobile phone addiction-anxiety symptoms, the most influential symptoms were Failure to cut down the time, Anxiety if not used for some time, and Alleviate loneliness. Irritability was the most prominent bridging symptom. Gender difference had no effect on network structure. Nodes in the network are not predictive of sleep quality.

CONCLUSION

Failure to cut down the time is the most important symptom, suggesting that measures should be taken to reduce the amount of time spent on mobile phones. For example, increase outdoor exercise, increase the real company of friends and family, in order to reduce the occurrence of mobile phone addiction and anxiety.

Longitudinal associations between social media use, mental well-being and structural brain development across adolescence

Youth of today grow up in a digital social world but the effects on well-being and brain development remain debated. This study tracked longitudinal associations between structural brain development, social media use and mental well-being.

The study demonstrated two pathways of heterogeneity in brain development. First, adolescents who used social media more than their peers showed higher baseline cortical thickness in lateral prefrontal cortex (PFC) and medial PFC; and stronger decreases in the lateral PFC and temporal parietal junction. In contrast, adolescents with lower mental well-being showed lower baseline levels of surface area in the medial PFC and posterior superior temporal sulcus relative to their peers. Whereas the associations between structural brain development and well-being remained significant after correction for multiple testing, the results for social media use did not survive FDR correction.

These findings demonstrate that although social media use and mental well-being were both associated with differential trajectories of brain development, the associations we report are distinct. These results show a nuanced perspective on the presumed relations between social media use and well-being and provide a starting point to further examine neural mechanisms that could explain which adolescents thrive by social media and which might be harmed.

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Longitudinal study with three time points across adolescence on MPFC, TPJ, pSTS and LPFC development.

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Cortical thickness development differed between high vs low social media users.

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Surface area development differed between low vs high mental well-being subgroups.

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Associations with well-being remained significant after stringent FDR correction.

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Social media and well-being are distinctly associated with structural brain development.

Validation of a questionnaire on problematic use of smartphones among a rural population of West Bengal

Background

While a smartphone can be a hugely productive tool, excessive use of this device can interfere with work, education, our physical and mental health, and productivity. Nowadays, we do not just use our smartphones, but we rely on them.

Objectives

The present study aims to develop and validate an instrument measuring the problematic use of smartphones among adults in a rural area of West Bengal, India.

Methods

The questionnaire on problematic use of smartphone is a self-designed tool. The items were selected by literature review. The psychometric properties of the questionnaire were assessed by content validity, construct validity, and reliability. Exploratory factor analysis was performed to identify the factors.

Results

Forty-two items were generated by literature review. After final analysis, the main questionnaire contained 28 items with 5 domains, namely "impulsive use of phone," "dependence," "impaired control," "denial," "decreased productivity," and "emotional attachment." The Cronbach's alpha value for three domains was found to be >0.7 and >0.8 for the other three domains.

Conclusion

Excessive mobile phone use is associated with various adverse consequences which is emerging as a public health problem in a large number of population in India. Problematic use of smartphone questionnaire is a valid and reliable tool to assess the pattern of mobile use among Indian population.

Prevalence and impact of the use of electronic gadgets on the health of children in secondary schools in Bangladesh: A cross-sectional study

BACKGROUND AND AIMS

Use of technological gadgets has rapidly been increasing among adolescents, which may result in health issues and technology addiction. This study focuses on the prevalence of usage of technological gadgets and health-related complications among secondary school-going children of Bangladesh.

METHODS

A total of 1803 secondary school students from 21 different districts of Bangladesh participated in the study. The children were asked questions relating to their access to electronic gadgets, time spent on outdoor activities, and whether they experienced any health-complications as an after-effect of the usage. A binary logistic regression model was adapted considering time spent on gadgets as an independent variable and health problems (physical and mental) as the dependent variable.

RESULTS

Among all the gadgets, 67.11% of the participants were reported to use mobile phones on a daily basis. Due to the ongoing COVID-19 pandemic, 24.48% of respondents used electronic gadgets for attending online classes. The participants were reported to use gadgets significantly more (P < .05) in 2020 as compared to 2019. Children showed less tendency to spend time in outdoor activities. More than 50% of the participants spend time doing outdoor activities for less than 1 hour daily. An association between gadget use and health problems like headache, backache, visual disturbance, and sleeping disturbance has been observed in our study.

CONCLUSION

This study demonstrates that different socio-demographic factors have influence on the use of gadgets by children, and this use has greatly been affecting both the physical and mental health of the secondary school-going students of Bangladesh.

The association between obesity and problematic smartphone use among school-age children and adolescents: a cross-sectional study in Shanghai

BACKGROUND

The study aimed to investigate the association between content-based problematic smartphone use and obesity in school-age children and adolescents, including variations in the association by educational stage and sex.

METHODS

Two-stage non-probability sampling was used to recruit 8419 participants from nineteen primary schools, five middle schools, and thirteen high schools in Shanghai in December 2017. Obesity was identified by body mass index (BMI), which was obtained from the school physical examination record, while problematic smartphone use was measured by the Revised Problematic Smartphone Use Classification Scale as the independent variable.

RESULTS

The rates of obesity varied with educational stages, while problematic smartphone use increased with educational stages. Male students reported higher obesity rates (37.1%vs19.4%, P < 0.001) and greater problematic smartphone use scores (25.65 ± 10.37 vs 22.88 ± 8.94, P < 0.001) than female students. Problematic smartphone use for entertainment (smartphone users addicted to entertainment games, music, videos, novels and other applications) was positively associated to obesity status for primary school [odds ratio (OR), 1.030; 95% confidence interval (95% CI), 1.005-1.057] and high school students (OR, 1.031; 95% CI, 1.004-1.059). For female students, problematic smartphone use for entertainment was positively associated with obesity status (OR, 1.046; 95% CI, 1.018-1.075).

CONCLUSIONS

Problematic smartphone use may be associated with obesity in children and adolescents. The association differed based on the educational stage and sex, and the difference possessed dimensional specificity.

The Effects of Korean Parents' Smartphone Addiction on Korean Children's Smartphone Addiction: Moderating Effects of Children's Gender and Age

Background: Smartphone addiction among children and adolescents has a negative effect, as excessive use of smartphones can cause physical symptoms, such as fatigue, indigestion, and sleep problems, as well as psychopathological problems, such as depression, anxiety, and impulsiveness. Materials and Methods: This study was carried out using the Korean Children and Youth Panel Survey 2019 conducted by the National Youth Policy Institute. The total number of participants was 4656 youths (2290 in grade 5 and 2366 in grade 8), and the dependent and independent variables were smartphone addiction in children and parents, respectively. Multiple regression analysis was conducted by Stata 15.0 SE. Results: First, the level of parents' smartphone addiction affected that of children and adolescents. Second, the children's and adolescents' age affected the level of smartphone addiction, while their gender did not affect it. Third, the relationship between the levels of parents' and children's smartphone addiction was not moderated by the genders and ages of the children and adolescents. Conclusions: It was confirmed that as parents' smartphone addiction increased, that of children increased, and smartphone addiction was found to increase in the second grade of middle school (12 years old) rather than grade 5 of elementary school (10 years old). Parents' and children's smartphone addiction was not moderated by children's and adolescents' gender and age.

Reciprocal longitudinal relations between peer victimization and mobile phone addiction: The explanatory mechanism of adolescent depression

INTRODUCTION

Being victimized by peers has been shown to be associated with a range of adolescent problems, including mobile phone addiction (MPA). Although being victimized is assumed to lead to problem behavior, the reverse could also occur. In this longitudinal study we tested the reciprocal effects of victimization and MPA, taking into account the role of adolescent depression in these effects.

METHODS

The sample included 1987 adolescents from middle schools in Guangdong and Shandong Provinces, China (56.10% male; M_age at Wave 1 = 12.32). Three waves of questionnaire data were collected at half-year intervals during the transition from 7th to 8th grade. Cross-lagged models were adopted for data analysis.

RESULTS

Peer victimization at W1/W2 predicted MPA at W2/W3, and the inverse relation was also significant: MPA at W1/W2 positively predicted peer victimization at W2/W3. Furthermore, the bidirectional association between peer victimization and MPA was mediated by adolescent depression.

CONCLUSIONS

This is the first longitudinal study on the relation between MPA and associated problems. Victimization by peers and MPA appear to have mutual influences over time that are explained in part by adolescent depression. The results have potential applied value for promoting adolescent adjustment.

Adaptation and Psychometric Analysis of the Test of Mobile Phone Dependence-Brief Version in Italian Adolescents

Since the diffusion of recent models of mobile phones, anyone with an internet connection can communicate continuously and search for information. This raises some questions about the possible consequences of problematic mobile phone use (PMPU) in a complex life phase such as adolescence. Therefore, we performed a psychometric analysis of the brief version of the Test of Mobile Phone Dependence (TMD) in Italy. The sample comprised 575 Italian adolescents aged 11 to 18 years. Data were collected using the TMD-brief, the Personality Inventory for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance Short Form. Regarding test dimensionality, the best-fit measurement model included four factors: "Abstinence"; "Abuse and interference with other activities"; "Tolerance"; and "Lack of control" (Satorra-Bentler χ2 (48) = 185.96, p < 0.01; robust root mean square error of approximation (RMSEA) = 0.079 (90% confidence interval (CI): 0.067; 0.091); robust TLI = 0.904; robust comparative fit index (CFI) = 0.930). The Italian version of the TMD-brief was found to have good reliability and psychometric properties, and a four-factorial structure. PMPU predicted significant sleep disturbances and this relationship was moderated by clinical personality traits. Findings from this study support the use of the Italian version of the TMD-brief as a screening tool to investigate PMPU in Italian adolescents.

Problematic Mobile Phone Use by Hong Kong Adolescents

Background

Recently there have been growing concerns about problematic mobile phone use by adolescent populations. This study aimed to address this concern through a study of severity and correlates of problematic mobile phone use with a sample of Hong Kong adolescents.

Methods

Data were collected from a sample of adolescents from three local secondary schools (ranging from high to low academic achievement levels) using a measuring scale (PCPU-Q, Yen et al., 2009) designated for Chinese adolescents. Participants were allocated into groups of “problematic users” and “non-problematic users” based on the number of occurrence of symptoms due to excessive and maladaptive use of mobile phone and possible functional impairments caused by problematic mobile phone use. A group of “at-risk users” was identified. A sample-based examination on distribution of these three groups of users was conducted via frequency counts and percentage calculation. A series of t-test were performed to make comparisons between “problematic” and “non-problematic” groups on selected personality and health related variable. Risk and protective factors were identified via correlational analysis and logistic regression analysis.

Results

Under a more stringent cut-off criterion of four or more reported symptoms (out of seven) plus one or more reported functional impairments (out of five), 22.9% of the adolescents participating in this study could be classified as problematic mobile phone users. However, a more lenient criterion (only 4 or more reported symptoms without consideration of functional impairment) reported a substantially more severe prevalence rate (29.3%). A new group of “at-risk” adolescents (6.4%) was identified with such a discrepancy of prevalence rate. Gender difference, some risk and protective factors were also identified for developing this technology-related problem.

Discussion and Conclusions

Adolescents who are vulnerable to suffer from this technology-related problem deserve more attention from helping professionals. Results of this study throw some insights on how to identify problematic mobile phone user applying a criterion-referenced approach. This study echoes a recent call for adopting a developmental perspective in understanding this problem and conducting research in this area. Anchored on present findings, effective interventions to tackle this rising problem among adolescents are suggested.

Interaction between physical activity and problematic mobile phone use on suicidality in Chinese college students

BACKGROUND

Previous research has found a relationship between problematic mobile phone use (PMPU) and suicidality. However, few studies have examined the interaction effects between low physical activity (PA) and PMPU on suicidality among college students. This study aimed to examine the interactions of PA and PMPU and their impact on suicidality in a school-based sample among Chinese college students.

METHODS

Analysis is based on date from two university in China, which recruited 4787 participants. Binomial logistic regression models were used to explore the associations of PA, PMPU with suicidal ideation and suicide attempt, as well as the interaction of PA and PMPU with suicidality.

RESULTS

The prevalence of suicide attempt and suicidal ideation were 3.5 and 7.2%, respectively. Low PA was significantly associated with suicide attempt (OR = 3.48, 95%CI: 2.52-4.81) and suicidal ideation (OR = 1.90, 95%CI: 1.46-2.46). PMPU was significantly associated with suicide attempt (OR = 3.65, 95%CI: 2.66-5.01) and suicidal ideation (OR = 2.83, 95%CI: 2.25-3.54). Interaction analysis indicated that low PA and PMPU were interactively associated with suicide attempt (OR = 9.51, 95%CI: 6.15-14.73, P < 0.001), RERI = 4.85(1.20-8.50), AP = 0.51(0.29-0.73), SI = 2.32(1.34-4.04). There was no additive interaction effects between PA and PMPU on suicidal ideation.

CONCLUSIONS

The findings reveals that the intervention programs of suicide attempt should consider the students PA levels and PMPU.

Problematic Mobile Phone and Smartphone Use Scales: A Systematic Review

The popularity of smartphones is undeniable in nearly all facets of society. Despite the many benefits attributed to the technology, concern has grown over the potential for excessive smartphone use to become problematic in nature. Due to the growing concerns surrounding the recognized and unrecognized implications of smartphone use, great efforts have been made through research to evaluate, label and identify problematic smartphone use mostly through the development and administration of scales assessing the behavior. This study examines 78 existing validated scales that have been developed over the past 13 years to measure, identify or characterize excessive or problematic smartphone use by evaluating their theoretical foundations and their psychometric properties. Our review determined that, despite an abundance of self-report scales examining the construct, many published scales lack sufficient internal consistency and test-retest reliability. Additionally, there is a lack of research supporting the theoretical foundation of many of the scales evaluated. Future research is needed to better characterize problematic smartphone use so that assessment tools can be more efficiently developed to evaluate the behavior in order to avoid the excessive publication of seemingly redundant assessment tools.

Smartphone and Facebook addictions share common risk and prognostic factors in a sample of undergraduate students

INTRODUCTION

To improve the comprehension of the interface between smartphone addiction (SA) and Facebook addiction (FA), we hypothesize that the occurrence of both technological addictions correlate, with higher levels of negative consequences. Moreover, we hypothesize that SA is associated with lower levels of social support satisfaction.

METHODS

We recruited a convenience sample of undergraduate students from Universidade Federal de Minas Gerais, with age ranging between 18 and 35 years. All subjects completed a self-fulfilled questionnaire comprising sociodemographic data, the Brazilian Smartphone Addiction Inventory (SPAI-BR), the Bergen Scale for Facebook Addiction, the Barrat Impulsivity Scale 11 (BIS-11), the Social Support Satisfaction Scale (SSSS), and the Brief Sensation Seeking Scale (BSSS-8). After completing the questionnaire, the interviewer conducted a Mini-International Neuropsychiatric Interview (MINI).

RESULTS

In the univariate analysis, SA associated with female gender, with ages 18 to 25 years, FA, substance abuse disorders, major depressive disorder, anxiety disorders, low scores in SSSS, high scores in BSSS-8, and high scores in BIS. The group with SA and FA presented a higher prevalence of substance abuse disorders, depression, and anxiety disorders when compared to the group with SA only.

CONCLUSION

In our sample, co-occurrence of SA and FA correlated with higher levels of negative consequences and lower levels of social support satisfaction. These results strongly suggest that SA and FA share some elements of vulnerability. Further studies are warranted to clarify the directions of these associations.

Psychometric Properties of the Italian Version of the Smartphone Application-Based Addiction Scale (SABAS)

The aim of the present study was to test the psychometric properties of the Italian version of the Smartphone Application-Based Addiction Scale (SABAS; Csibi et al., International Journal of Mental Health and Addiction, 16, 393–403, 2018), a short and easy to use six-item tool for screening the risk of addiction to smartphone-based applications. A further goal was to explore the impact on smartphone addiction of several variables related to smartphone use habits, perceived quality of life, and sociability measures. The data were collected online from 205 Italian-speaking volunteers (128 males and 77 females aged 18 to 99 years). The psychometric instruments included in the study were the SABAS and the Nomophobia Questionnaire (NMP-Q). Psychometric testing showed that the six items included in the SABAS comprised a unidimensional factor with good reliability (Cronbach’s alpha = .890). Therefore, the SABAS appears to be a reliable instrument to assess the risk of addiction to smartphone apps. Moreover, longer daily time spent using the smartphone was found to be positively correlated with the total SABAS and NMP-Q scores, while perceived quality of life and self-reported sociability were found to be negatively correlated with such scores.

Rates of Alexithymia and Its Association With Smartphone Addiction Among a Sample of University Students in Egypt

INTRODUCTION

Alexithymia is characterized by difficulties in describing feelings. Many studies have shown that there is a relation between alexithymia and different types of addictions. Nowadays, smartphone addiction is proposed to be a global problem. The current study focuses on the rates of alexithymia and its association with smartphone addiction in an Egyptian university.

MATERIALS AND METHODS

This is a cross-sectional study that was conducted in Ain Shams University. A sample of 200 university students was surveyed using Toronto Alexithymia Scale (TAS) and Smartphone Addiction Scale - Short Version (SAS-SV).

RESULTS

The results showed that 44 students (22%) had alexithymia. It was also found that around one third of the sample (N=65, 32.5%) met the criteria of smartphone addiction. There was a strong association between alexithymia and smartphone addiction (OR=4.33, 95% CI 2.15-8.74, p= < 0.001).

CONCLUSION

This study supports existing literature indicating the strong association between alexithymia and smartphone addiction.

Smartphone addiction in students: A qualitative examination of the components model of addiction using face-to-face interviews

BACKGROUND AND AIMS

Smartphone use has increased markedly over the past decade and recent research has demonstrated that a small minority of users experience problematic consequences, which in extreme cases have been contextualized as an addiction. To date, most research have been quantitative and survey-based. This study qualitatively examined the components model of addiction for both "addicted" and "non-addicted" users.

METHODS

A screening tool comprising 10 dichotomous items was administered to 40 college students. Of these, six addicted and six non-addicted participants were identified on the basis of their score on the screening tool and were asked to participate in a semi-structured interview. The interview questions were based on the components model of addiction comprising six domains (i.e., salience, withdrawal, conflict, relapse and reinstatement, tolerance, and mood modification). Directed content analysis was used to analyze the transcribed data and subthemes as well as emerging themes for the study as a whole were established.

RESULTS

There was some evidence of demarcation between smartphone addicts on the dimensions of salience, tolerance, withdrawal, and conflict. Mood modification was not much different in either group, and no participant reported relapse.

CONCLUSIONS

The non-addicted group had much greater control over their smartphone usage than the addicted group on four (of six) aforementioned dimensions of behavioral addiction. Consequently, the main findings of this study provided good support for the components model of behavioral addiction.

Mobile Intervention for Individuals With Psychosis, Dual Disorders, and Their Common Comorbidities: A Literature Review

Over 50% of people diagnosed with a severe mental illness, such as schizophrenia or bipolar disorder, will meet criteria for a substance use disorder in their lifetime. This dual disorder often starts during youth and leads to significant societal costs, including lower employability rates, more hospitalizations, and higher risk of homelessness and of suicide attempts when compared to those with a serious mental illness without substance misuse. Moreover, many individuals presenting with comorbid disorders also present with other psychological difficulties as well, such as personality disorders or anxiety and depression, also known as complex comorbid disorders. Transdiagnostic treatments that focus on core difficulties found in people with complex dual disorders, such as emotional regulation, are direly needed. Emotional regulation skills can help reduce distress related to psychotic symptoms and maintain abstinence in substance use disorders. New technologies in the field of communications have developed considerably over the past decade and have the potential to improve access to such treatments, a major problem in many health care settings. As such, this paper aims at: presenting core difficulties present in many individuals with dual disorders, reviewing the scientific literature pertaining to the use of mobile applications in mental health and addictions, and presenting the development and potential of a new application for emotional regulation for people with dual disorders.

Epidemiology of technology addiction among school students in rural India

OBJECTIVE

Penetration of mobile technology is rapidly rising. Excessive use leads to Technology addiction, which often start early in adolescence. The purpose of the present study was to assess Technology addiction and its correlates among school students in rural India.

METHODS

This cross sectional study was conducted among 885 school students in north India. Four schools were selected and participants aged 13-18 years, were enrolled randomly. A self-designed 45 item questionnaire was used to evaluate dependence syndrome (intense desire, impaired control, tolerance, withdrawal, persistence despite harm, neglect of alternate pleasure) as used for substance dependence in ICD-10. Screening for depression and anxiety was done by using patient health questionnaire (PHQ-9) and generalized anxiety disorder scale (GAD-7) respectively. Descriptive and logistic regression analyses were done.

RESULTS

The mean age of the study participants was 15.1 years. Among the participants, 30.3% (95% Confidence Interval = 27.2%-33.3%) met the dependence criteria. One-third (33%) of the students stated that their grades had gone down due to gadget use. Technology addiction was more among male students (odds ratio = 2.82, 95% CI = 1.43, 5.59), those having a personal mobile phone (2.98, (1.52-5.83), use smart phone (2.77, 1.46-5.26), use one additional gadget (2.12, 1.14-3.94) and those who were depressed (3.64, 2.04-6.49).

CONCLUSION

Increased mobile phone access in rural India is leading to technology addiction among school students. Certain demographic and gadget specific factors predict addiction. The technology addiction possibly contributes to poor academic performance and depression. This warrants studies on a larger scale, with interventions for judicious use of gadgets.

Mediating Effect of Sleep Quality on the Relationship Between Problematic Mobile Phone Use and Depressive Symptoms in College Students

Background and Aim: Problematic mobile phone use (PMPU) and depression are great public health concerns among adolescents. The aim of this study was to determine the association between PMPU and symptoms of depression, as well as the mediating role of sleep quality. Methods: A total of 4,624 college students participated in this study. The Self-rating Questionnaire for Adolescent Problematic Mobile Phone Use (SQAPMPU), Pittsburgh Sleep Quality Index (PSQI), and Patient Health Questionnaire-9 (PHQ-9) were administered to assess PMPU, sleep quality, and symptoms of depression. Mediation analysis was conducted using PROCESS macro in the SPSS software. Results: Of the participants, 27.5% were classified as PMPU, 44.9% exhibited symptoms of depression, and 15.6% reported sleep problems. Compared with those without PMPU, those with PMPU exhibited higher rates of sleep problems and depressive symptoms. The mediation analysis further revealed partial mediation effects of sleep quality on the association between PMPU and depression. Conclusions: This study demonstrated that PMPU was associated with mental health in college students, and sleep quality played a mediating role in this relationship. Our findings highlight the critical role of early intervention for depression with a focus on those with PMPU and, more specifically, on those with sleep problems.

Mobile Phone Use and Mental Health. A Review of the Research That Takes a Psychological Perspective on Exposure

The purpose of this study was to carry out a review of observational studies that consider links between mobile phone use and mental health from a psychological or behavioral perspective. Systematic literature searches in PubMed and PsycINFO for articles published until 2017 were done. Exclusion criteria included: papers that considered radiofrequency fields, attention, safety, relational consequences, sexual behavior, cyberbullying, and reviews, qualitative, and case or experimental studies. A total of 4738 papers were screened by title and abstract, 404 were retrieved in full text, and 290 were included. Only 5% had any longitudinal design. Self-reporting was the dominating method of measurement. One third of the studies included children or youth. A majority of adult populations consisted of university students and/or self-selected participants. The main research results included associations between frequent mobile phone use and mental health outcomes, such as depressive symptoms and sleep problems. Mobile phone use at bedtime was associated with, e.g., shorter sleep duration and lower sleep quality. "Problematic use" (dependency) was associated with several negative outcomes. In conclusion, associations between mobile phone use and adverse mental health outcomes are found in studies that take a psychological or behavioral perspective on the exposure. However, more studies of high quality are needed in order to draw valid conclusions about the mechanisms and causal directions of associations.

Investigating Associations Between Changes in Mobile Phone Use and Emotions Using the Experience Sampling Method: Pilot Study

Background

The use of mobile phones has become, especially for young people, an integrated part of everyday life. Using the experience sampling method (ESM) may provide further insight on the association between mobile phone use and mental health.

Objective

The objective of this study was to examine associations between mobile phone use and subtle changes in mental state.

Methods

The ESM-based PsyMate app was installed on the mobile phones of 2 healthy 20-year-old participants. Over a period of 3 months, participants rated their mental states at 10 semirandom moments in the flow of daily life. Each assessment included present state emotions, environmental circumstances, and phone use.

Results

Multilevel regression analyses indicated that an increase in mobile phone use was associated with a small increase in negative affect (particularly feeling bored and feeling lonely; P<.001) and small decreases in positive affect (P=.002) and concentration (P=.001). Treating the data as 2 separate N=1 studies revealed that the association with negative affect was present in both participants, whereas the associations with positive affect and concentration were evident in only 1 of the 2 participants.

Conclusions

This pilot study suggests that mobile phone use may be associated with person-specific and group-level changes in emotional state. A larger study is required to study these associations, possible causality, and factors driving underlying heterogeneity in the pattern of associations.

Trial registration

ClinicalTrials.gov NCT03221985; https://clinicaltrials.gov/ct2/show/NCT03221985 (archived by WebCite at http://www.webcitation.org/6zJnp61Wj)

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

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

Problematic Smartphone Use: Investigating Contemporary Experiences Using a Convergent Design

Internet-enabled smartphones are increasingly ubiquitous in the Western world. Research suggests a number of problems can result from mobile phone overuse, including dependence, dangerous and prohibited use. For over a decade, this has been measured by the Problematic Mobile Phone Use Questionnaire (PMPU-Q). Given the rapid developments in mobile technologies, changes of use patterns and possible problematic and addictive use, the aim of the present study was to investigate and validate an updated contemporary version of the PMPU-Q (PMPU-Q-R). A mixed methods convergent design was employed, including a psychometric survey (N = 512) alongside qualitative focus groups (N = 21), to elicit experiences and perceptions of problematic smartphone use. The results suggest the PMPU-Q-R factor structure can be updated to include smartphone dependence, dangerous driving, and antisocial smartphone use factors. Theories of problematic mobile phone use require consideration of the ubiquity and indispensability of smartphones in the present day and age, particularly regarding use whilst driving and in social interactions.

Self-reported dependence on mobile phones in young adults: A European cross-cultural empirical survey

Background and aims Despite many positive benefits, mobile phone use can be associated with harmful and detrimental behaviors. The aim of this study was twofold: to examine (a) cross-cultural patterns of perceived dependence on mobile phones in ten European countries, first, grouped in four different regions (North: Finland and UK; South: Spain and Italy; East: Hungary and Poland; West: France, Belgium, Germany, and Switzerland), and second by country, and (b) how socio-demographics, geographic differences, mobile phone usage patterns, and associated activities predicted this perceived dependence. Methods A sample of 2,775 young adults (aged 18-29 years) were recruited in different European Universities who participated in an online survey. Measures included socio-demographic variables, patterns of mobile phone use, and the dependence subscale of a short version of the Problematic Mobile Phone Use Questionnaire (PMPUQ; Billieux, Van der Linden, & Rochat, 2008). Results The young adults from the Northern and Southern regions reported the heaviest use of mobile phones, whereas perceived dependence was less prevalent in the Eastern region. However, the proportion of highly dependent mobile phone users was more elevated in Belgium, UK, and France. Regression analysis identified several risk factors for increased scores on the PMPUQ dependence subscale, namely using mobile phones daily, being female, engaging in social networking, playing video games, shopping and viewing TV shows through the Internet, chatting and messaging, and using mobile phones for downloading-related activities. Discussion and conclusions Self-reported dependence on mobile phone use is influenced by frequency and specific application usage.

Assessment of the accuracy of a new tool for the screening of smartphone addiction

OBJECTIVE

To translate, adapt and validate the Smartphone Addiction Inventory (SPAI) in a Brazilian population of young adults.

METHOD

We employed the translation and back-translation method for the adaptation of the Brazilian version SPAI (SPAI-BR). The sample consisted of 415 university students. Data was collected through an electronic questionnaire, which consisted of the SPAI-BR and the Goodman Criteria (gold standard). The retests were carried out 10-15 days after the initial tests with 130 individuals.

RESULTS

The SPAI-BR maintained semantic, idiomatic and conceptual equivalences from the original scale. The Confirmatory Factor Analysis confirmed the One-factor model of the SPAI with good fit indexes (x2 = 767.861, CFI = 0.913, TLI = 0.905, RMSE = 0.061, WRMR = 1.465). The Kuder-Richardson Coefficient showed good internal consistency. The analysis of the ROC curve established an area under the curve of 86.38%. The Intraclass-Correlation Coefficient of 0.926 between the test and the retest demonstrated an excellent temporal stability. The high correlation between SPAI-BR and the Goodman Criteria (rs = 0.750) established the convergent validity.

CONCLUSION

The SPAI-BR is a valid and reliable tool for the detection of Smartphone Addiction in Brazilian university students.

Exploratory investigation of theoretical predictors of nomophobia using the Mobile Phone Involvement Questionnaire (MPIQ)

Despite the advantages that the development of new technologies has brought to our lives, it is also true that the problematic use of technology can have negative effects on some people, as the prevalence of nomophobia, defined as the fear and anxiety of being unreachable via one's mobile phone. While some authors are beginning to study the relationship of nomophobia with variables such as age, no investigation has yet been carried out into psychological variables. Our study contributes to the literature by looking at personality, self-esteem, gender and age as predictors of nomophobia, evaluated by the Mobile Phone Involvement Questionnaire (MPIQ). The study comprised 242 Spanish students (46.7% men and 53.3% women; 49.2% studying for a high school certificate and 50.8% for a university degree). Multiple regressions were conducted, finding that self-esteem, extraversion, conscientiousness and emotional stability predict nomophobia. Finally, we discuss these results and provide suggestions for future research.

Gender Differences and Psychopathological Features Associated With Addictive Behaviors in Adolescents

BACKGROUND

The aims of the study were to assess prevalence and gender differences of addictive behaviors (substance- and non-substance-related) in an adolescent population, and their association with psychopathological features and academic performance.

MATERIAL AND METHODS

A sample of high school Italian students (n = 996; M = 240, F = 756) was examined using a self-report survey concerning sociodemographic characteristics, cigarette smoking, alcohol and substance use, perceived academic performance, activities, and behaviors (Internet use, gambling, and physical exercising). The Internet Addiction Test, the South Oaks Gambling Screen-revised Adolescent, and the Exercise Addiction Inventory-Short Form were administered to identify problematic behaviors. The Barratt Impulsiveness Scale for Adolescent, the Snaith-Hamilton Pleasure Scale, the Dissociative Experience Scale for Adolescent, and the Toronto Alexithymia Scale were used to investigate psychopathological dimensions.

RESULTS

Frequent alcohol intake and lifetime substances consumption were more common among males. The occurrence of other addictive behaviors was 22.1% for problematic Internet use (M = F), 9.7% for at-risk/problematic gambling (M > F), and 6.2% for maladaptive physical exercise (M = F). We also found an association between substance-/non-substance-related addictive behaviors and psychopathological dimensions. Addictive behaviors were more frequent among students reporting poor school performance.

CONCLUSION

Our study showed a relevant prevalence of addictive behaviors in a sample of Italian high school students, with specific gender differences. We underlined the cooccurrence of substance and non-substance-related addictive behaviors, and their association with worse school performance. Dissociative proneness, anhedonia, alexithymia, and impulsivity were associated with addictive behaviors in adolescents and might represent vulnerability factors for the development of psychiatric disorders in adulthood. A better understanding of psychopathological features associated with addictive behaviors might be useful for the prevention/early intervention.

Cell-Phone Addiction: A Review

We present a review of the studies that have been published about addiction to cell phones. We analyze the concept of cell-phone addiction as well as its prevalence, study methodologies, psychological features, and associated psychiatric comorbidities. Research in this field has generally evolved from a global view of the cell phone as a device to its analysis via applications and contents. The diversity of criteria and methodological approaches that have been used is notable, as is a certain lack of conceptual delimitation that has resulted in a broad spread of prevalent data. There is a consensus about the existence of cell-phone addiction, but the delimitation and criteria used by various researchers vary. Cell-phone addiction shows a distinct user profile that differentiates it from Internet addiction. Without evidence pointing to the influence of cultural level and socioeconomic status, the pattern of abuse is greatest among young people, primarily females. Intercultural and geographical differences have not been sufficiently studied. The problematic use of cell phones has been associated with personality variables, such as extraversion, neuroticism, self-esteem, impulsivity, self-identity, and self-image. Similarly, sleep disturbance, anxiety, stress, and, to a lesser extent, depression, which are also associated with Internet abuse, have been associated with problematic cell-phone use. In addition, the present review reveals the coexistence relationship between problematic cell-phone use and substance use such as tobacco and alcohol.

Development of a Brief Multicultural Version of the Test of Mobile Phone Dependence (TMDbrief) Questionnaire

The Test of Mobile Phone Dependence (TMD) questionnaire (Chóliz, 2012) evaluates the main features of mobile phone dependence: tolerance, abstinence syndrome, impaired impulse control, associated problems, excessive use, etc.

OBJECTIVE

The objective of this study was to develop a multicultural version of the TMD (TMDbrief) adapted to suit the novel communication tools of smartphones.

PROCEDURE

In this study, the TMD was completed by 2,028 young respondents in six distinct world regions: Southern Europe, Northwest Europe, South-America, Mesoamerica, Pakistan, and India.

RESULTS

Psychometric analysis of the reliability of the instrument and factor analysis were performed to adapt the TMDbrief for use in these regions. Differences among regions with respect to TMD Mobile Phone Dependence scores were obtained.

CONCLUSION

A brief questionnaire for the evaluation of mobile phone addiction in cross-cultural studies was successfully developed.

Altered Gray Matter Volume and White Matter Integrity in College Students with Mobile Phone Dependence

Mobile phone dependence (MPD) is a behavioral addiction that has become an increasing public mental health issue. While previous research has explored some of the factors that may predict MPD, the underlying neural mechanisms of MPD have not been investigated yet. The current study aimed to explore the microstructural variations associated with MPD as measured with functional Magnetic Resonance Imaging (fMRI). Gray matter volume (GMV) and white matter (WM) integrity [four indices: fractional anisotropy (FA); mean diffusivity (MD); axial diffusivity (AD); and radial diffusivity (RD)] were calculated via voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis, respectively. Sixty-eight college students (42 female) were enrolled and separated into two groups [MPD group, N = 34; control group (CG), N = 34] based on Mobile Phone Addiction Index (MPAI) scale score. Trait impulsivity was also measured using the Barratt Impulsiveness Scale (BIS-11). In light of underlying trait impulsivity, results revealed decreased GMV in the MPD group relative to controls in regions such as the right superior frontal gyrus (sFG), right inferior frontal gyrus (iFG), and bilateral thalamus (Thal). In the MPD group, GMV in the above mentioned regions was negatively correlated with scores on the MPAI. Results also showed significantly less FA and AD measures of WM integrity in the MPD group relative to controls in bilateral hippocampal cingulum bundle fibers (CgH). Additionally, in the MPD group, FA of the CgH was also negatively correlated with scores on the MPAI. These findings provide the first morphological evidence of altered brain structure with mobile phone overuse, and may help to better understand the neural mechanisms of MPD in relation to other behavioral and substance addiction disorders.

Problematic cell phone use for text messaging and substance abuse in early adolescence (11- to 13-year-olds)

The aim of our study was to examine the association between problematic cell phone use (PCPU) for text messaging and substance abuse in young adolescents. This cross-sectional study was conducted on the basis of an ad hoc questionnaire, during the 2014-2015 school year in a province of the Veneto Region (Italy); it involved a sample of 1156 students in grades 6 to 8 (11 to 13 years old). A self-report scale based on the Short Message Service (SMS) Problem Use Diagnostic Questionnaire (SMS-PUDQ) was administered to assess the sample's PCPU. A multivariate logistic regression model was applied to seek associations between PCPU (as the dependent variable) and independent variables. The proportion of students who reported a PCPU increased with age in girls (13.5% in 6th grade, 16.4% in 7th grade, and 19.5% in 8th grade), but not in boys (14.3% in 6th grade, 18.0% in 7th grade, and 14.8% in 8th grade). Logistic regression showed that drunkenness at least once and energy drink consumption raised the odds of PCPU, whereas reading books, higher average school marks, and longer hours of sleep were associated with lower odds of PCPU in early adolescence.

CONCLUSION

our findings confirm a widespread PCPU for text messaging among early adolescents. The odds of PCPU is greater in young people at risk of other substance abuse behavior.

Correlates of gambling on high-school grounds

OBJECTIVE

This study examined adolescent gambling on school grounds (GS+) and how such behavior was associated with gambling-related attitudes. Further, we examined whether GS+ moderated associations between at-risk problem-gambling (ARPG) and gambling behaviors related to gambling partners.

METHOD

Participants were 1988 high-school students who completed survey materials. Demographic, perceptions, attitudes, and gambling variables were stratified by problem-gambling severity (ARPG versus recreational gambling) and GS+ status. Chi-square and adjusted logistic regression models were used to examine relationships among study variables.

RESULTS

Nearly 40% (39.58%) of students reported past-year GS+, with 12.91% of GS+ students, relative to 2.63% of those who did not report gambling on school grounds (GS-), meeting DSM-IV criteria for pathological gambling (p<0.0001). In comparison to GS- students, GS+ students were more likely to report poorer academic achievement and more permissive attitudes towards gambling behaviors. Weaker links in GS+ students, in comparison with GS-, students, were observed between problem-gambling severity and gambling with family members (interaction odds ratio (IOR)=0.60; 95% CI=0.39-0.92) and gambling with friends (IOR=0.21; 95% CI=0.11-0.39).

CONCLUSIONS

GS+ is common and associated with pathological gambling and more permissive attitudes towards gambling. The finding that GS+ (relative to GS-) youth show differences in how problem-gambling is related to gambling partners (friends and family) warrants further investigation regarding whether and how peer and familial interactions might be improved to diminish youth problem-gambling severity. The high frequency of GS+ and its relationship with ARPG highlights a need for school administrators and personnel to consider interventions that target school-based gambling.

Co-occurrence of alcohol use disorder and behavioral addictions: relevance of impulsivity and craving

PURPOSE

The aims of the study were to evaluate the occurrence of behavioral addictions (BAs) in alcohol use disorder (AUD) subjects and to investigate the role of impulsivity, personality dimensions and craving.

METHODS

95 AUD outpatients (DSM-5) and 140 homogeneous controls were assessed with diagnostic criteria and specific tests for gambling disorder, compulsive buying, sexual, internet and physical exercise addictions, as well as with the Barratt Impulsiveness Scale (BIS-11) and Temperamental and Character Inventory-Revised (TCI-R). The Obsessive Compulsive Drinking Scale (OCDS) and Visual Analogue Scale for craving (VASc) were also administered to the AUD sample.

RESULTS

28.4% (n=27) of AUD subjects had at least one BA, as compared to 15% (n=21) of controls (χ(2)=6.27; p=.014). In AUD subjects, direct correlations between BIS-11 and Compulsive Buying Scale (CBS), Internet Addiction Disorder test (IAD), Exercise Addiction Inventory-Short Form (EAI-SF) scores (p<.01), between OCDS obsessive and CBS and VASc and CBS, IAD scores (p<.003), were found. BIS-11 (t=-2.36; p=.020), OCDS obsessive (Z=-4.13; p<.001), OCDS compulsive (Z=-2.12; p=.034) and VASc (Z=-4.94; p<.001) scores were higher in AUD subjects with co-occurring BAs. The occurrence of BAs was associated with higher impulsivity traits (BIS-11 scores; OR=1.08; p=.012) and higher craving levels (VASc scores; OR=2.48; p<.001).

CONCLUSIONS

Our findings emphasize a significant rate of co-occurrence of BAs in AUD. High levels of impulsivity and craving for alcohol seem to be associated with other addictive behaviors.

Problematic mobile phone use in adolescents: derivation of a short scale MPPUS-10

OBJECTIVES

Our aim was to derive a short version of the Mobile Phone Problem Use Scale (MPPUS) using data from 412 adolescents of the Swiss HERMES (Health Effects Related to Mobile phonE use in adolescentS) cohort.

METHODS

A German version of the original MPPUS consisting of 27 items was shortened by principal component analysis (PCA) using baseline data collected in 2012. For confirmation, the PCA was carried out again with follow-up data 1 year later.

RESULTS

PCA revealed four factors related to symptoms of addiction (Loss of Control, Withdrawal, Negative Life Consequences and Craving) and a fifth factor reflecting the social component of mobile phone use (Peer Dependence). The shortened scale (MPPUS-10) highly reflects the original MPPUS (Kendalls' Tau: 0.80 with 90% concordant pairs). Internal consistency of MPPUS-10 was good with Cronbach's alpha: 0.85. The results were confirmed using the follow-up data.

CONCLUSIONS

The MPPUS-10 is a suitable instrument for research in adolescents. It will help to further clarify the definition of problematic mobile phone use in adolescents and explore similarities and differences to other technological addictions.

Association between problematic cellular phone use and suicide: the moderating effect of family function and depression

BACKGROUND

Suicidal ideation and attempt among adolescents are risk factors for eventual completed suicide. Cellular phone use (CPU) has markedly changed the everyday lives of adolescents. Issues about how cellular phone use relates to adolescent mental health, such as suicidal ideation and attempts, are important because of the high rate of cellular phone usage among children in that age group. This study explored the association between problematic CPU and suicidal ideation and attempts among adolescents and investigated how family function and depression influence the association between problematic CPU and suicidal ideation and attempts.

METHODS

A total of 5051 (2872 girls and 2179 boys) adolescents who owned at least one cellular phone completed the research questionnaires. We collected data on participants' CPU and suicidal behavior (ideation and attempts) during the past month as well as information on family function and history of depression.

RESULTS

Five hundred thirty-two adolescents (10.54%) had problematic CPU. The rates of suicidal ideation were 23.50% and 11.76% in adolescents with problematic CPU and without problematic CPU, respectively. The rates of suicidal attempts in both groups were 13.70% and 5.45%, respectively. Family function, but not depression, had a moderating effect on the association between problematic CPU and suicidal ideation and attempt.

CONCLUSION

This study highlights the association between problematic CPU and suicidal ideation as well as attempts and indicates that good family function may have a more significant role on reducing the risks of suicidal ideation and attempts in adolescents with problematic CPU than in those without problematic CPU.

Occurence of internet addiction in a general population sample: a latent class analysis

BACKGROUND

Prevalence studies of Internet addiction in the general population are rare. In addition, a lack of approved criteria hampers estimation of its occurrence.

AIMS

This study conducted a latent class analysis (LCA) in a large general population sample to estimate prevalence.

METHODS

A telephone survey was conducted based on a random digit dialling procedure including landline telephone (n=14,022) and cell phone numbers (n=1,001) in participants aged 14-64. The Compulsive Internet Use Scale (CIUS) served as the basis for a LCA used to look for subgroups representing participants with Internet addiction or at-risk use. CIUS was given to participants reporting to use the Internet for private purposes at least 1 h on a typical weekday or at least 1 h on a day at the weekend (n=8,130).

RESULTS

A 6-class model showed best model fit and included two groups likely to represent Internet addiction and at-risk Internet use. Both groups showed less social participation and the Internet addiction group less general trust in other people. Proportions of probable Internet addiction were 1.0% (CI 0.9-1.2) among the entire sample, 2.4% (CI 1.9-3.1) in the age group 14-24, and 4.0% (CI 2.7-5.7) in the age group 14-16. No difference in estimated proportions between males and females was found. Unemployment (OR 3.13; CI 1.74-5.65) and migration background (OR 3.04; CI 2.12-4.36) were related to Internet addiction.

CONCLUSIONS

This LCA-based study differentiated groups likely to have Internet addiction and at-risk use in the general population and provides characteristics to further define this rather new disorder.

Epidemiological characteristics of mobile phone ownership and use in korean children and adolescents

OBJECTIVES

As public concern on possible harmful effects of mobile phone in children has been raised, information of epidemiological characteristics of mobile phone use in children and adolescents will be essential for public health policy.

METHODS

Using three databases (n=21,693) collected from 2008 to 2011, we examined characteristics of mobile phone ownership and use, and socioeconomic positions (SEP) in Korean children and adolescents.

RESULTS

The ownership rate and the amount of mobile phone use were higher in females than males, in higher school grades than lower grades, and at 2011 than 2008. The average age of first mobile phone ownership was shown to decrease from 12.5 years in currently high school students to 8.4 years in currently elementary school students at 2011. More than 90% of children in the 5th grade owned a mobile phone. More children owned a mobile phone in lower SEP communities than in higher SEP. Children with parents educated less than those with parents educated more were more likely to own and use mobile phone.

CONCLUSIONS

Considering the epidemiological characteristics of mobile phone use, precautionary measures to prevent unnecessary exposure to mobile phones are needed in children and adolescents.

Child injury control: trends, themes, and controversies

Injury is a major cause of morbidity and mortality among US children, and an important driver of health status globally. Despite its enormous burden, injury is preventable. Over the last 10 years, significant progress has been made in the reduction of unintentional injury among US children. However, aggregate trends mask important disparities by age group, region, and injury mechanism. Basic and translation research is needed to develop and test prevention strategies to address these new or recalcitrant problems. Motor vehicle occupant injury has fallen to historic lows, but challenges remain in protecting novice drivers and managing the distraction of new technologies. Injury to pedestrians has also declined, but likely as a result of decreased exposure as fewer children walk. This calls for a broader public health perspective to promote activity while enhancing safety. Deaths due to drowning are common and illustrate the difficulty in measuring and promoting appropriate supervision. Environmental modification and use of protective products may be a more appropriate response. Concussion in sport is another challenging issue: public health laws promote identification and appropriate management of concussed athletes, but less progress has been made on primary prevention of these injuries. Unintentional poisoning is on the rise, attributable to misuse of, and overdose with, prescription opioids. Injury deaths to infants are also increasing. This trend is driven in part by better death investigation that classifies more sleep-related deaths as suffocation events. Finally, we examine a sample of cross-cutting themes and controversies in injury control that might be amenable to empiric evaluation.

Adolescent sleep and cellular phone use: recent trends and implications for research

Adolescent sleep needs range from 8.5–10 hours per night, with older adolescents requiring less sleep than younger adolescents. On average, however, American adolescents receive between 7.5–8.5 hours of sleep per night, with many sleeping fewer than 6.5 hours on school nights. Cellular phone use is emerging as an important factor that interferes with both sleep quality and quantity, particularly as smartphones become more widely available to teens. This review paper has three objectives. First, we will describe adolescent sleep patterns and the effects of sleep deprivation on adolescent physical and mental health. Second, we will describe current trends in technology use among adolescents, making associations to how technology impacts sleep. Lastly, we will discuss some of the methodological barriers of conducting sleep and technology research with adolescents and young adults and offer suggestions for overcoming those barriers. We will also discuss implications for healthcare providers.