Smartphone addiction is increasing across the world: A meta-analysis of 24 countries

Predictors of smartphone addiction in adolescents with depression: combing the machine learning and moderated mediation model approach

Smartphone addiction (SA) significantly impacts the physical and mental health of adolescents, and can further exacerbate existing mental health issues in those with depression. However, fewer studies have focused on the predictors of SA in adolescents with depression. This study employs machine learning methods to identify key risk factors for SA, using the interpretable SHapley Additive exPlanations (SHAP) method to enhance interpretability. Additionally, by constructing a mediation moderation model, the interactions between significant risk factors are analyzed. The study included 2203 adolescents with depression. Machine learning results from four models (Random Forest, Support Vector Machine, Logistic Regression, XGBoost) consistently identified emotion-focused coping, rumination, and school bullying as the strongest predictors of SA. Further mediation moderation analyses based on the Interaction of Person-Affect-Cognition-Execution (I-PACE) model revealed that rumination significantly mediated the relationship between school bullying and SA, and emotion-focused coping significantly moderated the relationships between school bullying and both rumination and SA. This is the first study to use machine learning to explore the predictors of SA in depressive adolescents and further analyze the interactions among these predictors. Future interventions for SA in adolescents with depression may benefit from psychotherapy that addresses emotion-focused coping and rumination.

Distinct roles of specific metacognitive beliefs in adolescent problematic mobile phone use: A Cross-Lagged panel network analysis

Problematic mobile phone use (PMPU) among adolescents is increasingly recognized as a significant behavioral health concern. Previous studies have found general metacognitive beliefs can positively predict PMPU. However, the longitudinal relationship between specific metacognitive beliefs and addictive behaviors has not been fully explored. This study aimed to explore the longitudinal relationship between metacognitions about mobile phone use, metacognitions about desire thinking, and PMPU among adolescents using cross-lagged panel network analysis. A sample of 993 adolescents were surveyed at two points over six months. Findings indicated that negative metacognitions about mobile phone use and positive metacognitions about desire thinking emerged as two prominent bridge nodes. Negative metacognitions about mobile phone use were strongly associated with withdrawal and relapse symptoms, while positive metacognitions about desire thinking correlated with tolerance and relapse. These results suggest that interventions aimed at addressing PMPU should consider the distinct impacts of different metacognitive beliefs and tailor their approaches accordingly.

The relationship between meaning in life and self-regulated learning among college students: the mediating effect of psychological capital and the moderating effect of phubbing

BACKGROUND

Previous research on college students' learning problems has investigated the notion of self-regulated learning. However, relatively little research has explored the mechanism underlying the relationship between meaning in life and self-regulated learning on the basis of the self-regulated learning framework. Additionally, relatively few studies have examined the impact of phubbing behavior on the traits exhibited by the source of the behavior in question, particularly from the perspective of nonpersonal perception. Therefore, in this study, Pintrich's Self-Regulated Learning model is used as a theoretical framework; in addition, this study draws on conservation of resources theory, among other theories, to explain the relationships among relevant variables. It thus aims to develop a moderated mediation model that can be used to systematically examine the relationship between meaning in life and self-regulated learning as well as the mechanism underlying this relationship. On this basis, this study provides effective recommendations that can be used to enhance self-regulated learning among college students and promote high-quality learning outcomes.

METHODS

In this study, the Chinese Meaning in Life Questionnaire, the Youth Psychological Capital Questionnaire, the Youth Phubbing Scale-Chinese Version, and the Self-Regulated Learning Scale for College Students were used to survey 488 college students who were recruited from an undergraduate college in a province in central China.

RESULTS

(1) Meaning in life had a positive predictive effect on self-regulated learning (r2 = 0.51, p < 0.001). (2) Psychological capital mediated the relationship between meaning in life and self-regulated learning (indirect effects = 0.31, SE = 0.04, 95% CI=[0.23-0.38]). (3) The first half of the mediating path "meaning in life → psychological capital → self-regulated learning" and the direct path "meaning in life → self-regulated learning" were moderated by phubbing (β = 0.07, p < 0.01, β = 0.10, p < 0.001).

CONCLUSION

Meaning in life not only predicts self-regulated learning among college students directly and positively; it also influences self-regulated learning indirectly via the mediation of psychological capital. The effects of meaning in life on psychological capital and self-regulated learning are moderated by phubbing. Specifically, as the frequency of phubbing increases, the positive predictive effects of meaning in life on psychological capital and self-regulated learning become stronger.

Association Between Excessive Internet Use Time, Internet Addiction, and Physical-Mental Multimorbidity Among Chinese Adolescents: Cross-Sectional Study

BACKGROUND

In contemporary society, the lives of adolescents are profoundly influenced by the internet. While irrational internet use may have an impact on the physical and mental well-being of teenagers, the relationship between excessive internet use and physical-mental multimorbidity in adolescents remains unclear.

OBJECTIVE

The aim of this study was to examine the relationship between excessive internet use and physical-mental multimorbidity among adolescents in China.

METHODS

A total of 5842 students aged 13 to 18 years from Suzhou city in Eastern China were recruited. Four specific physical disorders and a mental disorder were considered to assess the physical-mental multimorbidity, that is, obesity, hypertension, myopia, dental caries, and depressive symptoms. Logistic regression models were used to evaluate the odds ratios (ORs) and 95% CIs between internet use time, internet addiction (IA) behaviors, and physical-mental multimorbidity. Mediation analyses were performed to explore the mediating effect of sleep duration, diet scores, and tobacco or alcohol consumption on the association between excessive internet use and physical-mental multimorbidity.

RESULTS

A total of 973 (16.7%) students exhibited physical-mental multimorbidity. Students with excessive internet use time (≥2 hours per day) were associated with 45% higher odds of physical-mental multimorbidity compared to their peers who reported internet use for <1 hour per day. Among children and adolescents, a significant J-shaped association was observed between internet use time and physical-mental multimorbidity (nonlinear P<.001). Diet score (16.3%) and tobacco or alcohol consumption (12.7%) partially mediated the relationship. Students who met 1 IA behavior (OR 2.44, 95% CI 2.00-2.98) or ≥2 IA behaviors (OR 5.80, 95% CI 4.90-6.86) were associated with higher odds of physical-mental multimorbidity. In the total population, a positive nonlinear correlation was identified between the number of IA behaviors and physical-mental multimorbidity (nonlinear P<.001). Sleep duration (2.3%), dietary scores (6.1%), and tobacco or alcohol consumption (6.2%) partially mediated the association.

CONCLUSIONS

Excessive internet use is associated with increased odds of physical-mental multimorbidity among adolescents. Sleep duration, dietary quality, and tobacco or alcohol consumption may partially mediate this relationship. These findings highlight the need for monitoring and promoting healthy internet habits as well as addressing lifestyle factors in order to prevent and control physical-mental multimorbidity among adolescents. This research will also provide references for managing internet use and physical-mental health as well as for future longitudinal studies.

Psychological education in higher education: Opportunities and challenges in the Internet+ era

In the context of "Internet+," the rapid development and integration of information technology in China have brought new opportunities and challenges to psychological education in higher education. Compared with traditional psychological education, the high information throughput and multichannel presentation of "Internet+" have altered students’ cognitive characteristics. Consequently, traditional psychological education methods are no longer suitable for the current environment, and education methods pose new challenges for higher education. New media technologies within the "Internet+" framework have played a crucial role in psychological education. Further research is needed to explore new applications for enhancing the quality of psychological education in higher education institutions. This paper reviews the current opportunities and challenges faced by psychological education in the context of "Internet+", and explores a mechanism-driven, collaborative, and efficient educational strategy that is responsive to new conditions.

Classification of internet addiction using machine learning on electroencephalography synchronization and functional connectivity

BACKGROUND

Internet addiction (IA) refers to excessive internet use that causes cognitive impairment or distress. Understanding the neurophysiological mechanisms underpinning IA is crucial for enabling an accurate diagnosis and informing treatment and prevention strategies. Despite the recent increase in studies examining the neurophysiological traits of IA, their findings often vary. To enhance the accuracy of identifying key neurophysiological characteristics of IA, this study used the phase lag index (PLI) and weighted PLI (WPLI) methods, which minimize volume conduction effects, to analyze the resting-state electroencephalography (EEG) functional connectivity. We further evaluated the reliability of the identified features for IA classification using various machine learning methods.

METHODS

Ninety-two participants (42 with IA and 50 healthy controls (HCs)) were included. PLI and WPLI values for each participant were computed, and values exhibiting significant differences between the two groups were selected as features for the subsequent classification task.

RESULTS

Support vector machine (SVM) achieved an 83% accuracy rate using PLI features and an improved 86% accuracy rate using WPLI features. t-test results showed analogous topographical patterns for both the WPLI and PLI. Numerous connections were identified within the delta and gamma frequency bands that exhibited significant differences between the two groups, with the IA group manifesting an elevated level of phase synchronization.

CONCLUSIONS

Functional connectivity analysis and machine learning algorithms can jointly distinguish participants with IA from HCs based on EEG data. PLI and WPLI have substantial potential as biomarkers for identifying the neurophysiological traits of IA.

Do regular exercise, gender, and age influence smartphone addiction? Analyzing screen time and smartphone deprivation symptoms

Background

Headless smartphone use, known as smartphone addiction (SA), is associated with mental health issues and behavioral dependencies. While physical activity (PA) has been suggested as a protective factor, research remains inconclusive. The present study examines whether regular exercise influences SA, smartphone deprivation, and daily smartphone screen time while assessing gender and age as risk factors.

Methods

This cross-sectional study with 701 participants (392 exercisers, 309 non-exercisers) assessed SA with the Smartphone Application-Based Addiction Scale (SABAS) and deprivation feelings with the Hungarian Smartphone Withdrawal Symptom Scale (HSWSS). Daily smartphone use was self-reported. Multivariate analysis of covariance examined the effects of exercise status, gender, and age on SA-related variables.

Results

Exercise status did not significantly affect SA, deprivation feelings, or screen time (p > 0.05). However, the correlation between SA and smartphone screen time was stronger (p < 0.05) in non-exercisers (r = 0.407) than in exercisers (r = 0.274). Gender and age were significant predictors: females reported higher SA and usage, and younger age was associated with greater SA, deprivation symptoms, and more screen time.

Conclusion

While exercise may not reduce SA, exercisers exhibit a weaker link between SA and smartphone use, suggesting less problematic usage, possibly due to more utilitarian (e.g., sports-related) rather than hedonic use. Females report higher SA, feelings of deprivation, and screen time than males, while age correlates with increased SA, feelings of deprivation, and screen time. Future research should examine psychosocial mechanisms and diverse smartphone usage patterns in addiction in connection with exercise behavior.

Coworker Phubbing and Links to the Psychosocial Work Environment Among Electricians in Sweden

"Phubbing" (phone snubbing) has been consistently associated with negative intra- and interpersonal outcomes across various social contexts. However, the potential impact of phubbing on horizontal workplace relationships has not been extensively explored. The present study aimed to examine associations between coworker phubbing during breaks and social support and community, horizontal trust, and organizational commitment among electricians in Sweden. An auxiliary aim was to adapt and validate a coworker phubbing scale. In Studies 1a and 1b, confirmatory factor analysis was used to assess and validate the coworker phubbing scale in two samples. In Study 2, structural equation modeling was used to examine the relationship between phubbing and included psychosocial work environment measures. Exposure to phubbing from coworkers was associated with lower perceived support and community, trust, and commitment. The associations were stronger for more severe phubbing behaviors. Engaging in phubbing others was not considerably linked to the psychosocial measures. Younger participants reported engaging in more phubbing and lower perceived exposure to more severe phubbing. Smartphone habits at work may have implications for the psychosocial work environment and, by extension, important outcomes such as well-being, job satisfaction, performance, and turnover.

Self-Compassion and Smartphone Addiction Tendency Among College Students: The Chain-Mediating Effect of Self-Concept Clarity and Experiential Avoidance

Smartphone addiction has emerged as a pressing public health issue in recent years, which negatively impacts university students' academic performance, physical and mental health, and social functioning. Therefore, it is crucial to explore the significant factors related to smartphone addiction. While previous research has suggested a potential link between self-compassion and problematic internet or smartphone use, studies specifically examining the relationship between self-compassion and smartphone addiction tendency remain limited. From a positive psychology perspective, this study aims to explore the relationship between self-compassion and smartphone addiction tendency, as well as its internal mechanism. A total of 641 Chinese college students were recruited to complete online questionnaires assessing their self-compassion, self-concept clarity, experiential avoidance, and smartphone addiction tendency. The results show that self-compassion not only directly and negatively predicts smartphone addiction tendency, but also indirectly predicts it through the independent mediating effects of self-concept clarity and experiential avoidance. Additionally, there is a chain-mediating effect of self-concept clarity and experiential avoidance. This study provides a new perspective for the prevention and intervention of smartphone addiction tendency among college students.

Adaptation and Validation of the Spanish Version of the Smartphone Application-Based Addiction Scale (SABAS)

Smartphone addiction is very prevalent among university students and can negatively impact both their physical and mental health. This study aimed to translate the smartphone application-based addiction scale (SABAS) into Spanish and evaluate its psychometric properties among Spanish university students. A total of 297 university students (222 women and 75 men) participated in this study (M age = 20.88, SD = 4.58) by completing a sociodemographic questionnaire, the smartphone addiction scale-short version, the depression, anxiety, and stress scale-21, the fear of missing out scale, and the SABAS. The SABAS was translated into Spanish using the forward-backward method. The factor structure was analyzed using confirmatory factor analysis, while reliability was assessed with Cronbach's alpha and McDonald's omega coefficients. The SABAS showed acceptable reliability (α = 0.72; ω = 0.73), and all of its items were kept. Factor analysis revealed that the Spanish version of the SABAS was unifactorial and demonstrated excellent validity (χ2 = 10.285; p = 0.246; RMSEA = 0.034; CFI = 0.991; SRMR = 0.030). Significant associations were also observed between the SABAS score and the number of hours of smartphone use, fear of missing out, and psychological distress. Despite its brevity, the Spanish version of the SABAS provides good validity and reliability. Therefore, it can be used as a tool for screening smartphone addiction in Spanish university students.

Relationship of Smartphone Addiction with Cyberbullying, Alcohol Use, Depression, and Anxiety Among University Students

Smartphone addiction is one of the major social issues among young people these days. The current study aims to identify the determinants of smartphone addiction and examine the association between smartphone addiction and multiple behavioral/psychological problems. The study sample consisted of 1105 university students from Singapore. Students in the high-risk smartphone use group reported higher levels of smartphone addiction, cybervictimization, and depressive and anxiety symptoms. Depressive and anxiety symptoms showed a positive association with smartphone addiction. Additionally, both depressive and anxiety symptoms had significant indirect effects when assessing two separate simple mediation models. When testing the parallel mediation model, the indirect effect of cybervictimization on smartphone addiction occurred through anxiety but not depression. Based on these findings, the current study proposed the implementation of routine screening and the provision of multi-level services in education settings. Nevertheless, the study has limitations related to the study population and the use of self-reported questionnaires.

Association between Near Work, Physical Activities and Myopia in Korean Adults During COVID-19 Outbreak

PURPOSE

This study investigated the relationship between near work hours and myopia in Korean adults.

METHODS

We used data from the 2021 Korean National Health and Nutrition Examination Survey. Associations between near work time, physical activity, and myopia were assessed using chi-square tests and multiple logistic regression analyses.

RESULTS

The overall prevalence of myopia was 60.2% in adults aged 19-59 years. The prevalence of myopia was 46.2% for individuals who used smart devices for less than one hour per day, while it was 68.0% for those who used smart devices for more than four hours. In the multiple logistic regression analysis, the odds ratio (OR) for myopia was significantly higher among individuals using smart devices for 3 hours (OR = 1.55, 95% CI = 1.08-2.23) or more than 4 hours (OR = 1.75, 95% CI = 1.27-2.42), compared to users with less than 1 hour of usage. Regarding sitting time, the OR for myopia was significantly higher in individuals who sat for more than 12 hours (OR = 1.66, 95% CI = 1.05-2.61) compared to those who sat less than 4 hours.

CONCLUSION

This study found that near work and sitting times were positively associated with myopia. Given the high prevalence of myopia and its implications for serious eye diseases, it is essential to implement measures to manage myopia. Considering the increased near work hours resulting from the COVID-19 pandemic, it is necessary to adopt supplementary measures, such as ensuring sufficient rest time for the eyes and adjusting the brightness of lights, to improve eye health.

Reciprocal associations of future time perspective and smartphone addiction among Chinese college students: Disaggregation of between-person and within-person effects

Smartphone addiction negatively affects physical and mental health. Future time perspective, a key personality and social cognitive factor, may not only be a protective factor for addictive behaviors but may also be shaped during the development of addiction. Based on three waves of data collected from Chinese college students (N = 622, 46.95% male, Mage = 18.16, SD = 1.49), this study examined the within-person and between-person effects on the associations between future time perspective and smartphone addiction. The results of the traditional cross-lagged model demonstrated a bidirectional negative association between future time perspective and smartphone addiction. The results of the random intercept cross-lagged panel model also indicated a reciprocal negative within-person effect between future time perspective and smartphone use consistently over time while controlling for the significantly negative between-person effect. These findings deepen the understanding of the longitudinal relationship between future time perspective and smartphone addiction.

Techonoference and Problematic Smartphone Use: The Roles of Attachment and Environmental Sensitivity

The present study examined the potential mediation effects of parental attachment and peer attachment, and the moderating effect of environmental sensitivity between parental technoference and adolescents' problematic smartphone use. A sample of 908 junior high school students (Mage = 13.41 years, SD = 0.76) anonymously completed questionnaires. The results revealed that : (1) both mother and father attachment could mediate the pathway from parental technoference to adolescents' problematic smartphone use; (2) adolescent's environmental sensitivity moderated the direct and indirect pathway between parental technoference, mother attachment, and adolescents' problematic smartphone use. Specifically, adolescents with higher environmental sensitivity had greater problematic smartphone use when they experienced greater parental technoference. Moreover, adolescents with lower environmental sensitivity exhibited less problematic smartphone use when they had better mother-child attachment. The present study revealed a complex interplay between family and individual factors that contribute to adolescents' problematic smartphone use.

Flourishing through Social Development Activities and Social Support: A Holistic Strategy for Problematic Smartphone Use

While some research has indicated the relationship between participation in social development activities (PSDA) and perceived social support (PSS) with problematic smartphone use (PSU), there has been a lack of studies examining these relationships through the lens of the flourishing theory, particularly among adolescents. To address this gap in the literature, this study conducted between April and May 2022 included 4965 high school students from 20 different cities in Türkiye. Researchers utilized questionnaires assessing participants' demographic information, levels of participation in social development activities, The Smartphone Application-Based Addiction Scale, The Short Version of the Scales of General Well-Being (GWB), and The Multidimensional Scale of Perceived Social Support as instruments. Structural Equation Modeling was employed for analyzing the relationships between variables using IBM SPSS v26 and AMOS v24 software packages. Hierarchical regression analysis was used to understand how GWB and PSS were associated with the relationships between PSDA and PSU. Findings indicated a predominantly negative relationship between PSDA and PSU, with GWB mediating this relationship negatively across all PSDA and PSS playing a contributory role in many indirect relationships between PSDA and PSU, if not directly. The importance of the approach in interventions aimed at addressing PSU was emphasized.

Differential roles of problematic media use by mothers and toddlers in the relation between parenting stress and toddlers' socioemotional development

The increasing prevalence of digital media devices in families with young children has raised concerns over problematic media use. However, the link between toddlers' problematic media use, their socioemotional development, and the influence of parental factors remains unclear. The current study examined the roles of problematic media use by both mothers and toddlers in the association between maternal parenting stress and toddlers' socioemotional development. Participants comprised 215 mothers and 73 lead child care classroom teachers of toddlers aged 24-36 months enrolled in child care centers in South Korea. Mothers reported parenting stress and problematic media use by themselves and their toddlers, and child care teachers reported toddlers' socioemotional development. The results from structural equation modeling analysis revealed that maternal parenting stress was related to toddlers' socioemotional development both directly and indirectly through toddlers' problematic media use, both alone and in conjunction with mothers' problematic media use. Although maternal parenting stress was related to mothers' problematic media use, mothers' problematic media use was not directly related to toddlers' socioemotional development. These findings underscore the importance of toddlers' problematic media use in their socioemotional development and highlight the need for comprehensive approaches that address family dynamics, such as maternal parenting stress and problematic media use.

Problematic smartphone use in a representative sample of US adults: Prevalence and predictors

The exponential growth in worldwide smartphone adoption has led to mounting concerns about problematic smartphone use (PSU), with some studies of variably defined PSU yielding prevalence rates as high as 20 to 30%. The present study aims to (a) estimate the prevalence of PSU while emphasizing functional impairment, and (b) examine the degree to which a set of demographic, contextual, behavioral and mental health variables can predict PSU. A representative U.S. sample of 1,989 participants completed an online survey using a cross-sectional design aimed at examining PSU. Data were analyzed using two different but complementary machine learning algorithms. The results indicate a PSU prevalence of 0.75% to 1.2 % when a functional impairment criterion is required. The most important predictors of PSU are related to smartphone use behavior, followed by contextual factors (being a parent of under-age children, increase in use during the COVID-19 pandemic), age and some psychopathological factors. Overall, the study suggests that the prevalence of functionally impairing PSU may be much lower than what has been reported based on less stringent definitions. The results highlight the necessity to account for impact on key spheres of functioning in diagnosing PSU to avoid pathologizing a ubiquitous behavior that may be intensive but not necessarily pathological. They also open up relevant perspectives for the prevention of PSU.

The relationship between social support and smartphone addiction: the mediating role of negative emotions and self-control

BACKGROUND

With the rapid development of the internet, smartphones have become an indispensable part of our lives. However, prolonged, excessive and uncontrolled use may lead to the hidden danger of smartphone addiction, posing a threat to users' physical and mental health. Previous studies have shown that social support may be a factor in alleviating smartphone addiction. However, its specific mechanism needs further exploration. The purpose of this study is to examine the chain mediating effects of negative emotions and self-control on the relationship between social support and smartphone addiction.

METHODS

A cross-sectional survey was conducted from January 2022 to April 2023 in Sichuan Province, China, with 5,188 respondents aged 15 years or older. Spearman's correlation analysis was used to determine correlations between social support, negative emotions, self-control, and smartphone addiction. We construct a Structural Equation Model (SEM) to explore the pathways of smartphone addiction across different age groups.

RESULTS

Social support, negative emotions, self-control, and smartphone addiction were found to be significantly related (p < 0.01).In the population aged 15-44, a complete SEM pathway analysis was achieved, while for the population aged 45-64, a simplified version of the pathway analysis was obtained. Among the population aged 65 and above, multiple pathways were found to be nonsignificant. For the full sample, social support not only exhibited a negative correlation with smartphone addiction (β = -0.410; 95% CI: -0.534 to -0.320) but also influenced smartphone addiction through three specific pathways: via negative emotions (β = -0.041; 95% CI: -0.066 to -0.021), via self-control (β = -0.087; 95% CI: -0.119 to -0.063), and via a sequential effect of negative emotions and self-control (β = -0.047; 95% CI: -0.062 to -0.036). The 15-44 age group demonstrated similar pathways to the full sample, whereas the 45-64 age group lost the pathway mediated solely by negative emotions.

CONCLUSIONS

Our study shows that high social support reduces smartphone addiction by diminishing negative emotions and improving self-control.The effect is more pronounced in the 15-44 age group.We suggest strengthening the social support system through more activities and urge relevant departments to improve the mental health education, enhance self-control training, and promote mental well-being to help avoid smartphone addiction.

TRIAL REGISTRATION

Clinical trial number: not applicable.

Exploring the relationship between physical activity and smartphone addiction among college students in Western China

Background

Smartphone addiction (SA) refers to a behavioral disorder characterized by an irresistible compulsion to excessively engage with mobile devices. Currently, the evidence regarding the relationship between physical activity (PA), exercise intensity (EI), and SA is limited, particularly within Chinese populations. This study aims to explore the correlation between PA, EI, and SA, specifically investigating how PA and EI impact SA to better understand the nature of this relationship.

Methods

A cross-sectional study was conducted involving college students from over 20 universities in Western China. Data were collected on participants' engagement in PA, EI, and SA. Additionally, covariates such as age, gender, ethnicity, academic classification, university location, discipline, year of study, hometown region, sibling status, relationship status, and social interactions were recorded. Multivariate logistic regression models were used to assess the association between PA, EI, and SA. Stratified and interaction analyses were performed to examine whether the relationship remained consistent across different subgroups.

Results

Of the 3,506 college students surveyed, 1,905 (54.3%) experienced SA. The prevalence of SA was 11.3% lower in the group that engaged in PA compared to those who did not. In the fully adjusted model, PA was negatively associated with SA (OR = 0.70, 95% CI: 0.59-0.82, p < 0.001). EI was also inversely associated with SA. Moderate- and vigorous-intensity exercise had odds ratios of 0.81 (95% CI: 0.67-0.98, p = 0.034) and 0.83 (95% CI: 0.68-1.00, p = 0.046), respectively, compared with low-intensity exercise. Similar patterns were observed in subgroup analyses (all p values for interaction >0.05).

Conclusion

The findings indicate a significant negative association between PA, EI, and SA, highlighting the potential of promoting PA and higher EI as strategies to reduce SA among college students.

Lying flat to play on smartphone excessively: the role of self-esteem

Introduction

With the rapid development of their countries, Chinese young people today face intense stress. Some cope by striving for high-quality resources (involution), while others adopt a passive approach, lowering their desires (lying flat). This study explores the relationship between lying flat and problematic smartphone use (PSU), focusing on the role of self-esteem.

Methods

We conducted three studies (N = 886) using both cross-sectional (Study 1) and experimental (Study 2 and Study 3) designs to examine the correlational and causal links between lying flat, self-esteem, and PSU.

Results

The studies demonstrated a significant relationship between lying flat and PSU, with self-esteem serving as a mediator. Additionally, Study 3 showed a causal effect of self-esteem on smartphone use desire.

Discussion

These findings provide insight into why and how lying flat affects self-esteem and smartphone use behaviors and desires, highlighting the psychological mechanisms behind the trends observed in Chinese youth.

Smartphone Addiction, Screen Time, and Physical Activity of Different Academic Majors and Study Levels in University Students

Smartphone addiction is increasing among university students. This study aims to explore the differences in screen time and physical activity among university students with and without smartphone addiction, considering their study majors and levels. One hundred and twenty participants from sixteen faculties were included, divided into three academic majors (health sciences, social sciences and humanities, and science and technology). Data were collected using a screen time behavior questionnaire and a screen time application. Physical activity was measured using the Global Physical Activity Questionnaire (GPAQ). This study demonstrated that the smartphone addiction group had higher screen time on both smartphones (p = 0.02) and other devices (p = 0.04). Students in the social sciences and humanities majors had insufficient physical activity according to WHO recommendations. The results showed no correlation between screen time and physical activity, study time, academic major, or study level (p ≥ 0.05). However, a low correlation was observed between physical activity and study time (r2 = 0.27; p < 0.05), as well as study level (r2 = -0.31; p < 0.05). Our findings show that the total screen time for university students with and without smartphone addiction exceeded 8 h per day. Real-life activities should be promoted to reduce screen time. Encouraging physical activity among senior students and those in social science and humanities majors is crucial for fostering healthy behaviors in the future. Physical education and recreational activities should be emphasized in these groups, along with the development of programs or class activities designed to promote physical activity and reduce screen time.

Long-Term Impact of Using Mobile Phones and Playing Computer Games on the Brain Structure and the Risk of Neurodegenerative Diseases: Large Population-Based Study

BACKGROUND

Despite the increasing popularity of electronic devices, the longitudinal effects of daily prolonged electronic device usage on brain health and the aging process remain unclear.

OBJECTIVE

The aim of this study was to investigate the impact of the daily use of mobile phones/computers on the brain structure and the risk of neurodegenerative diseases.

METHODS

We used data from the UK Biobank, a longitudinal population-based cohort study, to analyze the impact of mobile phone use duration, weekly usage time, and playing computer games on the future brain structure and the future risk of various neurodegenerative diseases, including all-cause dementia (ACD), Alzheimer disease (AD), vascular dementia (VD), all-cause parkinsonism (ACP), and Parkinson disease (PD). All the characteristics of using mobile phones and playing computer games were collected through face-to-face interviews at baseline, and outcomes were extracted from the algorithmic combinations of self-reported medical conditions, hospital admissions, and death registries. In addition, a group of participants underwent magnetic resonance imaging (MRI) at follow-up. Cox regression and linear regression were performed.

RESULTS

The study included over 270,000 participants for risk analysis, with a mean baseline age of approximately 55.85 (SD 8.07) years. The average follow-up duration was approximately 13.9 (SD 1.99) years. Lengthy mobile phone use was associated with a reduced risk of ACD (2-4 years: hazard ratio [HR] 0.815, 95% CI 0.729-0.912, P<.001; 5-8 years: HR 0.749, 95% CI 0.677-0.829, P<.001; >8 years: HR 0.830, 95% CI 0.751-0.918, P<.001), AD (5-8 years: HR 0.787, 95% CI 0.672-0.922, P=.003), and VD (2-4 years: HR 0.616, 95% CI 0.477-0.794, P<.001; 5-8 years: HR 0.729, 95% CI 0.589-0.902, P=.004; >8 years: HR 0.750, 95% CI 0.605-0.930, P=.009) compared to rarely using mobile phones. Additionally, lengthy mobile phone use was linked to a decreased risk of ACP (5-8 years: HR 0.747, 95% CI 0.637-0.875, P<.001; >8 years: HR 0.774, 95% CI 0.663-0.904, P=.001) and PD (5-8 years: HR 0.760, 95% CI 0.644-0.897, P=.001; >8 years: HR 0.777, 95% CI 0.660-0.913, P=.002) in participants older than 60 years. However, higher weekly usage time did not confer additional risk reduction compared to lower weekly usage of mobile phones. The neuroimaging analysis involved 35,643 participants, with an average duration of approximately 9.0 years between baseline and neuroimaging scans. Lengthy mobile phone use was related to a thicker cortex in different areas of the brain.

CONCLUSIONS

Lengthy mobile phone use is associated with a reduced risk of neurodegenerative diseases and improved brain structure compared to minimal usage. Our research provides valuable background knowledge for future studies on the impact of modern electronic devices on brain health.

Mobile phone addiction and negative emotions: an empirical study among adolescents in Jiangxi Province

Background

The relationship between mobile phone addiction and negative affect among adolescents is characterized by intricate interconnections. These factors have an impact on the emotional and psychological well-being of young people. While previous studies have provided preliminary insights into this relationship, further in-depth exploration and research is required to fully understand the complex mechanisms behind these relationships and to identify any group differences.

Methods

This study collected questionnaire data from 493 adolescents aged 17-22 years old in Jiangxi Province. The data were analyzed using Pearson correlation analysis, restricted cubic spline (RCS), and structural equation modelling (SEM) with the aim of exploring the mechanisms and differences in the effects of mobile phone addiction on negative emotions of different youth groups.

Results

The findings of the study indicated notable discrepancies in mobile phone addiction by gender and place of residence. Secondly, mobile phone addiction among adolescents positively drives negative emotions. The findings revealed that negative emotions triggered by mobile phone addiction were significantly higher among rural adolescents than urban adolescents; male adolescents exhibited higher levels than female adolescents in the same place of residence. Additionally, family factors, physical exercise and psychological resilience can directly or indirectly inhibit mobile phone addiction among adolescents. Finally, adolescents' psychological resilience can significantly alleviate the negative emotions associated with mobile phone addiction. Physical exercise and family factors can reduce the negative emotional impact of mobile phone addiction by increasing psychological resilience.

Conclusions

This study employs the relationship between mobile phone addiction and negative emotions in adolescents, reveals the complex mechanisms and group differences behind these relationships, and provides a fresh perspective for understanding the impact of mobile phone addiction on adolescents' mental health, as well as a scientific basis for the development of effective interventions.

Parental Technoference and Child Problematic Media Use: Meta-Analysis

BACKGROUND

Parental technoference, the interruption of parent-child interactions by technology, has been associated with negative outcomes in children's media use. However, the magnitude of this relationship and its moderating factors remain unclear.

OBJECTIVE

This study aims to systematically examine the relationship between parental technoference and child problematic media use, as well as to identify moderating factors such as age, parental technoference group, study design, and type of problematic media use.

METHODS

Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted up to August 2024 across multiple databases, including Web of Science, EBSCO, ProQuest, PubMed, PsycINFO, and China National Knowledge Infrastructure, using predefined search strings. A total of 53 studies with a total of 60,555 participants (mean age of 13.84, SD 1.18 years) were included. Inclusion criteria comprised studies involving children under the age of 22 years, assessing the association between parental technoference and child problematic media use with valid measures, and reporting necessary statistical data. Exclusion criteria included studies focusing on other child outcomes, having sample sizes <30, or being case reports or review papers. The risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A random-effects meta-analysis was performed using R (version 4.2.1; R Foundation for Statistical Computing) with the meta and metafor packages to evaluate the association and conduct moderator analyses.

RESULTS

The meta-analysis identified a significant positive association between parental technoference and child problematic media use (r=0.296, 95% CI 0.259-0.331). Moderator analyses revealed that both parental technoference group (P<.001) and study design (P=.008) significantly influenced this relationship. Specifically, the association was stronger when both parents engaged in technoference compared to when only 1 parent did, and in cross-sectional studies compared to longitudinal studies. Age, gender, publication status, and type of problematic media use did not significantly moderate the relationship (all P>.05).

CONCLUSIONS

This meta-analysis provides robust evidence of the association between parental technoference and child problematic media use. The findings highlight the need for family-based interventions and underscore the importance of longitudinal research to understand the temporal dynamics of this relationship better.

TRIAL REGISTRATION

PROSPERO CRD42023471997; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=471997.

Network analysis of autism traits and problematic mobile phone use and their associations with depression among Chinese college students

The current study employed network analysis to examine the relationship between symptoms from factor level about autism traits and problematic mobile phone use (PMPU) and to explore their associations with depression. We measured the above three variables in 949 college students in China with Autism Spectrum Quotient (AQ), Smartphone Addiction Scale (SAS), Center for Epidemiological Studies Depression Scale (CES-D). Central and bridge symptoms were pinpointed through the examination of centrality index. In the AQ and PMPU network, results revealed that WD ("Withdrawal"), COR ("Cyberspace-oriented relationship") and OU ("Overuse") emerged as the core symptoms. AS ("Attention switching"), CO ("Communication") and COR ("Cyberspace-oriented relationship") were the most symptoms bridging the AQ and PMPU communities, suggesting that these symptoms could serve as focal points for interventions aimed at college students with concurrent autism traits and PMPU. SK ("Social skills"), COR ("Cyberspace-oriented relationship"), CO ("Communication"), and DLD ("Daily-life disturbance") were most strongly associated with depression. In addition, future research should consider various measurement tools and methods to investigate the location of AD ("Attention to detail"), because AD was an isolated symptom in the flow network of depression.

The Influence of Negative Emotions on Mobile Phone Addiction Among Chinese College Students: The Mediating Role of Negative Coping Styles and the Moderating Role of Gender

Background

Negative emotions (depression and anxiety) are highly correlated with mobile phone addiction among college students, but the underlying mechanisms between variables need further exploration. The aim of this study is to further elucidate the relationship between negative emotions and mobile phone addiction among college students, with negative coping styles as the mediating variable and gender as the moderating variable.

Methods

A survey was conducted on 509 college students from two universities in Anhui Province, China, covering topics such as mobile phone addiction, depression, anxiety, and negative coping styles. SPSS software was used to analyze the relationship between variables.

Results

Depression, anxiety, negative coping styles, and mobile phone addiction are all significantly positively correlated. Negative coping styles mediate the relationship between depression, anxiety, and mobile phone addiction among college students. Gender regulates the relationship between depression/anxiety and mobile phone addiction. Specifically, the impact of negative emotions (depression and anxiety) on mobile phone addiction is greater in the male group than in the female group.

Conclusion

This study further reveals the psychological mechanisms behind the relationship between negative emotions (depression and anxiety) and mobile phone addiction. Negative coping styles are the mediating factor in this relationship, while gender is the moderating factor in this relationship.

Online social support and problematic Internet Use-a meta-analysis

INTRODUCTION

The internet is a crucial platform for individuals to gain social support, enhancing their well-being. However, research indicated that while online social support (OSS) has positive aspects, it also carries potential drawbacks and can lead to problematic Internet use (PIU). This study aims to examine the complex relationship between OSS and PIU.

METHODS

Adhering to the PRISMA guidelines, a systematic literature search was performed across five English and three Chinese databases. A total of 1966 articles were initially screened by title, followed by abstract, and finally, full text. And the random-effects model was used to synthesize the included 31 studies.

RESULTS

31 studies were identified, encompassing a total sample of 22,375 participants. Meta-analysis revealed a moderate and significant correlation between OSS and PIU (r = 0.293), and it was significantly moderated by gender and the measurement methods of PIU. Notably, the relationship was more pronounced in studies with a higher proportion of female participants; when PIU was measured by problematic social media use, the relationship with OSS was stronger than studies that measured PIU by general problematic Internet use or problematic mobile phone use.

CONCLUSION

These findings contribute to a comprehensive understanding of the association between OSS and PIU, and carry implications for identifying and addressing the potential risks associated with social support provision in the digital realm.

Tales of hope and hesitation: Smoking cessation experts' views on the opportunities and risks of digital behaviour change interventions

Objective

Smoking remains a global health challenge, with 1.14 billion active smokers worldwide. Many of these smokers seek cessation support. The rise of mHealth offers novel intervention methods, providing monitoring and tailored feedback. This study aimed to map the opportunities and challenges of integrating digital behaviour change interventions (mHealth) into smoking cessation practices by understanding professionals' perceptions of these tools.

Methods

A qualitative study was conducted involving semi-structured interviews with 11 experienced smoking cessation professionals in Flanders, Belgium. Data collection occurred between January and April 2023. Inductive thematic analysis was performed to identify key patterns and themes in the experts' views regarding mHealth interventions.

Results

The analysis revealed four primary themes: (1) The Inexorable March of Technology - experts acknowledged the inevitability of technology in smoking cessation but varied in enthusiasm; (2) The Shimmering Mirage of Possibility - technology was viewed as supplementary, offering efficiency and support but limited in depth; (3) The Footnotes to Enthusiasm - experts expressed concerns over privacy, inclusivity, and the potential for technology to displace human care; and (4) The Human Anchor - the irreplaceable role of human connection and therapeutic alliance, which digital tools might not be able to replicate.

Conclusion

Experts believe mHealth interventions can augment smoking cessation support but should not replace human-driven care. A blended approach, integrating digital tools with traditional therapeutic relationships, offers the most promise. Addressing concerns about privacy, inclusivity, and most importantly the limits of digital therapeutic alliances is essential for successful mHealth implementation in smoking cessation.

Young people's preferences and motivations for STI partner notification: observational findings from the 2024 Sex, Drugs and Rock 'n' Roll survey

Background Partner notification is an important step in the control of sexually transmissible infections (STIs). STIs remain at high rates among young people and can have serious reproductive consequences if left untreated. This study aimed to determine the preferences and motivations for partner notification among young people in Australia. Methods Quantitative and free-text qualitative data were collected through the 2024 Sex, Drugs and Rock 'n' Roll survey, an annual cross-sectional survey conducted among people aged 15-29years old in Victoria, Australia. Respondents were recruited using convenience sampling through social media advertisements. Counts and proportions were calculated for the preferences and motivations for partner notification by regular and casual sexual partners as well as methods of communication. Inductive content analysis was used to analyse free-text responses. Results The partner notification module of the survey was completed by 1163 people (60.3% identified as women, 40.2% as heterosexual) who provided a total of 1720 free-text responses. The majority, 1056 (90.8%) stated that they would notify their sexual partners and 1142 (98.2%) would want to be notified by a sexual partner of an STI risk. Qualitative analysis highlighted that respondents felt that partner notification is the responsible thing to do to look after their own and their partner's health and protect others by reducing transmission. Few stated that embarrassment and fear of repercussions may make them less likely to notify their partners or that it would depend on the type of relationship. Most preferred to notify regular partners face-to-face (941, 80.9%) and casual partners via text message (785, 67.5%). Conclusion Almost all young people want to notify and be notified by partners of an STI risk regardless of age, gender or sexual identity. Tailoring resources by communication method and partner type is one way in which practitioners and public health authorities can support young people in undertaking this important step in STI control.

Impact of smartphone addiction on health status, mental well-being, and sleep quality among medical students in Sudan

BACKGROUND

Smartphone use has rapidly increased worldwide. It was estimated that worldwide use of smartphones surpassed 4.3 billion in 2023, which means 54% of the world's population now uses smartphones. However, research shows that excessive smartphone use poses health risks and decreases sleep quality, which can be detrimental for students. This study investigates the impact of problematic smartphone usage on health status, mental health, and sleep quality among medical students enrolled in Sudanese universities.

METHODS

A cross-sectional study was conducted from January to March 2024, targeting medical students and recent graduates from Sudanese universities through an online survey. Data were collected using validated scales for smartphone addiction, sleep quality, suboptimal health status, and mental health. Descriptive and correlation analyses were performed using SPSS software v28.0.0.

RESULTS

Out of 231 respondents (69% female, mean age 22.7), 67.6% exhibited high levels of smartphone addiction. Significant correlations were found between smartphone addiction and poor sleep quality (r = 0.462, p < 0.001), suboptimal health (r = 0.527, p < 0.001), and mental health issues (r = 0.365, p < 0.001). Single students had higher addiction and stress scores, while those living in Sudan showed higher suboptimal health scores.

CONCLUSIONS

Problematic smartphone use (PSU) is prevalent among Sudanese medical students, negatively affecting mental health and sleep.

Improvement of Presbyopia, Dry Eye, Intraocular Pressure, and Near Vision Through Cassiae Tea Consumption

Background and Objectives: This study aimed to illustrate a novel method for improving presbyopia by drinking cassiae tea. Materials and Methods: A total of 425 eyes from 425 participants (aged 52.5 ± 9.5 years) were recruited and divided into several experimental groups over a 6-month period. Participants consumed cassiae tea daily (10 g of cassiae semen brewed in 500 cc of water). Meanwhile, control group participants consumed 500 cc of plain water along with 1000 mg of vitamin C each day. Experiments 1 and 2: Participants with severe dry eye and intraocular pressure (IOP) > 30 mmHg were enrolled, and outcomes were assessed for these conditions, respectively. Experiments 3, 4, and 7: These experiments evaluated pupil size, near vision, and serum superoxide dismutase (SOD) levels in two groups of volunteers. Experiment 5: Different quantities of cassiae tea were prescribed to various groups, and near vision was measured. Experiment 6: Three questionnaires assessed presbyopic symptoms after cassiae tea consumption. Experiment 8: The antioxidant activity of cassiae tea compared with other bioactive compounds and Chinese herbs was evaluated using the DPPH test. Results: By the fourth month of the study, participants experienced increased tear volume and reduced IOP. Pupil size constricted, near vision improved, and serum SOD levels increased. Furthermore, greater consumption of cassiae tea was correlated with better near vision. The antioxidant activity of cassiae tea was found to surpass that of anthocyanins, wolfberry, and vitamin C. Conclusions: Drinking cassiae tea improves dry eye symptoms, reduces IOP, regulates pupil size, and enhances near vision due to its excellent antioxidant and pharmacological properties. These benefits may particularly aid individuals with presbyopia and those engaged in near-distance activities, such as smartphone use.

Weak and interfered self-control fails to block problematic mobile phone use: The role of craving and desire thinking

Problematic mobile phone use (PMPU) has become a worldwide phenomenon with negative impacts on adolescents' daily lives. While self-control has been shown to be related to PMPU, little is known about the underlying mechanisms of this association. Based on the Interaction of Person-Affect-Cognition-Execution model and the strength model of self-control, the current study aims to examine the association between self-control and PMPU, to identify the indirect role of craving, and to determine whether and how the two components of desire thinking exert differential moderating effects. A sample of 1424 adolescents was recruited to complete the scales of self-control, craving, desire thinking, and PMPU. The results suggested that self-control was indirectly associated with PMPU through craving. Furthermore, this indirect association was moderated by verbal perseveration, rather than imaginal prefiguration. Specifically, the indirect association was stronger for adolescents with higher verbal perseveration. The findings deepen our understanding of how self-control is related to PMPU and distinguish the effects of two components of desire thinking among adolescents.

Smartphone addiction, depression, distress, eustress, loneliness, and sleep deprivation in adolescents: a latent profile and network analysis approach

BACKGROUND

Previous research on adolescent smartphone addiction has tended to focus on general populations that are assumed to be homogeneous, overlooking latent profiles. Furthermore, previous research has not focused on potentially important differences in the latent profiles of adolescent smartphone addiction in networks. The present study aimed to reveal the latent profiles of smartphone addiction, depression, stress, eustress, loneliness, and sleep deprivation in adolescents, and general and latent profiles were examined in the network.

METHODS

The study group consisted of 436 (222 boys and 214 girls) adolescents, aged between 13 and 18 years. The findings of the present study were provided using Pearson correlation, ANOVA, latent profile analysis and network analysis. The data were analyzed using SPSS, JASP, and Mplus.

RESULTS

The results of the study showed solutions with three latent profiles. The non-addicted group constituted 20.87%, the addicted group covered 29.82% and the risky group included 49.31% of the study group. Although the general profile and the addicted latent group had similar characteristics, the differences in the risky and non-addicted groups contributed to the current literature by providing a further and remarkable perspective on smartphone addiction, depression, distress, eustress, loneliness, and sleep deprivation in adolescents.

CONCLUSIONS

The theoretical and practical implications of the present results will provide contributions to researchers and practitioners in understanding smartphone addiction.

Technology-Supported Physical Activity and Its Potential as a Tool to Promote Young Women's Physical Activity and Physical Literacy: Systematic Review

BACKGROUND

Despite the known benefits of physical activity (PA), rates of engagement in PA remain low globally. Low engagement in PA among young women can impact their health. Technology-supported PA may increase PA and physical literacy (PL; skills that can support PA) among young women.

OBJECTIVE

This systematic review aims to investigate the (1) associations between technology-supported PA and PA levels, (2) associations between technology-supported PA and PL levels, and (3) types of technology-supported PA that are associated with higher levels of PA engagement among young women aged 13 to 24 years. This age range was chosen as it includes two transitional periods characterized by decreases in PA.

METHODS

We searched 6 databases: Applied Science and Technology Source, Education Source, Embase, MEDLINE Complete, Global Health, and SPORTDiscus. Eligible studies were original research published in English between January 1, 2010, and April 24, 2024; focused on young women; and involving either technology-supported PA interventions or research exploring the correlation between technology and PA and PL. The findings of the review were presented descriptively. Study quality was assessed using the JBI Critical Appraisal tools. There were no deviations from the registered protocol.

RESULTS

In total, 23 (0.1%) studies (10,233 participants) from 23,609 records were included: randomized controlled trials (n=9, 39%), nonrandomized or retrospective observational studies (n=9, 39%), and cross-sectional studies (n=5, 22%). Of the 23 studies, 12 (52%) focused on young adults (aged ≥19 y), 9 (39%) involved adolescents (aged <19 y), and 2 (9%) focused on both groups. Nine studies (39%) were theory based. Common types of technology-supported PA were interactive websites or social media platforms (10/23, 43%), wearable fitness trackers (4/23, 17%), and mobile apps (4/23, 17%). PA or PL were predominantly self-reported (18/23, 78%). A total of 53 PA outcomes were measured: 36% (19/53) reported a positive impact on PA from mobile apps (9/15; 60% of analyses), interactive websites or social media platforms (8/27; 30% of analyses) and wearable fitness trackers (2/11; 18% of analyses). The impact on PL was weak (2/7; 29% of analyses). Eight studies (35%) were rated high, 7 (30%) medium, and 8 (35%) low in quality.

CONCLUSIONS

There was limited evidence that technology-supported PA improved young women's PA or PL. The evidence was limited by poor study quality and a lack of theoretical frameworks. In addition, little information was provided on the designs of the technology used. Future interventions seeking to improve young women's PA and PL should focus on the development of mobile apps underpinned by behavior change theory and addressing whole domains of PL rather than specific elements. Given that technology continues to rapidly advance, further studies are needed to demonstrate the impact of technology-supported PA in improving PA and PL among young women.

Path analysis reveals cross-country differences between Czech and Chinese university students in effect of internet and smartphone addiction, mental health, and personality traits on academic achievement in the post-pandemic era

Despite extensive evidence on the impact of various mental health issues including smartphone/internet addiction, and personality traits on academic achievement, little is known about the complex interactions between multiple of these factors simultaneously, as well as cross-country differences in these nuanced relationships. In particular, understanding the role of the mentioned addictions has become increasingly important in recent years in the context of the COVID-19 pandemic. The aim of this cross-country study was to investigate, using path analysis, the complex relationships between mental health determinants (depression, anxiety, stress, resilience, and smartphone/internet addiction) and academic achievement in 1785 Czech and Chinese university students using an online battery of psychological tests. The results confirmed the previously described effect of multiple factors (anxiety, stress, resilience, smartphone/internet addiction, personality traits, and sex, Extraversion, Agreeableness, Conscientiousness) on academic achievement, overlapping in most cases for both groups of students. At the same time, however, different country-dependent patterns of interactions emerged. For the Czech students, the variables formed a complex network of interacting factors, whereas for the Chinese students, the effect of each cluster of factors was separate for individual domains of academic achievement. These cross-country differences have implications particularly for planning and targeting the most effective interventions to promote and develop academic achievement.

The dimensional validity and reliability of the Italian smartphone addiction inventory of Yemeni university students

The increasing usage of smartphones globally necessitates the creation of reliable and valid scales to evaluate their psychological effects, particularly within academic settings such as universities. The current study aimed to identify the factorial structure of the Smartphone Addiction Inventory (SPAI) in the Republic of Yemen. The sample consisted of 1920 university students (1136 males and 784 females). The data was analyzed with the AMOS V25 statistical program. The results of the factor analysis supported the goodness of fit of the five-factor model to the data with excellent indices: RMSEA = 0.052, CFI = 0.910, GFI = 0.931, AGFI = 0.915, TLI = 0.907, NFI = 0.915, RFI = 0.916, and RMR = 0.032, all of which are within the ideal range to support the goodness of fit of the model to the factorial structure of the inventory, as the values of the explained variances ranged between 0.740 and 0.834., with indices of reliability in measurement. The results of the confirmatory factor analysis revealed that four items loaded on the Time Spent factor, four items on the Compulsivity factor, eight items on the Daily Life Interference factor, five items on the Craving factor, and three items on the Sleep Interference factor, with all loadings being statistically significant (>0.001). Based on these findings, research direction and recommendations were provided.

A multi-school study in England, to assess problematic smartphone usage and anxiety and depression

AIM

To assess the association between problematic smartphone usage and anxiety and depression in adolescents.

METHODS

A cross-sectional study in five schools in the UK were included. The primary outcome was moderate anxiety (GAD-7 ≥10) symptoms and secondary outcomes were moderate depression symptoms (PHQ-9 ≥10) and insomnia. Problematic smartphone usage was assessed using screentime and the Smartphone Addiction Scale. A multi-level logistic regression was fitted and adjusted Odds Ratio (aOR) with 95% confidence intervals (95% CI) reported. A mediation analysis was conducted.

RESULTS

Of the five included schools, 657 adolescents aged 16-18 years were enrolled. The median age was 17.5 years (17-18 [IQR]) and 508 (77.3%) were female. Of these 188 (28.6%) exhibited moderate anxiety and 226 (34.4%) moderate depression symptoms. Almost two thirds (421, 64.1%) have tried to cut down their smartphone use and 81 (12.5%) wanted help to reduce use. Problematic smartphone use was associated with increased anxiety (aOR = 2.03, 95% CI 1.28-3.23); depression (aOR = 2.96, 95% CI 1.80-4.86); and insomnia (aOR = 1.64, 95% CI 1.08-2.50). Screentime was not associated with anxiety (β = 0.99, 95% CI 0.91-1.08); or depression (β = 0.98, 95% CI 0.89-1.07). Problematic smartphone use had a significant direct, indirect and total effect on both anxiety and depression.

CONCLUSION

Problematic smartphone usage was associated with anxiety and depression, independent of screentime. Interventions are needed to reduce problematic use.

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.

Association between internet addiction and musculoskeletal disorders in Iranian medical sciences students

BACKGROUND

The utilization of the Internet can lead to adverse outcomes in students' lives. Prolonged Internet usage may result in academic failure, an elevated risk of musculoskeletal problems, and the emergence of issues impacting the lives of students and their peers. This study aimed to explore the relationship between Internet addiction and musculoskeletal disorders (MSDs) among students in the field of medical sciences.

METHODS

In this cross-sectional study, 314 medical sciences students in Semnan, Iran, were assessed using the census sampling method. The participants' Internet addiction status and the presence of MSDs were determined through Young's Internet Addiction questionnaire and the Nordic self-report questionnaire, respectively. Data underwent analysis employing logistic regression test to ascertain the relationship between Internet addiction and MSDs.

RESULTS

Among the 314 participating students in this research, about 21% and 1.6% of the participants were lay open to and suffered from Internet addiction, respectively. Internet addiction was associated with the presence of pain, discomfort, burning, or numbness in the neck, wrist, upper back, hips, and thighs. For each unit increase in the Internet addiction score, the chance of neck and wrist pain rises by 3% compared to a 2% increase in upper back and hip/thigh pain.

CONCLUSION

The findings of this study indicate that excessive Internet use is linked to a heightened risk of MSDs in medical sciences students. Consequently, it is imperative to raise awareness about these complications and promote the adoption of proper posture when using the Internet. Further research is also warranted among diverse student populations to investigate the impact of Internet addiction.

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

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

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

Background

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

Methods

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

Results

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

Conclusion

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

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

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

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

FINDINGS

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

CONCLUSIONS

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

CLINICAL IMPLICATIONS

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

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

Background

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

Objective

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

Methods

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

Results

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

Conclusion

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

Fatigue, Internet Addiction and Symptoms of Long COVID-A Cross-Sectional Study of Polish Students

Introduction: Fatigue is the most persistent symptom in patients with long COVID. Moreover, Internet addiction itself has become a pandemic long-term effect. The aim of this study was to investigate the degree of fatigue and Internet addiction in a group of students with COVID-19 and to determine the relationship between fatigue and addiction in students with and without long COVID symptoms. Material and methods: A cross-sectional study was conducted among 402 Polish students aged 19-26. The 183 students who had COVID-19 signaled the presence of long COVID symptoms, which corresponded to 45.5% of the surveyed group. The Modified Fatigue Impact Scale was used to assess the level of fatigue, and the Kimberly Young questionnaire was used to assess the level of Internet addiction. Results: 19.7% (95% c.i.: 15.9-23.9%) of the students surveyed had a moderate level of Internet dependence (Internet addiction measure value of 50 points or more). Most of them did not complain of high levels of fatigue. Higher levels of dependence and fatigue were observed in subjects with long COVID symptoms (MFIS mean value was 26.5 in this group vs. 17.7 in the others; p = 0.0000 ***). The higher the respondents' level of dependence, the more they tended to feel tired (correlations were stronger in those with long COVID symptoms: rS = 0.23; p = 0.0017 **). Conclusions: In view of the results obtained, the study presented here has the potential to contribute to the international debate on the long-term health consequences of the COVID-19 pandemic and strategies to address them. The study provides data that may be useful in the development of educational and health policies that target the psychophysical well-being of patients with long COVID symptoms. This process should be considered as a long-term endeavor.

Does an App a Day Keep the Doctor Away? AI Symptom Checker Applications, Entrenched Bias, and Professional Responsibility

The growing prominence of artificial intelligence (AI) in mobile health (mHealth) has given rise to a distinct subset of apps that provide users with diagnostic information using their inputted health status and symptom information-AI-powered symptom checker apps (AISympCheck). While these apps may potentially increase access to health care, they raise consequential ethical and legal questions. This paper will highlight notable concerns with AI usage in the health care system, further entrenchment of preexisting biases in the health care system and issues with professional accountability. To provide an in-depth analysis of the issues of bias and complications of professional obligations and liability, we focus on 2 mHealth apps as examples-Babylon and Ada. We selected these 2 apps as they were both widely distributed during the COVID-19 pandemic and make prominent claims about their use of AI for the purpose of assessing user symptoms. First, bias entrenchment often originates from the data used to train AI systems, causing the AI to replicate these inequalities through a "garbage in, garbage out" phenomenon. Users of these apps are also unlikely to be demographically representative of the larger population, leading to distorted results. Second, professional accountability poses a substantial challenge given the vast diversity and lack of regulation surrounding the reliability of AISympCheck apps. It is unclear whether these apps should be subject to safety reviews, who is responsible for app-mediated misdiagnosis, and whether these apps ought to be recommended by physicians. With the rapidly increasing number of apps, there remains little guidance available for health professionals. Professional bodies and advocacy organizations have a particularly important role to play in addressing these ethical and legal gaps. Implementing technical safeguards within these apps could mitigate bias, AIs could be trained with primarily neutral data, and apps could be subject to a system of regulation to allow users to make informed decisions. In our view, it is critical that these legal concerns are considered throughout the design and implementation of these potentially disruptive technologies. Entrenched bias and professional responsibility, while operating in different ways, are ultimately exacerbated by the unregulated nature of mHealth.

Could physical activity alleviate smartphone addiction in university students? A systematic literature review

Objectives

Recently, the widespread surge in smartphone addiction (SA) has raised major global health concerns and prompted researchers to scrutinize the inverse relationship between physical activity (PA) and the risk of SA. This systematic literature review aims to synthesize the empirical research on the relationship between PA and SA among university students representing the most affected age group.

Methods

Adopting the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we explored five databases: PubMed, Social Sciences Research Network (SSRN), Oxford Research Archive, Journal Storage (JSTOR), and Google Scholar. We used the Mixed Methods Appraisal Tools (MMAT) for quality assessment.

Results

Thirty-one studies met the inclusion criteria. Twenty-eight of them were cross-sectional, and three were experimental. The 31 studies emerged from 12 countries, most stemming (45.16%) from China. Their findings suggest an inverse relationship between PA and SA in the examined population. However, the direct relationship may be weak based on correlational studies, while intervention research yields noteworthy effects. Still, other factors like resilience may mediate the studied relationship. Methodological concerns render the results of correlational studies tentative.

Conclusions

Regular PA could be a promising preventive measure for SA. Future work should use objective PA indices in longitudinal research designs while assessing the type and duration of smartphone applications used via device meters. In correlational studies, interviews should follow up on the high SA risk or too much device use. In conclusion, moderate evidence indicates that PA can reduce SA among university students.

Cohort profile: The Social media, smartphone use and Self-harm in Young People (3S-YP) study-A prospective, observational cohort study of young people in contact with mental health services

OBJECTIVES

The Social media, Smartphone use and Self-Harm (3S-YP) study is a prospective observational cohort study to investigate the mechanisms underpinning associations between social media and smartphone use and self-harm in a clinical youth sample. We present here a comprehensive description of the cohort from baseline data and an overview of data available from baseline and follow-up assessments.

METHODS

Young people aged 13-25 years were recruited from a mental health trust in England and followed up for 6 months. Self-report data was collected at baseline and monthly during follow-up and linked with electronic health records (EHR) and user-generated data.

FINDINGS

A total of 362 young people enrolled and provided baseline questionnaire data. Most participants had a history of self-harm according to clinical (n = 295, 81.5%) and broader definitions (n = 296, 81.8%). At baseline, there were high levels of current moderate/severe anxiety (n = 244; 67.4%), depression (n = 255; 70.4%) and sleep disturbance (n = 171; 47.2%). Over half used social media and smartphones after midnight on weekdays (n = 197, 54.4%; n = 215, 59.4%) and weekends (n = 241, 66.6%; n = 263, 72.7%), and half met the cut-off for problematic smartphone use (n = 177; 48.9%). Of the cohort, we have questionnaire data at month 6 from 230 (63.5%), EHR data from 345 (95.3%), social media data from 110 (30.4%) and smartphone data from 48 (13.3%).

CONCLUSION

The 3S-YP study is the first prospective study with a clinical youth sample, for whom to investigate the impact of digital technology on youth mental health using novel data linkages. Baseline findings indicate self-harm, anxiety, depression, sleep disturbance and digital technology overuse are prevalent among clinical youth. Future analyses will explore associations between outcomes and exposures over time and compare self-report with user-generated data in this cohort.

Effects of evening smartphone use on sleep and declarative memory consolidation in male adolescents and young adults

Exposure to short-wavelength light before bedtime is known to disrupt nocturnal melatonin secretion and can impair subsequent sleep. However, while it has been demonstrated that older adults are less affected by short-wavelength light, there is limited research exploring differences between adolescents and young adults. Furthermore, it remains unclear whether the effects of evening short-wavelength light on sleep architecture extend to sleep-related processes, such as declarative memory consolidation. Here, we recorded polysomnography from 33 male adolescents (15.42 ± 0.97 years) and 35 male young adults (21.51 ± 2.06 years) in a within-subject design during three different nights to investigate the impact of reading for 90 min either on a smartphone with or without a blue-light filter or from a printed book. We measured subjective sleepiness, melatonin secretion, sleep physiology and sleep-dependent memory consolidation. While subjective sleepiness remained unaffected, we observed a significant melatonin attenuation effect in both age groups immediately after reading on the smartphone without a blue-light filter. Interestingly, adolescents fully recovered from the melatonin attenuation in the following 50 min before bedtime, whereas adults still, at bedtime, exhibited significantly reduced melatonin levels. Sleep-dependent memory consolidation and the coupling between sleep spindles and slow oscillations were not affected by short-wavelength light in both age groups. Nevertheless, adults showed a reduction in N3 sleep during the first night quarter. In summary, avoiding smartphone use in the last hour before bedtime is advisable for adolescents and young adults to prevent sleep disturbances. Our research empirically supports general sleep hygiene advice and can inform future recommendations regarding the use of smartphones and other screen-based devices before bedtime.